S T A T E O F N E W Y O R K
________________________________________________________________________
4207
2015-2016 Regular Sessions
I N S E N A T E
March 9, 2015
___________
Introduced by COMMITTEE ON RULES -- read twice and ordered printed, and
when printed to be committed to the Committee on Finance
AN ACT to amend the education law, in relation to delivery of
prescriptions off premises of a pharmacy; to amend the public health
law, in relation to physician profiles, the promotion of public and
private umbilical cord blood banking, financial responsibility and
reimbursement data for early intervention program and electronic
health records; to amend the state finance law, in relation to estab-
lishing the state health innovation plan account; to provide more
accountability in expenditures made by the Statewide Health Informa-
tion Network for New York (SHIN-NY); to repeal subdivision 9 of
section 2803 of the public health law relating to reports to the
commissioner of health by general hospitals regarding working condi-
tions and limits on working hours for certain members of the hospi-
tal's staff; and to repeal paragraph (e) of subdivision 13 of section
2995-a of the public health law relating to physician profiles (Part
A); to amend the social services law, in relation to the codification
of the global cap; to amend the public health law, in relation to
hospital payments; to amend parts A and B of chapter 1 of the laws of
2002, relating to the health care reform act of 2000, in relation to
upper payment limits; to amend part B of chapter 59 of the laws of
2011, amending the public health law relating to rates of payment and
medical assistance, in relation to managed care supplemental payments;
to amend part H of chapter 59 of the laws of 2011, amending the public
health law relating to general hospital inpatient reimbursement for
annual rates, in relation to supplemental Medicaid managed care
payments; to amend the public health law, in relation to establishing
an energy efficiency and/or disaster preparedness demonstration
program for residential health care facilities; to amend the social
services law, in relation to working disabled eligibility; to amend
the social services law, in relation to family planning benefits; to
amend the social services law, in relation to foster care; to amend
the public health law, in relation to case payment rates for pediatric
ventilator services; to authorize the commissioner of health to estab-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD20016-01-5
S. 4207 2
lish young adult special populations demonstration programs; to amend
the public health law, in relation to rates of payments at residential
health care facilities and directing the commissioner of health to
allow the provision of off-site services; to amend the social services
law, in relation to prescriber determination and classes of drugs in
Medicaid managed care, establishing a health technology assessment
committee within the medical assistance program; to amend the public
health law, in relation to establishing a hospital-home care-physician
collaboration program; to amend the public health law, in relation to
universal standards for coding of payment of claims for long term care
and electronic payment of claims; to amend the social services law, in
relation to services provided by school-based health centers; to amend
chapter 165 of the laws of 1991, amending the public health law and
other laws relating to establishing payments for medical assistance,
in relation to the effectiveness thereof; to amend the public health
law, in relation to reporting by the commissioner of health on the
health information technology demonstration program; to amend the
social services law, in relation to provision and reimbursement of
transportation costs; to amend the public health law, in relation to
temporary adjustment to reimbursement rates for vital access provid-
ers; to amend the social services law, in relation to expansion of
medical assistance coverage; to amend part H of chapter 59 of the laws
of 2011, amending the public health law and other laws relating to
general hospital inpatient reimbursement for annual rates, in relation
to medicaid payments to nursing homes; to amend the public health law,
in relation to residential health care facilities; to amend the public
health law, in relation to requiring the commissioner of health to
establish an office of accountability; to amend the social services
law, in relation to supplemental medical assistance rates; to amend
the public health law, in relation to quality related measures for
general hospitals receiving payments for inpatient services; to repeal
sections 50, 51, 52 and 53 of part C of chapter 60 of the laws of 2014
amending the social services law and other laws relating to eliminat-
ing prescriber prevails for brand name drugs with generic equivalents,
in relation to eligibility for medical assistance and the basic health
program; to amend the social services law, in relation to requiring
the independent actuary to provide a complete actuarial memorandum; to
repeal certain provisions of the social services law relating to pres-
criber determination and classes of drugs in Medicaid managed care; to
repeal section 365-d of the social services law relating to early and
periodic screening diagnosis and treatment outreach demonstration
projects; to repeal paragraph (e) of subdivision 8 of section 2511 of
the public health law relating to subsidy payments; and providing for
the repeal of certain provisions upon expiration thereof (Part B); to
amend part A of chapter 56 of the laws of 2013 amending chapter 59 of
the laws of 2011 amending the public health law and other laws to
general hospital reimbursement for annual rates relating to the cap on
local Medicaid expenditures, in relation to rates of payment paid to
certain providers by the Child Health Plus Program; and to amend part
H of chapter 111 of the laws of 2010 relating to increasing Medicaid
payments to providers through managed care organizations and providing
equivalent fees through an ambulatory patient group methodology, in
relation to rates of payment paid to certain providers by the Child
Health Plus Program (Part C); 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
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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 effec-
tiveness thereof; to amend the public health law, in relation to
hospital assessments; to amend chapter 659 of the laws of 1997,
constituting the long term care integration and finance act of 1997,
in relation to the effectiveness thereof; to amend chapter 474 of the
laws of 1996, amending the education law and other laws relating to
rates for residential health care facilities, in relation to the
effectiveness thereof; to amend part C of chapter 58 of the laws of
2007, amending the social services law and other laws relating to
enacting the major components of legislation necessary to implement
the health and mental hygiene budget for the 2007-2008 state fiscal
year, in relation to delay of certain administrative costs; 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 reimbursements and the effectiveness thereof; to amend
chapter 474 of the laws of 1996, amending the education law and other
laws relating to rates for residential healthcare facilities, in
relation to reimbursements; to amend chapter 451 of the laws of 2007,
amending the public health law, the social services law and the insur-
ance law, relating to providing enhanced consumer and provider
protections, in relation to the effectiveness thereof; to amend the
public health law, in relation to rates of payment for long term home
health care programs and making such provisions permanent; to amend
chapter 303 of the laws of 1999, amending the New York state medical
care facilities finance agency act relating to financing health facil-
ities, in relation to the effectiveness thereof; to amend chapter 165
of the laws of 1991, amending the public health law and other laws
relating to establishing payments for medical assistance, in relation
to the effectiveness thereof; to amend the public authorities law, in
relation to the transfer of certain funds; to amend subdivision (i) of
section 111 of part H of chapter 59 of the laws of 2011, relating to
enacting into law major components of legislation necessary to imple-
ment the health and mental hygiene budget for the 2011-2012 state
fiscal plan, in relation to the effectiveness of program oversight and
administration of managed long term care plans; to amend chapter 659
of the laws of 1997, amending the public health law and other laws
relating to creation of continuing care retirement communities, in
relation to the effectiveness thereof; to amend the public health law,
in relation to residential health care facility, and certified home
health agency services payments; to amend part B of chapter 109 of the
laws of 2010, amending the social services law relating to transporta-
tion costs; to amend the social services law, in relation to contract-
ing for transportation services; to amend chapter 459 of the laws of
1996 amending the public health law relating to recertification of
persons providing emergency medical care, in relation to making such
provisions permanent; to amend chapter 505 of the laws of 1995, amend-
ing the public health law relating to the operation of department of
health facilities, in relation to making such provisions permanent; to
amend the insurance law, in relation to exempting certain insurance
companies from risk-based capital for property/casualty insurance; and
to amend the insurance law, in relation to certain medical malpractice
rates; to amend subdivision (o) of section 111 of part H of chapter 59
of the laws of 2011, amending the public health law relating to state
wide planning and research cooperative system and general powers and
S. 4207 4
duties, in relation to the effectiveness of certain provisions; to
amend chapter 56 of the laws of 2013 amending chapter 59 of the laws
of 2011 amending the public health law and other laws relating to
general hospital reimbursement for annual rates relating to the cap on
local Medicaid expenditures, in relation to extending the provisions
of such chapter; to amend chapter 58 of the laws of 2008 amending the
elder law and other laws relating to reimbursement to participating
provider pharmacies and prescription drug coverage, in relation to the
effectiveness thereof (Part D); to amend the public health law, in
relation to the payment of certain funds for uncompensated care (Part
E); intentionally omitted (Part F); to amend the insurance law, in
relation to rating of individual and small group health insurance
contracts and policies (Part G); to amend the public health law, in
relation to the establishment and operation of limited services clin-
ics (Part H); intentionally omitted (Part I); intentionally omitted
(Part J); to amend the public health law, in relation to streamlining
the certificate of need process for hospitals and diagnostic and
treatment clinics providing primary care, public health and health
planning council reviews, defining "construction" for purposes of
hospitals, eliminating the requirement for a public need for a hospi-
tal prior to its approval by the public health and health planning
council, applications for construction of hospitals and the improper
delegation of authority to a management consultant by the governing
authority of a general hospital (Part K); to amend the public health
law, in relation to office-based surgery workgroups, facility fees,
reporting and ambulatory surgery center accreditation (Part L); to
amend the public health law, in relation to requiring notice and
submission of a plan prior to discontinuing fluoridation of a public
water supply (Part M); intentionally omitted (Part N); to amend chap-
ter 111 of the laws of 2010 relating to the recovery of exempt income
by the office of mental health for community residences and family-
based treatment programs, in relation to the effectiveness thereof
(Part O); to amend the education law, in relation to authorizing
contracts for the provision of special education and related services
for certain patients hospitalized in hospitals operated by the office
of mental health; and to amend part M of chapter 56 of the laws of
2012 amending the education law, relating to authorizing contracts for
the provision of special education and related services for certain
patients hospitalized in hospitals operated by the office of mental
health, in relation to the effectiveness thereof (Part P); to amend
the public health law and the public authorities law, in relation to
establishing a private equity pilot program (Part Q); 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 R); to amend the social services law, the executive law and the
mental hygiene law, in relation to providing professional services to
individuals with developmental disabilities in non-certified settings;
in relation to the exemption of the nurse practice act for direct care
staff in non-certified settings funded, authorized or approved by the
office for people with developmental disabilities; and to repeal
certain provisions of the mental hygiene law relating thereto (Part
S); to amend the mental hygiene law, in relation to clarifying the
authority of the commissioners in the department of mental hygiene to
design and implement time-limited demonstration programs (Part T); to
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amend the mental hygiene law, in relation to directing the commission-
er of developmental disabilities to establish a procedure through
which persons with developmental disabilities may choose to remain in
a nonintegrated setting (Part U); to amend the mental hygiene law, in
relation to providing state operated opportunities for people with
developmental disabilities (Part V); to amend the mental hygiene law,
in relation to monthly status reports on community investments (Part
W); relating to the administration of services to people with develop-
mental disabilities (Part X); to amend the mental hygiene law, in
relation to requiring an annual geographic analysis of supports and
services in community settings for individuals with developmental
disabilities (Part Y); to amend the education law, in relation to
including nurse practitioners as a provider of services for purposes
of collaborative drug therapy management; 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 the authori-
zation for pharmacists to perform collaborative drug therapy manage-
ment permanent (Part Z); to amend the mental hygiene law, in relation
to establishing a community housing wait list (Part AA); to amend the
public health law and the education law, in relation to providing for
the use of opioid antagonists in schools for opioid overdose
prevention (Part BB); to amend part A of chapter 56 of the laws of
2013 amending chapter 59 of the laws of 2011 amending the public
health law and other laws relating to general hospital reimbursement
for annual rates relating to the cap on local Medicaid expenditures,
in relation to establishing rate protections for behavioral health
essential providers and the effectiveness thereof; to amend section 1
of part H of chapter 111 of the laws of 2010, relating to increasing
Medicaid payments to providers through managed care organizations and
providing equivalent fees through an ambulatory patient group method-
ology, in relation to transfer of funds and the effectiveness thereof
(Part CC); to amend the mental hygiene law, in relation to integrated
housing for individuals with developmental disabilities (Part DD); to
amend the mental hygiene law, in relation to a temporary adjustment to
reimbursement rates for behavioral health (Part EE); to amend the
public health law, in relation to requiring the commissioner of health
to provide certain records to the temporary president of the senate
and the speaker of the assembly; requiring the commissioner of health
to convene a task force to evaluate and make recommendations related
to increasing the transparency and accountability of the health care
reform act resources fund; and to amend the public health law, in
relation to physician loan repayment awards and the distribution of
grants for the health workforce retraining program; in relation to
covered lives assessments in the Rochester region (Part FF); and to
amend the public health law, in relation to the capital restructuring
program (Part GG)
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. This act enacts into law major components of legislation
2 which are necessary to implement the state fiscal plan for the 2015-2016
3 state fiscal year. Each component is wholly contained within a Part
4 identified as Parts A through GG. The effective date for each particular
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1 provision contained within such Part is set forth in the last section of
2 such Part. Any provision in any section contained within a Part, includ-
3 ing the effective date of the Part, which makes a reference to a section
4 "of this act", when used in connection with that particular component,
5 shall be deemed to mean and refer to the corresponding section of the
6 Part in which it is found. Section three of this act sets forth the
7 general effective date of this act.
8 PART A
9 Section 1. Intentionally omitted.
10 S 2. Intentionally omitted.
11 S 3. Intentionally omitted.
12 S 4. Intentionally omitted.
13 S 5. Subdivision 9 of section 2803 of the public health law is
14 REPEALED.
15 S 6. Intentionally omitted.
16 S 7. The second undesignated paragraph of paragraph (a) of subdivision
17 2 of section 6810 of the education law, as added by chapter 413 of the
18 laws of 2014, is amended to read as follows:
19 A pharmacy registered with the department pursuant to section sixty-
20 eight hundred eight OR SIXTY-EIGHT HUNDRED EIGHT-B of this article may
21 not deliver a new or refilled prescription off premises without the
22 consent of the patient or an individual authorized to consent on the
23 patient's behalf. [Consent shall include one of the following:
24 (1) the patient or authorized individual's signature of acceptance of
25 each prescription delivered;
26 (2) the pharmacy may contact the patient or other authorized individ-
27 ual for consent to deliver and must document consent in the patient
28 record; or
29 (3) for pharmacies that administer refill reminder or medication
30 adherence programs and deliver off premises, if a signature is not
31 received on each prescription, then the refill reminder program or medi-
32 cation adherence program shall be an OPT-IN program that is updated with
33 patient consent every one hundred eighty days accompanied by a docu-
34 mented patient record review by a licensed pharmacist from the providing
35 pharmacy and the patient before continuation of medication delivery can
36 occur] FOR THE PURPOSES OF THIS SECTION, CONSENT MAY BE OBTAINED IN THE
37 SAME MANNER AND PROCESS BY WHICH CONSENT IS DEEMED ACCEPTABLE UNDER THE
38 FEDERAL MEDICARE PART D PROGRAM.
39 S 8. Paragraph (h) of subdivision 1 of section 2995-a of the public
40 health law, as added by chapter 542 of the laws of 2000, is amended to
41 read as follows:
42 (h) current [speciality] SPECIALTY board certification and date of
43 certification;
44 S 9. The opening paragraph of subdivision 1-a of section 2995-a of the
45 public health law, as added by section 8 of part A of chapter 58 of the
46 laws of 2010, is amended to read as follows:
47 Each physician licensed and registered to practice in this state shall
48 within [one hundred twenty] THIRTY days of the [effective date of this
49 subdivision] TRANSMITTAL OF AN INITIAL PROFILE SURVEY and upon entering
50 or updating his or her profile information:
51 S 10. Subdivisions 3, 4, 6 and 9 of section 2995-a of the public
52 health law, subdivisions 3, 6 and 9 as added by chapter 542 of the laws
53 of 2000, and subdivision 4 as amended by chapter 477 of the laws of
54 2008, are amended to read as follows:
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1 3. Each physician who is self-insured for professional medical malp-
2 ractice shall periodically report to the department on forms and in the
3 time and manner required by the commissioner the information specified
4 in paragraph [(f)] (E) of subdivision one of this section, except that
5 the physician shall report the dollar amount (to the extent of the
6 physician's information and belief) for each judgment, award and settle-
7 ment and not a level of significance or context.
8 4. Each physician shall periodically report to the department on forms
9 and in the time and manner required by the commissioner any other infor-
10 mation as is required by the department for the development of profiles
11 under this section which is not otherwise reasonably obtainable. In
12 addition to such periodic reports and providing the same information,
13 each physician shall update his or her profile information within the
14 six months prior to the expiration date of such physician's registration
15 period, as a condition of registration renewal under article one hundred
16 thirty-one of the education law. EXCEPT FOR OPTIONAL INFORMATION
17 PROVIDED, PHYSICIANS SHALL NOTIFY THE DEPARTMENT OF ANY CHANGE IN THE
18 PROFILE INFORMATION WITHIN THIRTY DAYS OF SUCH CHANGE.
19 6. A physician may elect to have his or her profile omit certain
20 information provided pursuant to paragraphs (l), (m)[,] AND (n) [and
21 (q)] of subdivision one of this section. In collecting information for
22 such profiles and disseminating the same, the department shall inform
23 physicians that they may choose not to provide such information required
24 pursuant to paragraphs (l), (m)[,] AND (n) [and (q)] of subdivision one
25 of this section.
26 9. The department shall, in addition to hard copy physician profiles,
27 provide for electronic access to and copying of physician profiles
28 developed pursuant to this section through the system commonly known as
29 the Internet. THE DEPARTMENT SHALL UPDATE A PHYSICIAN'S ONLINE PROFILE
30 WITHIN THIRTY DAYS OF RECEIPT OF A COMPLETED PHYSICIAN PROFILE SURVEY OR
31 ANY CHANGE IN PROFILE INFORMATION.
32 S 11. Paragraph (d) of subdivision 13 of section 2995-a of the public
33 health law, as added by chapter 542 of the laws of 2000, is amended to
34 read as follows:
35 (d) Report. The department shall provide a report of its determi-
36 nations and recommendations to the governor and legislature, and make
37 such report publicly available, [within six months of the effective date
38 of this section] ON OR BEFORE JANUARY FIRST, TWO THOUSAND SIXTEEN. THE
39 DEPARTMENT SHALL REPORT ANNUALLY THEREAFTER TO THE LEGISLATURE ON THE
40 STATUS OF THE PHYSICIAN PROFILES AND ANY RECOMMENDATIONS FOR ADDITIONS,
41 CONSOLIDATIONS OR OTHER CHANGES DEEMED APPROPRIATE.
42 S 12. Paragraph (e) of subdivision 13 of subdivision 2995-a of the
43 public health law is REPEALED.
44 S 13. Subdivision 16 of section 2995-a of the public health law, as
45 added by chapter 542 of the laws of 2000, is amended to read as follows:
46 16. [If, after initial dissemination of the physician data required by
47 this section, the department determines that any such data is not useful
48 for making quality determinations, the department shall recommend to the
49 legislature the necessary statutory changes] HEALTH CARE PLANS SHALL
50 PROVIDE THE DEPARTMENT WITH A LISTING, BY SPECIALTY, OF ALL PARTICIPAT-
51 ING PROVIDERS AS REQUIRED TO BE DISCLOSED UNDER PARAGRAPH SEVENTEEN OF
52 SUBSECTION (A) OF SECTION THREE THOUSAND TWO HUNDRED SEVENTEEN-A OF THE
53 INSURANCE LAW, PARAGRAPH SEVENTEEN OF SUBSECTION (A) OF SECTION FOUR
54 THOUSAND THREE HUNDRED TWENTY-FOUR OF THE INSURANCE LAW, AND PARAGRAPH
55 (R) OF SUBDIVISION ONE OF SECTION FORTY-FOUR HUNDRED EIGHT OF THIS CHAP-
56 TER. THE HEALTH CARE PLAN SHALL NOTIFY THE DEPARTMENT WITHIN FIFTEEN
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1 DAYS OF THE ADDITION OR TERMINATION OF A PROVIDER FROM THE PLAN'S
2 NETWORK. THE DEPARTMENT SHALL PROVIDE THIS INFORMATION TO THE PHYSICIANS
3 AT ISSUE AND MAKE THIS INFORMATION AVAILABLE IN PHYSICIAN PROFILES
4 REQUIRED UNDER THIS SECTION.
5 S 14. The public health law is amended by adding a new article 43-C to
6 read as follows:
7 ARTICLE 43-C
8 PUBLIC AND PRIVATE UMBILICAL CORD BLOOD BANKING
9 SECTION 4371. PUBLIC AND PRIVATE UMBILICAL CORD BLOOD BANKING PROGRAM.
10 S 4371. PUBLIC AND PRIVATE UMBILICAL CORD BLOOD BANKING PROGRAM. 1.
11 THE PUBLIC AND PRIVATE UMBILICAL CORD BLOOD BANKING PROGRAM IS HEREBY
12 ESTABLISHED WITHIN THE DEPARTMENT TO PROMOTE PUBLIC AWARENESS OF THE
13 POTENTIAL BENEFITS OF PUBLIC OR PRIVATE UMBILICAL CORD BLOOD BANKING TO
14 FACILITATE PRE-DELIVERY ARRANGEMENTS FOR PUBLIC OR PRIVATE BANKING OF
15 UMBILICAL CORD BLOOD DONATIONS.
16 2. THE DEPARTMENT SHALL:
17 A. DEVELOP A PUBLIC EDUCATION AND OUTREACH CAMPAIGN VIA WRITTEN MATE-
18 RIALS, BROCHURES AND THE INTERNET TO PROMOTE PUBLIC OR PRIVATE UMBILICAL
19 CORD BLOOD BANKING AWARENESS AND EDUCATION OF THE GENERAL PUBLIC AND
20 POTENTIAL UMBILICAL CORD BLOOD DONORS OF THE BENEFITS OF PUBLIC OR
21 PRIVATE UMBILICAL CORD BLOOD BANKING; AND
22 B. DEVELOP EDUCATIONAL MATERIALS AND BROCHURES WHICH SHALL BE MADE
23 AVAILABLE TO THE GENERAL PUBLIC AND POTENTIAL UMBILICAL CORD BLOOD
24 DONORS THROUGH LOCAL DEPARTMENTS OF HEALTH; HEALTH CARE PRACTITIONERS,
25 INCLUDING OBSTETRICIANS, GYNECOLOGISTS, PEDIATRICIANS, AND MIDWIVES;
26 HEALTH MAINTENANCE ORGANIZATIONS; HOSPITALS; CLINICS, WALK-IN MEDICAL
27 CENTERS, MOBILE CARE UNITS, SURGI-CENTERS, AND URGENT CARE CENTERS; AND
28 CLINICS AND ORGANIZATIONS SERVING PREGNANT WOMEN.
29 3. THE COMMISSIONER SHALL ACCEPT AND EXPEND ANY GRANTS, AWARDS, OR
30 OTHER FUNDS OR APPROPRIATIONS AS MAY BE MADE AVAILABLE FOR THE PURPOSES
31 OF THIS ARTICLE, SUBJECT TO LIMITATIONS AS TO THE APPROVAL OF EXPENDI-
32 TURES AND AUDIT AS PRESCRIBED FOR STATE FUNDS BY THE STATE FINANCE LAW.
33 S 15. Section 2557 of the public health law is amended by adding a
34 new subdivision 4 to read as follows:
35 4. THE COMMISSIONER SHALL COLLECT DATA, BY MUNICIPALITY, ON THE EARLY
36 INTERVENTION PROGRAM AUTHORIZED UNDER THIS TITLE FOR PURPOSES OF IMPROV-
37 ING THE EFFICIENCY, COST, EFFECTIVENESS, AND QUALITY OF SUCH PROGRAM.
38 SUCH MUNICIPALITY DATA COLLECTION SHALL INCLUDE BUT NOT BE LIMITED TO:
39 (A) THE NUMBER AND AGES OF CHILDREN ENROLLED IN THE EARLY INTERVENTION
40 PROGRAM;
41 (B) THE TOTAL NUMBER OF CHILDREN, WITHIN A MUNICIPALITY, RECEIVING A
42 SINGLE SERVICE, THE PERCENTAGE OF THOSE CHILDREN BY SERVICE TYPE, AND
43 THE AVERAGE FREQUENCY OF VISITS PER WEEK FOR SUCH SERVICE TYPE;
44 (C) THE TOTAL NUMBER OF CHILDREN, WITHIN A MUNICIPALITY, RECEIVING
45 MULTIPLE SERVICES, THE PERCENTAGE OF THOSE CHILDREN BY SERVICE TYPE, THE
46 AVERAGE FREQUENCY OF VISITS PER WEEK FOR SUCH SERVICE TYPE AND THE AVER-
47 AGE NUMBER OF SERVICE TYPES THAT EACH CHILD RECEIVES;
48 (D) THE TOTAL NUMBER OF CHILDREN, WITHIN A MUNICIPALITY, RECEIVING
49 SERVICES BY SERVICE TYPE PER WEEK AND THE TOTAL NUMBER OF SERVICES BY
50 SERVICE TYPE PER WEEK AUTHORIZED BY EARLY INTERVENTION PROVIDERS BY
51 PROVIDER TYPE INCLUDING APPROVED AGENCIES, INSTITUTIONS, ORGANIZATIONS
52 AND INDEPENDENT PROVIDERS;
53 (E) THE NUMBER OF NEW YORK STATE APPROVED AGENCIES, INSTITUTIONS, OR
54 ORGANIZATIONS PROVIDING EARLY INTERVENTION SERVICES BY SERVICE SPECIALTY
55 OR SPECIALTIES AND THE NUMBER OF NEW YORK STATE APPROVED INDEPENDENT
S. 4207 9
1 PROVIDERS OF EARLY INTERVENTION SERVICES BY SERVICE SPECIALTY OR
2 SPECIALTIES;
3 (F) THE NUMBER AND PERCENTAGE OF CHILDREN RECEIVING A SINGLE SERVICE
4 BY TYPE OF NEW YORK APPROVED SERVICE PROVIDER, AND THE NUMBER AND
5 PERCENTAGE OF CHILDREN RECEIVING MULTIPLE SERVICES BY TYPE OF NEW YORK
6 STATE APPROVED SERVICE PROVIDER;
7 (G) THE NUMBER OF SERVICES, BY SERVICE TYPE AND PROVIDER TYPE, THAT
8 WERE IDENTIFIED ON THE IFSP THAT WERE NOT DELIVERED TO A CHILD;
9 (H) THE OVERALL NUMBER OF NEW YORK STATE APPROVED EVALUATORS;
10 (I) THE NUMBER OF FAMILIES RECEIVING FAMILY SUPPORTIVE SERVICES SUCH
11 AS FAMILY TRAINING, COUNSELING, PARENT SUPPORT GROUPS, AND RESPITE;
12 (J) THE NUMBER OF CHILDREN THAT HAVE THIRD PARTY REIMBURSEMENT;
13 (K) THE NUMBER OF MEDICAL ASSISTANCE CLAIMS SUBMITTED. THE PERCENTAGE
14 OF MEDICAL ASSISTANCE CLAIMS DENIED AND THE PERCENTAGE OF MEDICAL
15 ASSISTANCE CLAIMS PAID. THE REASONS FOR THE DENIALS.
16 (L) THE NUMBER OF CLAIMS SUBMITTED FOR OTHER THAN MEDICAL ASSISTANCE.
17 THE PERCENTAGE OF CLAIMS DENIED FOR OTHER THAN MEDICAL ASSISTANCE AND
18 THE PERCENTAGE OF CLAIMS PAID FOR OTHER THAN MEDICAL ASSISTANCE. THE
19 REASONS FOR THE DENIALS.
20 (M) BY MUNICIPALITY, THE LAPSE IN TIME BETWEEN THE COMPLETION OF A
21 FINAL IFSP AND THE INITIATION OF SERVICES FOR ALL CHILDREN; AND
22 (N) THE NUMBER AND DOLLAR AMOUNTS OF CLAIMS SUBMITTED, BY PAYOR, THAT
23 WERE NOT PAID WITHIN NINETY DAYS AND THE REASONS FOR NON-PAYMENT.
24 THE COMMISSIONER SHALL COLLECT AND ANALYZE SUCH DATA TO DETERMINE
25 SERVICE AND UTILIZATION PATTERNS AND PROVIDE APPROPRIATE OVERSIGHT OF
26 THE PROGRAM. THE COMMISSIONER SHALL REPORT THE INFORMATION AND ANALYSIS
27 REQUIRED BY THIS SUBDIVISION TO THE TEMPORARY PRESIDENT OF THE SENATE,
28 THE SPEAKER OF THE ASSEMBLY, THE MINORITY LEADER OF THE SENATE, AND THE
29 MINORITY LEADER OF THE ASSEMBLY FOR THE PERIOD MAY FIRST, TWO THOUSAND
30 FIFTEEN TO DECEMBER THIRTY-FIRST, TWO THOUSAND FIFTEEN ON OR BEFORE
31 MARCH FIRST, TWO THOUSAND SIXTEEN AND FOR EACH CALENDAR YEAR THEREAFTER
32 ON OR BEFORE MARCH FIRST FOR THE PRECEDING CALENDAR YEAR.
33 S 16. Title 1 of article 29-D of the public health law is amended by
34 adding a new section 2997-f to read as follows:
35 S 2997-F. ELECTRONIC HEALTH RECORDS. 1. ALL HOSPITALS LICENSED UNDER
36 ARTICLE TWENTY-EIGHT OF THIS CHAPTER, ALL OFFICE-BASED SURGERY PRACTICES
37 ACCREDITED PURSUANT TO SECTION TWO HUNDRED THIRTY-D OF THIS CHAPTER, AND
38 ANY HEALTH CARE PROVIDER LICENSED PURSUANT TO TITLE EIGHT OF THE EDUCA-
39 TION LAW WHO OPERATES A PRACTICE WHICH ACCEPTS UNSCHEDULED, WALK-IN
40 APPOINTMENTS FROM PATIENTS THAT ARE NOT REGULARLY SEEN BY THE PRACTI-
41 TIONER AND HAS EXTENDED HOURS OF OPERATION SHALL UTILIZE AND MAINTAIN AN
42 ELECTRONIC HEALTH RECORD SYSTEM THAT CONNECTS TO THE LOCAL REGIONAL
43 HEALTH INFORMATION ORGANIZATION TO FACILITATE THE EXCHANGE OF HEALTH
44 INFORMATION.
45 2. EACH REGIONAL HEALTH INFORMATION ORGANIZATION SHALL ENSURE IT IS
46 ACCESSIBLE AND CAPABLE OF CONNECTING ALL HOSPITALS AND HEALTH CARE
47 PROVIDERS UNDER THIS SECTION, AND ANY OTHER HEALTH CARE PROVIDER OR
48 QUALIFIED HEALTH ENTITY AND THEIR ELECTRONIC HEALTH RECORD VENDORS,
49 INCLUDING, BUT NOT LIMITED TO, PRIVATE PHYSICIAN PRACTICES AND COUNTY
50 HEALTH DEPARTMENTS THAT WISH TO CONNECT TO THE REGIONAL HEALTH INFORMA-
51 TION ORGANIZATION.
52 3. HEALTH CARE PROVIDERS MAY APPLY FOR ANY FUNDING AVAILABLE FOR
53 HEALTH INFORMATION TECHNOLOGY AND ELECTRONIC HEALTH RECORD INFRASTRUC-
54 TURE INCLUDING, BUT NOT LIMITED TO, THE STATE ELECTRONIC HEALTH RECORDS
55 LOAN PROGRAM UNDER SECTION TWENTY-EIGHT HUNDRED TWELVE OF THIS CHAPTER.
S. 4207 10
1 4. THE COMMISSIONER SHALL ESTABLISH A PROCESS BY WHICH THE HEALTH CARE
2 PROVIDERS COVERED BY THIS SECTION MAY APPLY FOR A WAIVER FROM THE ELEC-
3 TRONIC HEALTH RECORD REQUIREMENTS IMPOSED BY THIS SECTION DUE TO ECONOM-
4 IC HARDSHIP, TECHNOLOGICAL LIMITATIONS THAT ARE NOT REASONABLY WITHIN
5 THE CONTROL OF THE HEALTH CARE PROVIDER, OR OTHER EXCEPTIONAL CIRCUM-
6 STANCE DEMONSTRATED BY THE HEALTH CARE PROVIDER.
7 S 17. The state finance law is amended by adding a new section 97-yyyy
8 to read as follows:
9 S 97-YYYY. STATE HEALTH INNOVATION PLAN ACCOUNT. 1. THERE IS HEREBY
10 ESTABLISHED IN THE JOINT CUSTODY OF THE STATE COMPTROLLER AND THE
11 COMMISSIONER OF HEALTH AN ACCOUNT OF THE MISCELLANEOUS SPECIAL REVENUE
12 FUND TO BE KNOWN AS THE "STATE HEALTH INNOVATION PLAN ACCOUNT".
13 2. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, RULE OR REGULATION TO
14 THE CONTRARY, THE STATE COMPTROLLER IS HEREBY AUTHORIZED AND DIRECTED TO
15 RECEIVE FOR DEPOSIT TO THE CREDIT OF THE STATE HEALTH INNOVATION PLAN
16 ACCOUNT, MONIES RECEIVED PURSUANT TO THE STATE INNOVATION MODEL INITI-
17 ATIVE FROM THE CENTERS FOR MEDICARE AND MEDICAID INNOVATION.
18 3. MONEYS OF THE ACCOUNT, FOLLOWING APPROPRIATION BY THE LEGISLATURE,
19 SHALL BE MADE AVAILABLE TO THE DEPARTMENT OF HEALTH FOR SERVICES AND
20 EXPENSES OF THE STATE HEALTH INNOVATION PLAN.
21 S 18. Notwithstanding any other provision of law to the contrary, for
22 periods beginning on or after April 1, 2015, any funds provided to
23 support the Statewide Health Information Network (SHIN-NY) shall be
24 contingent on the submission of a plan to the legislature, prepared by
25 the commissioner of health in consultation with representatives of
26 hospitals, physicians, other providers and consumers, detailing specif-
27 ically how funds will be used to:
28 (1) support hospitals, physicians, and other providers in the achieve-
29 ment of federal meaningful use requirements;
30 (2) support DSRIP health information exchange and data requirements to
31 help performing provider systems and the state meet DSRIP quality goals;
32 (3) increase participation in regional health information organiza-
33 tions by providers at reasonable costs to the providers;
34 (4) finalize patient consent requirements; and
35 (5) address concerns regarding liability of providers that lawfully
36 share data that is then misused by other health information exchange
37 participants.
38 S 19. This act shall take effect immediately except that:
39 (a) section seven of this act shall be deemed to have been in full
40 force and effect on and after October 21, 2014;
41 (b) section fourteen of this act shall take effect on the one hundred
42 eightieth day after it shall have become a law; provided that effective
43 immediately, the addition, amendment and/or repeal of any rule or regu-
44 lation necessary for the implementation of such section on its effective
45 date are authorized and directed to be made and completed on or before
46 such effective date; and
47 (c) section sixteen of this act shall take effect two years after it
48 shall have become a law; provided, however, that, effective immediately,
49 the commissioner of health is authorized to promulgate any rules and
50 regulations necessary to ensure that regional health care organizations
51 are capable of complying with the provisions of such section on its
52 effective date.
53 PART B
54 Section 1. Intentionally omitted.
S. 4207 11
1 S 2. Intentionally omitted.
2 S 3. Intentionally omitted.
3 S 4. Intentionally omitted.
4 S 5. Intentionally omitted.
5 S 6. Intentionally omitted.
6 S 7. Intentionally omitted.
7 S 8. The social services law is amended by adding a new section 368-g
8 to read as follows:
9 S 368-G. LIMITATION ON GROWTH OF MEDICAL ASSISTANCE EXPENDITURES. 1.
10 CAP ESTABLISHED. (A) NOTWITHSTANDING SECTION NINETY-ONE OF PART H OF
11 CHAPTER FIFTY-NINE OF THE LAWS OF TWO THOUSAND ELEVEN, AS AMENDED, OR
12 ANY OTHER CONTRARY PROVISION OF LAW AND SUBJECT TO FEDERAL APPROVALS,
13 THE YEAR TO YEAR RATE OF GROWTH OF DEPARTMENT STATE FUNDS MEDICAL
14 ASSISTANCE SPENDING SHALL NOT EXCEED THE TEN YEAR ROLLING AVERAGE OF THE
15 MEDICAL COMPONENT OF THE CONSUMER PRICE INDEX AS PUBLISHED BY THE UNITED
16 STATES DEPARTMENT OF LABOR, BUREAU OF LABOR STATISTICS, FOR THE PRECED-
17 ING TEN YEARS; PROVIDED, HOWEVER, THAT FOR STATE FISCAL YEAR TWO THOU-
18 SAND THIRTEEN-TWO THOUSAND FOURTEEN OR ANY FISCAL YEAR THEREAFTER, THE
19 MAXIMUM ALLOWABLE ANNUAL INCREASE IN THE AMOUNT OF THE DEPARTMENT STATE
20 FUNDS MEDICAL ASSISTANCE SPENDING SHALL BE CALCULATED BY MULTIPLYING THE
21 DEPARTMENT STATE FUNDS MEDICAL ASSISTANCE SPENDING FOR THE PREVIOUS
22 YEAR, LESS THE AMOUNT OF ANY DEPARTMENT STATE OPERATIONS SPENDING
23 INCLUDED THEREIN, BY SUCH TEN YEAR ROLLING AVERAGE.
24 (B) EXCEPT AS PROVIDED IN PARAGRAPH (C) OF THIS SUBDIVISION, FOR STATE
25 FISCAL YEAR TWO THOUSAND THIRTEEN-TWO THOUSAND FOURTEEN OR ANY FISCAL
26 YEAR THEREAFTER, THE SPENDING LIMIT CALCULATED PURSUANT TO PARAGRAPH (A)
27 OF THIS SUBDIVISION SHALL BE INCREASED BY AN AMOUNT EQUAL TO THE DIFFER-
28 ENCE BETWEEN THE TOTAL SOCIAL SERVICES DISTRICT MEDICAL ASSISTANCE
29 EXPENDITURE AMOUNTS CALCULATED FOR SUCH PERIOD IN CONFORMANCE WITH
30 SUBDIVISIONS (B), (C), (C-1), AND (D) OF SECTION ONE OF PART C OF CHAP-
31 TER FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND FIVE AND THE TOTAL SOCIAL
32 SERVICES DISTRICT MEDICAL EXPENDITURE AMOUNTS THAT WOULD HAVE RESULTED
33 IF THE PROVISIONS OF SUBDIVISION (C-1) OF SUCH SECTION HAD NOT BEEN
34 APPLIED.
35 (C) WITH RESPECT TO A SOCIAL SERVICES DISTRICT THAT RESCINDS THE EXER-
36 CISE OF THE OPTION PROVIDED IN PARAGRAPH (I) OF SUBDIVISION (B) OF
37 SECTION TWO OF PART C OF CHAPTER FIFTY-EIGHT OF THE LAWS OF TWO THOUSAND
38 FIVE, FOR STATE FISCAL YEAR TWO THOUSAND THIRTEEN-TWO THOUSAND FOURTEEN
39 OR ANY FISCAL YEAR THEREAFTER, THE SPENDING LIMIT CALCULATED PURSUANT TO
40 SUBDIVISION ONE OF THIS SECTION SHALL BE REDUCED BY THE AMOUNT OF THE
41 MEDICAL ASSISTANCE EXPENDITURE AMOUNT CALCULATED FOR SUCH DISTRICT FOR
42 SUCH PERIOD.
43 2. SAVINGS ALLOCATION PLAN. NOTWITHSTANDING SECTION NINETY-TWO OF PART
44 H OF CHAPTER FIFTY-NINE OF THE LAWS OF TWO THOUSAND ELEVEN, AS AMENDED,
45 AND ANY OTHER CONTRARY PROVISION OF LAW AND SUBJECT TO THE AVAILABILITY
46 OF FEDERAL FINANCIAL PARTICIPATION, FOR STATE FISCAL YEARS TWO THOUSAND
47 ELEVEN-TWO THOUSAND TWELVE THROUGH TWO THOUSAND FIFTEEN-TWO THOUSAND
48 SIXTEEN, THE DIRECTOR OF THE BUDGET, IN CONSULTATION WITH THE COMMIS-
49 SIONER, SHALL ASSESS ON A MONTHLY BASIS, AS REFLECTED IN MONTHLY REPORTS
50 ISSUED PURSUANT TO SUBDIVISION FIVE OF THIS SECTION, KNOWN AND PROJECTED
51 DEPARTMENT STATE FUNDS MEDICAL ASSISTANCE EXPENDITURES BY CATEGORY OF
52 SERVICE AND BY GEOGRAPHIC REGIONS, AS DEFINED BY THE COMMISSIONER, AND
53 IF THE DIRECTOR OF THE BUDGET DETERMINES THAT SUCH EXPENDITURES ARE
54 EXPECTED TO CAUSE MEDICAL ASSISTANCE DISBURSEMENTS FOR SUCH PERIOD TO
55 EXCEED THE PROJECTED DEPARTMENT MEDICAL ASSISTANCE STATE FUNDS DISBURSE-
56 MENTS IN THE ENACTED BUDGET FINANCIAL PLAN PURSUANT TO SUBDIVISION THREE
S. 4207 12
1 OF SECTION TWENTY-THREE OF THE STATE FINANCE LAW, THE COMMISSIONER, IN
2 CONSULTATION WITH THE DIRECTOR OF THE BUDGET, SHALL DEVELOP A MEDICAL
3 ASSISTANCE SAVINGS ALLOCATION PLAN TO LIMIT SUCH SPENDING TO THE AGGRE-
4 GATE LIMIT LEVEL SPECIFIED IN THE ENACTED BUDGET FINANCIAL PLAN,
5 PROVIDED, HOWEVER, SUCH PROJECTIONS MAY BE ADJUSTED BY THE DIRECTOR OF
6 THE BUDGET TO ACCOUNT FOR ANY CHANGES IN THE NEW YORK STATE FEDERAL
7 MEDICAL ASSISTANCE PERCENTAGE AMOUNT ESTABLISHED PURSUANT TO THE FEDERAL
8 SOCIAL SECURITY ACT, CHANGES IN PROVIDER REVENUES, REDUCTIONS TO LOCAL
9 SOCIAL SERVICES DISTRICT MEDICAL ASSISTANCE ADMINISTRATION, AND BEGIN-
10 NING APRIL FIRST, TWO THOUSAND TWELVE, THE OPERATIONAL COSTS OF THE NEW
11 YORK STATE MEDICAL INDEMNITY FUND. SUCH PROJECTIONS MAY BE ADJUSTED BY
12 THE DIRECTOR OF THE BUDGET TO ACCOUNT FOR INCREASED OR EXPEDITED DEPART-
13 MENT OF HEALTH STATE FUNDS MEDICAL ASSISTANCE EXPENDITURES AS A RESULT
14 OF A NATURAL OR OTHER TYPE OF DISASTER, INCLUDING A GOVERNMENTAL DECLA-
15 RATION OF EMERGENCY. SUCH MEDICAL ASSISTANCE SAVINGS ALLOCATION PLAN
16 SHALL BE DESIGNED TO REDUCE THE DEPARTMENT STATE FUNDS MEDICAL ASSIST-
17 ANCE DISBURSEMENTS AUTHORIZED BY APPROPRIATIONS IN COMPLIANCE WITH THE
18 FOLLOWING GUIDELINES:
19 (A) REDUCTIONS SHALL BE MADE IN COMPLIANCE WITH APPLICABLE FEDERAL
20 LAW, INCLUDING THE PROVISIONS OF THE PATIENT PROTECTION AND AFFORDABLE
21 CARE ACT (P.L. 111-148), AS AMENDED BY THE HEALTH CARE AND EDUCATION
22 RECONCILIATION ACT OF 2010 (P.L. 111-152) (COLLECTIVELY "AFFORDABLE CARE
23 ACT") AND ANY SUBSEQUENT AMENDMENTS THERETO OR REGULATIONS PROMULGATED
24 THEREUNDER;
25 (B) REDUCTIONS SHALL BE MADE IN A MANNER THAT COMPLIES WITH THE STATE
26 MEDICAL ASSISTANCE PLAN APPROVED BY THE FEDERAL CENTERS FOR MEDICARE AND
27 MEDICAID SERVICES, PROVIDED, HOWEVER, THAT THE COMMISSIONER IS AUTHOR-
28 IZED TO SUBMIT ANY STATE PLAN AMENDMENT OR SEEK OTHER FEDERAL APPROVAL,
29 INCLUDING WAIVER AUTHORITY, TO IMPLEMENT THE PROVISIONS OF THE MEDICAL
30 ASSISTANCE SAVINGS ALLOCATION PLAN THAT MEETS THE OTHER CRITERIA SET
31 FORTH HEREIN;
32 (C) REDUCTIONS SHALL BE MADE IN A MANNER THAT MAXIMIZES FEDERAL FINAN-
33 CIAL PARTICIPATION, TO THE EXTENT PRACTICABLE, INCLUDING ANY FEDERAL
34 FINANCIAL PARTICIPATION THAT IS AVAILABLE OR IS REASONABLY EXPECTED TO
35 BECOME AVAILABLE, IN THE DISCRETION OF THE COMMISSIONER, UNDER THE
36 AFFORDABLE CARE ACT;
37 (D) REDUCTIONS SHALL BE MADE UNIFORMLY AMONG CATEGORIES OF SERVICES
38 AND GEOGRAPHIC REGIONS OF THE STATE, TO THE EXTENT PRACTICABLE, AND
39 SHALL BE MADE UNIFORMLY WITHIN A CATEGORY OF SERVICE, TO THE EXTENT
40 PRACTICABLE, EXCEPT WHERE THE COMMISSIONER DETERMINES THAT THERE ARE
41 SUFFICIENT GROUNDS FOR NON-UNIFORMITY, INCLUDING, BUT NOT LIMITED TO:
42 (I) THE EXTENT TO WHICH SPECIFIC CATEGORIES OF SERVICES CONTRIBUTED TO
43 DEPARTMENT MEDICAL ASSISTANCE STATE FUNDS SPENDING IN EXCESS OF THE
44 LIMITS SPECIFIED HEREIN; (II) THE NEED TO MAINTAIN SAFETY NET SERVICES
45 IN UNDERSERVED COMMUNITIES; OR (III) THE POTENTIAL BENEFITS OF PURSUING
46 INNOVATIVE PAYMENT MODELS CONTEMPLATED BY THE AFFORDABLE CARE ACT, IN
47 WHICH CASE SUCH GROUNDS SHALL BE SET FORTH IN THE MEDICAL ASSISTANCE
48 SAVINGS ALLOCATION PLAN;
49 (E) REDUCTIONS SHALL BE MADE IN A MANNER THAT DOES NOT UNNECESSARILY
50 CREATE ADMINISTRATIVE BURDENS FOR MEDICAL ASSISTANCE APPLICANTS AND
51 RECIPIENTS OR FOR PROVIDERS;
52 (F) THE COMMISSIONER SHALL SEEK THE INPUT OF THE LEGISLATURE, AS WELL
53 AS INPUT FROM ORGANIZATIONS REPRESENTING HEALTH CARE PROVIDERS, CONSUM-
54 ERS, BUSINESSES, WORKERS, HEALTH INSURERS, AND OTHERS WITH RELEVANT
55 EXPERTISE, IN DEVELOPING SUCH MEDICAL ASSISTANCE SAVINGS ALLOCATION PLAN
56 TO THE EXTENT THAT ALL OR PART OF SUCH PLAN IS LIKELY, AS DETERMINED BY
S. 4207 13
1 THE COMMISSIONER, TO HAVE A MATERIAL IMPACT ON THE OVERALL MEDICAL
2 ASSISTANCE PROGRAM, OR ON PARTICULAR CATEGORIES OF SERVICE, OR ON
3 PARTICULAR GEOGRAPHIC REGIONS OF THE STATE;
4 (G)(I) THE COMMISSIONER SHALL POST THE MEDICAL ASSISTANCE SAVINGS
5 ALLOCATION PLAN ON THE DEPARTMENT'S WEBSITE AND SHALL PROVIDE WRITTEN
6 COPIES OF SUCH PLAN TO THE CHAIRS OF THE SENATE FINANCE AND THE ASSEMBLY
7 WAYS AND MEANS COMMITTEES AT LEAST THIRTY DAYS BEFORE THE DATE ON WHICH
8 IMPLEMENTATION IS EXPECTED TO BEGIN;
9 (II) THE COMMISSIONER MAY REVISE THE MEDICAL ASSISTANCE SAVINGS ALLO-
10 CATION PLAN SUBSEQUENT TO THE PROVISION OF NOTICE AND PRIOR TO IMPLEMEN-
11 TATION BUT IS REQUIRED TO PROVIDE A NEW NOTICE PURSUANT TO SUBPARAGRAPH
12 (I) OF THIS PARAGRAPH ONLY IF THE COMMISSIONER DETERMINES, IN HIS OR HER
13 DISCRETION, THAT SUCH REVISIONS MATERIALLY ALTER THE PLAN;
14 (H) NOTWITHSTANDING THE PROVISIONS OF PARAGRAPHS (F) AND (G) OF THIS
15 SUBDIVISION, THE COMMISSIONER NEED NOT SEEK THE INPUT DESCRIBED IN PARA-
16 GRAPH (F) OF THIS SUBDIVISION OR PROVIDE NOTICE PURSUANT TO PARAGRAPH
17 (G) OF THIS SUBDIVISION IF, IN THE DISCRETION OF THE COMMISSIONER, EXPE-
18 DITED DEVELOPMENT AND IMPLEMENTATION OF A MEDICAL ASSISTANCE SAVINGS
19 ALLOCATION PLAN IS NECESSARY DUE TO A PUBLIC HEALTH EMERGENCY; FOR
20 PURPOSES OF THIS SECTION, A PUBLIC HEALTH EMERGENCY IS DEFINED AS:
21 (I) A DISASTER, NATURAL OR OTHERWISE, THAT SIGNIFICANTLY INCREASES THE
22 IMMEDIATE NEED FOR HEALTH CARE PERSONNEL IN AN AREA OF THE STATE;
23 (II) AN EVENT OR CONDITION THAT CREATES A WIDESPREAD RISK OF EXPOSURE
24 TO A SERIOUS COMMUNICABLE DISEASE, OR THE POTENTIAL FOR SUCH WIDESPREAD
25 RISK OF EXPOSURE; OR
26 (III) ANY OTHER EVENT OR CONDITION DETERMINED BY THE COMMISSIONER TO
27 CONSTITUTE AN IMMINENT THREAT TO PUBLIC HEALTH; AND
28 (I) NOTHING IN THIS SECTION SHALL BE DEEMED TO PREVENT ALL OR PART OF
29 SUCH MEDICAL SAVINGS ALLOCATION PLAN FROM TAKING EFFECT RETROACTIVELY,
30 TO THE EXTENT PERMITTED BY THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID
31 SERVICES.
32 3. POWERS OF THE COMMISSIONER TO ENACT SAVINGS ALLOCATION PLAN. IN
33 ACCORDANCE WITH THE MEDICAL ASSISTANCE SAVINGS ALLOCATION PLAN, THE
34 COMMISSIONER SHALL REDUCE DEPARTMENT STATE FUNDS MEDICAL ASSISTANCE
35 DISBURSEMENTS BY THE AMOUNT OF THE PROJECTED OVERSPENDING THROUGH,
36 ACTIONS INCLUDING, BUT NOT LIMITED TO MODIFYING OR SUSPENDING REIMBURSE-
37 MENT METHODS, INCLUDING BUT NOT LIMITED TO ALL FEES, PREMIUM LEVELS AND
38 RATES OF PAYMENT, NOTWITHSTANDING ANY PROVISION OF LAW THAT SETS A
39 SPECIFIC AMOUNT OR METHODOLOGY FOR ANY SUCH PAYMENTS OR RATES OF
40 PAYMENT; MODIFYING MEDICAL ASSISTANCE PROGRAM BENEFITS; SEEKING ALL
41 NECESSARY FEDERAL APPROVALS, INCLUDING, BUT NOT LIMITED TO WAIVERS,
42 WAIVER AMENDMENTS; AND SUSPENDING TIME FRAMES FOR NOTICE, APPROVAL OR
43 CERTIFICATION OF RATE REQUIREMENTS, NOTWITHSTANDING ANY PROVISION OF
44 LAW, RULE OR REGULATION TO THE CONTRARY, INCLUDING, BUT NOT LIMITED TO,
45 SECTIONS TWENTY-EIGHT HUNDRED SEVEN AND THIRTY-SIX HUNDRED FOURTEEN OF
46 THE PUBLIC HEALTH LAW, SECTION EIGHTEEN OF CHAPTER TWO OF THE LAWS OF
47 NINETEEN HUNDRED EIGHTY-EIGHT, AND SECTION 505.14(H) OF TITLE 18 OF THE
48 OFFICIAL COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW
49 YORK.
50 4. CAP DIVIDEND. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW AND
51 SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, FOR
52 STATE FISCAL YEARS BEGINNING ON AND AFTER APRIL FIRST, TWO THOUSAND
53 FOURTEEN, THE COMMISSIONER OF HEALTH, IN CONSULTATION WITH THE DIRECTOR
54 OF THE BUDGET, SHALL, PRIOR TO JANUARY FIRST OF EACH YEAR, DETERMINE THE
55 EXTENT OF SAVINGS THAT HAVE BEEN ACHIEVED AS A RESULT OF THE APPLICATION
56 OF THE PROVISIONS OF SUBDIVISIONS ONE AND TWO OF THIS SECTION, AND SHALL
S. 4207 14
1 FURTHER DETERMINE THE AVAILABILITY OF SUCH SAVINGS FOR DISTRIBUTION
2 DURING THE LAST QUARTER OF SUCH STATE FISCAL YEAR. IN DETERMINING SUCH
3 SAVINGS THE COMMISSIONER OF HEALTH, IN CONSULTATION WITH THE DIRECTOR OF
4 THE BUDGET, MAY EXEMPT THE MEDICAL ASSISTANCE ADMINISTRATION PROGRAM
5 FROM DISTRIBUTIONS UNDER THIS SECTION. THE COMMISSIONER OF HEALTH, IN
6 CONSULTATION WITH THE DIRECTOR OF THE BUDGET, MAY DISTRIBUTE FUNDS UP TO
7 AN AMOUNT EQUAL TO SUCH AVAILABLE SAVINGS IN ACCORDANCE WITH A DIVIDEND
8 ALLOCATION PLAN THAT UTILIZES A METHODOLOGY THAT DISTRIBUTES SUCH FUNDS
9 PROPORTIONATELY AMONG PROVIDERS AND PLANS IN NEW YORK'S MEDICAL ASSIST-
10 ANCE PROGRAM. IN DEVELOPING SUCH DIVIDEND ALLOCATION PLAN THE COMMIS-
11 SIONER OF HEALTH SHALL SEEK THE INPUT OF THE LEGISLATURE, AS WELL AS
12 ORGANIZATIONS REPRESENTING HEALTH CARE PROVIDERS, CONSUMERS, BUSINESSES,
13 WORKERS, HEALTH CARE INSURERS AND OTHERS WITH RELEVANT EXPERTISE. SUCH
14 DIVIDEND ALLOCATION PLAN SHALL UTILIZE THREE YEARS OF THE MOST RECENTLY
15 AVAILABLE SYSTEM-WIDE EXPENDITURE DATA REFLECTING BOTH MMIS AND MANAGED
16 CARE ENCOUNTERS. DISTRIBUTIONS TO MANAGED CARE PLANS SHALL BE BASED ON
17 THE ADMINISTRATIVE OUTLAYS STEMMING FROM PARTICIPATION IN THE MEDICAL
18 ASSISTANCE PROGRAM. THE COMMISSIONER OF HEALTH MAY IMPOSE MINIMUM THRES-
19 HOLD AMOUNTS IN DETERMINING PROVIDER ELIGIBILITY FOR DISTRIBUTIONS
20 PURSUANT TO THIS SECTION. NO LESS THAN FIFTY PERCENT OF THE AMOUNT
21 AVAILABLE FOR DISTRIBUTION SHALL BE MADE AVAILABLE FOR THE PURPOSE OF
22 ASSISTING ELIGIBLE PROVIDERS UTILIZING THE METHODOLOGY OUTLINED ABOVE.
23 THE REMAINDER OF THE DISTRIBUTIONS PURSUANT TO THIS SECTION SHALL BE
24 MADE AVAILABLE FOR THE PURPOSES OF ENSURING A MINIMUM LEVEL OF ASSIST-
25 ANCE TO FINANCIALLY DISTRESSED AND CRITICALLY NEEDED PROVIDERS AS IDEN-
26 TIFIED BY THE COMMISSIONER. THE COMMISSIONER OF HEALTH SHALL POST THE
27 MEDICAL ASSISTANCE SAVINGS DIVIDEND ALLOCATION PLAN ON THE DEPARTMENT OF
28 HEALTH'S WEBSITE AND SHALL PROVIDE WRITTEN COPIES OF SUCH PLAN TO THE
29 CHAIRS OF THE SENATE FINANCE AND THE ASSEMBLY WAYS AND MEANS COMMITTEES
30 AT LEAST THIRTY DAYS BEFORE THE DATE ON WHICH IMPLEMENTATION IS EXPECTED
31 TO BEGIN. THE COMMISSIONER OF HEALTH IS AUTHORIZED TO SEEK SUCH FEDERAL
32 APPROVALS AS MAY BE REQUIRED TO EFFECTUATE THE PROVISIONS OF THIS
33 SECTION, INCLUDING, BUT NOT LIMITED TO, TO PERMIT PAYMENT OF SUCH
34 DISTRIBUTIONS AS LUMPS SUMS AND TO SECURE WAIVERS FROM OTHERWISE APPLI-
35 CABLE FEDERAL UPPER PAYMENT LIMIT RESTRICTIONS ON SUCH PAYMENTS. THE
36 PROVISIONS OF THIS SECTION ARE SUBJECT TO THE REPORTING REQUIREMENTS SET
37 FORTH IN SUBDIVISION SEVEN OF THIS SECTION.
38 5. MONTHLY REPORTS. THE COMMISSIONER, IN CONSULTATION WITH THE DIREC-
39 TOR OF THE BUDGET, SHALL PREPARE A MONTHLY REPORT THAT SETS FORTH:
40 (A) KNOWN AND PROJECTED DEPARTMENT MEDICAL ASSISTANCE EXPENDITURES AS
41 DESCRIBED IN SUBDIVISION ONE OF THIS SECTION, AND FACTORS THAT COULD
42 RESULT IN MEDICAL ASSISTANCE DISBURSEMENTS FOR THE RELEVANT STATE FISCAL
43 YEAR TO EXCEED THE PROJECTED DEPARTMENT STATE FUNDS DISBURSEMENTS IN THE
44 ENACTED BUDGET FINANCIAL PLAN PURSUANT TO SUBDIVISION THREE OF SECTION
45 TWENTY-THREE OF THE STATE FINANCE LAW, INCLUDING SPENDING INCREASES OR
46 DECREASES DUE TO ENROLLMENT FLUCTUATIONS, RATE CHANGES, UTILIZATION
47 CHANGES, MEDICAL ASSISTANCE REDESIGN TEAM (MRT) INVESTMENTS, A SHIFT OF
48 BENEFICIARIES TO MANAGED CARE AND VARIATIONS IN OFFLINE MEDICAL ASSIST-
49 ANCE PAYMENTS;
50 (B) THE ACTIONS TAKEN TO IMPLEMENT ANY MEDICAL ASSISTANCE SAVINGS
51 ALLOCATION PLAN IMPLEMENTED PURSUANT TO SUBDIVISION FOUR OF THIS
52 SECTION, INCLUDING INFORMATION CONCERNING THE IMPACT OF SUCH ACTIONS ON
53 EACH CATEGORY OF SERVICE AND EACH GEOGRAPHIC REGION OF THE STATE;
54 (C) THE PRICE, INCLUDING, THE BASE RATE PLUS ANY UPCOMING RATE ADJUST-
55 MENT; UTILIZATION, INCLUDING CURRENT ENROLLMENT, PROJECTED ENROLLMENT
56 CHANGES AND ACUITY; MEDICAL ASSISTANCE REDESIGN TEAM INITIATIVES;
S. 4207 15
1 ONE-TIME INITIATIVES AND OTHER INITIATIVES DESCRIBING THE PROPOSED BUDG-
2 ET ACTION IMPACT; AND ANY PRIOR YEAR INITIATIVE WITH CURRENT AND FUTURE
3 YEAR IMPACTS FOR THE FOLLOWING CATEGORIES:
4 (I) INPATIENT;
5 (II) OUTPATIENT;
6 (III) EMERGENCY ROOM;
7 (IV) CLINIC;
8 (V) NURSING HOMES;
9 (VI) OTHER LONG TERM CARE;
10 (VII) MEDICAID MANAGED CARE;
11 (VIII) FAMILY HEALTH PLUS;
12 (IX) PHARMACY;
13 (X) TRANSPORTATION;
14 (XI) DENTAL;
15 (XII) NON-INSTITUTIONAL AND OTHER CATEGORIES;
16 (XIII) AFFORDABLE HOUSING;
17 (XIV) VITAL ACCESS PROVIDER SERVICES;
18 (XV) BEHAVIORAL HEALTH VITAL ACCESS PROVIDER SERVICES;
19 (XVI) FINGER LAKES HEALTH SERVICES AGENCY;
20 (XVII) AUDIT RECOVERIES AND SETTLEMENTS;
21 (D) INFORMATION AND DISBURSEMENTS OF GRANTS TO PROVIDERS, INCLUDING
22 BUT NOT LIMITED TO:
23 (I) DEMOGRAPHIC INFORMATION OF TARGETED RECIPIENTS;
24 (II) NUMBER OF RECIPIENTS;
25 (III) AWARD AMOUNTS AND TIMING OF AWARDS; AND
26 (E) ANY PROJECTED MEDICAL ASSISTANCE SAVINGS DETERMINED BY THE COMMIS-
27 SIONER PURSUANT TO SUBDIVISION FOUR OF THIS SECTION AND THE PROPOSED
28 ALLOCATION PLAN WITH REGARD TO SUCH SAVINGS.
29 (F) THE MONTHLY REPORTS REQUIRED BY THIS SUBDIVISION SHALL BE PROVIDED
30 TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF
31 THE ASSEMBLY, THE CHAIR OF THE SENATE FINANCE COMMITTEE, THE CHAIR OF
32 THE ASSEMBLY WAYS AND MEANS COMMITTEE, AND THE CHAIRS OF THE SENATE AND
33 ASSEMBLY HEALTH COMMITTEES. SUCH REPORTS AND RELATED DOCUMENTS PROVIDED
34 TO THE LEGISLATURE SHALL ALSO BE POSTED ON THE WEBSITE AS MAINTAINED BY
35 THE DEPARTMENT.
36 6. EXECUTIVE BUDGET SUMMARY. THE COMMISSIONER, IN CONSULTATION WITH
37 THE DIRECTOR OF THE BUDGET SHALL, UPON SUBMISSION OF THE EXECUTIVE BUDG-
38 ET TO THE LEGISLATURE, PROVIDE TO THE LEGISLATURE A DETAILED ACCOUNTING
39 OF:
40 (A) THE STATE MEDICAL ASSISTANCE STATE FUNDS EXPENDITURES ON THE CLOSE
41 OUT OF THE PRIOR YEAR;
42 (B) A CURRENT YEAR RE-ESTIMATE;
43 (C) THE PROSPECTIVE TWO-YEAR ESTIMATE; AND
44 (D) ANY OTHER INFORMATION DEEMED NECESSARY AND APPROPRIATE.
45 7. STAFF AVAILABILITY AND TRAINING. (A) THE COMMISSIONER AND THE
46 DIRECTOR OF THE BUDGET SHALL MAKE APPROPRIATE STAFF AVAILABLE TO MEET
47 WITH THE CHAIRS OF THE HEALTH COMMITTEES OF THE SENATE AND THE ASSEMBLY,
48 OR THEIR DESIGNEES, UPON THEIR REQUEST AND WITH REASONABLE NOTICE, TO
49 REVIEW EACH MONTHLY REPORT, AS DESCRIBED IN SUBDIVISION FIVE OF THIS
50 SECTION.
51 (B) THE COMMISSIONER SHALL MAKE TRAINING AVAILABLE TO DESIGNATED
52 LEGISLATIVE STAFF WITH REGARD TO THE SKILLS AND TECHNIQUES NEEDED TO
53 EFFECTIVELY ACCESS AND REVIEW RELEVANT MEDICAL ASSISTANCE DATA BASES
54 UNDER THE CONTROL OF THE DEPARTMENT, UPON THEIR REQUEST AND WITH REASON-
55 ABLE NOTICE.
56 S 9. Intentionally omitted.
S. 4207 16
1 S 10. Intentionally omitted.
2 S 11. Intentionally omitted.
3 S 12. Intentionally omitted.
4 S 13. Subdivision (e) of section 2826 of the public health law, as
5 added by section 27 of part C of chapter 60 of the laws of 2014, is
6 amended to read as follows:
7 (e) Notwithstanding any law to the contrary, general hospitals defined
8 as critical access hospitals pursuant to title XVIII of the federal
9 social security act shall be allocated no less than [five] SEVEN million
10 FIVE HUNDRED THOUSAND dollars annually pursuant to this section. The
11 department of health shall provide a report to the governor and legisla-
12 ture no later than [December] JUNE first, two thousand [fourteen]
13 FIFTEEN providing recommendations on how to ensure the financial stabil-
14 ity of, and preserve patient access to, critical access hospitals,
15 INCLUDING AN EXAMINATION OF PERMANENT MEDICAID RATE METHODOLOGY CHANGES.
16 S 14. Section 2826 of the public health law is amended by adding a new
17 subdivision (f) to read as follows:
18 (F) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
19 TO FEDERAL FINANCIAL PARTICIPATION, NO LESS THAN TEN MILLION DOLLARS
20 SHALL BE ALLOCATED TO PROVIDERS DESCRIBED IN THIS SUBDIVISION; PROVIDED,
21 HOWEVER THAT IF FEDERAL FINANCIAL PARTICIPATION IS UNAVAILABLE FOR ANY
22 ELIGIBLE PROVIDER, OR FOR ANY POTENTIAL INVESTMENT UNDER THIS SUBDIVI-
23 SION THEN THE NON-FEDERAL SHARE OF PAYMENTS PURSUANT TO THIS SUBDIVISION
24 MAY BE MADE AS STATE GRANTS.
25 (I) PROVIDERS SERVING RURAL AREAS AS SUCH TERM IS DEFINED IN SECTION
26 TWO THOUSAND NINE HUNDRED FIFTY-ONE OF THIS CHAPTER, INCLUDING BUT NOT
27 LIMITED TO HOSPITALS, RESIDENTIAL HEALTH CARE FACILITIES, DIAGNOSTIC AND
28 TREATMENT CENTERS, AMBULATORY SURGERY CENTERS AND CLINICS SHALL BE
29 ELIGIBLE FOR ENHANCED PAYMENTS OR REIMBURSEMENT UNDER A SUPPLEMENTAL
30 RATE METHODOLOGY FOR THE PURPOSE OF PROMOTING ACCESS AND IMPROVING THE
31 QUALITY OF CARE.
32 (II) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, AND SUBJECT
33 TO FEDERAL FINANCIAL PARTICIPATION, ESSENTIAL COMMUNITY PROVIDERS,
34 WHICH, FOR THE PURPOSES OF THIS SECTION, SHALL MEAN A PROVIDER THAT
35 OFFERS HEALTH SERVICES WITHIN A DEFINED AND ISOLATED GEOGRAPHIC REGION
36 WHERE SUCH SERVICES WOULD OTHERWISE BE UNAVAILABLE TO THE POPULATION OF
37 SUCH REGION, SHALL BE ELIGIBLE FOR ENHANCED PAYMENTS OR REIMBURSEMENT
38 UNDER A SUPPLEMENTAL RATE METHODOLOGY FOR THE PURPOSE OF PROMOTING
39 ACCESS AND IMPROVING QUALITY OF CARE. ELIGIBLE PROVIDERS UNDER THIS
40 PARAGRAPH MAY INCLUDE, BUT ARE NOT LIMITED TO, HOSPITALS, RESIDENTIAL
41 HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT CENTERS, AMBULATORY
42 SURGERY CENTERS AND CLINICS.
43 (III) IN MAKING SUCH PAYMENTS THE COMMISSIONER MAY CONTEMPLATE THE
44 EXTENT TO WHICH ANY SUCH PROVIDER RECEIVES ASSISTANCE UNDER SUBDIVISION
45 (A) OF THIS SECTION AND MAY REQUIRE SUCH PROVIDER TO SUBMIT A WRITTEN
46 PROPOSAL DEMONSTRATING THAT THE NEED FOR MONIES UNDER THIS SUBDIVISION
47 EXCEEDS MONIES OTHERWISE DISTRIBUTED PURSUANT TO THIS SECTION.
48 (IV) PAYMENTS UNDER THIS SUBDIVISION MAY INCLUDE, BUT NOT BE LIMITED
49 TO, TEMPORARY RATE ADJUSTMENTS, LUMP SUM MEDICAID PAYMENTS, SUPPLEMENTAL
50 RATE METHODOLOGIES AND ANY OTHER PAYMENTS AS DETERMINED BY THE COMMIS-
51 SIONER.
52 (V) PAYMENTS UNDER THIS SUBDIVISION SHALL BE SUBJECT TO APPROVAL BY
53 THE DIRECTOR OF THE BUDGET.
54 (VI) THE COMMISSIONER MAY PROMULGATE REGULATIONS TO EFFECTUATE THE
55 PROVISIONS OF THIS SUBDIVISION.
S. 4207 17
1 S 15. Subparagraph (iv) of paragraph (b) of subdivision 6 of section
2 367-a of the social services law, as amended by section 40 of part C of
3 chapter 58 of the laws of 2005, is amended to read as follows:
4 (iv) individuals [enrolled in health maintenance organizations or
5 other entities which provide comprehensive health services, or other
6 managed care programs for services covered by such programs, except that
7 such persons, other than persons otherwise exempted from co-payments
8 pursuant to subparagraphs (i), (ii), (iii) and (v) of this paragraph,
9 and other than those persons enrolled in a managed long term care
10 program, shall be subject to co-payments as described in subparagraph
11 (v) of paragraph (d) of this subdivision] WHOSE FAMILY INCOME IS LESS
12 THAN ONE HUNDRED PERCENT OF THE FEDERAL POVERTY LINE, AS DEFINED IN
13 SUBPARAGRAPH FOUR OF PARAGRAPH (A) OF SUBDIVISION ONE OF SECTION THREE
14 HUNDRED SIXTY-SIX OF THIS TITLE, FOR A FAMILY OF THE SAME SIZE; and
15 S 16. Section 12 of part A of chapter 1 of the laws of 2002, relating
16 to the health care reform act of 2000, is amended to read as follows:
17 S 12. Notwithstanding any inconsistent provision of law or regulation
18 to the contrary, and subject to the availability of federal financial
19 participation pursuant to title XIX of the federal social security act,
20 effective for the period September 1, 2001 through March 31, 2002, and
21 state fiscal years thereafter, UNTIL MARCH 31, 2012, the department of
22 health is authorized to pay a specialty hospital adjustment to public
23 general hospitals, as defined in subdivision 10 of section 2801 of the
24 public health law, other than those operated by the state of New York or
25 the state university of New York, receiving reimbursement for all inpa-
26 tient services under title XIX of the federal social security act pursu-
27 ant to paragraph (e) of subdivision 4 of section 2807-c of the public
28 health law, and located in a city with a population of over 1 million,
29 of up to four hundred sixty-three million dollars for the period Septem-
30 ber 1, 2001 through March 31, 2002 and up to seven hundred ninety-four
31 million dollars annually for state fiscal years thereafter as medical
32 assistance payments for inpatient services pursuant to title 11 of arti-
33 cle 5 of the social services law for patients eligible for federal
34 financial participation under title XIX of the federal social security
35 act based on each such hospital's proportionate share of the sum of all
36 inpatient discharges for all facilities eligible for an adjustment
37 pursuant to this section for the base year two years prior to the rate
38 year. Such proportionate share payment may be added to rates of payment
39 or made as aggregate payments to eligible public general hospitals.
40 S 17. Section 13 of part B of chapter 1 of the laws of 2002, relating
41 to the health care reform act of 2000, is amended to read as follows:
42 S 13. Notwithstanding any inconsistent provision of law or regulation
43 to the contrary, and subject to the availability of federal financial
44 participation pursuant to title XIX of the federal social security act,
45 effective for the period April 1, 2002 through March 31, 2003, and state
46 fiscal years thereafter UNTIL MARCH 31, 2012, the department of health
47 is authorized to pay a specialty hospital adjustment to public general
48 hospitals, as defined in subdivision 10 of section 2801 of the public
49 health law, other than those operated by the state of New York or the
50 state university of New York, receiving reimbursement for all inpatient
51 services under title XIX of the federal social security act pursuant to
52 paragraph (e) of subdivision 4 of section 2807-c of the public health
53 law, and located in a city with a population of over one million, of up
54 to two hundred eighty-six million dollars as medical assistance payments
55 for inpatient services pursuant to title 11 of article 5 of the social
56 services law for patients eligible for federal financial participation
S. 4207 18
1 under title XIX of the federal social security act based on each such
2 hospital's proportionate share of the sum of all inpatient discharges
3 for all facilities eligible for an adjustment pursuant to this section
4 for the base year two years prior to the rate year. Such proportionate
5 share payment may be added to rates of payment or made as aggregate
6 payments to eligible hospitals.
7 S 18. Notwithstanding any inconsistent provision of law or regulation
8 to the contrary, and subject to the availability of federal financial
9 participation pursuant to title XIX of the federal social security act,
10 effective for the period April 1, 2012, through March 31, 2013, and
11 state fiscal years thereafter, the department of health is authorized to
12 pay a public hospital adjustment to public general hospitals, as defined
13 in subdivision 10 of section 2801 of the public health law, other than
14 those operated by the state of New York or the state university of New
15 York, and located in a city with a population of over 1 million, of up
16 to one billion eighty million dollars annually as medical assistance
17 payments for inpatient services pursuant to title 11 of article 5 of the
18 social services law for patients eligible for federal financial partic-
19 ipation under title XIX of the federal social security act based on such
20 criteria and methodologies as the commissioner may from time to time set
21 through a memorandum of understanding with the New York city health and
22 hospitals corporation, and such adjustments shall be paid by means of
23 one or more estimated payments, with such estimated payments to be
24 reconciled to the commissioner of health's final adjustment determi-
25 nations after the disproportionate share hospital payment adjustment
26 caps have been calculated for such period under sections 1923(f) and (g)
27 of the federal social security act. Such adjustment payment may be added
28 to rates of payment or made as aggregate payments to eligible public
29 general hospitals.
30 S 19. Section 14 of part A of chapter 1 of the laws of 2002, relating
31 to the health care reform act of 2000, is amended to read as follows:
32 S 14. Notwithstanding any inconsistent provision of law, rule or regu-
33 lation to the contrary, and subject to the availability of federal
34 financial participation pursuant to title XIX of the federal social
35 security act, effective for the period January 1, 2002 through March 31,
36 2002, and state fiscal years thereafter UNTIL MARCH 31, 2011, the
37 department of health is authorized to increase the operating cost compo-
38 nent of rates of payment for general hospital outpatient services and
39 general hospital emergency room services issued pursuant to paragraph
40 (g) of subdivision 2 of section 2807 of the public health law for public
41 general hospitals, as defined in subdivision 10 of section 2801 of the
42 public health law, other than those operated by the state of New York or
43 the state university of New York, and located in a city with a popu-
44 lation of over one million, which experienced free patient visits in
45 excess of twenty percent of their total self-pay and free patient visits
46 based on data reported on exhibit 33 of their 1999 institutional cost
47 report and which experienced uninsured outpatient losses in excess of
48 seventy-five percent of their total inpatient and outpatient uninsured
49 losses based on data reported on exhibit 47 of their 1999 institutional
50 cost report, of up to thirty-four million dollars for the period January
51 1, 2002 through March 31, 2002 and up to one hundred thirty-six million
52 dollars annually for state fiscal years thereafter as medical assistance
53 payments for outpatient services pursuant to title 11 of article 5 of
54 the social services law for patients eligible for federal financial
55 participation under title XIX of the federal social security act based
56 on each such hospital's proportionate share of the sum of all outpatient
S. 4207 19
1 visits for all facilities eligible for an adjustment pursuant to this
2 section for the base year two years prior to the rate year. Such propor-
3 tionate share payment may be added to rates of payment or made as aggre-
4 gate payments to eligible public general hospitals.
5 S 20. Section 14 of part B of chapter 1 of the laws of 2002, relating
6 to the health care reform act of 2000, is amended to read as follows:
7 S 14. Notwithstanding any inconsistent provision of law or regulation
8 to the contrary, and subject to the availability of federal financial
9 participation pursuant to title XIX of the federal social security act,
10 effective for the period January 1, 2002 through March 31, 2002, and
11 state fiscal years thereafter UNTIL MARCH 31, 2011, the department of
12 health is authorized to increase the operating cost component of rates
13 of payment for general hospital outpatient services and general hospital
14 emergency room services issued pursuant to paragraph (g) of subdivision
15 2 of section 2807 of the public health law for public general hospitals,
16 as defined in subdivision 10 of section 2801 of the public health law,
17 other than those operated by the state of New York or the state univer-
18 sity of New York, and located in a city with a population of over one
19 million, which experienced free patient visits in excess of twenty
20 percent of their total self-pay and free patient visits based on data
21 reported on exhibit 33 of their 1999 institutional cost report and which
22 experienced uninsured outpatient losses in excess of seventy-five
23 percent of their total inpatient and outpatient uninsured losses based
24 on data reported on exhibit 47 of their 1999 institutional cost report,
25 of up to thirty-seven million dollars for the period January 1, 2002
26 through March 31, 2002 and one hundred fifty-one million dollars annual-
27 ly for state fiscal years thereafter as medical assistance payments for
28 outpatient services pursuant to title 11 of article 5 of the social
29 services law for patients eligible for federal financial participation
30 under title XIX of the federal social security act based on each such
31 hospital's proportionate share of the sum of all outpatient visits for
32 all facilities eligible for an adjustment pursuant to this section for
33 the base year two years prior to the rate year. Such proportionate share
34 payment may be added to rates of payment or made as aggregate payments
35 to eligible public general hospitals.
36 S 21. Notwithstanding any inconsistent provision of law, rule or regu-
37 lation to the contrary, and subject to the availability of federal
38 financial participation pursuant to title XIX of the federal social
39 security act, effective for the period April 1, 2011 through March 31,
40 2012, and state fiscal years thereafter, the department of health is
41 authorized to increase the operating cost component of rates of payment
42 for general hospital outpatient services and general hospital emergency
43 room services issued pursuant to paragraph (g) of subdivision 2 of
44 section 2807 of the public health law for public general hospitals, as
45 defined in subdivision 10 of section 2801 of the public health law,
46 other than those operated by the state of New York or the state univer-
47 sity of New York, and located in a city with a population over one
48 million, up to two hundred eighty-seven million dollars annually as
49 medical assistance payments for outpatient services pursuant to title 11
50 of article 5 of the social services law for patients eligible for feder-
51 al financial participation under title XIX of the federal social securi-
52 ty act based on such criteria and methodologies as the commissioner may
53 from time to time set through a memorandum of understanding with the New
54 York city health and hospitals corporation, and such adjustments shall
55 be paid by means of one or more estimated payments, with such estimated
56 payments to be reconciled to the commissioner of health's final adjust-
S. 4207 20
1 ment determinations after the disproportionate share hospital payment
2 adjustment caps have been calculated for such period under sections
3 1923(f) and (g) of the federal social security act. Such adjustment
4 payment may be added to rates of payment or made as aggregate payments
5 to eligible public general hospitals.
6 S 22. Section 16 of part A of chapter 1 of the laws of 2002, relating
7 to the health care reform act of 2000, is amended to read as follows:
8 S 16. Any amounts provided pursuant to sections eleven, twelve, thir-
9 teen and fourteen of this act shall be effective for purposes of deter-
10 mining payments for public general hospitals contingent on receipt of
11 all approvals required by federal law or regulations for federal finan-
12 cial participation in payments made pursuant to title XIX of the federal
13 social security act. If federal approvals are not granted for payments
14 based on such amounts or components thereof, payments to public general
15 hospitals shall be determined without consideration of such amounts or
16 such components. Public general hospitals shall refund to the state, or
17 the state may recoup from prospective payments, any overpayment
18 received, including those based on a retroactive reduction in the
19 payments. Any reduction in federal financial participation pursuant to
20 title XIX of the federal social security act related to federal upper
21 payment limits APPLICABLE TO PUBLIC GENERAL HOSPITALS OTHER THAN THOSE
22 OPERATED BY THE STATE UNIVERSITY OF NEW YORK shall be deemed to apply
23 first to amounts provided pursuant to sections eleven, twelve, thirteen
24 and fourteen of this act AND SECTIONS SIXTEEN AND NINETEEN OF A CHAPTER
25 OF THE LAWS OF TWO THOUSAND FIFTEEN.
26 S 23. Section 20 of part B of chapter 1 of the laws of 2002, relating
27 to the health care reform act of 2000, is amended to read as follows:
28 S 20. Any amounts provided pursuant to sections thirteen and fourteen
29 of this act shall be effective for purposes of determining payments for
30 public general hospitals contingent on receipt of all approvals required
31 by federal law or regulations for federal financial participation in
32 payments made pursuant to title XIX of the federal social security act.
33 If federal approvals are not granted for payments based on such amounts
34 or components thereof, payments to public general hospitals shall be
35 determined without consideration of such amounts or such components.
36 Public general hospitals shall refund to the state, or the state may
37 recoup from prospective payments, any overpayment received, including
38 those based on a retroactive reduction in the payments. Any reduction in
39 federal financial participation pursuant to title XIX of the federal
40 social security act related to federal upper payment limits APPLICABLE
41 TO PUBLIC GENERAL HOSPITALS OTHER THAN THOSE OPERATED BY THE STATE OF
42 NEW YORK OR THE STATE UNIVERSITY OF NEW YORK shall be deemed to apply
43 first to amounts provided pursuant to sections thirteen and fourteen of
44 this act AND SECTIONS SIXTEEN AND NINETEEN OF A CHAPTER OF THE LAWS OF
45 TWO THOUSAND FIFTEEN.
46 S 24. Intentionally omitted.
47 S 25. Intentionally omitted.
48 S 26. Intentionally omitted.
49 S 27. Intentionally omitted.
50 S 28. Sections 50, 51, 52 and 53 of part C of chapter 60 of the laws
51 of 2014 amending the social services law and other laws relating to
52 eliminating prescriber prevails for brand name drugs with generic equiv-
53 alents are REPEALED.
54 S 29. Section 1 of part B of chapter 59 of the laws of 2011, amending
55 the public health law relating to rates of payment and medical assist-
56 ance, is amended to read as follows:
S. 4207 21
1 Section 1. (a) Notwithstanding any inconsistent provision of law,
2 rule or regulation to the contrary, and subject to the availability of
3 federal financial participation, effective for the period April 1, 2011
4 through March 31, 2012, and each state fiscal year thereafter, the
5 department of health is authorized to make supplemental Medicaid
6 payments OR SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS for professional
7 services provided by physicians, nurse practitioners and physician
8 assistants who are participating in a plan for the management of clin-
9 ical practice at the State University of New York, in accordance with
10 title 11 of article 5 of the social services law for patients eligible
11 for federal financial participation under title XIX of the federal
12 social security act, in amounts that will increase fees for such profes-
13 sional services to an amount equal to the average commercial or Medicare
14 rate that would otherwise be received for such services rendered by such
15 physicians, nurse practitioners and physician assistants. The calcu-
16 lation of such supplemental fee payments shall be made in accordance
17 with applicable federal law and regulation and subject to the approval
18 of the division of the budget. Such supplemental Medicaid fee payments
19 may be added to the professional fees paid under the fee schedule [or],
20 made as aggregate lump sum payments to eligible clinical practice plans
21 authorized to receive professional fees OR MADE AS SUPPLEMENTAL PAYMENTS
22 MADE FOR SUCH PURPOSE AS DESCRIBED HEREIN TO MEDICAID MANAGED CARE
23 ORGANIZATIONS. SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS UNDER THIS
24 SECTION SHALL BE DISTRIBUTED TO PROVIDERS AS DETERMINED BY THE MANAGED
25 CARE MODEL CONTRACT AND MAY UTILIZE MANAGED CARE ORGANIZATION REPORTED
26 ENCOUNTER DATA AND OTHER SUCH METRICS AS DETERMINED BY THE DEPARTMENT OF
27 HEALTH IN ORDER TO ENSURE RATES OF PAYMENT EQUIVALENT TO THE AVERAGE
28 COMMERCIAL OR MEDICARE RATE THAT WOULD OTHERWISE BE RECEIVED FOR SUCH
29 SERVICES RENDERED BY SUCH PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN
30 ASSISTANTS.
31 (b) The affiliated State University of New York health science centers
32 shall be responsible for payment of one hundred percent of the non-fed-
33 eral share of such supplemental Medicaid payments OR SUPPLEMENTAL MEDI-
34 CAID MANAGED CARE PAYMENTS for all services provided by physicians,
35 nurse practitioners and physician assistants who are participating in a
36 plan for the management of clinical practice, in accordance with section
37 365-a of the social services law, regardless of whether another social
38 services district or the department of health may otherwise be responsi-
39 ble for furnishing medical assistance to the eligible persons receiving
40 such services.
41 S 30. Section 93 of part H of chapter 59 of the laws of 2011, amending
42 the public health law relating to general hospital inpatient reimburse-
43 ment for annual rates, is amended to read as follows:
44 S 93. 1. Notwithstanding any inconsistent provision of law, rule or
45 regulation to the contrary, and subject to the availability of federal
46 financial participation, effective for the period April 1, 2011 through
47 March 31, 2012, and each state fiscal year thereafter, the department of
48 health is authorized to make supplemental Medicaid payments OR SUPPLE-
49 MENTAL MEDICAID MANAGED CARE PAYMENTS for professional services provided
50 by physicians, nurse practitioners and physician assistants who are
51 employed by a public benefit corporation or a non-state operated public
52 general hospital operated by a public benefit corporation or who are
53 providing professional services at a facility of such public benefit
54 corporation as either a member of a practice plan or an employee of a
55 professional corporation or limited liability corporation under contract
56 to provide services to patients of such a public benefit corporation, in
S. 4207 22
1 accordance with title 11 of article 5 of the social services law for
2 patients eligible for federal financial participation under title XIX of
3 the federal social security act, in amounts that will increase fees for
4 such professional services to an amount equal to either the Medicare
5 rate or the average commercial rate that would otherwise be received for
6 such services rendered by such physicians, nurse practitioners and
7 physician assistants, provided, however, that such supplemental fee
8 payments shall not be available with regard to services provided at
9 facilities participating in the Medicare Teaching Election Amendment.
10 The calculation of such supplemental fee payments shall be made in
11 accordance with applicable federal law and regulation and subject to the
12 approval of the division of the budget. Such supplemental Medicaid fee
13 payments may be added to the professional fees paid under the fee sched-
14 ule [or], made as aggregate lump sum payments to entities authorized to
15 receive professional fees OR MADE AS SUPPLEMENTAL PAYMENTS MADE FOR SUCH
16 PURPOSE AS DESCRIBED HEREIN TO MEDICAID MANAGED CARE ORGANIZATIONS.
17 SUPPLEMENTAL MEDICAID MANAGED CARE PAYMENTS UNDER THIS SECTION SHALL BE
18 DISTRIBUTED TO PROVIDERS AS DETERMINED BY THE MANAGED CARE MODEL
19 CONTRACT AND MAY UTILIZE MANAGED CARE ORGANIZATION REPORTED ENCOUNTER
20 DATA AND OTHER SUCH METRICS AS DETERMINED BY THE DEPARTMENT OF HEALTH IN
21 ORDER TO ENSURE RATES OF PAYMENT EQUIVALENT TO THE AVERAGE COMMERCIAL OR
22 MEDICARE RATE THAT WOULD OTHERWISE BE RECEIVED FOR SUCH SERVICES
23 RENDERED BY SUCH PHYSICIANS, NURSE PRACTITIONERS AND PHYSICIAN ASSIST-
24 ANTS.
25 2. The supplemental Medicaid payments OR SUPPLEMENTAL MEDICAID MANAGED
26 CARE PAYMENTS for professional services authorized by subdivision one of
27 this section may be made only at the election of the public benefit
28 corporation or the local social services district in which the non-state
29 operated public general hospital is located. The electing public benefit
30 corporation or local social services district shall, notwithstanding the
31 social services district Medicaid cap provisions of Part C of chapter 58
32 of the laws of 2005, be responsible for payment of one hundred percent
33 of the non-federal share of such supplemental Medicaid payments, in
34 accordance with section 365-a of the social services law, regardless of
35 whether another social services district or the department of health may
36 otherwise be responsible for furnishing medical assistance to the eligi-
37 ble persons receiving such services. Social services district or public
38 benefit corporation funding of the non-federal share of any such
39 payments shall be deemed to be voluntary for purposes of the increased
40 federal medical assistance percentage provisions of the American Recov-
41 ery and Reinvestment Act of 2009, provided, however, that in the event
42 the federal Centers for Medicare and Medicaid Services determines that
43 such non-federal share payments are not voluntary payments for purposes
44 of such act, the provisions of this section shall be null and void.
45 S 31. Intentionally omitted.
46 S 32. Intentionally omitted.
47 S 33. Intentionally omitted.
48 S 34. Transportation assessment for people with developmental disabil-
49 ities and other populations. (a) The commissioner of the office for
50 people with developmental disabilities is authorized to contract with
51 one or more entities to conduct an assessment of the mobility and trans-
52 portation needs of persons with disabilities, including for integrated
53 employment opportunities in accordance with section 13.41 of the mental
54 hygiene law, as well as the mentally ill, those who engage in chemical
55 abuse or are chemically dependent, and the aging. The contractor shall
56 consult with the office for people with developmental disabilities,
S. 4207 23
1 department of transportation, department of health, office for the
2 aging, office of mental health, office of alcoholism and substance abuse
3 services, and stakeholders including consumer groups, transportation
4 providers and transportation systems in conducting the assessment. The
5 assessment shall include but not be limited to: the identification of
6 locally based transportation providers and transportation systems
7 equipped to participate in a possible pilot demonstration program;
8 considerations regarding the availability of public transportation,
9 public safety concerns and the duplication of services; reporting
10 requirements for cost savings and evaluation of whether specialized care
11 needs are being met; recommendations for the implementation of shared
12 software to enable entities to track services, manage costs among
13 providers, consolidate routes and provide a registry identifying partic-
14 ipating clients and any specialized care needs that must be met in order
15 to effectively provide transportation; recommendations for rate adjust-
16 ments or reimbursement changes; and identification of any legal, statu-
17 tory or regulatory, and funding barriers.
18 (b) Following the assessment, the contractor shall consult with the
19 office for people with developmental disabilities, department of trans-
20 portation, department of health, office for the aging, office of mental
21 health, office of alcoholism and substance abuse services, and stake-
22 holders including consumer groups, transportation providers and trans-
23 portation systems for the development of a pilot demonstration program
24 to coordinate medical and non-medical transportation services, maximize
25 funding sources, enhance community integration and any other related
26 tasks.
27 (c) The contractor shall report its findings from its assessment and
28 make recommendations regarding the creation of a transportation pilot
29 demonstration program for persons with disabilities, including for inte-
30 grated employment opportunities in accordance with section 13.41 of the
31 mental hygiene law, as well as the mentally ill, those who engage in
32 chemical abuse or are chemically dependent, and the aging, to the gover-
33 nor, the temporary president of the senate and the speaker of the assem-
34 bly no later than January 1, 2016. Any transportation pilot demon-
35 stration program resulting from the assessment authorized pursuant to
36 this section shall be subject to legislative approval.
37 S 35. Intentionally omitted.
38 S 36. Intentionally omitted.
39 S 37. Intentionally omitted.
40 S 38. Section 2808 of the public health law is amended by adding a new
41 subdivision 27 to read as follows:
42 27. FOR PERIODS ON OR AFTER APRIL FIRST, TWO THOUSAND FIFTEEN, THE
43 COMMISSIONER SHALL AUTHORIZE AN ENERGY EFFICIENCY AND/OR DISASTER
44 PREPAREDNESS DEMONSTRATION PROGRAM FOR RESIDENTIAL HEALTH CARE FACILI-
45 TIES. SUCH PROGRAM SHALL INCLUDE AN EVALUATION OF FACILITY ENERGY EFFI-
46 CIENCY AND DISASTER PREPAREDNESS STATUS AND A FACILITY BASED
47 COST/BENEFIT ANALYSIS OF POTENTIAL MODIFICATIONS. THE DEPARTMENT SHALL
48 DEVELOP A PLAN FOR THE PROGRAM, SUBJECT TO A MEMORANDUM OF UNDERSTANDING
49 WITH THE LEGISLATURE THAT, AT A MINIMUM, DETAILS: ELIGIBILITY FOR
50 PARTICIPATION, FUNDING SOURCES, PROJECTED COST SAVINGS TO FACILITIES AND
51 THE STATE, THE MANNER IN WHICH SAVINGS MAY BE SHARED BETWEEN THE STATE
52 AND FACILITIES, AN IMPLEMENTATION TIMELINE AND ANY OTHER PLAN SPECIFIC
53 INFORMATION AS APPROPRIATE.
54 S 39. Intentionally omitted.
55 S 40. Intentionally omitted.
56 S 41. Intentionally omitted.
S. 4207 24
1 S 42. Subdivision 12 of section 367-a of the social services law, as
2 amended by section 63-a of part C of chapter 58 of the laws of 2007, is
3 amended to read as follows:
4 12. Prior to receiving medical assistance under subparagraphs [twelve]
5 FIVE and [thirteen] SIX of paragraph [(a)] (C) of subdivision one of
6 section three hundred sixty-six of this title, a person whose net avail-
7 able income is at least one hundred fifty percent of the applicable
8 federal income official poverty line, as defined and updated by the
9 United States department of health and human services, must pay a month-
10 ly premium, in accordance with a procedure to be established by the
11 commissioner. The amount of such premium shall be twenty-five dollars
12 for an individual who is otherwise eligible for medical assistance under
13 such subparagraphs, and fifty dollars for a couple, both of whom are
14 otherwise eligible for medical assistance under such subparagraphs. No
15 premium shall be required from a person whose net available income is
16 less than one hundred fifty percent of the applicable federal income
17 official poverty line, as defined and updated by the United States
18 department of health and human services.
19 S 43. Subparagraph 6 of paragraph (b) of subdivision 1 of section 366
20 of the social services law, as added by section 1 of part D of chapter
21 56 of the laws of 2013, is amended to read as follows:
22 (6) An individual who is not otherwise eligible for medical assistance
23 under this section is eligible for coverage of family planning services
24 reimbursed by the federal government at a rate of ninety percent, and
25 for coverage of those services identified by the commissioner of health
26 as services generally performed as part of or as a follow-up to a
27 service eligible for such ninety percent reimbursement, including treat-
28 ment for sexually transmitted diseases, if his or her income does not
29 exceed the MAGI-equivalent of two hundred percent of the federal poverty
30 line for the applicable family size, which shall be calculated in
31 accordance with guidance issued by the secretary of the United States
32 department of health and human services[.]; PROVIDED FURTHER THAT THE
33 COMMISSIONER OF HEALTH IS AUTHORIZED TO ESTABLISH CRITERIA FOR PRESUMP-
34 TIVE ELIGIBILITY FOR SERVICES PROVIDED PURSUANT TO THIS SUBPARAGRAPH IN
35 ACCORDANCE WITH ALL APPLICABLE REQUIREMENTS OF FEDERAL LAW OR REGULATION
36 PERTAINING TO SUCH ELIGIBILITY.
37 S 44. Subdivision 1 of section 398-b of the social services law, as
38 added by section 44 of part C of chapter 60 of the laws of 2014, is
39 amended to read as follows:
40 1. Notwithstanding any inconsistent provision of law to the contrary
41 and subject to the availability of federal financial participation, the
42 commissioner is authorized to make grants [from] UP TO a gross amount of
43 five million dollars FOR STATE FISCAL YEAR TWO THOUSAND FOURTEEN--FIF-
44 TEEN AND UP TO A GROSS AMOUNT OF FIFTEEN MILLION DOLLARS FOR STATE
45 FISCAL YEAR TWO THOUSAND FIFTEEN--SIXTEEN to facilitate the transition
46 of foster care children placed with voluntary foster care agencies to
47 managed care. The use of such funds may include providing training and
48 consulting services to voluntary agencies to [access] ASSESS readiness
49 and make necessary infrastructure and organizational modifications,
50 collecting service utilization and other data from voluntary agencies
51 and other entities, and making investments in health information tech-
52 nology, including the infrastructure necessary to establish and maintain
53 electronic health records. Such funds shall be distributed pursuant to a
54 formula to be developed by the commissioner of health, in consultation
55 with the commissioner of the office of CHILDREN AND family [and child]
56 services. In developing such formula the commissioners may take into
S. 4207 25
1 account size and scope of provider operations as a factor relevant to
2 eligibility for such funds. Each recipient of such funds shall be
3 required to document and demonstrate the effective use of funds distrib-
4 uted herein. IF FEDERAL FINANCIAL PARTICIPATION IS UNAVAILABLE, THEN
5 THE NONFEDERAL SHARE OF PAYMENTS PURSUANT TO THIS SUBDIVISION MAY BE
6 MADE AS STATE GRANTS.
7 S 45. Intentionally omitted.
8 S 46. Intentionally omitted.
9 S 47. Intentionally omitted.
10 S 48. Intentionally omitted.
11 S 49. Subparagraph (i) of paragraph (e-2) of subdivision 4 of section
12 2807-c of the public health law, as added by section 13 of part C of
13 chapter 58 of the laws of 2009, is amended to read as follows:
14 (i) For physical medical rehabilitation services and for chemical
15 dependency rehabilitation services, the operating cost component of such
16 rates shall reflect the use of two thousand five operating costs for
17 each respective category of services as reported by each facility to the
18 department prior to July first, two thousand nine and as adjusted for
19 inflation pursuant to paragraph (c) of subdivision ten of this section,
20 as otherwise modified by any applicable statute, provided, however, that
21 such two thousand five reported operating costs, but not including
22 reported direct medical education cost, shall, for rate-setting
23 purposes, be held to a ceiling of one hundred ten percent of the average
24 of such reported costs in the region in which the facility is located,
25 as determined pursuant to clause (E) of subparagraph (iii) of paragraph
26 (1) of this subdivision; AND PROVIDED, FURTHER, THAT FOR PHYSICAL
27 MEDICAL REHABILITATION SERVICES, THE COMMISSIONER IS AUTHORIZED TO MAKE
28 ADJUSTMENTS TO SUCH RATES FOR THE PURPOSES OF REIMBURSING PEDIATRIC
29 VENTILATOR SERVICES.
30 S 50. Young adult special populations demonstration programs. The
31 commissioner of health shall be authorized to establish up to four young
32 adult special populations demonstration programs to provide cost effec-
33 tive, necessary services and enhanced quality of care for targeted popu-
34 lations in order to demonstrate the effectiveness of the programs.
35 Eligible individuals shall have severe and chronic medical or health
36 problems, or multiple disabling conditions which may be combined with
37 developmental disabilities. The programs shall provide more appropriate
38 settings and services for these individuals, help prevent out of state
39 placements and allow repatriation back to their home communities. Eligi-
40 ble operator applicants shall be not-for-profit with demonstrated exper-
41 tise in caring for the targeted population including persons with severe
42 and chronic medical or health problems or multiple disabling conditions
43 and a record of providing quality care.
44 Funds may include, but not be limited to, start up funds, capital
45 investments and enhanced rates.
46 Of the four demonstrations:
47 (a) at least one shall be designed to serve persons aged twenty-one to
48 thirty-five years of age who are aging out of pediatric acute care
49 hospitals or pediatric nursing homes; and
50 (b) at least one shall be designed to serve persons aged twenty-one to
51 thirty-five years of age who have a developmental disability in addition
52 to their severe and chronic medical or health problems and are aging out
53 of pediatric acute care hospitals, pediatric nursing homes or children's
54 residential homes operated under the jurisdiction of the office for
55 persons with developmental disabilities.
S. 4207 26
1 The department of health shall be responsible for monitoring the qual-
2 ity and appropriateness and effectiveness of the demonstration programs,
3 and shall report to the legislature no later than December 31, 2015 on
4 what efforts it has undertaken toward the establishment of these demon-
5 stration programs and shall report to the legislature two years follow-
6 ing the establishment of a demonstration program pursuant to this
7 section.
8 S 51. Paragraph d of subdivision 20 of section 2808 of the public
9 health law, as added by section 8 of part H of section 59 of the laws of
10 2011, is amended to read as follows:
11 d. Notwithstanding any contrary provision of law, rule or regulation,
12 for rate periods on and after April first, two thousand eleven THROUGH
13 MARCH THIRTY-FIRST, TWO THOUSAND FIFTEEN, the commissioner may reduce or
14 eliminate the payment factor for return on or return of equity in the
15 capital cost component of Medicaid rates of payment for services
16 provided by residential health care facilities.
17 S 52. Section 2803 of the public health law is amended by adding a new
18 subdivision 11 to read as follows:
19 11. NOTWITHSTANDING ANY PROVISION OF LAW, RULE OR REGULATION TO THE
20 CONTRARY, THE COMMISSIONER SHALL ALLOW DIAGNOSTIC AND TREATMENT CENTERS
21 AND OUTPATIENT CLINICS OF GENERAL HOSPITALS TO PROVIDE OFF-SITE SERVICES
22 TO EXISTING PATIENTS IN NEED OF PROFESSIONAL SERVICES AVAILABLE AT THE
23 DIAGNOSTIC AND TREATMENT CENTER OR GENERAL HOSPITAL OUTPATIENT CLINIC,
24 BUT, DUE TO THE INDIVIDUAL'S MEDICAL CONDITION, IS UNABLE TO RECEIVE
25 ON-SITE SERVICES AT THE DIAGNOSTIC AND TREATMENT CENTER OR GENERAL
26 HOSPITAL OUTPATIENT CLINIC.
27 S 53. Subdivision 25 of section 364-j of the social services law, as
28 added by section 55 of part D of chapter 56 of the laws of 2012, is
29 amended to read as follows:
30 25. [Effective January first, two thousand thirteen, notwithstanding]
31 NOTWITHSTANDING any provision of law to the contrary, managed care
32 providers shall cover medically necessary prescription drugs [in the
33 atypical antipsychotic therapeutic class], including non-formulary
34 drugs[, upon demonstration by]. IF the prescriber[,] DETERMINES after
35 consulting with the managed care provider, that such drugs, in the
36 prescriber's reasonable professional judgment, are medically necessary
37 and warranted, THE PRESCRIBER'S DETERMINATION SHALL BE FINAL.
38 S 54. Subdivision 25-a of section 364-j of the social services law is
39 REPEALED.
40 S 55. Section 365-d of the social services law is REPEALED and a new
41 section 365-d is added to read as follows:
42 S 365-D. HEALTH TECHNOLOGY ASSESSMENT COMMITTEE. 1. THE DEPARTMENT
43 SHALL CONVENE A HEALTH TECHNOLOGY ASSESSMENT COMMITTEE. THE COMMITTEE
44 SHALL, AT THE REQUEST OF THE COMMISSIONER, PROVIDE ADVICE AND MAKE
45 RECOMMENDATIONS REGARDING COVERAGE OF HEALTH TECHNOLOGY FOR PURPOSES OF
46 THE MEDICAL ASSISTANCE PROGRAM. THE COMMISSIONER SHALL CONSULT SUCH
47 COMMITTEE PRIOR TO ANY DETERMINATION TO EXCLUDE FROM COVERAGE ANY HEALTH
48 TECHNOLOGY FROM THE MEDICAL ASSISTANCE PROGRAM. FOR PURPOSES OF THIS
49 SECTION, "HEALTH TECHNOLOGY" MEANS MEDICAL DEVICES AND SURGICAL PROCE-
50 DURES USED IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE AND
51 OTHER MEDICAL CONDITIONS.
52 2. (A) THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL CONSIST OF
53 THIRTEEN MEMBERS, SEVEN OF WHOM SHALL BE APPOINTED BY THE COMMISSIONER,
54 THREE MEMBERS SHALL BE APPOINTED BY THE TEMPORARY PRESIDENT OF THE
55 SENATE, AND THREE MEMBERS SHALL BE APPOINTED BY THE SPEAKER OF THE
56 ASSEMBLY. MEMBERS SHALL SERVE THREE YEAR TERMS; EXCEPT THAT FOR THE
S. 4207 27
1 INITIAL APPOINTMENTS TO THE COMMITTEE, THREE MEMBERS APPOINTED BY THE
2 COMMISSIONER, AND ONE OF THE MEMBERS APPOINTED BY THE TEMPORARY PRESI-
3 DENT OF THE SENATE AND BY THE SPEAKER OF THE ASSEMBLY, SHALL SERVE ONE
4 YEAR TERMS, THREE MEMBERS APPOINTED BY THE COMMISSIONER, AND ONE OF THE
5 MEMBERS APPOINTED BY THE TEMPORARY PRESIDENT OF THE SENATE AND BY THE
6 SPEAKER OF THE ASSEMBLY, SHALL SERVE TWO YEAR TERMS; AND THE REMAINING
7 THREE MEMBERS SHALL SERVE THREE YEAR TERMS. COMMITTEE MEMBERS MAY BE
8 REAPPOINTED UPON THE COMPLETION OF THEIR TERMS. WITH THE EXCEPTION OF
9 THE CHAIRPERSON, NO MEMBER OF THE COMMITTEE SHALL BE AN EMPLOYEE OF THE
10 STATE OR ANY POLITICAL SUBDIVISION OF THE STATE, OTHER THAN FOR HIS OR
11 HER MEMBERSHIP ON THE COMMITTEE, EXCEPT FOR EMPLOYEES OF HEALTH CARE
12 FACILITIES OR UNIVERSITIES OPERATED BY THE STATE, A PUBLIC BENEFIT
13 CORPORATION, THE STATE UNIVERSITY OF NEW YORK OR MUNICIPALITIES.
14 (B) THE MEMBERSHIP OF SUCH COMMITTEE SHALL BE AS FOLLOWS:
15 (I) THREE PERSONS LICENSED AND ACTIVELY ENGAGED IN THE PRACTICE OF
16 MEDICINE IN THIS STATE;
17 (II) ONE PERSON LICENSED AND ACTIVELY ENGAGED IN THE PRACTICE OF NURS-
18 ING AS A NURSE PRACTITIONER, OR IN THE PRACTICE OF MIDWIFERY IN THIS
19 STATE;
20 (III) ONE PERSON WHO IS A REPRESENTATIVE OF A HEALTH TECHNOLOGY OR
21 MEDICAL DEVICE ORGANIZATION WITH A REGIONAL, STATEWIDE OR NATIONAL
22 CONSTITUENCY;
23 (IV) ONE PERSON WITH EXPERTISE IN HEALTH TECHNOLOGY ASSESSMENT WHO IS
24 A HEALTH CARE PROFESSIONAL LICENSED UNDER TITLE EIGHT OF THE EDUCATION
25 LAW;
26 (V) THREE PERSONS WHO SHALL BE CONSUMERS OR REPRESENTATIVES OF ORGAN-
27 IZATIONS WITH A REGIONAL OR STATEWIDE CONSTITUENCY AND WHO HAVE BEEN
28 INVOLVED IN ACTIVITIES RELATED TO HEALTH CARE CONSUMER ADVOCACY;
29 (VI) ONE PERSON WHO IS A REPRESENTATIVE OF A HOSPITAL ORGANIZATION
30 WITH A REGIONAL, NATIONAL OR STATEWIDE CONSTITUENCY;
31 (VII) ONE PERSON WHO IS A REPRESENTATIVE OF A HEALTH INSURANCE OR
32 MANAGED CARE ORGANIZATION WITH A REGIONAL, NATIONAL OR STATEWIDE CONSTI-
33 TUENCY;
34 (VIII) ONE PERSON WHO IS A HEALTH ECONOMIST; AND
35 (IX) A MEMBER OF THE DEPARTMENT WHO SHALL ACT AS CHAIRPERSON AS DESIG-
36 NATED BY THE COMMISSIONER.
37 (C) THE COMMITTEE MAY INVITE AND CONSULT WITH SCIENTIFIC, TECHNICAL OR
38 CLINICAL EXPERTS WITH DEMONSTRATABLE EXPERIENCE OR KNOWLEDGE OF THE
39 TECHNOLOGY UNDER REVIEW.
40 3. THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL BE A PUBLIC BODY
41 UNDER ARTICLE SEVEN OF THE PUBLIC OFFICERS LAW AND SUBJECT TO ARTICLE
42 SIX OF THE PUBLIC OFFICERS LAW. THE DEPARTMENT SHALL PROVIDE INTERNET
43 ACCESS TO ALL MEETINGS OF SUCH COMMITTEE THROUGH THE DEPARTMENT'S
44 WEBSITE.
45 4. THE MEMBERS OF THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL
46 RECEIVE NO COMPENSATION FOR THEIR SERVICES BUT SHALL BE REIMBURSED FOR
47 EXPENSES ACTUALLY AND NECESSARILY INCURRED IN THE PERFORMANCE OF THEIR
48 DUTIES. COMMITTEE MEMBERS SHALL BE DEEMED TO BE EMPLOYEES OF THE DEPART-
49 MENT FOR PURPOSES OF SECTION SEVENTEEN OF THE PUBLIC OFFICERS LAW, AND
50 SHALL NOT PARTICIPATE IN ANY MATTER FOR WHICH A CONFLICT OF INTEREST
51 EXISTS.
52 5. THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE SHALL, AT THE REQUEST OF
53 THE COMMISSIONER, CONSIDER ANY MATTER RELATING TO HEALTH TECHNOLOGY
54 ASSESSMENT. THE COMMISSIONER SHALL PROVIDE MEMBERS OF THE COMMITTEE
55 WITH ANY EVIDENCE OR INFORMATION RELATED TO THE HEALTH TECHNOLOGY
56 ASSESSMENT INCLUDING, BUT NOT LIMITED TO, INFORMATION SUBMITTED BY
S. 4207 28
1 MEMBERS OF THE PUBLIC. THE COMMISSIONER SHALL PROVIDE SIXTY DAYS PUBLIC
2 NOTICE ON THE DEPARTMENT'S WEBSITE PRIOR TO ANY MEETING OF THE COMMITTEE
3 TO DEVELOP RECOMMENDATIONS CONCERNING HEALTH TECHNOLOGY COVERAGE DETER-
4 MINATIONS. SUCH NOTICE SHALL INCLUDE A DESCRIPTION OF THE PROPOSED
5 HEALTH TECHNOLOGY TO BE REVIEWED, THE CONDITIONS OR DISEASES IMPACTED BY
6 THE HEALTH TECHNOLOGY, THE PROPOSALS TO BE CONSIDERED BY THE COMMITTEE,
7 AND THE SYSTEMATIC EVIDENCE-BASED ASSESSMENT PREPARED IN ACCORDANCE WITH
8 THIS SUBDIVISION. THE COMMITTEE SHALL ALLOW INTERESTED PARTIES A
9 REASONABLE OPPORTUNITY TO MAKE AN ORAL PRESENTATION TO THE COMMITTEE
10 RELATED TO THE HEALTH TECHNOLOGY TO BE REVIEWED AND TO SUBMIT WRITTEN
11 INFORMATION. THE COMMITTEE SHALL CONSIDER ANY INFORMATION PROVIDED BY
12 ANY INTERESTED PARTY, INCLUDING, BUT NOT LIMITED TO, HEALTH CARE PROVID-
13 ERS, HEALTH CARE FACILITIES, PATIENTS, CONSUMERS AND MANUFACTURERS. FOR
14 ALL HEALTH TECHNOLOGIES SELECTED FOR REVIEW, THE COMMISSIONER SHALL
15 CONDUCT A SYSTEMATIC EVIDENCE-BASED ASSESSMENT OF THE HEALTH TECHNOLO-
16 GY'S SAFETY AND CLINICAL EFFICACY. THE ASSESSMENT SHALL USE ESTABLISHED
17 SYSTEMATIC REVIEW ELEMENTS, SUCH AS A PICO (POPULATION, INTERVENTION,
18 COMPARATOR AND OUTCOMES) STATEMENT, KEY QUESTIONS, PRESPECIFIED INCLU-
19 SION AND EXCLUSION CRITERIA, STUDY QUALITY ASSESSMENT, AND DATA SYNTHE-
20 SIS. UPON COMPLETION, THE SYSTEMATIC, EVIDENCE-BASED ASSESSMENT SHALL BE
21 MADE AVAILABLE TO THE PUBLIC.
22 6. THE COMMISSIONER SHALL PROVIDE NOTICE OF ANY COVERAGE RECOMMENDA-
23 TIONS DEVELOPED BY THE COMMITTEE BY MAKING SUCH INFORMATION AVAILABLE ON
24 THE DEPARTMENT'S WEBSITE. SUCH PUBLIC NOTICE SHALL INCLUDE: A SUMMARY OF
25 THE DELIBERATIONS OF THE COMMITTEE; A SUMMARY OF THE POSITIONS OF THOSE
26 MAKING PUBLIC COMMENTS AT MEETINGS OF THE COMMITTEE AND ANY SAFETY AND
27 HEALTH OUTCOMES DATA SUBMITTED BY ANY INTERESTED PARTY; THE RESPONSE OF
28 THE COMMITTEE TO THOSE COMMENTS, IF ANY; THE CLINICAL EVIDENCE UPON
29 WHICH THE COMMITTEE BASES ITS RECOMMENDATIONS; AND THE FINDINGS AND
30 RECOMMENDATIONS OF THE COMMITTEE INCLUDING A FINAL EVIDENCE-BASED
31 SYSTEMATIC ASSESSMENT.
32 7. THE COMMISSIONER SHALL PROVIDE PUBLIC NOTICE ON THE DEPARTMENT'S
33 WEBSITE OF HIS OR HER FINAL DETERMINATION, INCLUDING: THE NATURE OF THE
34 DETERMINATION; AN ANALYSIS OF THE IMPACT OF THE COMMISSIONER'S DETERMI-
35 NATION ON STATE PUBLIC HEALTH PLAN POPULATIONS AND PROVIDERS; AND THE
36 PROJECTED FISCAL IMPACT TO THE STATE PUBLIC HEALTH PLAN PROGRAMS OF THE
37 COMMISSIONER'S DETERMINATION. THE COMMISSIONER'S FINAL DETERMINATION
38 SHALL NOT OCCUR PRIOR TO THE THIRTIETH DAY FROM THE POSTING OF THE
39 COMMITTEE'S RECOMMENDATIONS AND FINDINGS ON THE DEPARTMENT'S WEBSITE.
40 8. THE RECOMMENDATIONS OF THE HEALTH TECHNOLOGY ASSESSMENT COMMITTEE,
41 MADE PURSUANT TO THIS SECTION, SHALL BE BASED ON A REVIEW OF THE
42 EVIDENCE PRESENTED TO THE COMMITTEE, INCLUDING CLINICAL EFFECTIVENESS,
43 PATIENT OUTCOMES, IMPACT ON AT RISK AND UNDERSERVED POPULATIONS, AND
44 SAFETY. THE COMMITTEE SHALL TRIENNIALLY REVIEW PREVIOUS RECOMMENDATIONS
45 OF THE COMMITTEE AND PERMIT ORAL PRESENTATIONS AND THE SUBMISSION OF NEW
46 EVIDENCE AT SUCH TRIENNIAL REVIEW. SUCH REVIEW SHALL OCCUR PURSUANT TO
47 THE PROCEDURE ESTABLISHED IN SUBDIVISIONS FIVE AND SIX OF THIS SECTION.
48 THE COMMISSIONER MAY ALTER OR REVOKE HIS OR HER FINAL DETERMINATION
49 AFTER SUCH TRIENNIAL REVIEW PURSUANT TO THE PROCEDURE ESTABLISHED IN
50 SUBDIVISION SEVEN OF THIS SECTION.
51 9. THE DEPARTMENT SHALL PROVIDE ADMINISTRATIVE SUPPORT TO THE COMMIT-
52 TEE.
53 S 56. The public health law is amended by adding a new section 2805-x
54 to read as follows:
55 S 2805-X. HOSPITAL-HOME CARE-PHYSICIAN COLLABORATION PROGRAM. 1. THE
56 PURPOSE OF THIS SECTION SHALL BE TO FACILITATE INNOVATION IN HOSPITAL,
S. 4207 29
1 HOME CARE AGENCY AND PHYSICIAN COLLABORATION IN MEETING THE COMMUNITY'S
2 HEALTH CARE NEEDS. IT SHALL PROVIDE A FRAMEWORK TO SUPPORT VOLUNTARY
3 INITIATIVES IN COLLABORATION TO IMPROVE PATIENT CARE ACCESS AND MANAGE-
4 MENT, PATIENT HEALTH OUTCOMES, COST-EFFECTIVENESS IN THE USE OF HEALTH
5 CARE SERVICES AND COMMUNITY POPULATION HEALTH. SUCH COLLABORATIVE INITI-
6 ATIVES MAY ALSO INCLUDE PAYORS, SKILLED NURSING FACILITIES AND OTHER
7 INTERDISCIPLINARY PROVIDERS, PRACTITIONERS AND SERVICE ENTITIES.
8 2. FOR PURPOSES OF THIS SECTION:
9 (A) "HOSPITAL" SHALL INCLUDE A GENERAL HOSPITAL AS DEFINED IN THIS
10 ARTICLE OR OTHER INPATIENT FACILITY FOR REHABILITATION OR SPECIALTY CARE
11 WITHIN THE DEFINITION OF HOSPITAL IN THIS ARTICLE.
12 (B) "HOME CARE AGENCY" SHALL MEAN A CERTIFIED HOME HEALTH AGENCY, LONG
13 TERM HOME HEALTH CARE PROGRAM OR LICENSED HOME CARE SERVICES AGENCY AS
14 DEFINED IN ARTICLE THIRTY-SIX OF THIS CHAPTER.
15 (C) "PAYOR" SHALL MEAN A HEALTH PLAN APPROVED PURSUANT TO ARTICLE
16 FORTY-FOUR OF THIS CHAPTER, OR ARTICLE THIRTY-TWO OR FORTY-THREE OF THE
17 INSURANCE LAW.
18 (D) "PRACTITIONER" SHALL MEAN ANY OF THE HEALTH, MENTAL HEALTH OR
19 HEALTH RELATED PROFESSIONS LICENSED PURSUANT TO TITLE EIGHT OF THE
20 EDUCATION LAW.
21 3. THE COMMISSIONER IS AUTHORIZED TO PROVIDE FINANCING INCLUDING, BUT
22 NOT LIMITED TO, GRANTS OR POSITIVE ADJUSTMENTS IN MEDICAL ASSISTANCE
23 RATES OR PREMIUM PAYMENTS, TO THE EXTENT OF FUNDS AVAILABLE AND ALLO-
24 CATED OR APPROPRIATED THEREFOR, INCLUDING FUNDS PROVIDED TO THE STATE
25 THROUGH FEDERAL WAIVERS, FUNDS MADE AVAILABLE THROUGH STATE APPROPRI-
26 ATIONS AND/OR FUNDING THROUGH SECTION TWENTY-EIGHT HUNDRED SEVEN-V OF
27 THIS ARTICLE, AS WELL AS WAIVERS OF REGULATIONS UNDER TITLE TEN OF THE
28 NEW YORK CODES, RULES AND REGULATIONS, TO SUPPORT THE VOLUNTARY INITI-
29 ATIVES AND OBJECTIVES OF THIS SECTION.
30 4. HOSPITAL-HOME CARE-PHYSICIAN COLLABORATIVE INITIATIVES UNDER THIS
31 SECTION MAY INCLUDE, BUT SHALL NOT BE LIMITED TO:
32 (A) HOSPITAL-HOME CARE-PHYSICIAN INTEGRATION INITIATIVES, INCLUDING
33 BUT NOT LIMITED TO:
34 (I) TRANSITIONS IN CARE INITIATIVES TO HELP EFFECTIVELY TRANSITION
35 PATIENTS TO POST-ACUTE CARE AT HOME, COORDINATE FOLLOW-UP CARE AND
36 ADDRESS ISSUES CRITICAL TO CARE PLAN SUCCESS AND READMISSION AVOIDANCE;
37 (II) CLINICAL PATHWAYS FOR SPECIFIED CONDITIONS, GUIDING PATIENTS'
38 PROGRESS AND OUTCOME GOALS, AS WELL AS EFFECTIVE HEALTH SERVICES USE;
39 (III) APPLICATION OF TELEHEALTH/TELEMEDICINE SERVICES IN MONITORING
40 AND MANAGING PATIENT CONDITIONS, AND PROMOTING SELF-CARE/MANAGEMENT,
41 IMPROVED OUTCOMES AND EFFECTIVE SERVICES USE;
42 (IV) FACILITATION OF PHYSICIAN HOUSE CALLS TO HOMEBOUND PATIENTS
43 AND/OR TO PATIENTS FOR WHOM SUCH HOME VISITS ARE DETERMINED NECESSARY
44 AND EFFECTIVE FOR PATIENT CARE MANAGEMENT;
45 (V) ADDITIONAL MODELS FOR PREVENTION OF AVOIDABLE HOSPITAL READMIS-
46 SIONS AND EMERGENCY ROOM VISITS;
47 (VI) HEALTH HOME DEVELOPMENT;
48 (VII) DEVELOPMENT AND DEMONSTRATION OF NEW MODELS OF INTEGRATED OR
49 COLLABORATIVE CARE AND CARE MANAGEMENT NOT OTHERWISE ACHIEVABLE THROUGH
50 EXISTING MODELS; AND
51 (VIII) BUNDLED PAYMENT DEMONSTRATIONS FOR HOSPITAL-TO-POST-ACUTE-CARE
52 FOR SPECIFIED CONDITIONS OR CATEGORIES OF CONDITIONS, IN PARTICULAR,
53 CONDITIONS PREDISPOSED TO HIGH PREVALENCE OF READMISSION, INCLUDING
54 THOSE CURRENTLY SUBJECT TO FEDERAL/STATE PENALTY, AND OTHER DISCHARGES
55 WITH EXTENSIVE POST-ACUTE NEEDS;
S. 4207 30
1 (B) RECRUITMENT, TRAINING AND RETENTION OF HOSPITAL/HOME CARE DIRECT
2 CARE STAFF AND PHYSICIANS, IN GEOGRAPHIC OR CLINICAL AREAS OF DEMON-
3 STRATED NEED. SUCH INITIATIVES MAY INCLUDE, BUT ARE NOT LIMITED TO, THE
4 FOLLOWING ACTIVITIES:
5 (I) OUTREACH AND PUBLIC EDUCATION ABOUT THE NEED AND VALUE OF SERVICE
6 IN HEALTH OCCUPATIONS;
7 (II) TRAINING/CONTINUING EDUCATION AND REGULATORY FACILITATION FOR
8 CROSS-TRAINING TO MAXIMIZE FLEXIBILITY IN THE UTILIZATION OF STAFF,
9 INCLUDING:
10 (A) TRAINING OF HOSPITAL NURSES IN HOME CARE;
11 (B) DUAL CERTIFIED NURSE AIDE/HOME HEALTH AIDE CERTIFICATION; AND
12 (C) DUAL PERSONAL CARE AIDE/HHA CERTIFICATION;
13 (III) SALARY/BENEFIT ENHANCEMENT;
14 (IV) CAREER LADDER DEVELOPMENT; AND
15 (V) OTHER INCENTIVES TO PRACTICE IN SHORTAGE AREAS; AND
16 (C) HOSPITAL - HOME CARE - PHYSICIAN COLLABORATIVES FOR THE CARE AND
17 MANAGEMENT OF SPECIAL NEEDS, HIGH-RISK AND HIGH-COST PATIENTS, INCLUDING
18 BUT NOT LIMITED TO BEST PRACTICES, AND TRAINING AND EDUCATION OF DIRECT
19 CARE PRACTITIONERS AND SERVICE EMPLOYEES.
20 5. HOSPITALS AND HOME CARE AGENCIES WHICH ARE PROVIDED FINANCING OR
21 WAIVERS PURSUANT TO THIS SECTION SHALL REPORT TO THE COMMISSIONER ON THE
22 PATIENT, SERVICE AND COST EXPERIENCES PURSUANT TO THIS SECTION, INCLUD-
23 ING THE EXTENT TO WHICH THE PROJECT GOALS ARE ACHIEVED. THE COMMISSIONER
24 SHALL COMPILE AND MAKE SUCH REPORTS AVAILABLE ON THE DEPARTMENT'S
25 WEBSITE.
26 S 56-a. The public health law is amended by adding two new sections
27 3614-d and 3614-e to read as follows:
28 S 3614-D. UNIVERSAL STANDARDS FOR CODING OF PAYMENT OF CLAIMS FOR LONG
29 TERM CARE. STANDARDS FOR THE CODES OF CLAIMS OF PAYMENTS FOR PERSONAL
30 CARE, HOME HEALTH CARE SERVICES OR OTHER LONG TERM CARE SERVICES. IN THE
31 PROCESSING OF CODES OF CLAIMS SUBMITTED UNDER CONTRACTS OR AGREEMENTS
32 ISSUED OR ENTERED INTO OR BETWEEN CERTIFIED HOME HEALTH AGENCIES, LONG
33 TERM HOME HEALTH CARE PROGRAMS, LICENSED HOME CARE SERVICES PROGRAMS,
34 INSURERS, MANAGED LONG TERM CARE PLANS, MANAGED CARE PLANS OR ORGANIZA-
35 TIONS LICENSED OR OPERATED PURSUANT TO THE PROVISIONS OF THIS CHAPTER,
36 THE SOCIAL SERVICES LAW, OR THE INSURANCE LAW AND FOR ALL BILLS FOR
37 PERSONAL CARE, HOME HEALTH CARE SERVICES OR OTHER LONG TERM CARE
38 SERVICES RENDERED BY LICENSED HOME CARE SERVICES PROGRAMS, CERTIFIED
39 HOME HEALTH AGENCIES OR LONG TERM HOME HEALTH CARE PROGRAMS PURSUANT TO
40 SUCH CONTRACTS OR AGREEMENTS, ANY CERTIFIED HOME HEALTH CARE AGENCY,
41 LONG TERM HOME HEALTH CARE PROGRAM, INSURER, MANAGED LONG TERM CARE
42 PLANS, MANAGED CARE PLAN, OR ORGANIZATIONS LICENSED OR OPERATED PURSUANT
43 TO THE PROVISIONS OF THIS CHAPTER, THE SOCIAL SERVICES LAW, THE EXECU-
44 TIVE LAW OR THE INSURANCE LAW SHALL BE BASED ON UNIVERSAL BILLING CODES
45 APPROVED BY THE DEPARTMENT OR A NATIONALLY ACCREDITED ORGANIZATION AS
46 APPROVED BY THE DEPARTMENT; PROVIDED, HOWEVER, SUCH CODING SHALL BE
47 CONSISTENT WITH ANY CODES DEVELOPED AS PART OF THE UNIFORM ASSESSMENT
48 SYSTEM FOR LONG TERM CARE ESTABLISHED BY THE DEPARTMENT.
49 S 3614-E. ELECTRONIC PAYMENT OF CLAIMS. IN THE PAYMENT OF CLAIMS
50 SUBMITTED UNDER CONTRACTS OR AGREEMENTS ISSUED OR ENTERED INTO OR
51 BETWEEN CERTIFIED HOME HEALTH AGENCIES, LONG TERM HOME HEALTH CARE
52 PROGRAMS, LICENSED HOME CARE SERVICES PROGRAMS, FISCAL INTERMEDIARIES
53 OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL
54 SERVICES LAW, INSURERS, MANAGED LONG TERM CARE PLANS, MANAGED CARE PLANS
55 OR ORGANIZATIONS LICENSED OR OPERATED PURSUANT TO THE PROVISIONS OF THIS
56 CHAPTER, THE SOCIAL SERVICES LAW OR THE INSURANCE LAW AND FOR ALL BILLS
S. 4207 31
1 FOR PERSONAL CARE, HOME HEALTH CARE SERVICES, CONSUMER DIRECTED PERSONAL
2 ASSISTANCE SERVICES OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-
3 FIVE-F OF THE SOCIAL SERVICES LAW OR OTHER LONG TERM CARE SERVICES
4 RENDERED BY LICENSED HOME CARE SERVICES PROGRAMS, CERTIFIED HOME HEALTH
5 AGENCIES, LONG TERM HOME HEALTH CARE PROGRAMS OR A FISCAL INTERMEDIARY
6 OPERATING PURSUANT TO SECTION THREE HUNDRED SIXTY-FIVE-F OF THE SOCIAL
7 SERVICES LAW PURSUANT TO SUCH CONTRACTS OR AGREEMENTS, ANY CERTIFIED
8 HOME HEALTH CARE AGENCY, LONG TERM HOME HEALTH CARE PROGRAM, INSURER,
9 MANAGED LONG TERM CARE PLAN, MANAGED CARE PLAN OR ORGANIZATION LICENSED
10 OR OPERATED PURSUANT TO THE PROVISIONS OF THIS CHAPTER, THE SOCIAL
11 SERVICES LAW, THE EXECUTIVE LAW OR THE INSURANCE LAW, SUCH CLAIMS SHALL
12 BE PAID VIA ELECTRONIC FUNDS TRANSFER.
13 S 57. Subdivision 1 of section 364-j of the social services law is
14 amended by adding two new paragraphs (w) and (w-1) to read as follows:
15 (W) "SCHOOL-BASED HEALTH CENTER". A CLINIC LICENSED UNDER ARTICLE
16 TWENTY-EIGHT OF THE PUBLIC HEALTH LAW OR SPONSORED BY A FACILITY
17 LICENSED UNDER THE PUBLIC HEALTH LAW WHICH PROVIDES PRIMARY HEALTH CARE
18 SERVICES INCLUDING URGENT CARE, WELL CHILD CARE, REPRODUCTIVE HEALTH
19 CARE, DENTAL CARE, BEHAVIORAL HEALTH SERVICES, VISION CARE, AND MANAGE-
20 MENT OF CHRONIC DISEASES TO CHILDREN AND ADOLESCENTS WITHIN AN ELEMENTA-
21 RY, SECONDARY OR PREKINDERGARTEN PUBLIC SCHOOL SETTING.
22 (W-1) "SPONSORING ORGANIZATION". A FACILITY LICENSED UNDER ARTICLE
23 TWENTY-EIGHT OF THE PUBLIC HEALTH LAW WHICH ACTS AS THE SPONSOR FOR A
24 SCHOOL-BASED HEALTH CENTER.
25 S 58. Subdivision 2 of section 364-j of the social services law is
26 amended by adding a new paragraph (d) to read as follows:
27 (D) THE COMMISSIONER OF HEALTH SHALL BE AUTHORIZED TO INCLUDE THE
28 SERVICES OF A SCHOOL-BASED HEALTH CENTER IN THE MANAGED CARE PROGRAM
29 PURSUANT TO THIS SECTION ON AND AFTER JULY FIRST, TWO THOUSAND FIFTEEN
30 COMMENCING WITH NO FEWER THAN THREE SCHOOL-BASED HEALTH CENTERS THAT
31 VOLUNTEER TO BE PART OF A PILOT PROJECT FOR A PERIOD OF TWO YEARS. THE
32 COMMISSIONER OF HEALTH SHALL PROVIDE AN INTERIM REPORT ON THE IMPLEMEN-
33 TATION OF THE PILOT PROJECT TO THE TEMPORARY PRESIDENT OF THE SENATE AND
34 THE SPEAKER OF THE ASSEMBLY ON OR BEFORE JULY FIRST, TWO THOUSAND
35 SIXTEEN. THE COMMISSIONER OF HEALTH SHALL PROVIDE A FINAL REPORT ON THE
36 IMPLEMENTATION OF THE PILOT PROJECT TO THE TEMPORARY PRESIDENT OF THE
37 SENATE AND THE SPEAKER OF THE ASSEMBLY ON OR BEFORE JANUARY FIRST, TWO
38 THOUSAND SEVENTEEN. SUCH INTERIM AND FINAL REPORTS SHALL INCLUDE BUT NOT
39 BE LIMITED TO INFORMATION CONCERNING ACCESS BY CHILDREN AND ADOLESCENTS
40 TO PRIMARY HEALTH CARE SERVICES, URGENT CARE SERVICES, SERVICES FOR THE
41 MANAGEMENT OF CHRONIC DISEASE, WELL CHILD CARE, AND DENTAL CARE, AND THE
42 TIMELINESS AND ADEQUACY OF PAYMENT TO SCHOOL-BASED HEALTH CENTERS BY
43 MANAGED CARE PROVIDERS.
44 ON AND AFTER JULY FIRST, TWO THOUSAND SEVENTEEN, THE COMMISSIONER OF
45 HEALTH IS AUTHORIZED TO INCLUDE THE SERVICES OF A SCHOOL-BASED HEALTH
46 CENTER IN THE MANAGED CARE PROGRAM SUBJECT TO A PHASED-IN SCHEDULE BASED
47 ON GEOGRAPHY AND THE CAPABILITY OF THE SCHOOL-BASED HEALTH CENTER AND
48 THE MANAGED CARE PROVIDER TO PARTICIPATE IN THE PROGRAM. SUCH ASSESSMENT
49 OF CAPABILITY TO PARTICIPATE IN THE PROGRAM SHALL BE MADE BY THE COMMIS-
50 SIONER OF HEALTH AFTER CONSULTATION WITH THE INVOLVED SCHOOL-BASED
51 HEALTH CENTER, SPONSORING ORGANIZATION AND THE MANAGED CARE PROVIDER.
52 THE COMMISSIONER OF HEALTH SHALL TAKE INTO CONSIDERATION, ANY RELEVANT
53 FINDINGS OF THE FINAL AND INTERIM REPORTS.
54 S 59. Subdivision 3 of section 364-j of the social services law is
55 amended by adding a new paragraph (d-2) to read as follows:
S. 4207 32
1 (D-2) BEHAVIORAL HEALTH AND REPRODUCTIVE HEALTH CARE SERVICES PROVIDED
2 BY SCHOOL-BASED HEALTH CENTERS SHALL NOT BE PROVIDED TO MEDICAL ASSIST-
3 ANCE RECIPIENTS THROUGH MANAGED CARE PROGRAMS ESTABLISHED PURSUANT TO
4 THIS SECTION, AND SHALL CONTINUE TO BE PROVIDED OUTSIDE OF MANAGED CARE
5 PROGRAMS IN ACCORDANCE WITH APPLICABLE REIMBURSEMENT METHODOLOGIES.
6 "APPLICABLE REIMBURSEMENT METHODOLOGIES" SHALL MEAN:
7 (I) FOR SCHOOL-BASED HEALTH CENTERS SPONSORED BY A FEDERALLY QUALIFIED
8 HEALTH CENTER, RATES OF REIMBURSEMENT AND REQUIREMENTS IN ACCORDANCE
9 WITH THOSE MANDATED BY 42 U.S.C. SECS. 1396A(BB), 1396(M)(2)(A)(IX) AND
10 1936(A)(13)(C); AND
11 (II) FOR SCHOOL-BASED HEALTH CENTERS SPONSORED BY AN ENTITY LICENSED
12 PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH LAW THAT IS NOT A
13 FEDERALLY QUALIFIED HEALTH CENTER, RATES OF REIMBURSEMENT AT THE FEE FOR
14 SERVICE RATE FOR SUCH SERVICES IN EFFECT PRIOR TO THE ENACTMENT OF THIS
15 CHAPTER FOR THE AMBULATORY PATIENT GROUP RATE FOR THE APPLICABLE
16 SERVICE.
17 (III) FOR THE PURPOSES OF THIS PARAGRAPH, THE TERM "BEHAVIORAL HEALTH
18 SERVICES" SHALL MEAN PRIMARY PREVENTION, INDIVIDUAL MENTAL HEALTH
19 ASSESSMENT, TREATMENT AND FOLLOW-UP, CRISIS INTERVENTION, GROUP AND
20 FAMILY COUNSELING, AND SHORT AND LONG-TERM COUNSELING.
21 S 60. Subdivision (c) of section 62 of chapter 165 of the laws of
22 1991, amending the public health law and other laws relating to estab-
23 lishing payments for medical assistance, as amended by section 26 of
24 part D of chapter 59 of the laws of 2011, is amended to read as follows:
25 (c) [section 364-j of the social services law, as amended by section
26 eight of this act and subdivision 6 of section 367-a of the social
27 services law as added by section twelve of this act shall expire and be
28 deemed repealed on March 31, 2015 and] provided [further], that the
29 amendments to the provisions of section 364-j of the social services law
30 made by section eight of this act shall only apply to managed care
31 programs approved on or after the effective date of this act;
32 S 61. Subdivision 18-a of section 206 of the public health law, as
33 amended by section 11 of part A of chapter 58 of the laws of 2010, para-
34 graphs (b) and (d) as amended by section 16 of part A of chapter 60 of
35 the laws of 2014, paragraph (c) as amended by chapter 132 of the laws of
36 2014, is amended to read as follows:
37 18-a. [(a)] Health information technology demonstration program. (A)
38 (i) The commissioner is authorized to issue grant funding to one or more
39 organizations broadly representative of physicians licensed in this
40 state, from funds made available for the purpose of funding research and
41 demonstration projects under subparagraph (ii) of this paragraph
42 designed to promote the development of electronic health information
43 exchange technologies in order to facilitate the adoption of interopera-
44 ble health records.
45 (ii) Project funding shall be disbursed to projects pursuant to a
46 request for proposals based on criteria relating to promoting the effi-
47 cient and effective delivery of quality physician services. Demon-
48 stration projects eligible for funding under this paragraph shall
49 include, but not be limited to:
50 (A) efforts to incentivize electronic health record adoption;
51 (B) interconnection of physicians through regional collaborations;
52 (C) efforts to promote personalized health care and consumer choice;
53 (D) efforts to enhance health care outcomes and health status general-
54 ly through interoperable public health surveillance systems and stream-
55 lined quality monitoring.
S. 4207 33
1 (iii) The department shall issue a report to the governor, the tempo-
2 rary president of the senate and the speaker of the assembly within one
3 year following the issuance of the grants. Such report shall contain, at
4 a minimum, the following information: the demonstration projects imple-
5 mented pursuant to this paragraph, their date of implementation, their
6 costs and the appropriateness of a broader application of the health
7 information technology program to increase the quality and efficiency of
8 health care across the state.
9 (b) The commissioner shall:
10 (i) convene a workgroup to:
11 (A) evaluate the state's health information technology infrastructure
12 and systems, as well as other related plans and projects designed to
13 make improvements or modifications to such infrastructure and systems
14 including, but not limited to, the all payor database (APD), the state
15 planning and research cooperative system (SPARCS), regional health
16 information organizations (RHIOs), the statewide health information
17 network of New York (SHIN-NY) and medical assistance eligibility
18 systems; and
19 (B) develop recommendations for the state to move toward a comprehen-
20 sive health claims and clinical database aimed at improving quality of
21 care, efficiency, cost of care and patient satisfaction available in a
22 self-sustainable, non-duplicative, interactive and interoperable manner
23 that ensures safeguards for privacy, confidentiality and security;
24 (ii) submit [a] AN INTERIM report to the governor [and], the temporary
25 president of the senate and the speaker of the assembly, which shall
26 [fully consider the evaluation and recommendations of the workgroup]
27 DETAIL THE CONCERNS AND ISSUES ASSOCIATED WITH ESTABLISHING THE STATE'S
28 HEALTH INFORMATION TECHNOLOGY INFRASTRUCTURE CONSIDERED BY THE
29 WORKGROUP, on or before December first, two thousand fourteen[.]; AND
30 (III) SUBMIT A REPORT TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE
31 SENATE AND THE SPEAKER OF THE ASSEMBLY, WHICH SHALL FULLY CONSIDER THE
32 EVALUATION AND RECOMMENDATIONS OF THE WORKGROUP, ON OR BEFORE DECEMBER
33 FIRST, TWO THOUSAND FIFTEEN.
34 (c) The members of the workgroup shall include, at a minimum, three
35 members who represent RHIOs, two members employed by the department who
36 are involved in the development of the SHIN-NY and the APD, two members
37 who represent physicians, two members who represent hospitals, two
38 members who represent home care agencies, one member who represents
39 federally qualified health centers, ONE MEMBER WHO REPRESENTS COUNTY
40 HEALTH COMMISSIONERS, the chair of the senate health committee or his or
41 her designee, the chair of the assembly health committee or his or her
42 designee, and other individuals with expertise in matters relevant to
43 the charge of the workgroup.
44 (d) The commissioner may make such rules and regulations as may be
45 necessary to implement federal policies and disburse funds as required
46 by the American Recovery and Reinvestment Act of 2009 and to promote the
47 development of a self-sufficient SHIN-NY to enable widespread, non-du-
48 plicative interoperability among disparate health information systems,
49 including electronic health records, personal health records, health
50 care claims, payment and other administrative data, and public health
51 information systems, while protecting privacy and security. Such rules
52 and regulations shall include, but not be limited to, requirements for
53 organizations covered by 42 U.S.C. 17938 or any other organizations that
54 exchange health information through the SHIN-NY or any other statewide
55 health information system recommended by the workgroup. The commissioner
56 shall consider the FINAL REPORT AND recommendations of the workgroup. If
S. 4207 34
1 the commissioner acts in a manner inconsistent with the recommendations
2 of the workgroup, he or she shall provide the reasons therefor.
3 S 62. Subdivision 4 of section 365-h of the social services law, as
4 amended by section 20 of part B of chapter 109 of the laws of 2010, is
5 amended to read as follows:
6 4. The commissioner of health is authorized to assume responsibility
7 from a local social services official for the provision and reimburse-
8 ment of transportation costs under this section. If the commissioner
9 elects to assume such responsibility, the commissioner shall notify the
10 local social services official in writing as to the election, the date
11 upon which the election shall be effective and such information as to
12 transition of responsibilities as the commissioner deems prudent. The
13 commissioner is authorized to contract with a transportation manager or
14 managers to manage transportation services in any local social services
15 district, OTHER THAN TRANSPORTATION SERVICES PROVIDED OR ARRANGED FOR
16 ENROLLEES OF MANAGED LONG TERM CARE PLANS ISSUED CERTIFICATES OF AUTHOR-
17 ITY UNDER SECTION FORTY-FOUR HUNDRED THREE-F OF THE PUBLIC HEALTH LAW.
18 Any transportation manager or managers selected by the commissioner to
19 manage transportation services shall have proven experience in coordi-
20 nating transportation services in a geographic and demographic area
21 similar to the area in New York state within which the contractor would
22 manage the provision of services under this section. Such a contract or
23 contracts may include responsibility for: review, approval and process-
24 ing of transportation orders; management of the appropriate level of
25 transportation based on documented patient medical need; and development
26 of new technologies leading to efficient transportation services. If the
27 commissioner elects to assume such responsibility from a local social
28 services district, the commissioner shall examine and, if appropriate,
29 adopt quality assurance measures that may include, but are not limited
30 to, global positioning tracking system reporting requirements and
31 service verification mechanisms. Any and all reimbursement rates devel-
32 oped by transportation managers under this subdivision shall be subject
33 to the review and approval of the commissioner. Notwithstanding any
34 inconsistent provision of sections one hundred twelve and one hundred
35 sixty-three of the state finance law, or section one hundred forty-two
36 of the economic development law, or any other law, the commissioner is
37 authorized to enter into a contract or contracts under this subdivision
38 without a competitive bid or request for proposal process, provided,
39 however, that:
40 (a) the department shall post on its website, for a period of no less
41 than thirty days:
42 (i) a description of the proposed services to be provided pursuant to
43 the contract or contracts;
44 (ii) the criteria for selection of a contractor or contractors;
45 (iii) the period of time during which a prospective contractor may
46 seek selection, which shall be no less than thirty days after such
47 information is first posted on the website; and
48 (iv) the manner by which a prospective contractor may seek such
49 selection, which may include submission by electronic means;
50 (b) all reasonable and responsive submissions that are received from
51 prospective contractors in timely fashion shall be reviewed by the
52 commissioner; and
53 (c) the commissioner shall select such contractor or contractors that,
54 in his or her discretion, are best suited to serve the purposes of this
55 section.
S. 4207 35
1 S 63. Section 2826 of the public health law, as added by section 27 of
2 part C of chapter 60 of the laws of 2014, is amended to read as follows:
3 S 2826. [Temporary] VITAL ACCESS PROVIDER; TEMPORARY adjustment to
4 reimbursement rates. (a) Notwithstanding any provision of law to the
5 contrary, within funds appropriated and subject to the availability of
6 federal financial participation, the commissioner may grant approval of
7 a temporary adjustment to the non-capital components of rates, or make
8 temporary lump-sum Medicaid payments, to eligible general hospitals,
9 skilled nursing facilities, clinics and home care providers, provided
10 however, that should federal financial participation not be available
11 for any eligible provider, then payments pursuant to this subdivision
12 may be made as grants and shall not be deemed to be medical assistance
13 payments.
14 (b) Eligible providers shall include:
15 (i) providers undergoing closure;
16 (ii) providers impacted by the closure of other health care providers;
17 (iii) providers subject to mergers, acquisitions, consolidations or
18 restructuring; or
19 (iv) providers impacted by the merger, acquisition, consolidation or
20 restructuring of other health care providers.
21 (c) Providers seeking temporary rate adjustments under this section
22 shall demonstrate through submission of a written proposal to the
23 commissioner that the additional resources provided by a temporary rate
24 adjustment will achieve one or more of the following:
25 (i) protect or enhance access to care;
26 (ii) protect or enhance quality of care;
27 (iii) improve the cost effectiveness of the delivery of health care
28 services; or
29 (iv) otherwise protect or enhance the health care delivery system[, as
30 determined by the commissioner].
31 (d) (i) Such written proposal shall be submitted to the commissioner
32 at least sixty days prior to the requested effective date of the tempo-
33 rary rate adjustment, and shall include a proposed budget to achieve the
34 goals of the proposal. Any Medicaid payment issued pursuant to this
35 section shall be in effect for a specified period of time as determined
36 by the commissioner, of up to three years. At the end of the specified
37 timeframe such payments or adjustments to the non-capital component of
38 rates shall cease, and the provider shall be reimbursed in accordance
39 with the otherwise applicable rate-setting methodology as set forth in
40 applicable statutes and regulations. The commissioner may establish, as
41 a condition of receiving such temporary rate adjustments or grants,
42 benchmarks and goals to be achieved in conformity with the provider's
43 written proposal as approved by the commissioner and may also require
44 that the facility submit such periodic reports concerning the achieve-
45 ment of such benchmarks and goals as the commissioner deems necessary.
46 Failure to achieve satisfactory progress, as determined by the commis-
47 sioner, in accomplishing such benchmarks and goals shall be a basis for
48 ending the facility's temporary rate adjustment or grant prior to the
49 end of the specified timeframe. (ii) The commissioner [may] SHALL
50 require that applications submitted pursuant to this section be submit-
51 ted in response to and in accordance with a Request For Applications or
52 a Request For Proposals issued by the commissioner.
53 (e) FOR THE PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND FIFTEEN, TO
54 THE EXTENT PRACTICABLE BASED ON SUBMITTED RESPONSES TO THE COMMISSION-
55 ER'S REQUEST FOR APPLICATIONS OR REQUEST FOR PROPOSALS, THE COMMISSIONER
56 SHALL MAKE TEMPORARY ADJUSTMENTS TO RATES OF ELIGIBLE PROVIDERS WITHIN
S. 4207 36
1 AMOUNTS MADE AVAILABLE EQUITABLY ACROSS THE STATE; PROVIDED, HOWEVER,
2 THAT AT LEAST FORTY PERCENT OF FUNDS MADE AVAILABLE ANNUALLY SHALL BE
3 AWARDED TO ELIGIBLE PROVIDERS WHO ARE LOCATED IN COUNTIES WHOSE POPU-
4 LATION AT THE MOST RECENT CENSUS DOES NOT EXCEED NINE HUNDRED
5 TWENTY-FIVE THOUSAND AND WHOSE POPULATION PER SQUARE MILE DOES NOT
6 EXCEED ONE THOUSAND TWO HUNDRED.
7 (F) Notwithstanding any law to the contrary, general hospitals defined
8 as critical access hospitals pursuant to title XVIII of the federal
9 social security act shall be allocated no less than five million dollars
10 annually pursuant to this section. The department [of health] shall
11 provide a report to the governor and legislature no later than December
12 first, two thousand fourteen providing recommendations on how to ensure
13 the financial stability of, and preserve patient access to, critical
14 access hospitals.
15 (G) FOR PERIODS ON AND AFTER APRIL FIRST, TWO THOUSAND FIFTEEN, THE
16 COMMISSIONER SHALL PROVIDE A REPORT ON A QUARTERLY BASIS TO THE CHAIRS
17 OF THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, SENATE HEALTH AND ASSEM-
18 BLY HEALTH COMMITTEES WITH REGARD TO THE STATUS OF THE VITAL ACCESS
19 PROVIDER (VAP) TEMPORARY RATE ADJUSTMENT PROGRAM. SUCH REPORTS SHALL BE
20 SUBMITTED NO LATER THAN SIXTY DAYS AFTER THE CLOSE OF THE QUARTER, AND
21 SHALL INCLUDE THE MOST CURRENT INFORMATION ON VITAL ACCESS PROVIDER
22 TEMPORARY RATE ADJUSTMENTS OR GRANTS. THE REPORTS SHALL INCLUDE FOR ANY
23 VAP TEMPORARY RATE ADJUSTMENT OR GRANT MADE:
24 (I) THE AMOUNT OF ANY RATE ADJUSTMENT OR GRANT FOR ALL YEARS OF THE
25 AWARD;
26 (II) A DESCRIPTION OF HOW THE TEMPORARY RATE ADJUSTMENT OR GRANT
27 RECIPIENT WILL ACHIEVE ANY OF THE GOALS OF THE VITAL ACCESS PROVIDER
28 TEMPORARY RATE ADJUSTMENT PROGRAM PURSUANT TO SUBDIVISION (C) OF THIS
29 SECTION AND ANY ADDITIONAL INFORMATION OR FACTORS TAKEN INTO CONSIDER-
30 ATION BY THE COMMISSIONER IN APPROVING A TEMPORARY RATE ADJUSTMENT OR
31 GRANT PURSUANT TO THIS SECTION;
32 (III) THE STATUS OF THE TEMPORARY RATE ADJUSTMENT OR GRANT RECIPIENT
33 IN MEETING THE BENCHMARK OR GOALS ESTABLISHED BY THE COMMISSIONER;
34 (IV) A SUMMARY OF ANY PERIODIC REPORTS REQUIRED BY THE COMMISSIONER AS
35 A CONDITION OF RECEIVING A TEMPORARY RATE ADJUSTMENT OR GRANT; AND
36 (V) INFORMATION ON PROJECT SPENDING AND BUDGET.
37 (H) THE COMMISSIONER SHALL PROVIDE ON AN ANNUAL BASIS TO THE CHAIRS OF
38 THE SENATE FINANCE, ASSEMBLY WAYS AND MEANS, SENATE HEALTH AND ASSEMBLY
39 HEALTH COMMITTEES A SUMMARY OF THE STATEWIDE GEOGRAPHIC DISTRIBUTION OF
40 FUNDS.
41 S 64. The opening paragraph of subdivision 2 of section 363-a of the
42 social services law is designated paragraph (a) and a new paragraph (b)
43 is added to read as follows:
44 (B) NOTWITHSTANDING ANY INCONSISTENT PROVISION OF SECTION TWO HUNDRED
45 ONE OF THE PUBLIC HEALTH LAW, THIS SECTION OR ANY OTHER PROVISION OF
46 LAW, AMENDMENTS PROMULGATED BY THE DEPARTMENT OF HEALTH THAT WOULD ADD A
47 NEW COVERED BENEFIT OR BENEFITS, OR EXPANSION OF BENEFIT COVERAGE, UNDER
48 THE STATE'S MEDICAID PROGRAM SHALL REQUIRE LEGISLATIVE APPROVAL PRIOR TO
49 THE EFFECTIVE DATE OF ANY CHANGE TO THE PLAN.
50 S 65. Paragraph 2 of subdivision (a) of section 90 of part H of chap-
51 ter 59 of the laws of 2011, amending the public health law and other
52 laws, relating to general hospital inpatient reimbursement for annual
53 rates, as amended by section 38 of part C of chapter 60 of the laws of
54 2014, is amended and two new paragraphs 3 and 4 are added to read as
55 follows:
S. 4207 37
1 (2) [Alternative] SUBJECT TO PARAGRAPH THREE OF THIS SUBDIVISION,
2 ALTERNATIVE methods of cost containment as authorized and implemented
3 pursuant to paragraph one of this subdivision shall continue to be
4 applied and maintained for periods on and after April 1, 2014, provided,
5 however, that the commissioner of health, in consultation with the
6 director of the budget, is authorized to terminate such alternative
7 methods upon a finding that they are no longer necessary to maintain
8 essential cost savings; PROVIDED, FURTHER, HOWEVER, THAT ON AND AFTER
9 APRIL FIRST, TWO THOUSAND FIFTEEN THIS PARAGRAPH SHALL NOT APPLY TO
10 FACILITIES OPERATING PURSUANT TO ARTICLE SIXTEEN OF THE MENTAL HYGIENE
11 LAW.
12 (3) NOTWITHSTANDING ANY PROVISION OF LAW OR REGULATION TO THE CONTRARY
13 AND SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL PARTICIPATION, THE
14 COMMISSIONER SHALL INCREASE MEDICAID PAYMENTS TO NURSING HOMES AND ADULT
15 DAY HEALTH CARE PROGRAMS BY ONE PERCENT FOR ALL PERIODS ON AND AFTER
16 APRIL 1, 2015 DURING WHICH AN ALTERNATIVE METHOD OF COST CONTAINMENT IS
17 APPLIED AND MAINTAINED PURSUANT TO PARAGRAPH TWO OF THIS SUBDIVISION.
18 FOR THIS PURPOSE, RATES OF PAYMENT TO MEDICAID MANAGED CARE PLANS SHALL
19 BE INCREASED BY ONE PERCENT FOR SUCH SERVICES, AND SUCH PLANS SHALL
20 REFLECT SUCH RATE INCREASES IN THE RATES PAID TO THE PROVIDERS OF SUCH
21 SERVICES. IF AND UNTIL SUCH TIME AS THE COMMISSIONER OF HEALTH RECEIVES
22 FROM THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES FINAL
23 APPROVAL OF THE REVISION IN RATES OF PAYMENT AUTHORIZED BY THIS PARA-
24 GRAPH AND FINAL APPROVAL OF THE UNIVERSAL SETTLEMENT OF NURSING HOME
25 RATE APPEALS AND LAWSUITS, THE ALTERNATIVE METHOD OF COST CONTAINMENT
26 APPLIED AND MAINTAINED TO NURSING HOMES AND ADULT DAY HEALTH ARE
27 PROGRAMS PURSUANT TO PARAGRAPH TWO OF THIS SUBDIVISION SHALL BE
28 SUSPENDED AND BE OF NO FORCE OR EFFECT UNTIL THE EFFECTIVE DATE OF SUCH
29 APPROVALS.
30 (4) NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, THE
31 0.8 PERCENT NON-REIMBURSABLE ASSESSMENT ALTERNATIVE METHOD OF COST
32 CONTAINMENT IMPOSED UPON SKILLED NURSING FACILITIES PURSUANT TO THE
33 PROVISIONS OF PARAGRAPH ONE OF THIS SUBDIVISION BEGINNING FOR THE STATE
34 FISCAL YEAR APRIL 1, 2011 SHALL END ON MARCH 31, 2014. ASSESSMENT
35 PAYMENTS MADE BY SKILLED NURSING PROVIDERS FOR THE PERIOD ON AND AFTER
36 APRIL 1, 2014 THROUGH MARCH 31, 2015 SHALL BE REFUNDED TO SUCH PROVID-
37 ERS. THIS ASSESSMENT MAY BE REINSTITUTED PROSPECTIVELY IN FUTURE FISCAL
38 YEARS UPON THE RATIFICATION OF A LEGALLY BINDING UNIVERSAL SETTLEMENT
39 BETWEEN THE STATE AND ALL AFFECTED SKILLED NURSING PROVIDERS FOR CERTAIN
40 RATE APPEALS AND LITIGATION BROUGHT BY CURRENT OR FORMER OWNERS RELATING
41 TO THE STATE'S PRE-PRICING RATE METHODOLOGY.
42 S 66. Paragraph (d) of subdivision 2-a of section 2808 of the public
43 health law, as added by chapter 483 of the laws of 1978, is amended to
44 read as follows:
45 (d) For facilities granted operating certificates on or after March
46 tenth, nineteen hundred seventy-five, recognition of real property costs
47 in such regulations shall be based upon historical costs to the owner of
48 the facility, provided that payment for real property costs shall not be
49 in excess of the actual debt service, including principal and interest,
50 and payment with respect to owner's equity, AND FURTHER PROVIDED THAT,
51 EFFECTIVE APRIL FIRST, TWO THOUSAND FIFTEEN, THE COMMISSIONER MAY MODIFY
52 SUCH PAYMENTS FOR REAL PROPERTY COSTS FOR PURPOSES OF EFFECTUATING A
53 SHARED SAVINGS PROGRAM, WHEREBY FACILITIES SHARE A MINIMUM OF FIFTY
54 PERCENT OF SAVINGS, FOR FACILITIES THAT ELECT TO REFINANCE THEIR MORT-
55 GAGE LOANS. For purposes of this subdivision, owner's equity shall be
56 calculated without regard to any surplus created by revaluation of
S. 4207 38
1 assets and shall not include amounts resulting from mortgage amorti-
2 zation where the payment therefor has been provided by real property
3 cost reimbursement.
4 S 67. Subdivision 1 of section 206 of the public health law is amended
5 by adding a new paragraph (v) to read as follows:
6 (V) ESTABLISH AN OFFICE OF ACCOUNTABILITY WITHIN THE DEPARTMENT. THE
7 OFFICE OF ACCOUNTABILITY SHALL BE RESPONSIBLE FOR ENSURING ALL WORK-
8 GROUPS REQUIRED UNDER THIS CHAPTER ARE TIMELY CONVENED AND ALL REPORTS
9 REQUIRED UNDER THIS CHAPTER ARE TIMELY DISTRIBUTED. THE OFFICE SHALL
10 REVIEW AND REPORT TO THE LEGISLATURE BY JANUARY FIRST, TWO THOUSAND
11 SIXTEEN, AND ANNUALLY THEREAFTER, ON THE FOLLOWING:
12 (1) THE DATE EACH STATUTORILY REQUIRED REPORT WAS DISTRIBUTED, AND TO
13 WHOM IT WAS DISTRIBUTED;
14 (2) ANY REPORTS THAT WERE REQUIRED BY LAW AND NOT PROVIDED, WITH AN
15 EXPLANATION OF WHY SUCH REPORT WAS NOT PROVIDED;
16 (3) RECOMMENDATIONS FOR STREAMLINING REPORTING REQUIREMENTS WHICH MAY
17 INCLUDE RECOMMENDED STATUTORY AMENDMENTS TO MAKE REPORT DEADLINES AND
18 RECIPIENTS MORE CONSISTENT, TO PROVIDE THE REPORTS IN ELECTRONIC FORMAT,
19 TO CONSOLIDATE ANY RELATED REPORTING REQUIREMENTS, OR TO REPEAL REPORT-
20 ING REQUIREMENTS NO LONGER DEEMED NECESSARY;
21 (4) ALL CURRENTLY ACTIVE WORKGROUPS, AD HOC WORKGROUPS, ADVISORY
22 COMMITTEES OR TASKFORCES THE DEPARTMENT IS RUNNING OR ENGAGED IN EITHER
23 DIRECTLY OR IN COMBINATION WITH OTHER AGENCIES OR DEPARTMENTS AND THE
24 STATUS OF EACH SUCH GROUP; AND
25 (5) ANY STATUTORILY REQUIRED WORKGROUP THAT HAS NOT MET WITHIN THE
26 LAST YEAR, WITH AN EXPLANATION OF WHY THIS GROUP IS INACTIVE, WHICH MAY
27 INCLUDE A RECOMMENDATION TO REPEAL THE WORKGROUP IF THE PURPOSE OF THE
28 GROUP HAVE BEEN FULFILLED.
29 THIS REPORT MAY BE PROVIDED ELECTRONICALLY AND SHALL BE PROVIDED TO THE
30 TEMPORARY PRESIDENT OF THE SENATE, SPEAKER OF THE ASSEMBLY, CHAIR OF THE
31 SENATE STANDING COMMITTEE ON HEALTH, AND THE CHAIR OF THE ASSEMBLY
32 HEALTH COMMITTEE.
33 S 68. Paragraph (t) of subdivision 1 of section 206 of the public
34 health law, as added by section 112 of part E of chapter 56 of the laws
35 of 2013, is amended to read as follows:
36 (t) [The department shall submit as part of its annual report prepared
37 pursuant to] SUBMIT AN ANNUAL REPORT TO THE LEGISLATURE ON OR BEFORE THE
38 FIFTEENTH DAY OF MAY, FOR THE PRECEDING CALENDAR YEAR, AS REQUIRED BY
39 section one hundred sixty-four of the executive law[, which may be
40 submitted in electronic format,]. THE ANNUAL REPORT SHALL BE A compre-
41 hensive [information including, but not limited to, a detailed
42 description] REPORT of the department's mission, priorities and goals
43 for the upcoming year, achievements of the past year, ONGOING INITI-
44 ATIVES and any relevant data and statistics. THE ANNUAL REPORT SHALL
45 PROVIDE A LIST OF ALL OTHER REPORTS ISSUED BY THE DEPARTMENT WITHIN THE
46 PRECEDING YEAR, AND INFORMATION ON HOW SUCH REPORTS CAN BE OBTAINED.
47 THIS REPORT MAY BE PROVIDED ELECTRONICALLY AND SHALL BE PROVIDED TO THE
48 TEMPORARY PRESIDENT OF THE SENATE, SPEAKER OF THE ASSEMBLY, CHAIR OF THE
49 SENATE STANDING COMMITTEE ON HEALTH, AND THE CHAIR OF THE ASSEMBLY
50 HEALTH COMMITTEE.
51 S 69. The opening paragraph of subdivision 1 and subdivision 3 of
52 section 367-s of the social services law, as amended by section 8 of
53 part C of chapter 60 of the laws of 2014, are amended to read as
54 follows:
55 Notwithstanding any provision of law to the contrary, a supplemental
56 medical assistance payment shall be made on an annual basis to providers
S. 4207 39
1 of emergency medical transportation services in an aggregate amount not
2 to exceed four million dollars for two thousand six, six million dollars
3 for two thousand seven, six million dollars for two thousand eight,
4 [and] six million dollars for the period May first, two thousand four-
5 teen through March thirty-first, two thousand fifteen, AND SIX MILLION
6 DOLLARS ANNUALLY BEGINNING WITH THE PERIOD APRIL FIRST, TWO THOUSAND
7 FIFTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SIXTEEN pursuant to the
8 following methodology:
9 3. If all necessary approvals under federal law and regulation are not
10 obtained to receive federal financial participation in the payments
11 authorized by this section, payments under this section shall be made in
12 an aggregate amount not to exceed two million dollars for two thousand
13 six, three million dollars for two thousand seven, three million dollars
14 for two thousand eight [and], three million dollars for the period May
15 first, two thousand fourteen through March thirty-first, two thousand
16 fifteen, AND THREE MILLION DOLLARS ANNUALLY BEGINNING WITH THE PERIOD
17 APRIL FIRST, TWO THOUSAND FIFTEEN THROUGH MARCH THIRTY-FIRST, TWO THOU-
18 SAND SIXTEEN. In such case, the multiplier set forth in paragraph (b) of
19 subdivision one of this section shall be deemed to be two million
20 dollars or three million dollars as applicable to the annual period.
21 S 70. Paragraph (e) of subdivision 8 of section 2511 of the public
22 health law is REPEALED.
23 S 71. Subparagraph (v) of paragraph (b) of subdivision 35 of section
24 2807-c of the public health law, as amended by section 67-a of part C of
25 chapter 60 of the laws of 2014, is amended to read as follows:
26 (v) such regulations shall incorporate quality related measures,
27 including, but not limited to, potentially preventable re-admissions
28 (PPRs) and provide for rate adjustments or payment disallowances related
29 to PPRs and other potentially preventable negative outcomes (PPNOs),
30 which shall be calculated in accordance with methodologies as determined
31 by the commissioner, provided, however, that such methodologies shall be
32 based on a comparison of the actual and risk adjusted expected number of
33 PPRs and other PPNOs in a given hospital and with benchmarks established
34 by the commissioner and provided further that such rate adjustments or
35 payment disallowances shall result in an aggregate reduction in Medicaid
36 payments of no less than thirty-five million dollars for the period July
37 first, two thousand ten through March thirty-first, two thousand eleven
38 and no less than fifty-one million dollars for annual periods beginning
39 April first, two thousand eleven through March thirty-first, two thou-
40 sand [fifteen] SIXTEEN, provided further that such aggregate reductions
41 shall be offset by Medicaid payment reductions occurring as a result of
42 decreased PPRs during the period July first, two thousand ten through
43 March thirty-first, two thousand eleven and the period April first, two
44 thousand eleven through March thirty-first, two thousand [fifteen]
45 SIXTEEN and as a result of decreased PPNOs during the period April
46 first, two thousand eleven through March thirty-first, two thousand
47 [fifteen] SIXTEEN; and provided further that for the period July first,
48 two thousand ten through March thirty-first, two thousand [fifteen]
49 SIXTEEN, such rate adjustments or payment disallowances shall not apply
50 to behavioral health PPRs; or to readmissions that occur on or after
51 fifteen days following an initial admission. By no later than July
52 first, two thousand eleven the commissioner shall enter into consulta-
53 tions with representatives of the health care facilities subject to this
54 section regarding potential prospective revisions to applicable method-
55 ologies and benchmarks set forth in regulations issued pursuant to this
56 subparagraph;
S. 4207 40
1 S 72. Subdivision 18 of section 364-j of the social services law is
2 amended by adding two new paragraphs (c) and (d) to read as follows:
3 (C) THE DEPARTMENT OF HEALTH SHALL REQUIRE THE INDEPENDENT ACTUARY
4 SELECTED PURSUANT TO PARAGRAPH (B) OF THIS SUBDIVISION TO PROVIDE A
5 COMPLETE ACTUARIAL MEMORANDUM, ALONG WITH ALL ACTUARIAL ASSUMPTIONS MADE
6 AND ALL OTHER DATA, MATERIALS AND METHODOLOGIES USED IN THE DEVELOPMENT
7 OF RATES, TO MANAGED CARE PROVIDERS THIRTY DAYS PRIOR TO SUBMISSION OF
8 SUCH RATES TO THE CENTERS OF MEDICARE AND MEDICAID SERVICES FOR
9 APPROVAL. MANAGED CARE PROVIDERS MAY REQUEST ADDITIONAL REVIEW OF THE
10 ACTUARIAL SOUNDNESS OF THE RATE SETTING PROCESS AND/OR METHODOLOGY.
11 (D) THE DEPARTMENT OF HEALTH SHALL ANNUALLY PROVIDE TO THE TEMPORARY
12 PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY THE ANNUAL MEDI-
13 CAID MANAGED CARE OPERATING REPORTS SUBMITTED TO THE DEPARTMENT FROM
14 MANAGED CARE PLANS THAT CONTRACT WITH THE STATE TO MANAGE SERVICES
15 PROVIDED UNDER THE MEDICAID PROGRAM.
16 S 73. Notwithstanding any inconsistent provision of law, rule or regu-
17 lation to the contrary, for purposes of implementing the provisions of
18 the public health law and the social services law, references to titles
19 XIX and XXI of the federal social security act in the public health law
20 and the social services law shall be deemed to include and also to mean
21 any successor titles thereto under the federal social security act.
22 S 74. Notwithstanding any inconsistent provision of law, rule or regu-
23 lation, the effectiveness of the provisions of sections 2807 and 3614 of
24 the public health law, section 18 of chapter 2 of the laws of 1988, and
25 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
26 or certification of rates of payment, are hereby suspended and without
27 force or effect for purposes of implementing the provisions of this act.
28 S 75. Severability clause. If any clause, sentence, paragraph, subdi-
29 vision, section or part of this act shall be adjudged by any court of
30 competent jurisdiction to be invalid, such judgment shall not affect,
31 impair or invalidate the remainder thereof, but shall be confined in its
32 operation to the clause, sentence, paragraph, subdivision, section or
33 part thereof directly involved in the controversy in which such judgment
34 shall have been rendered. It is hereby declared to be the intent of the
35 legislature that this act would have been enacted even if such invalid
36 provisions had not been included herein.
37 S 76. This act shall take effect immediately and shall be deemed to
38 have been in full force and effect on and after April 1, 2015, section
39 eight of this act shall expire and be deemed repealed March 31, 2016:
40 1. section thirteen of this act shall take effect June 1, 2015;
41 2. any rules or regulations necessary to implement the provisions of
42 this act may be promulgated and any procedures, forms, or instructions
43 necessary for such implementation may be adopted and issued on or after
44 the date this act shall have become a law;
45 3. this act shall not be construed to alter, change, affect, impair or
46 defeat any rights, obligations, duties or interests accrued, incurred or
47 conferred prior to the effective date of this act;
48 4. the commissioner of health and the superintendent of financial
49 services and any appropriate council may take steps necessary to imple-
50 ment this act prior to its effective date;
51 5. notwithstanding any inconsistent provision of the state administra-
52 tive procedure act or any other provision of law, rule or regulation,
53 the commissioner of health and the superintendent of financial services
54 and any appropriate council is authorized to adopt or amend or promul-
55 gate on an emergency basis any regulation he or she or such council
S. 4207 41
1 determines necessary to implement any provision of this act on its
2 effective date;
3 6. the provisions of this act shall become effective notwithstanding
4 the failure of the commissioner of health or the superintendent of
5 financial services or any council to adopt or amend or promulgate regu-
6 lations implementing this act;
7 7. sections fifty-three and fifty-four of this act shall take effect
8 on the sixtieth day after it shall have become a law; provided that
9 effective immediately, the commissioner of health may make regulations
10 and take other actions necessary to implement such sections on such
11 effective date; provided further that the amendments to section 364-j of
12 the social services law made by section fifty-three of this act shall
13 not affect the repeal of such section and shall be deemed repealed ther-
14 ewith;
15 7-a. section fifty-six-a of this act shall apply to any coding of
16 payment of claims for long term care on or after January 1, 2016;
17 8. sections fifty-seven, fifty-eight and fifty-nine of this act shall
18 take effect June 30, 2015; provided, further, that the amendments to
19 section 364-j of the social services law made by sections fifty-seven,
20 fifty-eight and fifty-nine of this act shall not affect the repeal of
21 such section as provided in section 11 of chapter 710 of the laws of
22 1988, as amended, and shall be deemed repealed therewith;
23 9. the amendments to paragraphs (b) and (d) of subdivision 18-a of
24 section 206 of the public health law, made by section sixty-one of this
25 act, shall not affect the expiration of such paragraphs and shall expire
26 therewith;
27 10. the amendments to subdivision 4 of section 365-h of the social
28 services law, made by section sixty-two of this act, shall not affect
29 the repeal of such section and shall be deemed repealed therewith;
30 11. the amendments to subdivision 18 of section 364-j of the social
31 services law made by section seventy-two of this act shall not affect
32 the repeal of such section and shall be deemed to be repealed therewith;
33 and
34 12. section seventy of this act shall take effect January 1, 2016.
35 PART C
36 Section 1. Section 48-a of part A of chapter 56 of the laws of 2013
37 amending chapter 59 of the laws of 2011 amending the public health law
38 and other laws relating to general hospital reimbursement for annual
39 rates relating to the cap on local Medicaid expenditures, as amended by
40 section 13 of part C of chapter 60 of the laws of 2014, is amended to
41 read as follows:
42 S 48-a. 1. Notwithstanding any contrary provision of law, the commis-
43 sioners of the office of alcoholism and substance abuse services and the
44 office of mental health are authorized, subject to the approval of the
45 director of the budget, to transfer to the commissioner of health state
46 funds to be utilized as the state share for the purpose of increasing
47 payments under the medicaid program to managed care organizations
48 licensed under article 44 of the public health law or under article 43
49 of the insurance law. Such managed care organizations shall utilize such
50 funds for the purpose of reimbursing providers licensed pursuant to
51 article 28 of the public health law or article 31 or 32 of the mental
52 hygiene law for ambulatory behavioral health services, as determined by
53 the commissioner of health, in consultation with the commissioner of
54 alcoholism and substance abuse services and the commissioner of the
S. 4207 42
1 office of mental health, provided to medicaid eligible outpatients. Such
2 reimbursement shall be in the form of fees for such services which are
3 equivalent to the payments established for such services under the ambu-
4 latory patient group (APG) rate-setting methodology as utilized by the
5 department of health, the office of alcoholism and substance abuse
6 services, or the office of mental health for rate-setting purposes;
7 provided, however, that the increase to such fees that shall result from
8 the provisions of this section shall not, in the aggregate and as deter-
9 mined by the commissioner of health, in consultation with the commis-
10 sioner of alcoholism and substance abuse services and the commissioner
11 of the office of mental health, be greater than the increased funds made
12 available pursuant to this section. The increase of such ambulatory
13 behavioral health fees to providers available under this section shall
14 be for all rate periods on and after the effective date of [the] SECTION
15 13 OF PART C OF chapter 60 of the laws of 2014 [which amended this
16 section] through December 31, [2016] 2018 for patients in the city of
17 New York, for all rate periods on and after the effective date of [the]
18 SECTION 13 OF PART C OF chapter 60 of the laws of 2014 [which amended
19 this section] through [June 30, 2017] DECEMBER 31, 2018 for patients
20 outside the city of New York, and for all rate periods on and after the
21 effective date of such chapter [of the laws of 2014 which amended this
22 section] through December 31, [2017] 2018 for all services provided to
23 persons under the age of twenty-one; provided, however, that managed
24 care organizations and providers may negotiate different rates and meth-
25 ods of payment during such periods described above, subject to the
26 approval of the department of health. The department of health shall
27 consult with the office of alcoholism and substance abuse services and
28 the office of mental health in determining whether such alternative
29 rates shall be approved. The commissioner of health may, in consultation
30 with the commissioner of alcoholism and substance abuse services and the
31 commissioner of the office of mental health, promulgate regulations,
32 including emergency regulations promulgated prior to October 1, 2015 to
33 establish rates for ambulatory behavioral health services, as are neces-
34 sary to implement the provisions of this section. Rates promulgated
35 under this section shall be included in the report required under
36 section 45-c of part A of this chapter.
37 2. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, THE FEES PAID BY
38 MANAGED CARE ORGANIZATIONS LICENSED UNDER ARTICLE 44 OF THE PUBLIC
39 HEALTH LAW OR UNDER ARTICLE 43 OF THE INSURANCE LAW, TO PROVIDERS
40 LICENSED PURSUANT TO ARTICLE 28 OF THE PUBLIC HEALTH LAW OR ARTICLE 31
41 OR 32 OF THE MENTAL HYGIENE LAW, FOR AMBULATORY BEHAVIORAL HEALTH
42 SERVICES PROVIDED TO PATIENTS ENROLLED IN THE CHILD HEALTH INSURANCE
43 PROGRAM PURSUANT TO TITLE ONE-A OF ARTICLE 25 OF THE PUBLIC HEALTH LAW,
44 SHALL BE IN THE FORM OF FEES FOR SUCH SERVICES WHICH ARE EQUIVALENT TO
45 THE PAYMENTS ESTABLISHED FOR SUCH SERVICES UNDER THE AMBULATORY PATIENT
46 GROUP (APG) RATE-SETTING METHODOLOGY. THE COMMISSIONER OF HEALTH SHALL
47 CONSULT WITH THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
48 AND THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH IN DETERMINING SUCH
49 SERVICES AND ESTABLISHING SUCH FEES. SUCH AMBULATORY BEHAVIORAL HEALTH
50 FEES TO PROVIDERS AVAILABLE UNDER THIS SECTION SHALL BE FOR ALL RATE
51 PERIODS ON AND AFTER THE EFFECTIVE DATE OF THIS CHAPTER THROUGH DECEMBER
52 31, 2018 FOR PATIENTS IN THE CITY OF NEW YORK, AND FOR ALL RATE PERIODS
53 ON AND AFTER THE EFFECTIVE DATE OF THIS CHAPTER THROUGH DECEMBER 31,
54 2018 FOR PATIENTS OUTSIDE THE CITY OF NEW YORK, PROVIDED, HOWEVER, THAT
55 MANAGED CARE ORGANIZATIONS AND PROVIDERS MAY NEGOTIATE DIFFERENT RATES
56 AND METHODS OF PAYMENT DURING SUCH PERIODS DESCRIBED ABOVE, SUBJECT TO
S. 4207 43
1 THE APPROVAL OF THE DEPARTMENT OF HEALTH. THE DEPARTMENT OF HEALTH
2 SHALL CONSULT WITH THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
3 AND THE OFFICE OF MENTAL HEALTH IN DETERMINING WHETHER SUCH ALTERNATIVE
4 RATES SHALL BE APPROVED.
5 S 2. Section 1 of part H of chapter 111 of the laws of 2010 relating
6 to increasing Medicaid payments to providers through managed care organ-
7 izations and providing equivalent fees through an ambulatory patient
8 group methodology, as amended by section 15 of part C of chapter 60 of
9 the laws of 2014, is amended to read as follows:
10 Section 1. A. Notwithstanding any contrary provision of law, the
11 commissioners of mental health and alcoholism and substance abuse
12 services are authorized, subject to the approval of the director of the
13 budget, to transfer to the commissioner of health state funds to be
14 utilized as the state share for the purpose of increasing payments under
15 the medicaid program to managed care organizations licensed under arti-
16 cle 44 of the public health law or under article 43 of the insurance
17 law. Such managed care organizations shall utilize such funds for the
18 purpose of reimbursing providers licensed pursuant to article 28 of the
19 public health law, or pursuant to article 31 or article 32 of the mental
20 hygiene law for ambulatory behavioral health services, as determined by
21 the commissioner of health in consultation with the commissioner of
22 mental health and commissioner of alcoholism and substance abuse
23 services, provided to medicaid eligible outpatients. Such reimbursement
24 shall be in the form of fees for such services which are equivalent to
25 the payments established for such services under the ambulatory patient
26 group (APG) rate-setting methodology as utilized by the department of
27 health or by the office of mental health or office of alcoholism and
28 substance abuse services for rate-setting purposes; provided, however,
29 that the increase to such fees that shall result from the provisions of
30 this section shall not, in the aggregate and as determined by the
31 commissioner of health in consultation with the commissioners of mental
32 health and alcoholism and substance abuse services, be greater than the
33 increased funds made available pursuant to this section. The increase of
34 such behavioral health fees to providers available under this section
35 shall be for all rate periods on and after the effective date of [the]
36 SECTION 15 OF PART C OF chapter 60 of the laws of 2014 [which amended
37 this section] through December 31, [2016] 2018 for patients in the city
38 of New York, for all rate periods on and after the effective date of
39 [the] SECTION 15 OF PART C OF chapter 60 of the laws of 2014 [which
40 amended this section] through [June 30, 2017] DECEMBER 31, 2018 for
41 patients outside the city of New York, and for all rate periods on and
42 after the effective date of [the] SECTION 15 OF PART C OF chapter 60 of
43 the laws of 2014 [which amended this section] through December 31,
44 [2017] 2018 for all services provided to persons under the age of twen-
45 ty-one; provided, however, that managed care organizations and providers
46 may negotiate different rates and methods of payment during such periods
47 described, subject to the approval of the department of health. The
48 department of health shall consult with the office of alcoholism and
49 substance abuse services and the office of mental health in determining
50 whether such alternative rates shall be approved. The commissioner of
51 health may, in consultation with the commissioners of mental health and
52 alcoholism and substance abuse services, promulgate regulations, includ-
53 ing emergency regulations promulgated prior to October 1, 2013 that
54 establish rates for behavioral health services, as are necessary to
55 implement the provisions of this section. Rates promulgated under this
S. 4207 44
1 section shall be included in the report required under section 45-c of
2 part A of chapter 56 of the laws of 2013.
3 B. NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, THE FEES PAID BY
4 MANAGED CARE ORGANIZATIONS LICENSED UNDER ARTICLE 44 OF THE PUBLIC
5 HEALTH LAW OR UNDER ARTICLE 43 OF THE INSURANCE LAW, TO PROVIDERS
6 LICENSED PURSUANT TO ARTICLE 28 OF THE PUBLIC HEALTH LAW OR ARTICLE 31
7 OR 32 OF THE MENTAL HYGIENE LAW, FOR AMBULATORY BEHAVIORAL HEALTH
8 SERVICES PROVIDED TO PATIENTS ENROLLED IN THE CHILD HEALTH INSURANCE
9 PROGRAM PURSUANT TO TITLE ONE-A OF ARTICLE 25 OF THE PUBLIC HEALTH LAW,
10 SHALL BE IN THE FORM OF FEES FOR SUCH SERVICES WHICH ARE EQUIVALENT TO
11 THE PAYMENTS ESTABLISHED FOR SUCH SERVICES UNDER THE AMBULATORY PATIENT
12 GROUP (APG) RATE-SETTING METHODOLOGY. THE COMMISSIONER OF HEALTH SHALL
13 CONSULT WITH THE COMMISSIONER OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES
14 AND THE COMMISSIONER OF THE OFFICE OF MENTAL HEALTH IN DETERMINING SUCH
15 SERVICES AND ESTABLISHING SUCH FEES. SUCH AMBULATORY BEHAVIORAL HEALTH
16 FEES TO PROVIDERS AVAILABLE UNDER THIS SECTION SHALL BE FOR ALL RATE
17 PERIODS ON AND AFTER THE EFFECTIVE DATE OF THIS CHAPTER THROUGH DECEMBER
18 31, 2018 FOR PATIENTS IN THE CITY OF NEW YORK, AND FOR ALL RATE PERIODS
19 ON AND AFTER THE EFFECTIVE DATE OF THIS CHAPTER THROUGH DECEMBER 31,
20 2018 FOR PATIENTS OUTSIDE THE CITY OF NEW YORK, PROVIDED, HOWEVER, THAT
21 MANAGED CARE ORGANIZATIONS AND PROVIDERS MAY NEGOTIATE DIFFERENT RATES
22 AND METHODS OF PAYMENT DURING SUCH PERIODS DESCRIBED ABOVE, SUBJECT TO
23 THE APPROVAL OF THE DEPARTMENT OF HEALTH. THE DEPARTMENT OF HEALTH SHALL
24 CONSULT WITH THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES AND
25 THE OFFICE OF MENTAL HEALTH IN DETERMINING WHETHER SUCH ALTERNATIVE
26 RATES SHALL BE APPROVED.
27 S 3. Notwithstanding any inconsistent provision of law, rule or regu-
28 lation, for purposes of implementing the provisions of the public health
29 law and the social services law, references to titles XIX and XXI of the
30 federal social security act in the public health law and the social
31 services law shall be deemed to include and also to mean any successor
32 titles thereto under the federal social security act.
33 S 4. Notwithstanding any inconsistent provision of law, rule or regu-
34 lation, the effectiveness of the provisions of sections 2807 and 3614 of
35 the public health law, section 18 of chapter 2 of the laws of 1988, and
36 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
37 or certification of rates of payment, are hereby suspended and without
38 force or effect for purposes of implementing the provisions of this act.
39 S 5. Severability clause. If any clause, sentence, paragraph, subdivi-
40 sion, section or part of this act shall be adjudged by any court of
41 competent jurisdiction to be invalid, such judgment shall not affect,
42 impair or invalidate the remainder thereof, but shall be confined in its
43 operation to the clause, sentence, paragraph, subdivision, section or
44 part thereof directly involved in the controversy in which such judgment
45 shall have been rendered. It is hereby declared to be the intent of the
46 legislature that this act would have been enacted even if such invalid
47 provisions had not been included herein.
48 S 6. This act shall take effect immediately and shall be deemed to
49 have been in full force and effect on and after April 1, 2015. Provided,
50 however that:
51 1. any rules or regulations necessary to implement the provisions of
52 this act may be promulgated and any procedures, forms, or instructions
53 necessary for such implementation may be adopted and issued on or after
54 the date this act shall have become a law;
S. 4207 45
1 2. this act shall not be construed to alter, change, affect, impair or
2 defeat any rights, obligations, duties or interests accrued, incurred or
3 conferred prior to the effective date of this act;
4 3. the commissioner of health and the superintendent of the department
5 of financial services and any appropriate council may take any steps
6 necessary to implement this act prior to its effective date;
7 4. notwithstanding any inconsistent provision of the state administra-
8 tive procedure act or any other provision of law, rule or regulation,
9 the commissioner of health and the superintendent of the department of
10 financial services and any appropriate council is authorized to adopt or
11 amend or promulgate on an emergency basis any regulation he or she or
12 such council determines necessary to implement any provision of this act
13 on its effective date;
14 5. the provisions of this act shall become effective notwithstanding
15 the failure of the commissioner of health or the superintendent of the
16 department of financial services or any council to adopt or amend or
17 promulgate regulations implementing this act; and
18 6. the amendments to section 48-a of part A of chapter 56 of the laws
19 of 2013 made by section one of this act shall not affect the repeal of
20 such section and shall be deemed repealed therewith and the amendments
21 to section 1 of part H of chapter 111 of the laws of 2010 made by
22 section two of this act shall not affect the expiration of such section
23 and shall be deemed to expire therewith.
24 PART D
25 Section 1. Section 11 of chapter 884 of the laws of 1990, amending the
26 public health law relating to authorizing bad debt and charity care
27 allowances for certified home health agencies, as amended by section 3
28 of part B of chapter 56 of the laws of 2013, is amended to read as
29 follows:
30 S 11. This act shall take effect immediately and:
31 (a) sections one and three shall expire on December 31, 1996,
32 (b) sections four through ten shall expire on June 30, [2015] 2017,
33 and
34 (c) provided that the amendment to section 2807-b of the public health
35 law by section two of this act shall not affect the expiration of such
36 section 2807-b as otherwise provided by law and shall be deemed to
37 expire therewith.
38 S 2. Subdivision 2 of section 246 of chapter 81 of the laws of 1995,
39 amending the public health law and other laws relating to medical
40 reimbursement and welfare reform, as amended by section 4 of part B of
41 chapter 56 of the laws of 2013, is amended to read as follows:
42 2. Sections five, seven through nine, twelve through fourteen, and
43 eighteen of this act shall be deemed to have been in full force and
44 effect on and after April 1, 1995 through March 31, 1999 and on and
45 after July 1, 1999 through March 31, 2000 and on and after April 1, 2000
46 through March 31, 2003 and on and after April 1, 2003 through March 31,
47 2006 and on and after April 1, 2006 through March 31, 2007 and on and
48 after April 1, 2007 through March 31, 2009 and on and after April 1,
49 2009 through March 31, 2011 and sections twelve, thirteen and fourteen
50 of this act shall be deemed to be in full force and effect on and after
51 April 1, 2011 through March 31, 2015 AND ON AND AFTER APRIL 1, 2015
52 THROUGH MARCH 31, 2017;
S. 4207 46
1 S 3. Subparagraph (vi) of paragraph (b) of subdivision 2 of section
2 2807-d of the public health law, as amended by section 5 of part B of
3 chapter 56 of the laws of 2013, 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.
30 S 4. Section 88 of chapter 659 of the laws of 1997, constituting the
31 long term care integration and finance act of 1997, as amended by
32 section 6 of part B of chapter 56 of the laws of 2013, is amended to
33 read as follows:
34 S 88. Notwithstanding any provision of law to the contrary, all oper-
35 ating demonstrations, as such term is defined in paragraph (c) of subdi-
36 vision 1 of section 4403-f of the public health law as added by section
37 eighty-two of this act, due to expire prior to January 1, 2001 shall be
38 deemed to [expire on December 31, 2015] REMAIN IN FULL FORCE AND EFFECT
39 SUBSEQUENT TO SUCH DATE.
40 S 5. Subdivision 1 of section 194 of chapter 474 of the laws of 1996,
41 amending the education law and other laws relating to rates for residen-
42 tial health care facilities, as amended by section 9 of part B of chap-
43 ter 56 of the laws of 2013, is amended to read as follows:
44 1. Notwithstanding any inconsistent provision of law or regulation,
45 the trend factors used to project reimbursable operating costs to the
46 rate period for purposes of determining rates of payment pursuant to
47 article 28 of the public health law for residential health care facili-
48 ties for reimbursement of inpatient services provided to patients eligi-
49 ble for payments made by state governmental agencies on and after April
50 1, 1996 through March 31, 1999 and for payments made on and after July
51 1, 1999 through March 31, 2000 and on and after April 1, 2000 through
52 March 31, 2003 and on and after April 1, 2003 through March 31, 2007 and
53 on and after April 1, 2007 through March 31, 2009 and on and after April
54 1, 2009 through March 31, 2011 and on and after April 1, 2011 through
55 March 31, 2013 and on and after April 1, 2013 through March 31, 2015,
56 AND ON AND AFTER APRIL 1, 2015 THROUGH MARCH 31, 2017 shall reflect no
S. 4207 47
1 trend factor projections or adjustments for the period April 1, 1996,
2 through March 31, 1997.
3 S 6. Subdivision 1 of section 89-a of part C of chapter 58 of the laws
4 of 2007, amending the social services law and other laws relating to
5 enacting the major components of legislation necessary to implement the
6 health and mental hygiene budget for the 2007-2008 state fiscal year, as
7 amended by section 10 of part B of chapter 56 of the laws of 2013, is
8 amended to read as follows:
9 1. Notwithstanding paragraph (c) of subdivision 10 of section 2807-c
10 of the public health law and section 21 of chapter 1 of the laws of
11 1999, as amended, and any other inconsistent provision of law or regu-
12 lation to the contrary, in determining rates of payments by state
13 governmental agencies effective for services provided beginning April 1,
14 2006, through March 31, 2009, and on and after April 1, 2009 through
15 March 31, 2011, and on and after April 1, 2011 through March 31, 2013,
16 and on and after April 1, 2013 through March 31, 2015, AND ON AND AFTER
17 APRIL 1, 2015 THROUGH MARCH 31, 2017 for inpatient and outpatient
18 services provided by general hospitals and for inpatient services and
19 outpatient adult day health care services provided by residential health
20 care facilities pursuant to article 28 of the public health law, the
21 commissioner of health shall apply a trend factor projection of two and
22 twenty-five hundredths percent attributable to the period January 1,
23 2006 through December 31, 2006, and on and after January 1, 2007,
24 provided, however, that on reconciliation of such trend factor for the
25 period January 1, 2006 through December 31, 2006 pursuant to paragraph
26 (c) of subdivision 10 of section 2807-c of the public health law, such
27 trend factor shall be the final US Consumer Price Index (CPI) for all
28 urban consumers, as published by the US Department of Labor, Bureau of
29 Labor Statistics less twenty-five hundredths of a percentage point.
30 S 7. Paragraph (f) of subdivision 1 of section 64 of chapter 81 of the
31 laws of 1995, amending the public health law and other laws relating to
32 medical reimbursement and welfare reform, as amended by section 11 of
33 part B of chapter 56 of the laws of 2013, is amended to read as follows:
34 (f) Prior to February 1, 2001, February 1, 2002, February 1, 2003,
35 February 1, 2004, February 1, 2005, February 1, 2006, February 1, 2007,
36 February 1, 2008, February 1, 2009, February 1, 2010, February 1, 2011,
37 February 1, 2012, February 1, 2013 [and], February 1, 2014 [and], Febru-
38 ary 1, 2015, FEBRUARY 1, 2016 AND FEBRUARY 1, 2017 the commissioner of
39 health shall calculate the result of the statewide total of residential
40 health care facility days of care provided to beneficiaries of title
41 XVIII of the federal social security act (medicare), divided by the sum
42 of such days of care plus days of care provided to residents eligible
43 for payments pursuant to title 11 of article 5 of the social services
44 law minus the number of days provided to residents receiving hospice
45 care, expressed as a percentage, for the period commencing January 1,
46 through November 30, of the prior year respectively, based on such data
47 for such period. This value shall be called the 2000, 2001, 2002, 2003,
48 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and],
49 2015, 2016 AND 2017 statewide target percentage respectively.
50 S 8. Subparagraph (ii) of paragraph (b) of subdivision 3 of section 64
51 of chapter 81 of the laws of 1995, amending the public health law and
52 other laws relating to medical reimbursement and welfare reform, as
53 amended by section 12 of part B of chapter 56 of the laws of 2013, is
54 amended to read as follows:
55 (ii) If the 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
56 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND
S. 4207 48
1 2017 statewide target percentages are not for each year at least three
2 percentage points higher than the statewide base percentage, the commis-
3 sioner of health shall determine the percentage by which the statewide
4 target percentage for each year is not at least three percentage points
5 higher than the statewide base percentage. The percentage calculated
6 pursuant to this paragraph shall be called the 1997, 1998, 2000, 2001,
7 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013,
8 2014 [and], 2015, 2016 AND 2017 statewide reduction percentage respec-
9 tively. If the 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
10 2007, 2008, 2009, 2010, 2011, 2012, 2013[;], 2014 [and], 2015, 2016 AND
11 2017 statewide target percentage for the respective year is at least
12 three percentage points higher than the statewide base percentage, the
13 statewide reduction percentage for the respective year shall be zero.
14 S 9. Subparagraph (iii) of paragraph (b) of subdivision 4 of section
15 64 of chapter 81 of the laws of 1995, amending the public health law and
16 other laws relating to medical reimbursement and welfare reform, as
17 amended by section 13 of part B of chapter 56 of the laws of 2013, is
18 amended to read as follows:
19 (iii) The 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008,
20 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 statewide
21 reduction percentage shall be multiplied by one hundred two million
22 dollars respectively to determine the 1998, 2000, 2001, 2002, 2003,
23 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and],
24 2015, 2016 AND 2017 statewide aggregate reduction amount. If the 1998
25 and the 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009,
26 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 statewide
27 reduction percentage shall be zero respectively, there shall be no 1998,
28 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011,
29 2012, 2013, 2014 [and], 2015, 2016 AND 2017 reduction amount.
30 S 10. Section 228 of chapter 474 of the laws of 1996, amending the
31 education law and other laws relating to rates for residential health
32 care facilities, as amended by section 14-a of part B of chapter 56 of
33 the laws of 2013, is amended to read as follows:
34 S 228. 1. Definitions. (a) Regions, for purposes of this section,
35 shall mean a downstate region to consist of Kings, New York, Richmond,
36 Queens, Bronx, Nassau and Suffolk counties and an upstate region to
37 consist of all other New York state counties. A certified home health
38 agency or long term home health care program shall be located in the
39 same county utilized by the commissioner of health for the establishment
40 of rates pursuant to article 36 of the public health law.
41 (b) Certified home health agency (CHHA) shall mean such term as
42 defined in section 3602 of the public health law.
43 (c) Long term home health care program (LTHHCP) shall mean such term
44 as defined in subdivision 8 of section 3602 of the public health law.
45 (d) Regional group shall mean all those CHHAs and LTHHCPs, respective-
46 ly, located within a region.
47 (e) Medicaid revenue percentage, for purposes of this section, shall
48 mean CHHA and LTHHCP revenues attributable to services provided to
49 persons eligible for payments pursuant to title 11 of article 5 of the
50 social services law divided by such revenues plus CHHA and LTHHCP reven-
51 ues attributable to services provided to beneficiaries of Title XVIII of
52 the federal social security act (medicare).
53 (f) Base period, for purposes of this section, shall mean calendar
54 year 1995.
55 (g) Target period. For purposes of this section, the 1996 target peri-
56 od shall mean August 1, 1996 through March 31, 1997, the 1997 target
S. 4207 49
1 period shall mean January 1, 1997 through November 30, 1997, the 1998
2 target period shall mean January 1, 1998 through November 30, 1998, the
3 1999 target period shall mean January 1, 1999 through November 30, 1999,
4 the 2000 target period shall mean January 1, 2000 through November 30,
5 2000, the 2001 target period shall mean January 1, 2001 through November
6 30, 2001, the 2002 target period shall mean January 1, 2002 through
7 November 30, 2002, the 2003 target period shall mean January 1, 2003
8 through November 30, 2003, the 2004 target period shall mean January 1,
9 2004 through November 30, 2004, and the 2005 target period shall mean
10 January 1, 2005 through November 30, 2005, the 2006 target period shall
11 mean January 1, 2006 through November 30, 2006, and the 2007 target
12 period shall mean January 1, 2007 through November 30, 2007 and the 2008
13 target period shall mean January 1, 2008 through November 30, 2008, and
14 the 2009 target period shall mean January 1, 2009 through November 30,
15 2009 and the 2010 target period shall mean January 1, 2010 through
16 November 30, 2010 and the 2011 target period shall mean January 1, 2011
17 through November 30, 2011 and the 2012 target period shall mean January
18 1, 2012 through November 30, 2012 and the 2013 target period shall mean
19 January 1, 2013 through November 30, 2013, and the 2014 target period
20 shall mean January 1, 2014 through November 30, 2014 and the 2015 target
21 period shall mean January 1, 2015 through November 30, 2015 AND THE 2016
22 TARGET PERIOD SHALL MEAN JANUARY 1, 2016 THROUGH NOVEMBER 30, 2016 AND
23 THE 2017 TARGET PERIOD SHALL MEAN JANUARY 1, 2017 THROUGH NOVEMBER 30,
24 2017.
25 2. (a) Prior to February 1, 1997, for each regional group the commis-
26 sioner of health shall calculate the 1996 medicaid revenue percentages
27 for the period commencing August 1, 1996 to the last date for which such
28 data is available and reasonably accurate.
29 (b) Prior to February 1, 1998, prior to February 1, 1999, prior to
30 February 1, 2000, prior to February 1, 2001, prior to February 1, 2002,
31 prior to February 1, 2003, prior to February 1, 2004, prior to February
32 1, 2005, prior to February 1, 2006, prior to February 1, 2007, prior to
33 February 1, 2008, prior to February 1, 2009, prior to February 1, 2010,
34 prior to February 1, 2011, prior to February 1, 2012, prior to February
35 1, 2013, prior to February 1, 2014 [and], prior to February 1, 2015, AND
36 PRIOR TO FEBRUARY 1, 2016 AND PRIOR TO FEBRUARY 1, 2017 for each
37 regional group the commissioner of health shall calculate the prior
38 year's medicaid revenue percentages for the period commencing January 1
39 through November 30 of such prior year.
40 3. By September 15, 1996, for each regional group the commissioner of
41 health shall calculate the base period medicaid revenue percentage.
42 4. (a) For each regional group, the 1996 target medicaid revenue
43 percentage shall be calculated by subtracting the 1996 medicaid revenue
44 reduction percentages from the base period medicaid revenue percentages.
45 The 1996 medicaid revenue reduction percentage, taking into account
46 regional and program differences in utilization of medicaid and medicare
47 services, for the following regional groups shall be equal to:
48 (i) one and one-tenth percentage points for CHHAs located within the
49 downstate region;
50 (ii) six-tenths of one percentage point for CHHAs located within the
51 upstate region;
52 (iii) one and eight-tenths percentage points for LTHHCPs located with-
53 in the downstate region; and
54 (iv) one and seven-tenths percentage points for LTHHCPs located within
55 the upstate region.
S. 4207 50
1 (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,
2 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 for
3 each regional group, the target medicaid revenue percentage for the
4 respective year shall be calculated by subtracting the respective year's
5 medicaid revenue reduction percentage from the base period medicaid
6 revenue percentage. The medicaid revenue reduction percentages for 1997,
7 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010,
8 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017, taking into account
9 regional and program differences in utilization of medicaid and medicare
10 services, for the following regional groups shall be equal to for each
11 such year:
12 (i) one and one-tenth percentage points for CHHAs located within the
13 downstate region;
14 (ii) six-tenths of one percentage point for CHHAs located within the
15 upstate region;
16 (iii) one and eight-tenths percentage points for LTHHCPs located with-
17 in the downstate region; and
18 (iv) one and seven-tenths percentage points for LTHHCPs located within
19 the upstate region.
20 (c) For each regional group, the 1999 target medicaid revenue percent-
21 age shall be calculated by subtracting the 1999 medicaid revenue
22 reduction percentage from the base period medicaid revenue percentage.
23 The 1999 medicaid revenue reduction percentages, taking into account
24 regional and program differences in utilization of medicaid and medicare
25 services, for the following regional groups shall be equal to:
26 (i) eight hundred twenty-five thousandths (.825) of one percentage
27 point for CHHAs located within the downstate region;
28 (ii) forty-five hundredths (.45) of one percentage point for CHHAs
29 located within the upstate region;
30 (iii) one and thirty-five hundredths percentage points (1.35) for
31 LTHHCPs located within the downstate region; and
32 (iv) one and two hundred seventy-five thousandths percentage points
33 (1.275) for LTHHCPs located within the upstate region.
34 5. (a) For each regional group, if the 1996 medicaid revenue percent-
35 age is not equal to or less than the 1996 target medicaid revenue
36 percentage, the commissioner of health shall compare the 1996 medicaid
37 revenue percentage to the 1996 target medicaid revenue percentage to
38 determine the amount of the shortfall which, when divided by the 1996
39 medicaid revenue reduction percentage, shall be called the 1996
40 reduction factor. These amounts, expressed as a percentage, shall not
41 exceed one hundred percent. If the 1996 medicaid revenue percentage is
42 equal to or less than the 1996 target medicaid revenue percentage, the
43 1996 reduction factor shall be zero.
44 (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
45 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016, AND
46 2017, for each regional group, if the medicaid revenue percentage for
47 the respective year is not equal to or less than the target medicaid
48 revenue percentage for such respective year, the commissioner of health
49 shall compare such respective year's medicaid revenue percentage to such
50 respective year's target medicaid revenue percentage to determine the
51 amount of the shortfall which, when divided by the respective year's
52 medicaid revenue reduction percentage, shall be called the reduction
53 factor for such respective year. These amounts, expressed as a percent-
54 age, shall not exceed one hundred percent. If the medicaid revenue
55 percentage for a particular year is equal to or less than the target
S. 4207 51
1 medicaid revenue percentage for that year, the reduction factor for that
2 year shall be zero.
3 6. (a) For each regional group, the 1996 reduction factor shall be
4 multiplied by the following amounts to determine each regional group's
5 applicable 1996 state share reduction amount:
6 (i) two million three hundred ninety thousand dollars ($2,390,000) for
7 CHHAs located within the downstate region;
8 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
9 within the upstate region;
10 (iii) one million two hundred seventy thousand dollars ($1,270,000)
11 for LTHHCPs located within the downstate region; and
12 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
13 located within the upstate region.
14 For each regional group reduction, if the 1996 reduction factor shall
15 be zero, there shall be no 1996 state share reduction amount.
16 (b) For 1997, 1998, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007,
17 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017, for
18 each regional group, the reduction factor for the respective year shall
19 be multiplied by the following amounts to determine each regional
20 group's applicable state share reduction amount for such respective
21 year:
22 (i) two million three hundred ninety thousand dollars ($2,390,000) for
23 CHHAs located within the downstate region;
24 (ii) seven hundred fifty thousand dollars ($750,000) for CHHAs located
25 within the upstate region;
26 (iii) one million two hundred seventy thousand dollars ($1,270,000)
27 for LTHHCPs located within the downstate region; and
28 (iv) five hundred ninety thousand dollars ($590,000) for LTHHCPs
29 located within the upstate region.
30 For each regional group reduction, if the reduction factor for a
31 particular year shall be zero, there shall be no state share reduction
32 amount for such year.
33 (c) For each regional group, the 1999 reduction factor shall be multi-
34 plied by the following amounts to determine each regional group's appli-
35 cable 1999 state share reduction amount:
36 (i) one million seven hundred ninety-two thousand five hundred dollars
37 ($1,792,500) for CHHAs located within the downstate region;
38 (ii) five hundred sixty-two thousand five hundred dollars ($562,500)
39 for CHHAs located within the upstate region;
40 (iii) nine hundred fifty-two thousand five hundred dollars ($952,500)
41 for LTHHCPs located within the downstate region; and
42 (iv) four hundred forty-two thousand five hundred dollars ($442,500)
43 for LTHHCPs located within the upstate region.
44 For each regional group reduction, if the 1999 reduction factor shall
45 be zero, there shall be no 1999 state share reduction amount.
46 7. (a) For each regional group, the 1996 state share reduction amount
47 shall be allocated by the commissioner of health among CHHAs and LTHHCPs
48 on the basis of the extent of each CHHA's and LTHHCP's failure to
49 achieve the 1996 target medicaid revenue percentage, calculated on a
50 provider specific basis utilizing revenues for this purpose, expressed
51 as a proportion of the total of each CHHA's and LTHHCP's failure to
52 achieve the 1996 target medicaid revenue percentage within the applica-
53 ble regional group. This proportion shall be multiplied by the applica-
54 ble 1996 state share reduction amount calculation pursuant to paragraph
55 (a) of subdivision 6 of this section. This amount shall be called the
56 1996 provider specific state share reduction amount.
S. 4207 52
1 (b) For 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006,
2 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014 [and], 2015, 2016 AND
3 2017 for each regional group, the state share reduction amount for the
4 respective year shall be allocated by the commissioner of health among
5 CHHAs and LTHHCPs on the basis of the extent of each CHHA's and LTHHCP's
6 failure to achieve the target medicaid revenue percentage for the appli-
7 cable year, calculated on a provider specific basis utilizing revenues
8 for this purpose, expressed as a proportion of the total of each CHHA's
9 and LTHHCP's failure to achieve the target medicaid revenue percentage
10 for the applicable year within the applicable regional group. This
11 proportion shall be multiplied by the applicable year's state share
12 reduction amount calculation pursuant to paragraph (b) or (c) of subdi-
13 vision 6 of this section. This amount shall be called the provider
14 specific state share reduction amount for the applicable year.
15 8. (a) The 1996 provider specific state share reduction amount shall
16 be due to the state from each CHHA and LTHHCP and may be recouped by the
17 state by March 31, 1997 in a lump sum amount or amounts from payments
18 due to the CHHA and LTHHCP pursuant to title 11 of article 5 of the
19 social services law.
20 (b) The provider specific state share reduction amount for 1997, 1998,
21 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010,
22 2011, 2012, 2013, 2014 [and], 2015, 2016 AND 2017 respectively, shall be
23 due to the state from each CHHA and LTHHCP and each year the amount due
24 for such year may be recouped by the state by March 31 of the following
25 year in a lump sum amount or amounts from payments due to the CHHA and
26 LTHHCP pursuant to title 11 of article 5 of the social services law.
27 9. CHHAs and LTHHCPs shall submit such data and information at such
28 times as the commissioner of health may require for purposes of this
29 section. The commissioner of health may use data available from third-
30 party payors.
31 10. On or about June 1, 1997, for each regional group the commissioner
32 of health shall calculate for the period August 1, 1996 through March
33 31, 1997 a medicaid revenue percentage, a reduction factor, a state
34 share reduction amount, and a provider specific state share reduction
35 amount in accordance with the methodology provided in paragraph (a) of
36 subdivision 2, paragraph (a) of subdivision 5, paragraph (a) of subdivi-
37 sion 6 and paragraph (a) of subdivision 7 of this section. The provider
38 specific state share reduction amount calculated in accordance with this
39 subdivision shall be compared to the 1996 provider specific state share
40 reduction amount calculated in accordance with paragraph (a) of subdivi-
41 sion 7 of this section. Any amount in excess of the amount determined in
42 accordance with paragraph (a) of subdivision 7 of this section shall be
43 due to the state from each CHHA and LTHHCP and may be recouped in
44 accordance with paragraph (a) of subdivision 8 of this section. If the
45 amount is less than the amount determined in accordance with paragraph
46 (a) of subdivision 7 of this section, the difference shall be refunded
47 to the CHHA and LTHHCP by the state no later than July 15, 1997. CHHAs
48 and LTHHCPs shall submit data for the period August 1, 1996 through
49 March 31, 1997 to the commissioner of health by April 15, 1997.
50 11. If a CHHA or LTHHCP fails to submit data and information as
51 required for purposes of this section:
52 (a) such CHHA or LTHHCP shall be presumed to have no decrease in medi-
53 caid revenue percentage between the applicable base period and the
54 applicable target period for purposes of the calculations pursuant to
55 this section; and
S. 4207 53
1 (b) the commissioner of health shall reduce the current rate paid to
2 such CHHA and such LTHHCP by state governmental agencies pursuant to
3 article 36 of the public health law by one percent for a period begin-
4 ning on the first day of the calendar month following the applicable due
5 date as established by the commissioner of health and continuing until
6 the last day of the calendar month in which the required data and infor-
7 mation are submitted.
8 12. The commissioner of health shall inform in writing the director of
9 the budget and the chair of the senate finance committee and the chair
10 of the assembly ways and means committee of the results of the calcu-
11 lations pursuant to this section.
12 S 11. Subdivision 5-a of section 246 of chapter 81 of the laws of
13 1995, amending the public health law and other laws relating to medical
14 reimbursement and welfare reform, as amended by section 15 of part B of
15 chapter 56 of the laws of 2013, is amended to read as follows:
16 5-a. Section sixty-four-a of this act shall be deemed to have been in
17 full force and effect on and after April 1, 1995 through March 31, 1999
18 and on and after July 1, 1999 through March 31, 2000 and on and after
19 April 1, 2000 through March 31, 2003 and on and after April 1, 2003
20 through March 31, 2007, and on and after April 1, 2007 through March 31,
21 2009, and on and after April 1, 2009 through March 31, 2011, and on and
22 after April 1, 2011 through March 31, 2013, and on and after April 1,
23 2013 through March 31, 2015, AND ON AND AFTER APRIL 1, 2015 THROUGH
24 MARCH 31, 2017;
25 S 12. Section 64-b of chapter 81 of the laws of 1995, amending the
26 public health law and other laws relating to medical reimbursement and
27 welfare reform, as amended by section 16 of part B of chapter 56 of the
28 laws of 2013, is amended to read as follows:
29 S 64-b. Notwithstanding any inconsistent provision of law, the
30 provisions of subdivision 7 of section 3614 of the public health law, as
31 amended, shall remain and be in full force and effect on April 1, 1995
32 through March 31, 1999 and on July 1, 1999 through March 31, 2000 and on
33 and after April 1, 2000 through March 31, 2003 and on and after April 1,
34 2003 through March 31, 2007, and on and after April 1, 2007 through
35 March 31, 2009, and on and after April 1, 2009 through March 31, 2011,
36 and on and after April 1, 2011 through March 31, 2013, and on and after
37 April 1, 2013 through March 31, 2015, AND ON AND AFTER APRIL 1, 2015
38 THROUGH MARCH 31, 2017.
39 S 13. Subdivision 1 of section 20 of chapter 451 of the laws of 2007,
40 amending the public health law, the social services law and the insur-
41 ance law, relating to providing enhanced consumer and provider
42 protections, as amended by section 17 of part B of chapter 56 of the
43 laws of 2013, is amended to read as follows:
44 1. sections four, eleven and thirteen of this act shall take effect
45 immediately and shall expire and be deemed repealed June 30, [2015]
46 2017;
47 S 14. The opening paragraph of subdivision 7-a of section 3614 of the
48 public health law, as amended by section 18 of part B of chapter 56 of
49 the laws of 2013, is amended to read as follows:
50 Notwithstanding any inconsistent provision of law or regulation, for
51 the purposes of establishing rates of payment by governmental agencies
52 for long term home health care programs for the period April first, two
53 thousand five, through December thirty-first, two thousand five, and for
54 the period January first, two thousand six through March thirty-first,
55 two thousand seven, and on and after April first, two thousand seven
56 through March thirty-first, two thousand nine, and on and after April
S. 4207 54
1 first, two thousand nine through March thirty-first, two thousand elev-
2 en, and on and after April first, two thousand eleven through March
3 thirty-first, two thousand thirteen and on and after April first, two
4 thousand thirteen through March thirty-first, two thousand fifteen, AND
5 ON AND AFTER APRIL 1ST, TWO THOUSAND FIFTEEN THROUGH MARCH THIRTY-FIRST,
6 TWO THOUSAND SEVENTEEN the reimbursable base year administrative and
7 general costs of a provider of services shall not exceed the statewide
8 average of total reimbursable base year administrative and general costs
9 of such providers of services.
10 S 15. Subdivision 12 of section 246 of chapter 81 of the laws of 1995,
11 amending the public health law and other laws relating to medical
12 reimbursement and welfare reform, as amended by section 21 of part B of
13 chapter 56 of the laws of 2013, is amended to read as follows:
14 12. Sections one hundred five-b through one hundred five-f of this act
15 shall expire March 31, [2015] 2017.
16 S 16. Section 3 of chapter 303 of the laws of 1999, amending the New
17 York state medical care facilities finance agency act relating to
18 financing health facilities, as amended by section 30 of part A of chap-
19 ter 59 of the laws of 2011, is amended to read as follows:
20 S 3. This act shall take effect immediately, provided, however, that
21 subdivision 15-a of section 5 of section 1 of chapter 392 of the laws of
22 1973, as added by section one of this act, shall expire and be deemed
23 repealed June 30, [2015] 2019; and provided further, however, that the
24 expiration and repeal of such subdivision 15-a shall not affect or
25 impair in any manner any health facilities bonds issued, or any lease or
26 purchase of a health facility executed, pursuant to such subdivision
27 15-a prior to its expiration and repeal and that, with respect to any
28 such bonds issued and outstanding as of June 30, [2015] 2019, the
29 provisions of such subdivision 15-a as they existed immediately prior to
30 such expiration and repeal shall continue to apply through the latest
31 maturity date of any such bonds, or their earlier retirement or redemp-
32 tion, for the sole purpose of authorizing the issuance of refunding
33 bonds to refund bonds previously issued pursuant thereto.
34 S 17. Subdivision (c) of section 62 of chapter 165 of the laws of
35 1991, amending the public health law and other laws relating to estab-
36 lishing payments for medical assistance, as amended by section 26 of
37 part D of chapter 59 of the laws of 2011, is amended to read as follows:
38 (c) section 364-j of the social services law, as amended by section
39 eight of this act and subdivision 6 of section 367-a of the social
40 services law as added by section twelve of this act shall expire and be
41 deemed repealed on March 31, [2015] 2019 and provided further, that the
42 amendments to the provisions of section 364-j of the social services law
43 made by section eight of this act shall only apply to managed care
44 programs approved on or after the effective date of this act;
45 S 18. Subdivision 3 of section 1680-j of the public authorities law,
46 as amended by section 9 of part C of chapter 59 of the laws of 2011, is
47 amended to read as follows:
48 3. Notwithstanding any law to the contrary, and in accordance with
49 section four of the state finance law, the comptroller is hereby author-
50 ized and directed to transfer from the health care reform act (HCRA)
51 resources fund (061) to the general fund, upon the request of the direc-
52 tor of the budget, up to $6,500,000 on or before March 31, 2006, and the
53 comptroller is further hereby authorized and directed to transfer from
54 the healthcare reform act (HCRA); Resources fund (061) to the Capital
55 Projects Fund, upon the request of the director of budget, up to
56 $139,000,000 for the period April 1, 2006 through March 31, 2007, up to
S. 4207 55
1 $171,100,000 for the period April 1, 2007 through March 31, 2008, up to
2 $208,100,000 for the period April 1, 2008 through March 31, 2009, up to
3 $151,600,000 for the period April 1, 2009 through March 31, 2010, up to
4 $215,743,000 for the period April 1, 2010 through March 31, 2011, up to
5 $433,366,000 for the period April 1, 2011 through March 31, 2012, up to
6 $150,806,000 for the period April 1, 2012 through March 31, 2013, up to
7 $78,071,000 for the period April 1, 2013 through March 31, 2014, and up
8 to $86,005,000 for the period April 1, 2014 through March 31, 2015, AND
9 UP TO $86,005,000 FOR THE PERIOD APRIL 1, 2015 THROUGH DECEMBER 31,
10 2017.
11 S 19. Subdivision (i) of section 111 of part H of chapter 59 of the
12 laws of 2011, relating to enacting into law major components of legis-
13 lation necessary to implement the health and mental hygiene budget for
14 the 2011-2012 state fiscal plan, is amended to read as follows:
15 (i) the amendments to paragraph (b) and subparagraph (i) of paragraph
16 (g) of subdivision 7 of section 4403-f of the public health law made by
17 section forty-one-b of this act shall expire and be repealed April 1,
18 [2015] 2019;
19 S 20. Section 97 of chapter 659 of the laws of 1997, amending the
20 public health law and other laws relating to creation of continuing care
21 retirement communities, as amended by section 65-b of part A of chapter
22 57 of the laws of 2006, is amended to read as follows:
23 S 97. This act shall take effect immediately, provided, however, that
24 the amendments to subdivision 4 of section 854 of the general municipal
25 law made by section seventy of this act shall not affect the expiration
26 of such subdivision and shall be deemed to expire therewith and provided
27 further that sections sixty-seven and sixty-eight of this act shall
28 apply to taxable years beginning on or after January 1, 1998 and
29 provided further that sections eighty-one through eighty-seven of this
30 act shall expire and be deemed repealed on December 31, [2015] 2019 and
31 provided further, however, that the amendments to section ninety of this
32 act shall take effect January 1, 1998 and shall apply to all policies,
33 contracts, certificates, riders or other evidences of coverage of long
34 term care insurance issued, renewed, altered or modified pursuant to
35 section 3229 of the insurance law on or after such date.
36 S 21. Paragraph (b) of subdivision 17 of section 2808 of the public
37 health law, as amended by section 98 of part H of chapter 59 of the laws
38 of 2011, is amended to read as follows:
39 (b) Notwithstanding any inconsistent provision of law or regulation to
40 the contrary, for the state fiscal [year] YEARS beginning April first,
41 two thousand ten and ending March thirty-first, two thousand [fifteen]
42 NINETEEN, the commissioner shall not be required to revise certified
43 rates of payment established pursuant to this article for rate periods
44 prior to April first, two thousand [fifteen] NINETEEN, based on consid-
45 eration of rate appeals filed by residential health care facilities or
46 based upon adjustments to capital cost reimbursement as a result of
47 approval by the commissioner of an application for construction under
48 section twenty-eight hundred two of this article, in excess of an aggre-
49 gate annual amount of eighty million dollars for each such state fiscal
50 year provided, however, that for the period April first, two thousand
51 eleven through March thirty-first, two thousand twelve such aggregate
52 annual amount shall be fifty million dollars. In revising such rates
53 within such fiscal limit, the commissioner shall, in prioritizing such
54 rate appeals, include consideration of which facilities the commissioner
55 determines are facing significant financial hardship as well as such
56 other considerations as the commissioner deems appropriate and, further,
S. 4207 56
1 the commissioner is authorized to enter into agreements with such facil-
2 ities or any other facility to resolve multiple pending rate appeals
3 based upon a negotiated aggregate amount and may offset such negotiated
4 aggregate amounts against any amounts owed by the facility to the
5 department, including, but not limited to, amounts owed pursuant to
6 section twenty-eight hundred seven-d of this article; provided, however,
7 that the commissioner's authority to negotiate such agreements resolving
8 multiple pending rate appeals as hereinbefore described shall continue
9 on and after April first, two thousand [fifteen] NINETEEN. Rate adjust-
10 ments made pursuant to this paragraph remain fully subject to approval
11 by the director of the budget in accordance with the provisions of
12 subdivision two of section twenty-eight hundred seven of this article.
13 S 22. Paragraph (a) of subdivision 13 of section 3614 of the public
14 health law, as added by section 4 of part H of chapter 59 of the laws of
15 2011, is amended to read as follows:
16 (a) Notwithstanding any inconsistent provision of law or regulation
17 and subject to the availability of federal financial participation,
18 effective April first, two thousand twelve through March thirty-first,
19 two thousand [fifteen] NINETEEN, payments by government agencies for
20 services provided by certified home health agencies, except for such
21 services provided to children under eighteen years of age and other
22 discreet groups as may be determined by the commissioner pursuant to
23 regulations, shall be based on episodic payments. In establishing such
24 payments, a statewide base price shall be established for each sixty day
25 episode of care and adjusted by a regional wage index factor and an
26 individual patient case mix index. Such episodic payments may be further
27 adjusted for low utilization cases and to reflect a percentage limita-
28 tion of the cost for high-utilization cases that exceed outlier thresh-
29 olds of such payments.
30 S 23. Subdivision (a) of section 40 of part B of chapter 109 of the
31 laws of 2010, amending the social services law relating to transporta-
32 tion costs, is amended to read as follows:
33 (a) sections two, three, three-a, three-b, three-c, three-d, three-e
34 and twenty-one of this act shall take effect July 1, 2010; sections
35 fifteen, sixteen, seventeen, eighteen and nineteen of this act shall
36 take effect January 1, 2011; and provided further that section twenty of
37 this act shall be deemed repealed [four] SIX years after the date the
38 contract entered into pursuant to section 365-h of the social services
39 law, as amended by section twenty of this act, is executed; provided
40 that the commissioner of health shall notify the legislative bill draft-
41 ing commission upon the execution of the contract entered into pursuant
42 to section 367-h of the social services law in order that the commission
43 may maintain an accurate and timely effective data base of the official
44 text of the laws of the state of New York in furtherance of effectuating
45 the provisions of section 44 of the legislative law and section 70-b of
46 the public officers law;
47 S 24. Subdivision 4 of section 365-h of the social services law, as
48 added by section 20 of part B of chapter 109 of the laws of 2010, is
49 amended to read as follows:
50 4. The commissioner of health is authorized to assume responsibility
51 from a local social services official for the provision and reimburse-
52 ment of transportation costs under this section. If the commissioner
53 elects to assume such responsibility, the commissioner shall notify the
54 local social services official in writing as to the election, the date
55 upon which the election shall be effective and such information as to
56 transition of responsibilities as the commissioner deems prudent. The
S. 4207 57
1 commissioner is authorized to contract with a transportation manager or
2 managers to manage transportation services in any local social services
3 district. Any transportation manager or managers selected by the commis-
4 sioner to manage transportation services shall have proven experience in
5 coordinating transportation services in a geographic and demographic
6 area similar to the area in New York state within which the contractor
7 would manage the provision of services under this section. Such a
8 contract or contracts may include responsibility for: review, approval
9 and processing of transportation orders; management of the appropriate
10 level of transportation based on documented patient medical need; and
11 development of new technologies leading to efficient transportation
12 services. If the commissioner elects to assume such responsibility from
13 a local social services district, the commissioner shall examine and, if
14 appropriate, adopt quality assurance measures that may include, but are
15 not limited to, global positioning tracking system reporting require-
16 ments and service verification mechanisms. Any and all reimbursement
17 rates developed by transportation managers under this subdivision shall
18 be subject to the review and approval of the commissioner. [Notwith-
19 standing any inconsistent provision of sections one hundred twelve and
20 one hundred sixty-three of the state finance law, or section one hundred
21 forty-two of the economic development law, or any other law, the commis-
22 sioner is authorized to enter into a contract or contracts under this
23 subdivision without a competitive bid or request for proposal process,
24 provided, however, that:
25 (a) the department shall post on its website, for a period of no less
26 than thirty days:
27 (i) a description of the proposed services to be provided pursuant to
28 the contract or contracts;
29 (ii) the criteria for selection of a contractor or contractors;
30 (iii) the period of time during which a prospective contractor may
31 seek selection, which shall be no less than thirty days after such
32 information is first posted on the website; and
33 (iv) the manner by which a prospective contractor may seek such
34 selection, which may include submission by electronic means;
35 (b) all reasonable and responsive submissions that are received from
36 prospective contractors in timely fashion shall be reviewed by the
37 commissioner; and
38 (c) the commissioner shall select such contractor or contractors that,
39 in his or her discretion, are best suited to serve the purposes of this
40 section.]
41 S 25. Intentionally omitted.
42 S 26. Section 2 of chapter 459 of the laws of 1996, amending the
43 public health law relating to recertification of persons providing emer-
44 gency medical care, as amended by chapter 106 of the laws of 2011, is
45 amended to read as follows:
46 S 2. This act shall take effect immediately and shall expire and be
47 deemed repealed July 1, [2015] 2018.
48 S 27. Section 4 of chapter 505 of the laws of 1995, amending the
49 public health law relating to the operation of department of health
50 facilities, as amended by section 29 of part A of chapter 59 of the laws
51 of 2011, is amended to read as follows:
52 S 4. This act shall take effect immediately; provided, however, that
53 the provisions of paragraph (b) of subdivision 4 of section 409-c of the
54 public health law, as added by section three of this act, shall take
55 effect January 1, 1996 [and shall expire and be deemed repealed twenty
56 years from the effective date thereof].
S. 4207 58
1 S 28. Subdivision (o) of section 111 of part H of chapter 59 of the
2 laws of 2011, amending the public health law relating to the statewide
3 health information network of New York and the statewide planning and
4 research cooperative system and general powers and duties, is amended to
5 read as follows:
6 (o) sections thirty-eight and thirty-eight-a of this act shall expire
7 and be deemed repealed March 31, [2015] 2017;
8 S 29. Section 4-a of part A of chapter 56 of the laws of 2013 amending
9 chapter 59 of the laws of 2011 amending the public health law and other
10 laws relating to general hospital reimbursement for annual rates relat-
11 ing to the cap on local Medicaid expenditures, is amended to read as
12 follows:
13 S 4-a. Notwithstanding paragraph (c) of subdivision 10 of section
14 2807-c of the public health law, section 21 of chapter 1 of the laws of
15 1999, or any other contrary provision of law, in determining rates of
16 payments by state governmental agencies effective for services provided
17 on and after January 1, [2015] 2017 through March 31, [2015] 2017, for
18 inpatient and outpatient services provided by general hospitals, for
19 inpatient services and adult day health care outpatient services
20 provided by residential health care facilities pursuant to article 28 of
21 the public health law, except for residential health care facilities or
22 units of such facilities providing services primarily to children under
23 twenty-one years of age, for home health care services provided pursuant
24 to article 36 of the public health law by certified home health agen-
25 cies, long term home health care programs and AIDS home care programs,
26 and for personal care services provided pursuant to section 365-a of the
27 social services law, the commissioner of health shall apply no greater
28 than zero trend factors attributable to the [2015] 2017 calendar year in
29 accordance with paragraph (c) of subdivision 10 of section 2807-c of the
30 public health law, provided, however, that such no greater than zero
31 trend factors attributable to such [2015] 2017 calendar year shall also
32 be applied to rates of payment provided on and after January 1, [2015]
33 2017 through March 31, [2015] 2017 for personal care services provided
34 in those local social services districts, including New York city, whose
35 rates of payment for such services are established by such local social
36 services districts pursuant to a rate-setting exemption issued by the
37 commissioner of health to such local social services districts in
38 accordance with applicable regulations, and provided further, however,
39 that for rates of payment for assisted living program services provided
40 on and after January 1, [2015] 2017 through March 31, [2015] 2017, such
41 trend factors attributable to the [2015] 2017 calendar year shall be
42 established at no greater than zero percent.
43 S 30. Section 1325 of the insurance law, as added by chapter 489 of
44 the laws of 2012, is amended to read as follows:
45 S 1325. Exemption. For the purposes of exempting certain insurance
46 companies from the provisions of section one thousand three hundred
47 twenty-four of this article, the superintendent shall exempt, through
48 December thirty-first, two thousand [sixteen] NINETEEN, those stock and
49 non-stock insurance companies to which subparagraph (B) of paragraph two
50 of subsection (b) of such section applies.
51 S 31. Subsection (c) of section 2343 of the insurance law, as amended
52 by chapter 489 of the laws of 2012, is amended to read as follows:
53 (c) Notwithstanding any other provision of this chapter, no applica-
54 tion for an order of rehabilitation or liquidation of a domestic insurer
55 whose primary liability arises from the business of medical malpractice
56 insurance, as that term is defined in subsection (b) of section five
S. 4207 59
1 thousand five hundred one of this chapter, shall be made on the grounds
2 specified in subsection (a) or (c) of section seven thousand four
3 hundred two of this chapter at any time prior to December thirty-first,
4 two thousand [sixteen] NINETEEN.
5 S 32. Section 32 of part A of chapter 58 of the laws of 2008, amending
6 the elder law and other laws relating to reimbursement to participating
7 provider pharmacies and prescription drug coverage, as amended by
8 section 37 of part A of chapter 60 of the laws of 2014, is amended to
9 read as follows:
10 S 32. This act shall take effect immediately and shall be deemed to
11 have been in full force and effect on and after April 1, 2008; provided
12 however, that sections one, six-a, nineteen, twenty, twenty-four, and
13 twenty-five of this act shall take effect July 1, 2008; provided however
14 that sections sixteen, seventeen and eighteen of this act shall expire
15 April 1, 2017; provided, however, that the amendments made by section
16 twenty-eight of this act shall take effect on the same date as section 1
17 of chapter 281 of the laws of 2007 takes effect; provided further, that
18 sections twenty-nine, thirty, and thirty-one of this act shall take
19 effect October 1, 2008; provided further, that section twenty-seven of
20 this act shall take effect January 1, 2009; and provided further, that
21 section twenty-seven of this act shall expire and be deemed repealed
22 March 31, [2015] 2017; and provided, further, however, that the amend-
23 ments to subdivision 1 of section 241 of the education law made by
24 section twenty-nine of this act shall not affect the expiration of such
25 subdivision and shall be deemed to expire therewith and provided that
26 the amendments to section 272 of the public health law made by section
27 thirty of this act shall not affect the repeal of such section and shall
28 be deemed repealed therewith.
29 S 33. Notwithstanding any inconsistent provision of law, rule or regu-
30 lation, for purposes of implementing the provisions of the public health
31 law and the social services law, references to titles XIX and XXI of the
32 federal social security act in the public health law and the social
33 services law shall be deemed to include and also to mean any successor
34 titles thereto under the federal social security act.
35 S 34. Notwithstanding any inconsistent provision of law, rule or regu-
36 lation, the effectiveness of the provisions of sections 2807 and 3614 of
37 the public health law, section 18 of chapter 2 of the laws of 1988, and
38 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
39 or certification of rates of payment, are hereby suspended and without
40 force or effect for purposes of implementing the provisions of this act.
41 S 35. Severability clause. If any clause, sentence, paragraph, subdi-
42 vision, section or part of this act shall be adjudged by any court of
43 competent jurisdiction to be invalid, such judgment shall not affect,
44 impair or invalidate the remainder thereof, but shall be confined in its
45 operation to the clause, sentence, paragraph, subdivision, section or
46 part thereof directly involved in the controversy in which such judgment
47 shall have been rendered. It is hereby declared to be the intent of the
48 legislature that this act would have been enacted even if such invalid
49 provisions had not been included herein.
50 S 36. This act shall take effect immediately and shall be deemed to
51 have been in full force and effect on and after April 1, 2015 provided,
52 that:
53 1. section eighteen of this act shall take effect on the same date as
54 the reversion of subdivision 3 of section 1680-j of the public authori-
55 ties law as provided in subdivision (a) of section 70 of part HH of
56 chapter 57 of the laws of 2013, as amended;
S. 4207 60
1 2. any rules or regulations necessary to implement the provisions of
2 this act may be promulgated and any procedures, forms, or instructions
3 necessary for such implementation may be adopted and issued on or after
4 the date this act shall have become a law;
5 3. this act shall not be construed to alter, change, affect, impair or
6 defeat any rights, obligations, duties or interests accrued, incurred or
7 conferred prior to the effective date of this act;
8 4. the commissioner of health and the superintendent of the department
9 of financial services and any appropriate council may take any steps
10 necessary to implement this act prior to its effective date;
11 5. the provisions of this act shall become effective notwithstanding
12 the failure of the commissioner of health or the superintendent of the
13 department of financial services or any council to adopt or amend or
14 promulgate regulations implementing this act.
15 PART E
16 Section 1. Subdivision 5-d of section 2807-k of the public health
17 law, as added by section 1 of part C of chapter 56 of the laws of 2013,
18 is amended to read as follows:
19 5-d. (a) Notwithstanding any inconsistent provision of this section,
20 section twenty-eight hundred seven-w of this article or any other
21 contrary provision of law, and subject to the availability of federal
22 financial participation, for periods on and after January first, two
23 thousand thirteen, through December thirty-first, two thousand [fifteen]
24 EIGHTEEN, all funds available for distribution pursuant to this section,
25 except for funds distributed pursuant to subparagraph (v) of paragraph
26 (b) of subdivision five-b of this section, and all funds available for
27 distribution pursuant to section twenty-eight hundred seven-w of this
28 article, shall be reserved and set aside and distributed in accordance
29 with the provisions of this subdivision.
30 (b) The commissioner shall promulgate regulations, and may promulgate
31 emergency regulations, establishing methodologies for the distribution
32 of funds as described in paragraph (a) of this subdivision and such
33 regulations shall include, but not be limited to, the following:
34 (i) Such regulations shall establish methodologies for determining
35 each facility's relative uncompensated care need amount based on unin-
36 sured inpatient and outpatient units of service from the cost reporting
37 year two years prior to the distribution year, multiplied by the appli-
38 cable medicaid rates in effect January first of the distribution year,
39 as summed and adjusted by a statewide cost adjustment factor and reduced
40 by the sum of all payment amounts collected from such uninsured
41 patients, and as further adjusted by application of a nominal need
42 computation that shall take into account each facility's medicaid inpa-
43 tient share.
44 (ii) Annual distributions pursuant to such regulations for the two
45 thousand thirteen through two thousand [fifteen] EIGHTEEN calendar years
46 shall be in accord with the following:
47 (A) one hundred thirty-nine million four hundred thousand dollars
48 shall be distributed as Medicaid Disproportionate Share Hospital ("DSH")
49 payments to major public general hospitals; and
50 (B) nine hundred ninety-four million nine hundred thousand dollars as
51 Medicaid DSH payments to eligible general hospitals, other than major
52 public general hospitals.
53 (iii)(A) Such regulations shall establish transition adjustments to
54 the distributions made pursuant to clauses (A) and (B) of subparagraph
S. 4207 61
1 (ii) of this paragraph such that no facility experiences a reduction in
2 indigent care pool payments pursuant to this subdivision that is greater
3 than the percentages, as specified in clause (C) of this subparagraph as
4 compared to the average distribution that each such facility received
5 for the three calendar years prior to two thousand thirteen pursuant to
6 this section and section twenty-eight hundred seven-w of this article.
7 (B) Such regulations shall also establish adjustments limiting the
8 increases in indigent care pool payments experienced by facilities
9 pursuant to this subdivision by an amount that will be, as determined by
10 the commissioner and in conjunction with such other funding as may be
11 available for this purpose, sufficient to ensure full funding for the
12 transition adjustment payments authorized by clause (A) of this subpara-
13 graph.
14 (C) No facility shall experience a reduction in indigent care pool
15 payments pursuant to this subdivision that: for the calendar year begin-
16 ning January first, two thousand thirteen, is greater than two and one-
17 half percent; for the calendar year beginning January first, two thou-
18 sand fourteen, is greater than five percent; and, for the calendar year
19 beginning on January first, two thousand fifteen, is greater than seven
20 and one-half percent, AND FOR THE CALENDAR YEAR BEGINNING ON JANUARY
21 FIRST, TWO THOUSAND SIXTEEN, IS GREATER THAN TEN PERCENT; AND FOR THE
22 CALENDAR YEAR BEGINNING ON JANUARY FIRST, TWO THOUSAND SEVENTEEN, IS
23 GREATER THAN TWELVE AND ONE-HALF PERCENT; AND FOR THE CALENDAR YEAR
24 BEGINNING ON JANUARY FIRST, TWO THOUSAND EIGHTEEN, IS GREATER THAN
25 FIFTEEN PERCENT.
26 (iv) Such regulations shall reserve one percent of the funds available
27 for distribution in the two thousand fourteen [and], two thousand
28 fifteen AND TWO THOUSAND SIXTEEN calendar years pursuant to this subdi-
29 vision, subdivision fourteen-f of section twenty-eight hundred seven-c
30 of this article, and sections two hundred eleven and two hundred twelve
31 of chapter four hundred seventy-four of the laws of nineteen hundred
32 ninety-six, in a "financial assistance compliance pool" and shall estab-
33 lish methodologies for the distribution of such pool funds to facilities
34 based on their level of compliance, as determined by the commissioner,
35 with the provisions of subdivision nine-a of this section.
36 (c) The commissioner shall annually report to the governor and the
37 legislature on the distribution of funds under this subdivision includ-
38 ing, but not limited to:
39 (i) the impact on safety net providers, including community providers,
40 rural general hospitals and major public general hospitals;
41 (ii) the provision of indigent care by units of services and funds
42 distributed by general hospitals; and
43 (iii) the extent to which access to care has been enhanced.
44 S 2. Intentionally omitted
45 S 3. Notwithstanding any inconsistent provision of law, rule or regu-
46 lation, for purposes of implementing the provisions of the public health
47 law and the social services law, references to titles XIX and XXI of the
48 federal social security act in the public health law and the social
49 services law shall be deemed to include and also to mean any successor
50 titles thereto under the federal social security act.
51 S 4. Notwithstanding any inconsistent provision of law, rule or regu-
52 lation, the effectiveness of the provisions of sections 2807 and 3614 of
53 the public health law, section 18 of chapter 2 of the laws of 1988, and
54 18 NYCRR 505.14(h), as they relate to time frames for notice, approval
55 or certification of rates of payment, are hereby suspended and without
56 force or effect for purposes of implementing the provisions of this act.
S. 4207 62
1 S 5. Severability clause. If any clause, sentence, paragraph, subdivi-
2 sion, section or part of this act shall be adjudged by any court of
3 competent jurisdiction to be invalid, such judgment shall not affect,
4 impair or invalidate the remainder thereof, but shall be confined in its
5 operation to the clause, sentence, paragraph, subdivision, section or
6 part thereof directly involved in the controversy in which such judgment
7 shall have been rendered. It is hereby declared to be the intent of the
8 legislature that this act would have been enacted even if such invalid
9 provisions had not been included herein.
10 S 6. This act shall take effect immediately and shall be deemed to
11 have been in full force and effect on and after April 1, 2015; provided,
12 that:
13 a. any rules or regulations necessary to implement the provisions of
14 this act may be promulgated and any procedures, forms, or instructions
15 necessary for such implementation may be adopted and issued on or after
16 the date this act shall have become a law;
17 b. this act shall not be construed to alter, change, affect, impair or
18 defeat any rights, obligations, duties or interests accrued, incurred or
19 conferred prior to the effective date of this act;
20 c. the commissioner of health and the superintendent of financial
21 services and any appropriate council may take any steps necessary to
22 implement this act prior to its effective date;
23 d. the provisions of this act shall become effective notwithstanding
24 the failure of the commissioner of health or the superintendent of
25 financial services or any council to adopt or amend or promulgate regu-
26 lations implementing this act.
27 PART F
28 Intentionally Omitted
29 PART G
30 Section 1. Intentionally Omitted
31 S 2. Intentionally Omitted
32 S 3. Intentionally Omitted
33 S 4. Intentionally Omitted
34 S 5. Intentionally Omitted
35 S 6. Intentionally Omitted
36 S 7. Paragraph 1 of subsection (a) of section 3231 of the insurance
37 law, as amended by section 69 of part D of chapter 56 of the laws of
38 2013, is amended to read as follows:
39 (1) No individual health insurance policy and no group health insur-
40 ance policy covering between one and fifty employees or members of the
41 group, EXCEPT AS SET FORTH IN SUBSECTION (H) OF THIS SECTION, or between
42 one and one hundred employees or members of the group for policies
43 issued or renewed on or after January first, two thousand sixteen exclu-
44 sive of spouses and dependents, hereinafter referred to as a small
45 group, providing hospital and/or medical benefits, including medicare
46 supplemental insurance, shall be issued in this state unless such policy
47 is community rated and, notwithstanding any other provisions of law, the
48 underwriting of such policy involves no more than the imposition of a
49 pre-existing condition limitation if otherwise permitted by this arti-
50 cle.
S. 4207 63
1 S 8. Paragraph 1 of subsection (h) of section 3231 of the insurance
2 law, as added by chapter 501 of the laws of 1992, is amended to read as
3 follows:
4 (1) Notwithstanding any other provision of this chapter, no insurer,
5 subsidiary of an insurer, or controlled person of a holding company
6 system may act as an administrator or claims paying agent, as opposed to
7 an insurer, on behalf of small groups which, if they purchased insur-
8 ance, would be subject to this section. No insurer, subsidiary of an
9 insurer, or controlled person of a holding company may provide stop
10 loss, catastrophic or reinsurance coverage to small groups which, if
11 they purchased insurance, would be subject to this section. FOR PURPOSES
12 OF THIS SUBSECTION, "SMALL GROUP" SHALL MEAN A GROUP COMPRISED OF
13 BETWEEN ONE AND FIFTY EMPLOYEES OR MEMBERS, EXCLUSIVE OF SPOUSES AND
14 DEPENDENTS.
15 S 9. Paragraph 1 of subsection (a) of section 4317 of the insurance
16 law, as amended by section 72 of part D of chapter 56 of the laws of
17 2013, is amended to read as follows:
18 (1) No individual health insurance contract and no group health insur-
19 ance contract covering between one and fifty employees or members of the
20 group, EXCEPT AS SET FORTH IN SUBSECTION (E) OF THIS SECTION, or between
21 one and one hundred employees or members of the group for policies
22 issued or renewed on or after January first, two thousand sixteen exclu-
23 sive of spouses and dependents, including contracts for which the premi-
24 ums are paid by a remitting agent for a group, hereinafter referred to
25 as a small group, providing hospital and/or medical benefits, including
26 Medicare supplemental insurance, shall be issued in this state unless
27 such contract is community rated and, notwithstanding any other
28 provisions of law, the underwriting of such contract involves no more
29 than the imposition of a pre-existing condition limitation if otherwise
30 permitted by this article.
31 S 10. Paragraph 1 of subsection (e) of section 4317 of the insurance
32 law, as amended by section 72 of part D of chapter 56 of the laws of
33 2013, is amended to read as follows:
34 (1) Notwithstanding any other provision of this chapter, no insurer,
35 subsidiary of an insurer, or controlled person of a holding company
36 system may act as an administrator or claims paying agent, as opposed to
37 an insurer, on behalf of small groups which, if they purchased insur-
38 ance, would be subject to this section. No insurer, subsidiary of an
39 insurer, or controlled person of a holding company may provide stop
40 loss, catastrophic or reinsurance coverage to small groups which, if
41 they purchased insurance, would be subject to this section. FOR
42 PURPOSES OF THIS SUBSECTION, "SMALL GROUP" SHALL MEAN A GROUP COMPRISED
43 OF BETWEEN ONE AND FIFTY EMPLOYEES OR MEMBERS, EXCLUSIVE OF SPOUSES AND
44 DEPENDENTS.
45 S 11. This act shall take effect immediately.
46 PART H
47 Section 1. Section 2801-a of the public health law is amended by
48 adding a new subdivision 17 to read as follows:
49 17. (A) DIAGNOSTIC OR TREATMENT CENTERS ESTABLISHED TO PROVIDE HEALTH
50 CARE SERVICES WITHIN THE SPACE OF A RETAIL BUSINESS OPERATION, SUCH AS A
51 PHARMACY OR A STORE OPEN TO THE GENERAL PUBLIC, OR WITHIN SPACE USED BY
52 AN EMPLOYER FOR PROVIDING HEALTH CARE SERVICES TO ITS EMPLOYEES, MAY BE
53 OPERATED BY LEGAL ENTITIES FORMED UNDER THE LAWS OF THE STATE OF NEW
54 YORK: (I) WHOSE STOCKHOLDERS OR MEMBERS, AS APPLICABLE, ARE NOT NATURAL
S. 4207 64
1 PERSONS; (II) WHOSE PRINCIPAL STOCKHOLDERS AND MEMBERS, AS APPLICABLE,
2 AND CONTROLLING PERSONS COMPLY WITH ALL APPLICABLE REQUIREMENTS OF THIS
3 SECTION; AND (III) THAT DEMONSTRATE, TO THE SATISFACTION OF THE PUBLIC
4 HEALTH AND HEALTH PLANNING COUNCIL, SUFFICIENT EXPERIENCE AND EXPERTISE
5 IN DELIVERING HIGH QUALITY HEALTH CARE SERVICES. SUCH DIAGNOSTIC AND
6 TREATMENT CENTERS SHALL BE REFERRED TO IN THIS SECTION AS "LIMITED
7 SERVICES CLINICS".
8 (B) FOR PURPOSES OF PARAGRAPH (A) OF THIS SUBDIVISION, THE PUBLIC
9 HEALTH AND HEALTH PLANNING COUNCIL SHALL ADOPT AND AMEND RULES AND REGU-
10 LATIONS, NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION, TO
11 ADDRESS ANY MATTER IT DEEMS PERTINENT TO THE ESTABLISHMENT OF LIMITED
12 SERVICES CLINICS. SUCH RULES AND REGULATIONS SHALL INCLUDE, BUT NOT BE
13 LIMITED TO, PROVISIONS GOVERNING OR RELATING TO: (I) ANY DIRECT OR INDI-
14 RECT CHANGES OR TRANSFERS OF OWNERSHIP INTERESTS OR VOTING RIGHTS IN
15 SUCH ENTITIES OR THEIR STOCKHOLDERS OR MEMBERS, AS APPLICABLE; (II)
16 PUBLIC HEALTH AND HEALTH PLANNING COUNCIL APPROVAL OF ANY CHANGE IN
17 CONTROLLING INTERESTS, PRINCIPAL STOCKHOLDERS, CONTROLLING PERSONS,
18 PARENT COMPANY OR SPONSORS; (III) OVERSIGHT OF THE OPERATOR AND ITS
19 SHAREHOLDERS OR MEMBERS, AS APPLICABLE, INCLUDING LOCAL GOVERNANCE OF
20 THE LIMITED SERVICES CLINICS; AND (IV) THE CHARACTER AND COMPETENCE AND
21 QUALIFICATIONS OF, AND CHANGES RELATING TO, THE DIRECTORS AND OFFICERS
22 OF THE OPERATOR AND ITS PRINCIPAL STOCKHOLDERS, CONTROLLING PERSONS,
23 PARENT COMPANY OR SPONSORS.
24 (C) THE FOLLOWING PROVISIONS OF THIS SECTION SHALL NOT APPLY TO LIMIT-
25 ED SERVICES CLINICS: (I) PARAGRAPH (A) OF SUBDIVISION THREE OF THIS
26 SECTION; (II) PARAGRAPH (B) OF SUBDIVISION THREE OF THIS SECTION, RELAT-
27 ING TO STOCKHOLDERS AND MEMBERS OTHER THAN PRINCIPAL STOCKHOLDERS AND
28 PRINCIPAL MEMBERS; (III) PARAGRAPH (C) OF SUBDIVISION FOUR OF THIS
29 SECTION, RELATING TO THE DISPOSITION OF STOCK OR VOTING RIGHTS; AND (IV)
30 PARAGRAPH (E) OF SUBDIVISION FOUR OF THIS SECTION, RELATING TO THE
31 OWNERSHIP OF STOCK OR MEMBERSHIP.
32 (D) A LIMITED SERVICES CLINIC SHALL BE DEEMED TO BE A "HEALTH CARE
33 PROVIDER" FOR THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAP-
34 TER. A PRESCRIBER PRACTICING IN A LIMITED SERVICE CLINIC SHALL NOT BE
35 DEEMED TO BE IN THE EMPLOY OF A PHARMACY OR PRACTICING IN A HOSPITAL FOR
36 PURPOSES OF SUBDIVISION TWO OF SECTION SIXTY-EIGHT HUNDRED SEVEN OF THE
37 EDUCATION LAW.
38 (E) THE COMMISSIONER SHALL PROMULGATE REGULATIONS SETTING FORTH OPERA-
39 TIONAL AND PHYSICAL PLANT STANDARDS FOR LIMITED SERVICES CLINICS, WHICH
40 MAY BE DIFFERENT FROM THE REGULATIONS OTHERWISE APPLICABLE TO DIAGNOSTIC
41 OR TREATMENT CENTERS, INCLUDING, BUT NOT LIMITED TO:
42 (I) REQUIRING THAT LIMITED SERVICES CLINICS ATTAIN AND MAINTAIN
43 ACCREDITATION AND REQUIRING TIMELY REPORTING TO THE DEPARTMENT IF A
44 LIMITED SERVICE CLINIC LOSES ITS ACCREDITATION;
45 (II) DESIGNATING OR LIMITING THE TREATMENTS AND SERVICES THAT MAY BE
46 PROVIDED, INCLUDING:
47 (1) PROHIBITING THE PROVISION OF SERVICES TO PATIENTS TWENTY-FOUR
48 MONTHS OF AGE OR YOUNGER;
49 (2) THE PROVISION OF SPECIFIC IMMUNIZATIONS TO PATIENTS YOUNGER THAN
50 EIGHTEEN YEARS OF AGE;
51 (III) REQUIRING LIMITED SERVICE CLINICS TO ACCEPT WALK-INS AND OFFER
52 EXTENDED BUSINESS HOURS;
53 (IV) SETTING FORTH GUIDELINES FOR ADVERTISING AND SIGNAGE, DISCLOSURE
54 OF OWNERSHIP INTERESTS, INFORMED CONSENT, RECORD KEEPING, REFERRAL FOR
55 TREATMENT AND CONTINUITY OF CARE, CASE REPORTING TO THE PATIENT'S PRIMA-
56 RY CARE OR OTHER HEALTH CARE PROVIDERS, DESIGN, CONSTRUCTION, FIXTURES,
S. 4207 65
1 AND EQUIPMENT. SIGNAGE SHALL ALSO BE REQUIRED TO INDICATE THAT
2 PRESCRIPTIONS AND OVER-THE-COUNTER SUPPLIES MAY BE PURCHASED BY A
3 PATIENT FROM ANY BUSINESS AND DO NOT NEED TO BE PURCHASED ON-SITE; AND
4 (V) REQUIRING THE OPERATOR TO DIRECTLY EMPLOY A MEDICAL DIRECTOR WHO
5 IS LICENSED AND CURRENTLY REGISTERED TO PRACTICE MEDICINE IN THE STATE
6 OF NEW YORK.
7 (F) SUCH REGULATIONS ALSO SHALL PROMOTE AND STRENGTHEN PRIMARY CARE
8 THROUGH: (I) THE INTEGRATION OF SERVICES PROVIDED BY LIMITED SERVICES
9 CLINICS WITH THE SERVICES PROVIDED BY THE PATIENT'S OTHER HEALTH CARE
10 PROVIDERS; AND (II) THE REFERRAL OF PATIENTS TO APPROPRIATE HEALTH CARE
11 PROVIDERS, INCLUDING APPROPRIATE TRANSMISSION OF PATIENT HEALTH RECORDS.
12 (G) A LIMITED SERVICES CLINIC SHALL PROVIDE TREATMENT WITHOUT DISCRIM-
13 INATION AS TO RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, DISABILITY,
14 SEXUAL ORIENTATION OR SOURCE OF PAYMENT.
15 (H) NOTWITHSTANDING THIS SUBDIVISION AND ANY OTHER LAW OR REGULATION
16 TO THE CONTRARY AND SUBJECT TO THE PROVISIONS OF SECTION TWENTY-EIGHT
17 HUNDRED TWO OF THIS ARTICLE, A DIAGNOSTIC AND TREATMENT CENTER, COMMUNI-
18 TY HEALTH CENTER OR FEDERALLY QUALIFIED HEALTH CENTER MAY OPERATE A
19 LIMITED SERVICES CLINIC WHICH MEETS THE REGULATION PROMULGATED PURSUANT
20 TO PARAGRAPH (D) OF THIS SUBDIVISION REGARDING OPERATIONAL AND PHYSICAL
21 PLANT STANDARDS FOR LIMITED SERVICES CLINICS.
22 S 1-a. Section 2802 of the public health law is amended by adding a
23 new subdivision 8 to read as follows:
24 8. NOTWITHSTANDING ANY LAW, RULE OR REGULATION TO THE CONTRARY, A
25 GENERAL HOSPITAL ESTABLISHED PURSUANT TO SECTION TWENTY-EIGHT HUNDRED
26 ONE-A OF THIS ARTICLE MAY SUBMIT AN APPLICATION PURSUANT TO THIS SECTION
27 TO OPERATE A LIMITED SERVICES CLINIC THAT MEETS THE REGULATIONS PROMUL-
28 GATED PURSUANT TO PARAGRAPH (D) OF SUBDIVISION SEVENTEEN OF SECTION
29 TWENTY-EIGHT HUNDRED ONE-A OF THIS ARTICLE REGARDING OPERATIONAL AND
30 PHYSICAL PLANT STANDARDS.
31 S 2. Intentionally omitted.
32 S 3. Intentionally omitted.
33 S 4. Intentionally omitted.
34 S 5. Intentionally omitted.
35 S 6. This act shall take effect immediately.
36 PART I
37 Intentionally omitted.
38 PART J
39 Intentionally Omitted
40 PART K
41 Section 1. Subdivisions 1, 2 and 3 of section 2802 of the public
42 health law, subdivisions 1 and 2 as amended by section 58 of part A of
43 chapter 58 of the laws of 2010, subdivision 3 as amended by chapter 609
44 of the laws of 1982 and paragraph (e) of subdivision 3 as amended by
45 chapter 731 of the laws of 1993, are amended to read as follows:
46 1. An application for such construction shall be filed with the
47 department, together with such other forms and information as shall be
48 prescribed by, or acceptable to, the department. Thereafter the depart-
49 ment shall forward a copy of the application and accompanying documents
S. 4207 66
1 to the public health and health planning council, and the health systems
2 agency, if any, having geographical jurisdiction of the area where the
3 hospital is located.
4 2. The commissioner shall not act upon an application for construction
5 of a hospital until the public health and health planning council and
6 the health systems agency have had a reasonable time to submit their
7 recommendations, and unless (a) the applicant has obtained all approvals
8 and consents required by law for its incorporation or establishment
9 (including the approval of the public health and health planning council
10 pursuant to the provisions of this article) provided, however, that the
11 commissioner may act upon an application for construction by an appli-
12 cant possessing a valid operating certificate when the application qual-
13 ifies for review without the recommendation of the council pursuant to
14 regulations adopted by the council and approved by the commissioner; and
15 (b) the commissioner is satisfied as to the public need for the
16 construction, at the time and place and under the circumstances
17 proposed, provided however that[,] in the case of an application by a
18 hospital established or operated by an organization defined in subdivi-
19 sion one of section four hundred eighty-two-b of the social services
20 law, the needs of the members of the religious denomination concerned,
21 for care or treatment in accordance with their religious or ethical
22 convictions, shall be deemed to be public need[.]; AND FURTHER PROVIDED
23 THAT: (I) AN APPLICATION BY A GENERAL HOSPITAL OR DIAGNOSTIC AND TREAT-
24 MENT CENTER, ESTABLISHED UNDER THIS ARTICLE, TO CONSTRUCT A FACILITY TO
25 PROVIDE PRIMARY CARE SERVICES, AS DEFINED IN REGULATION, MAY BE APPROVED
26 WITHOUT REGARD FOR PUBLIC NEED; OR (II) AN APPLICATION BY A GENERAL
27 HOSPITAL OR A DIAGNOSTIC AND TREATMENT CENTER, ESTABLISHED UNDER THIS
28 ARTICLE, TO UNDERTAKE CONSTRUCTION THAT DOES NOT INVOLVE A CHANGE IN
29 CAPACITY, THE TYPES OF SERVICES PROVIDED, MAJOR MEDICAL EQUIPMENT,
30 FACILITY REPLACEMENT, OR THE GEOGRAPHIC LOCATION OF SERVICES, MAY BE
31 APPROVED WITHOUT REGARD FOR PUBLIC NEED.
32 3. Subject to the provisions of paragraph (b) of subdivision two OF
33 THIS SECTION, the commissioner in approving the construction of a hospi-
34 tal shall take into consideration and be empowered to request informa-
35 tion and advice as to (a) the availability of facilities or services
36 such as preadmission, ambulatory or home care services which may serve
37 as alternatives or substitutes for the whole or any part of the proposed
38 hospital construction;
39 (b) the need for special equipment in view of existing utilization of
40 comparable equipment at the time and place and under the circumstances
41 proposed;
42 (c) the possible economies and improvements in service to be antic-
43 ipated from the operation of joint central services including, but not
44 limited to laboratory, research, radiology, pharmacy, laundry and
45 purchasing;
46 (d) the adequacy of financial resources and sources of future revenue,
47 PROVIDED THAT THE COMMISSIONER MAY, BUT IS NOT REQUIRED TO, CONSIDER THE
48 ADEQUACY OF FINANCIAL RESOURCES AND SOURCES OF FUTURE REVENUE IN
49 RELATION TO APPLICATIONS UNDER SUBPARAGRAPHS (I) AND (II) OF PARAGRAPH
50 (B) OF SUBDIVISION TWO OF THIS SECTION; and
51 (e) whether the facility is currently in substantial compliance with
52 all applicable codes, rules and regulations, provided, however, that the
53 commissioner shall not disapprove an application solely on the basis
54 that the facility is not currently in substantial compliance, if the
55 application is specifically:
56 (i) to correct life safety code or patient care deficiencies;
S. 4207 67
1 (ii) to correct deficiencies which are necessary to protect the life,
2 health, safety and welfare of facility patients, residents or staff;
3 (iii) for replacement of equipment that no longer meets the generally
4 accepted operational standards existing for such equipment at the time
5 it was acquired; and
6 (iv) for decertification of beds and services.
7 S 2. Subdivisions 1, 2 and 3 of section 2807-z of the public health
8 law, as amended by chapter 400 of the laws of 2012, are amended to read
9 as follows:
10 1. Notwithstanding any provision of this chapter or regulations or any
11 other state law or regulation, for any eligible capital project as
12 defined in subdivision six of this section, the department shall have
13 thirty days [of] AFTER receipt of the certificate of need OR
14 CONSTRUCTION application, PURSUANT TO SECTION TWENTY-EIGHT HUNDRED TWO
15 OF THIS ARTICLE, for a limited or administrative review to deem such
16 application complete. If the department determines the application is
17 incomplete or that more information is required, the department shall
18 notify the applicant in writing within thirty days of the date of the
19 application's submission, and the applicant shall have twenty business
20 days to provide additional information or otherwise correct the defi-
21 ciency in the application.
22 2. For an eligible capital project requiring a limited or administra-
23 tive review, within ninety days of the department deeming the applica-
24 tion complete, the department shall make a decision to approve or disap-
25 prove the certificate of need OR CONSTRUCTION application for such
26 project. If the department determines to disapprove the project, the
27 basis for such disapproval shall be provided in writing; however, disap-
28 proval shall not be based on the incompleteness of the application. If
29 the department fails to take action to approve or disapprove the appli-
30 cation within ninety days of the certificate of need application being
31 deemed complete, the application will be deemed approved.
32 3. For an eligible capital project requiring full review by the coun-
33 cil, the certificate of need OR CONSTRUCTION application shall be placed
34 on the next council agenda following the department deeming the applica-
35 tion complete.
36 S 3. Section 2801-a of the public health law is amended by adding a
37 new subdivision 3-b to read as follows:
38 3-B. NOTWITHSTANDING ANY OTHER PROVISIONS OF THIS CHAPTER TO THE
39 CONTRARY, THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL MAY APPROVE THE
40 ESTABLISHMENT OF DIAGNOSTIC OR TREATMENT CENTERS TO BE ISSUED OPERATING
41 CERTIFICATES FOR THE PURPOSE OF PROVIDING PRIMARY CARE, AS DEFINED BY
42 THE COMMISSIONER IN REGULATIONS, WITHOUT REGARD TO THE REQUIREMENTS OF
43 PUBLIC NEED AND FINANCIAL RESOURCES AS SET FORTH IN SUBDIVISION THREE OF
44 THIS SECTION.
45 S 4. Subdivision 3 of section 2801-a of the public health law, as
46 amended by section 57 of part A of chapter 58 of the laws of 2010, is
47 amended to read as follows:
48 3. The public health and health planning council shall not approve a
49 certificate of incorporation, articles of organization or application
50 for establishment unless it is satisfied, insofar as applicable, as to
51 (a) the public need for the existence of the institution at the time and
52 place and under the circumstances proposed, provided, however, that in
53 the case of an institution proposed to be established or operated by an
54 organization defined in subdivision one of section one hundred seventy-
55 two-a of the executive law, the needs of the members of the religious
56 denomination concerned, for care or treatment in accordance with their
S. 4207 68
1 religious or ethical convictions, shall be deemed to be public need; (b)
2 the character, competence, and standing in the community, of the
3 proposed incorporators, directors, sponsors, MEMBERS, PRINCIPAL MEMBERS,
4 stockholders, [members] PRINCIPAL STOCKHOLDERS or operators; with
5 respect to any proposed incorporator, director, sponsor, MEMBER, PRINCI-
6 PAL MEMBER, stockholder, [member] PRINCIPAL STOCKHOLDER or operator who
7 is already or within the past [ten] FIVE years has been an incorporator,
8 director, sponsor, member, principal stockholder, principal member, or
9 operator of any hospital, private proprietary home for adults, residence
10 for adults, or non-profit home for the aged or blind which has been
11 issued an operating certificate by the state department of social
12 services, or a halfway house, hostel or other residential facility or
13 institution for the care, custody or treatment of the mentally disabled
14 which is subject to approval by the department of mental hygiene, no
15 approval shall be granted unless the public health and health planning
16 council, having afforded an adequate opportunity to members of health
17 systems agencies, if any, having geographical jurisdiction of the area
18 where the institution is to be located to be heard, shall affirmatively
19 find by substantial evidence as to each such incorporator, director,
20 sponsor, MEMBER, PRINCIPAL MEMBER, principal stockholder or operator
21 that a substantially consistent high level of care is being or was being
22 rendered in each such hospital, home, residence, halfway house, hostel,
23 or other residential facility or institution with which such person is
24 or was affiliated; for the purposes of this paragraph, the public health
25 and health planning council shall adopt rules and regulations, subject
26 to the approval of the commissioner, to establish the criteria to be
27 used to determine whether a substantially consistent high level of care
28 has been rendered, provided, however, that there shall not be a finding
29 that a substantially consistent high level of care has been rendered
30 where there have been violations of the state hospital code, or other
31 applicable rules and regulations, that (i) threatened to directly affect
32 the health, safety or welfare of any patient or resident, and (ii) were
33 recurrent or were not promptly corrected, UNLESS THE PROPOSED INCORPORA-
34 TOR, DIRECTOR, SPONSOR, MEMBER, PRINCIPAL MEMBER, STOCKHOLDER, PRINCIPAL
35 STOCKHOLDER, OR OPERATOR DEMONSTRATES, AND THE PUBLIC HEALTH AND HEALTH
36 PLANNING COUNCIL FINDS, THAT THE VIOLATIONS CANNOT BE ATTRIBUTED TO THE
37 ACTION OR INACTION OF SUCH PROPOSED INCORPORATOR, DIRECTOR, SPONSOR,
38 MEMBER, PRINCIPAL MEMBER, STOCKHOLDER, PRINCIPAL STOCKHOLDER, OR OPERA-
39 TOR DUE TO THE TIMING, EXTENT OR MANNER OF THE AFFILIATION; (c) the
40 financial resources of the proposed institution and its sources of
41 future revenues; and (d) such other matters as it shall deem pertinent.
42 S 5. Paragraphs (b) and (c) of subdivision 4 of section 2801-a of the
43 public health law, as amended by section 57 of part A of chapter 58 of
44 the laws of 2010, are amended to read as follows:
45 (b) [(i)] Any transfer, assignment or other disposition of ten percent
46 or more of [an] DIRECT OR INDIRECT interest or voting rights in [a part-
47 nership or limited liability company, which is the] AN operator of a
48 hospital to a new STOCKHOLDER, partner or member, OR ANY TRANSFER,
49 ASSIGNMENT OR OTHER DISPOSITION OF A DIRECT OR INDIRECT INTEREST OR
50 VOTING RIGHTS OF SUCH AN OPERATOR WHICH RESULTS IN THE OWNERSHIP OR
51 CONTROL OF MORE THAN TEN PERCENT OF THE INTEREST OR VOTING RIGHTS OF
52 SUCH OPERATOR BY ANY PERSON NOT PREVIOUSLY APPROVED BY THE PUBLIC HEALTH
53 AND HEALTH PLANNING COUNCIL, OR ITS PREDECESSOR, FOR THAT OPERATOR shall
54 be approved by the public health and health planning council, in accord-
55 ance with the provisions of subdivisions two and three of this section,
56 except that: (A) any such change shall be subject to the approval by the
S. 4207 69
1 public health and health planning council in accordance with paragraph
2 (b) of subdivision three of this section only with respect to the new
3 STOCKHOLDER, partner or member, and any remaining STOCKHOLDERS, partners
4 or members who have not been previously approved for that facility in
5 accordance with such paragraph, and (B) such change shall not be subject
6 to paragraph (a) of subdivision three of this section. IN THE ABSENCE OF
7 SUCH APPROVAL, THE OPERATING CERTIFICATE OF SUCH HOSPITAL SHALL BE
8 SUBJECT TO REVOCATION OR SUSPENSION.
9 [(ii)] (C) (I) With respect to a transfer, assignment or disposition
10 involving less than ten percent of [an] A DIRECT OR INDIRECT interest or
11 voting rights in [such partnership or limited liability company] AN
12 OPERATOR OF A HOSPITAL to a new STOCKHOLDER, partner or member, no prior
13 approval of the public health and health planning council shall be
14 required EXCEPT WHERE REQUIRED BY PARAGRAPH (B) OF THIS SUBDIVISION.
15 However, no such transaction shall be effective unless at least ninety
16 days prior to the intended effective date thereof, the [partnership or
17 limited liability company] OPERATOR fully completes and files with the
18 public health and health planning council notice on a form, to be devel-
19 oped by the public health and health planning council, which shall
20 disclose such information as may reasonably be necessary for the public
21 health and health planning council to determine whether it should bar
22 the transaction for any of the reasons set forth in item (A), (B), (C)
23 or (D) below. Within ninety days from the date of receipt of such
24 notice, the public health and health planning council may bar any trans-
25 action under this subparagraph: (A) if the equity position of the [part-
26 nership or limited liability company,] OPERATOR, determined in accord-
27 ance with generally accepted accounting principles, would be reduced as
28 a result of the transfer, assignment or disposition; (B) if the trans-
29 action would result in the ownership of a [partnership or membership]
30 DIRECT OR INDIRECT interest OR VOTING RIGHTS by any persons who have
31 been convicted of a felony described in subdivision five of section
32 twenty-eight hundred six of this article; (C) if there are reasonable
33 grounds to believe that the proposed transaction does not satisfy the
34 character and competence criteria set forth in subdivision three of this
35 section; or (D) UPON THE RECOMMENDATION OF THE DEPARTMENT, if the trans-
36 action, together with all transactions under this subparagraph for the
37 [partnership] OPERATOR, or successor, during any five year period would,
38 in the aggregate, involve twenty-five percent or more of the interest in
39 the [partnership] OPERATOR. The public health and health planning coun-
40 cil shall state specific reasons for barring any transaction under this
41 subparagraph and shall so notify each party to the proposed transaction.
42 [(iii) With respect to a transfer, assignment or disposition of an
43 interest or voting rights in such partnership or limited liability
44 company to any remaining partner or member, which transaction involves
45 the withdrawal of the transferor from the partnership or limited liabil-
46 ity company, no prior approval of the public health and health planning
47 council shall be required. However, no such transaction shall be effec-
48 tive unless at least ninety days prior to the intended effective date
49 thereof, the partnership or limited liability company fully completes
50 and files with the public health and health planning council notice on a
51 form, to be developed by the public health and health planning council,
52 which shall disclose such information as may reasonably be necessary for
53 the public health and health planning council to determine whether it
54 should bar the transaction for the reason set forth below. Within ninety
55 days from the date of receipt of such notice, the public health and
56 health planning council may bar any transaction under this subparagraph
S. 4207 70
1 if the equity position of the partnership or limited liability company,
2 determined in accordance with generally accepted accounting principles,
3 would be reduced as a result of the transfer, assignment or disposition.
4 The public health and health planning council shall state specific
5 reasons for barring any transaction under this subparagraph and shall so
6 notify each party to the proposed transaction.
7 (c) Any transfer, assignment or other disposition of ten percent or
8 more of the stock or voting rights thereunder of a corporation which is
9 the operator of a hospital or which is a member of a limited liability
10 company which is the operator of a hospital to a new stockholder, or any
11 transfer, assignment or other disposition of the stock or voting rights
12 thereunder of such a corporation which results in the ownership or
13 control of more than ten percent of the stock or voting rights there-
14 under of such corporation by any person not previously approved by the
15 public health and health planning council, or its predecessor, for that
16 corporation shall be subject to approval by the public health and health
17 planning council, in accordance with the provisions of subdivisions two
18 and three of this section and rules and regulations pursuant thereto;
19 except that: any such transaction shall be subject to the approval by
20 the public health and health planning council in accordance with para-
21 graph (b) of subdivision three of this section only with respect to a
22 new stockholder or a new principal stockholder; and shall not be subject
23 to paragraph (a) of subdivision three of this section. In the absence of
24 such approval, the operating certificate of such hospital shall be
25 subject to revocation or suspension.]
26 (II) No prior approval of the public health and health planning coun-
27 cil shall be required with respect to a transfer, assignment or disposi-
28 tion of ten percent or more of [the stock] A DIRECT OR INDIRECT INTEREST
29 or voting rights [thereunder of a corporation which is the] IN AN opera-
30 tor of a hospital [or which is a member of a limited liability company
31 which is the owner of a hospital] to any person previously approved by
32 the public health and health planning council, or its predecessor, for
33 that [corporation] OPERATOR. However, no such transaction shall be
34 effective unless at least ninety days prior to the intended effective
35 date thereof, the [stockholder] OPERATOR FULLY completes and files with
36 the public health and health planning council notice on forms to be
37 developed by the public health and health planning council, which shall
38 disclose such information as may reasonably be necessary for the public
39 health and health planning council to determine whether it should bar
40 the transaction. Such transaction will be final as of the intended
41 effective date unless, prior thereto, the public health and health plan-
42 ning council shall state specific reasons for barring such transactions
43 under this paragraph and shall notify each party to the proposed trans-
44 action. Nothing in this paragraph shall be construed as permitting a
45 person not previously approved by the public health and health planning
46 council for that [corporation] OPERATOR to become the owner of ten
47 percent or more of the [stock of a corporation which is] INTEREST OR
48 VOTING RIGHTS, DIRECTLY OR INDIRECTLY, IN the operator of a hospital [or
49 which is a member of a limited liability company which is the owner of a
50 hospital] without first obtaining the approval of the public health and
51 health planning council.
52 S 6. Subdivision 1 of section 3611-a of the public health law, as
53 amended by section 67 of part A of chapter 58 of the laws of 2010, is
54 amended to read as follows:
55 1. Any change in the person who, or any transfer, assignment, or other
56 disposition of an interest or voting rights of ten percent or more, or
S. 4207 71
1 any transfer, assignment or other disposition which results in the
2 ownership or control of an interest or voting rights of ten percent or
3 more, in a limited liability company or a partnership which is the oper-
4 ator of a licensed home care services agency or a certified home health
5 agency shall be approved by the public health and health planning coun-
6 cil, in accordance with the provisions of subdivision four of section
7 thirty-six hundred five of this article relative to licensure or subdi-
8 vision two of section thirty-six hundred six of this article relative to
9 certificate of approval, except that:
10 (a) Public health and health planning council approval shall be
11 required only with respect to the person, or the member or partner that
12 is acquiring the interest or voting rights; and
13 (b) With respect to certified home health agencies, such change shall
14 not be subject to the public need assessment described in paragraph (a)
15 of subdivision two of section thirty-six hundred six of this article.
16 (c) IN THE ABSENCE OF SUCH APPROVAL, THE LICENSE OR CERTIFICATE OF
17 APPROVAL SHALL BE SUBJECT TO REVOCATION OR SUSPENSION.
18 (D) (I) No prior approval of the public health and health planning
19 council shall be required with respect to a transfer, assignment or
20 disposition of:
21 [(i)] (A) an interest or voting rights to any person previously
22 approved by the public health and health planning council, or its prede-
23 cessor, for that operator; or
24 [(ii)] (B) an interest or voting rights of less than ten percent in
25 the operator. [However, no]
26 (II) NO such transaction UNDER SUBPARAGRAPH (I) OF THIS PARAGRAPH
27 shall be effective unless at least ninety days prior to the intended
28 effective date thereof, the [partner or member] OPERATOR completes and
29 files with the public health and health planning council notice on forms
30 to be developed by the public health council, which shall disclose such
31 information as may reasonably be necessary for the public health and
32 health planning council to determine whether it should bar the trans-
33 action. Such transaction will be final as of the intended effective date
34 unless, prior thereto, the public health and health planning council
35 shall state specific reasons for barring such transactions under this
36 paragraph and shall notify each party to the proposed transaction.
37 S 7. Subdivision 5 of section 2801 of the public health law, as added
38 by chapter 795 of the laws of 1965 and as renumbered by chapter 653 of
39 the laws of 1975, is amended to read as follows:
40 5. "Construction" means the erection, building, [or] substantial
41 [acquisition, alteration,] reconstruction, [improvement, extension or
42 modification] OR SUBSTANTIAL CHANGE IN CLINICAL SERVICES of a hospital,
43 including [its equipment;] the inspection and supervision thereof[; and
44 the studies, surveys, designs, plans, working drawings, specifications,
45 procedures and other actions necessary thereto].
46 S 8. Subdivisions 3 and 3-a of section 2801-a of the public health
47 law, as amended by section 57 of part A of chapter 58 of the laws of
48 2010, are amended to read as follows:
49 3. The public health and health planning council shall not approve a
50 certificate of incorporation, articles of organization or application
51 for establishment unless it is satisfied, insofar as applicable, as to
52 [(a) the public need for the existence of the institution at the time
53 and place and under the circumstances proposed, provided, however, that
54 in the case of an institution proposed to be established or operated by
55 an organization defined in subdivision one of section one hundred seven-
56 ty-two-a of the executive law, the needs of the members of the religious
S. 4207 72
1 denomination concerned, for care or treatment in accordance with their
2 religious or ethical convictions, shall be deemed to be public need;
3 (b)] the character, competence, and standing in the community, of the
4 proposed incorporators, directors, sponsors, stockholders, members or
5 operators; with respect to any proposed incorporator, director, sponsor,
6 stockholder, member or operator who is already or within the past [ten]
7 FIVE years has been an incorporator, director, sponsor, member, princi-
8 pal stockholder, principal member, or operator of any hospital, private
9 proprietary home for adults, residence for adults, or non-profit home
10 for the aged or blind which has been issued an operating certificate by
11 the [state] department [of social services], or a halfway house, hostel
12 or other residential facility or institution for the care, custody or
13 treatment of the mentally disabled which is subject to approval by the
14 department of mental hygiene, no approval shall be granted unless the
15 public health and health planning council, having afforded an adequate
16 opportunity to members of [health systems agencies] FINGER LAKES HEALTH
17 SYSTEM AGENCY, if any, having geographical jurisdiction of the area
18 where the institution is to be located to be heard, shall affirmatively
19 find by substantial evidence as to each such incorporator, director,
20 sponsor, principal stockholder or operator that a substantially consist-
21 ent high level of care is being or was being rendered in each such
22 hospital, home, residence, halfway house, hostel, or other residential
23 facility or institution with which such person is or was affiliated; for
24 the purposes of this paragraph, the public health and health planning
25 council shall adopt rules and regulations, subject to the approval of
26 the commissioner, to establish the criteria to be used to determine
27 whether a substantially consistent high level of care has been rendered,
28 provided, however, that there shall not be a finding that a substantial-
29 ly consistent high level of care has been rendered where there have been
30 violations of the state hospital code, or other applicable rules and
31 regulations, that [(i)] (A) threatened to directly affect the health,
32 safety or welfare of any patient or resident, and [(ii)] (B) were recur-
33 rent or were not promptly corrected; [(c)] the financial resources of
34 the proposed institution and its sources of future revenues; and [(d)]
35 such other matters as it shall deem pertinent.
36 3-a. Notwithstanding any other provisions of this chapter, the public
37 health council is hereby empowered to approve the establishment, for
38 demonstration purposes, of not more than one existing hospital within
39 the geographical jurisdiction of each health systems agency established
40 under the provisions of subdivision (c) of section twenty-nine hundred
41 four of this chapter. The purposes of such hospitals shall be to offer
42 and provide nursing home services, board and lodging to persons requir-
43 ing such services within one hospital. [The public health council may
44 approve the establishment of such hospitals without regard to the
45 requirement of public need as set forth in subdivision three of this
46 section.]
47 S 9. Subparagraph (i) of paragraph (b) of subdivision 4 of section
48 2801-a of the public health law, as amended by section 57 of part A of
49 chapter 58 of the laws of 2010, is amended to read as follows:
50 (i) Any transfer, assignment or other disposition of ten percent or
51 more of an interest or voting rights in a partnership or limited liabil-
52 ity company, which is the operator of a hospital to a new partner or
53 member, shall be approved by the public health and health planning coun-
54 cil, in accordance with the provisions of subdivisions two and three of
55 this section, except that[: (A)] any such change shall be subject to the
56 approval by the public health and health planning council in accordance
S. 4207 73
1 with [paragraph (b) of] subdivision three of this section only with
2 respect to the new partner or member, and any remaining partners or
3 members who have not been previously approved for that facility in
4 accordance with such [paragraph, and (B) such change shall not be
5 subject to paragraph (a) of] subdivision [three of this section].
6 S 10. Paragraph (c) of subdivision 4 of section 2801-a of the public
7 health law, as amended by section 57 of part A of chapter 58 of the laws
8 of 2010, is amended to read as follows:
9 (c) Any transfer, assignment or other disposition of ten percent or
10 more of the stock or voting rights thereunder of a corporation which is
11 the operator of a hospital or which is a member of a limited liability
12 company which is the operator of a hospital to a new stockholder, or any
13 transfer, assignment or other disposition of the stock or voting rights
14 thereunder of such a corporation which results in the ownership or
15 control of more than ten percent of the stock or voting rights there-
16 under of such corporation by any person not previously approved by the
17 public health and health planning council, or its predecessor, for that
18 corporation shall be subject to approval by the public health and health
19 planning council, in accordance with the provisions of subdivisions two
20 and three of this section and rules and regulations pursuant thereto;
21 except that: any such transaction shall be subject to the approval by
22 the public health and health planning council in accordance with [para-
23 graph (b) of] subdivision three of this section only with respect to a
24 new stockholder or a new principal stockholder[; and shall not be
25 subject to paragraph (a) of subdivision three of this section]. In the
26 absence of such approval, the operating certificate of such hospital
27 shall be subject to revocation or suspension. No prior approval of the
28 public health and health planning council shall be required with respect
29 to a transfer, assignment or disposition of ten percent or more of the
30 stock or voting rights thereunder of a corporation which is the operator
31 of a hospital or which is a member of a limited liability company which
32 is the owner of a hospital to any person previously approved by the
33 public health and health planning council, or its predecessor, for that
34 corporation. However, no such transaction shall be effective unless at
35 least ninety days prior to the intended effective date thereof, the
36 stockholder completes and files with the public health and health plan-
37 ning council notice on forms to be developed by the public health and
38 health planning council, which shall disclose such information as may
39 reasonably be necessary for the public health and health planning coun-
40 cil to determine whether it should bar the transaction. Such transaction
41 will be final as of the intended effective date unless, prior thereto,
42 the public health and health planning council shall state specific
43 reasons for barring such transactions under this paragraph and shall
44 notify each party to the proposed transaction. Nothing in this paragraph
45 shall be construed as permitting a person not previously approved by the
46 public health and health planning council for that corporation to become
47 the owner of ten percent or more of the stock of a corporation which is
48 the operator of a hospital or which is a member of a limited liability
49 company which is the owner of a hospital without first obtaining the
50 approval of the public health and health planning council.
51 S 11. Subparagraph (i) of paragraph (g) and subparagraph (i) of para-
52 graph (h) of subdivision 4 of section 2801-a of the public health law,
53 as amended by section 57 of part A of chapter 58 of the laws of 2010,
54 are amended to read as follows:
S. 4207 74
1 (i) the character, competence and standing in the community of each
2 proposed trustee operator pursuant to the provisions of [paragraph (b)
3 of] subdivision three of this section; and
4 (i) the character, competence and standing in the community of the
5 proposed conservator operator or committee operator pursuant to the
6 provisions of [paragraph (b) of] subdivision three of this section; and
7 S 12. Paragraph (a) of subdivision 14 of section 2801-a of the public
8 health law, as amended by section 57 of part A of chapter 58 of the laws
9 of 2010, is amended to read as follows:
10 (a) The public health and health planning council may approve the
11 establishment of not-for-profit rural health networks as defined in
12 article twenty-nine-A of this chapter, pursuant to the provisions of
13 subdivisions two and three of this section, except that the public
14 health and health planning council shall not consider the [public need
15 for and] financial resources and sources of future revenues of such
16 networks which do not seek approval to operate a hospital. In addition
17 to character and competence, the public health and health planning coun-
18 cil may take into consideration available network plans.
19 S 13. Paragraph (b) of subdivision 15 of section 2801-a of the public
20 health law, as amended by section 57 of part A of chapter 58 of the laws
21 of 2010, is amended to read as follows:
22 (b) The following provisions of this section shall not apply to diag-
23 nostic or treatment centers operated pursuant to this subdivision: (i)
24 [paragraph (b) of] subdivision three of this section, relating to stock-
25 holders and members; (ii) paragraph (c) of subdivision four of this
26 section, relating to the disposition of stock or voting rights; and
27 (iii) paragraph (e) of subdivision four of this section, relating to the
28 ownership of stock or membership.
29 S 14. Subdivision 4 of section 2801-e of the public health law, as
30 added by chapter 750 of the laws of 2004, is amended to read as follows:
31 4. Any reductions in the number of operational residential health care
32 facility beds resulting from this demonstration shall not be considered
33 to create additional public need for residential health care facility
34 beds [under this article].
35 S 15. Paragraph (c) of subdivision 6 of section 2801-e of the public
36 health law, as amended by chapter 257 of the laws of 2005, is amended to
37 read as follows:
38 (c) The commissioner may, as necessary, waive existing methodologies
39 for determining public need under [this article,] article thirty-six of
40 this chapter and article seven of the social services law, as well as
41 enrollment limitations under section forty-four hundred three-f of this
42 chapter, to accommodate permanent conversions of beds to other programs
43 or services on the basis that any such increases in capacity are linked
44 to commensurate reductions in the number of residential health care
45 facility beds.
46 S 16. Subdivision 2 of section 2802 of the public health law, as
47 amended by section 58 of part A of chapter 58 of the laws of 2010, is
48 amended to read as follows:
49 2. The commissioner shall not act upon an application for construction
50 of a hospital until the public health and health planning council and
51 the [health systems agency] FINGER LAKES HEALTH SYSTEM AGENCY have had a
52 reasonable time to submit their recommendations, and unless [(a)] the
53 applicant has obtained all approvals and consents required by law for
54 its incorporation or establishment (including the approval of the public
55 health and health planning council pursuant to the provisions of this
56 article) provided, however, that the commissioner may act upon an appli-
S. 4207 75
1 cation for construction by an applicant possessing a valid operating
2 certificate when the application qualifies for review without the recom-
3 mendation of the council pursuant to regulations adopted by the council
4 and approved by the commissioner[; and (b) the commissioner is satisfied
5 as to the public need for the construction, at the time and place and
6 under the circumstances proposed, provided however that, in the case of
7 an application by a hospital established or operated by an organization
8 defined in subdivision one of section four hundred eighty-two-b of the
9 social services law, the needs of the members of the religious denomi-
10 nation concerned, for care or treatment in accordance with their reli-
11 gious or ethical convictions, shall be deemed to be public need].
12 S 17. Paragraph (a) of subdivision 6 of section 2806 of the public
13 health law, as amended by chapter 77 of the laws of 1977, such subdivi-
14 sion as renumbered by chapter 896 of the laws of 1977, is amended to
15 read as follows:
16 (a) Notwithstanding the provisions of subdivisions two through four of
17 this section, the commissioner shall suspend, limit, modify, or revoke a
18 hospital operating certificate, after taking into consideration [the
19 total number of beds necessary to meet the public need,] the availabili-
20 ty of facilities or services such as preadmission, ambulatory, home care
21 or other services which may serve as alternatives or substitutes for the
22 whole or any part of any such hospital facility, and, in the case of
23 modification, the level of care and the nature and type of services
24 provided or required by all or some of the patients in or seeking admis-
25 sion to such hospital facility, and whether such level of care is
26 consistent with the operating certificate of the hospital, and after
27 finding that suspending, limiting, modifying, or revoking the operating
28 certificate of such facility would be within the public interest [in
29 order to conserve health resources by restricting the number of beds
30 and/or the level of services to those which are actually needed].
31 S 18. Paragraph (f) of subdivision 6 of section 2806 of the public
32 health law, as added by chapter 769 of the laws of 1977, is amended to
33 read as follows:
34 (f) In determining whether there is a [public need] NECESSITY for any
35 services or facilities as required by this subdivision, the commissioner
36 shall consider the advice of the state health planning and development
37 agency designated pursuant to the provisions of the national health
38 planning and resources development act of nineteen hundred seventy-four
39 and any amendments thereto and the state health plan developed there-
40 under.
41 S 19. Subdivision 1 of section 2874-a of the public health law, as
42 added by chapter 934 of the laws of 1985, is amended to read as follows:
43 1. The medical care facilities finance agency shall not make a mort-
44 gage loan to eligible secured hospital borrowers unless [the commission-
45 er has recommended the project based on public need,] the hospital
46 discloses the financial resources available to it, and the hospital
47 complies with the provisions of article twenty-eight of this chapter. In
48 considering the financial resources available to support a project, the
49 commissioner shall take into account programs designed to offset eligi-
50 ble secured hospital borrowers' past and current unmet bad debt and
51 charity care losses.
52 S 20. Section 2802 of the public health law is amended by adding two
53 new subdivisions 8 and 9 to read as follows:
54 8. NOTWITHSTANDING ANY LAW, RULE, OR REGULATION TO THE CONTRARY, THIS
55 SUBDIVISION SHALL APPLY TO ANY APPLICATION FOR CONSTRUCTION REQUIRED
56 UNDER THIS SECTION WITH THE EXCEPTION OF THOSE FEDERALLY QUALIFIED
S. 4207 76
1 HEALTH CENTER CAPITAL PROJECTS SUBJECT TO SECTION TWENTY-EIGHT HUNDRED
2 SEVEN-Z OF THIS ARTICLE.
3 (A) FOR AN APPLICATION REQUIRING A LIMITED OR ADMINISTRATIVE REVIEW,
4 WITHIN NINETY CALENDAR DAYS OF THE DEPARTMENT DEEMING THE APPLICATION
5 COMPLETE, THE COMMISSIONER SHALL MAKE A DECISION TO APPROVE OR DISAP-
6 PROVE THE APPLICATION. IF THE COMMISSIONER DETERMINES TO DISAPPROVE THE
7 APPLICATION, THE BASIS FOR SUCH DISAPPROVAL SHALL BE PROVIDED IN WRIT-
8 ING; HOWEVER, DISAPPROVAL SHALL NOT BE BASED ON THE INCOMPLETENESS OF
9 THE APPLICATION. IF THE COMMISSIONER FAILS TO TAKE ACTION TO APPROVE OR
10 DISAPPROVE THE APPLICATION WITHIN NINETY CALENDAR DAYS OF THE APPLICA-
11 TION BEING DEEMED COMPLETE, THE APPLICATION SHALL BE DEEMED APPROVED.
12 (B) FOR AN APPLICATION REQUIRING FULL REVIEW BY THE COUNCIL, THE
13 APPLICATION SHALL BE PLACED ON THE NEXT COUNCIL AGENDA FOLLOWING THE
14 DEPARTMENT DEEMING THE APPLICATION COMPLETE.
15 (C) WHERE THE COMMISSIONER OR DEPARTMENT REQUIRES THE APPLICANT TO
16 SUBMIT INFORMATION TO SATISFY A CONTINGENCY FOR A CONSTRUCTION PROJECT,
17 THE COMMISSIONER OR DEPARTMENT SHALL HAVE THIRTY CALENDAR DAYS TO REVIEW
18 AND APPROVE OR DISAPPROVE THE SUBMITTED INFORMATION. IF THE COMMISSIONER
19 OR DEPARTMENT DETERMINES THAT THE SUBMITTED INFORMATION IS INCOMPLETE,
20 IT SHALL SO NOTIFY THE APPLICANT IN WRITING AND PROVIDE THE APPLICANT
21 WITH TEN CALENDAR DAYS TO CORRECT THE DEFICIENCY OR PROVIDE ADDITIONAL
22 INFORMATION. IF THE COMMISSIONER OR DEPARTMENT DETERMINES THAT THE
23 SUBMITTED INFORMATION DOES NOT SATISFY THE CONTINGENCY, THE BASIS FOR
24 SUCH DISAPPROVAL SHALL BE PROVIDED IN WRITING; HOWEVER, DISAPPROVAL
25 SHALL NOT BE BASED ON THE INCOMPLETENESS OF THE APPLICATION. WITHIN
26 FIFTEEN CALENDAR DAYS OF COMPLETE SATISFACTION OF A CONTINGENCY, THE
27 COMMISSIONER OR DEPARTMENT SHALL TRANSMIT THE FINAL APPROVAL LETTER TO
28 THE APPLICANT.
29 (D) THE DEPARTMENT SHALL DEVELOP EXPEDITED PRE-OPENING SURVEY PROC-
30 ESSES FOR APPLICATIONS APPROVED UNDER THIS SECTION, BUT UNDER NO CIRCUM-
31 STANCES SHALL PRE-OPENING SURVEY REVIEWS BE SCHEDULED LATER THAN THIRTY
32 CALENDAR DAYS AFTER FINAL APPROVAL, CONSTRUCTION COMPLETION AND NOTIFI-
33 CATION OF SUCH COMPLETION OF THE DEPARTMENT.
34 9. WITH REGARD TO ANY CONSTRUCTION PROJECT REQUIRING SUBMISSION OF AN
35 APPLICATION PURSUANT TO THIS SECTION WHERE THE COMMISSIONER HAS DETER-
36 MINED THAT A WRITTEN CERTIFICATION BY AN ARCHITECT OR ENGINEER LICENSED
37 PURSUANT TO ARTICLE ONE HUNDRED FORTY-FIVE OR ONE HUNDRED FORTY-SEVEN OF
38 THE EDUCATION LAW THAT THE PROJECT MEETS APPLICABLE REGULATIONS OF THE
39 DEPARTMENT CAN BE ACCEPTED, THE SUBMISSION BY THE APPLICANT OF SUCH
40 COMPLETE AND FULLY EXECUTED CERTIFICATION BY CERTIFIED OR REGISTERED
41 MAIL WITH A RETURN RECEIPT SIGNED BY THE DEPARTMENT SHALL CONSTITUTE A
42 FULFILLMENT OF THE CERTIFICATION REQUIREMENT AND THE DEPARTMENT SHALL
43 PROCEED WITH THE PROCESSING OF SUCH APPLICATION. NOTHING IN THIS SECTION
44 SHALL BE CONSTRUED AS PROHIBITING THE DEPARTMENT UPON SURVEY FROM
45 REQUIRING SUBSEQUENT CORRECTIONS TO THE PROJECT TO MEET THE APPLICABLE
46 REGULATIONS.
47 S 21. Subdivision 1 of section 2806-a of the public health law is
48 amended by adding a new paragraph (g) to read as follows:
49 (G) "IMPROPER DELEGATION OF AUTHORITY TO A MANAGEMENT CONSULTANT BY
50 THE GOVERNING AUTHORITY OR OPERATOR" OF A GENERAL HOSPITAL SHALL
51 INCLUDE, BUT NOT BE LIMITED TO, THE DELEGATION OF (I) AUTHORITY TO HIRE
52 OR FIRE THE ADMINISTRATOR OR OTHER KEY MANAGEMENT EMPLOYEES; (II) MAIN-
53 TENANCE AND CONTROL OF THE BOOKS AND RECORDS; (III) AUTHORITY OVER THE
54 DISPOSITION OF ASSETS AND THE INCURRING OF LIABILITIES ON BEHALF OF THE
55 FACILITY; AND (IV) THE ADOPTION AND ENFORCEMENT OF POLICIES REGARDING
56 THE OPERATION OF THE FACILITY. THE CRITERIA SET FORTH IN THIS PARAGRAPH
S. 4207 77
1 SHALL NOT BE THE SOLE DETERMINING FACTORS, BUT INDICATORS TO BE CONSID-
2 ERED WITH SUCH OTHER FACTORS THAT MAY BE PERTINENT IN PARTICULAR
3 INSTANCES. PROFESSIONAL EXPERTISE SHALL BE EXERCISED IN THE UTILIZATION
4 OF THE CRITERIA. ALL OF THE LISTED INDICIA NEED NOT BE PRESENT IN A
5 GIVEN INSTANCE FOR THERE TO BE AN IMPROPER DELEGATION OF AUTHORITY.
6 S 22. Paragraph (a) of subdivision 2 of section 2806-a of the public
7 health law, as added by section 50 of part E of chapter 56 of the laws
8 of 2013, is amended to read as follows:
9 (a) In the event that: (i) a facility seeks extraordinary financial
10 assistance and the commissioner finds that the facility is experiencing
11 serious financial instability that is jeopardizing existing or continued
12 access to essential services within the community, or (ii) the commis-
13 sioner finds that there are conditions within the facility that serious-
14 ly endanger the life, health or safety of residents or patients, the
15 commissioner may appoint a temporary operator to assume sole control and
16 sole responsibility for the operations of that facility, OR (III) THE
17 COMMISSIONER FINDS THAT THERE HAS BEEN AN IMPROPER DELEGATION OF AUTHOR-
18 ITY TO A MANAGEMENT CONSULTANT BY THE GOVERNING AUTHORITY OR OPERATOR OF
19 A GENERAL HOSPITAL, THE COMMISSIONER SHALL APPOINT A TEMPORARY OPERATOR
20 TO ASSUME SOLE CONTROL AND SOLE RESPONSIBILITY FOR THE OPERATIONS OF
21 THAT FACILITY. The appointment of the temporary operator shall be effec-
22 tuated pursuant to this section and shall be in addition to any other
23 remedies provided by law.
24 S 23. Subdivision 5 of section 2806-a of the public health law, as
25 added by section 50 of part E of chapter 56 of the laws of 2013, is
26 amended to read as follows:
27 5. (a) The initial term of the appointment of the temporary operator
28 shall not exceed one hundred eighty days. After one hundred eighty days,
29 if the commissioner determines that termination of the temporary opera-
30 tor would cause significant deterioration of the quality of, or access
31 to, health care or residential care in the community or that reappoint-
32 ment is necessary to correct the conditions within the facility that
33 seriously endanger the life, health or safety of residents or patients,
34 or the financial instability that required the appointment of the tempo-
35 rary operator, the commissioner may authorize up to two additional nine-
36 ty-day terms.
37 (b) Upon the completion of the two ninety-day terms referenced in
38 paragraph (a) of this subdivision,
39 (i) if the established operator is the debtor in a bankruptcy proceed-
40 ing, and the commissioner determines that the temporary operator
41 requires additional terms to operate the facility during the pendency of
42 the bankruptcy proceeding and to carry out any plan resulting from the
43 proceeding, the commissioner may reappoint the temporary operator for
44 additional ninety-day terms until the termination of the bankruptcy
45 proceeding, provided that the commissioner shall provide for notice and
46 a hearing as set forth in subdivision six of this section; [or]
47 (ii) if the established operator requests the reappointment of the
48 temporary operator, the commissioner may reappoint the temporary opera-
49 tor for one additional ninety-day term, pursuant to an agreement between
50 the established operator, the temporary operator and the department[.];
51 OR
52 (III) IF THE COMMISSIONER FINDS THAT CONDITIONS REGARDING THE IMPROPER
53 DELEGATION OF AUTHORITY TO A MANAGEMENT CONSULTANT BY THE GOVERNING
54 AUTHORITY OR OPERATOR OF A GENERAL HOSPITAL HAVE NOT BEEN REMEDIED, HE
55 SHALL SUBMIT A RECOMMENDATION TO THE PUBLIC HEALTH AND HEALTH PLANNING
S. 4207 78
1 COUNCIL FOR REMEDIAL ACTION PURSUANT TO PARAGRAPH (I) OF SUBDIVISION
2 FOUR OF SECTION TWENTY-EIGHT HUNDRED ONE-A OF THIS ARTICLE.
3 (c) Within fourteen days prior to the termination of each term of the
4 appointment of the temporary operator, the temporary operator shall
5 submit to the commissioner and to the established operator a report
6 describing:
7 (i) the actions taken during the appointment to address such deficien-
8 cies and financial instability,
9 (ii) objectives for the continuation of the temporary operatorship if
10 necessary and a schedule for satisfaction of such objectives,
11 (iii) recommended actions for the ongoing operation of the facility
12 subsequent to the term of the temporary operator INCLUDING RECOMMENDA-
13 TIONS REGARDING THE PROPER MANAGEMENT OF THE FACILITY AND ONGOING AGREE-
14 MENTS WITH MANAGEMENT CONSULTANTS; and
15 (iv) with respect to the first ninety-day term referenced in paragraph
16 (a) of this subdivision, a plan for sustainable operation to avoid
17 closure, or transformation of the facility which may include any option
18 permissible under this chapter or the social services law and implement-
19 ing regulations thereof. The report shall reflect best efforts to
20 produce a full and complete accounting.
21 (d) The term of the initial appointment and of any subsequent reap-
22 pointment may be terminated prior to the expiration of the designated
23 term, if the established operator and the commissioner agree on a plan
24 of correction and the implementation of such plan.
25 S 24. Subdivision 4 of section 2801-a of the public health law is
26 amended by adding a new paragraph (i) to read as follows:
27 (I) UPON RECOMMENDATION BY THE COMMISSIONER, IF THE PUBLIC HEALTH AND
28 HEALTH PLANNING COUNCIL FINDS BY SUBSTANTIAL EVIDENCE THAT AN IMPROPER
29 DELEGATION OF AUTHORITY TO A MANAGEMENT CONSULTANT BY A GOVERNING
30 AUTHORITY OR OPERATOR OF A GENERAL HOSPITAL HAS OCCURRED AS DEFINED BY
31 PARAGRAPH (G) OF SUBDIVISION ONE OF SECTION TWENTY-EIGHT HUNDRED SIX-A
32 OF THIS ARTICLE, THE OPERATING CERTIFICATE OF SUCH HOSPITAL SHALL BE
33 SUBJECT TO REVOCATION OR SUSPENSION.
34 S 25. This act shall take effect immediately; provided, however, that
35 sections seven through twenty of this act shall take effect January 1,
36 2016; provided, further, that the amendments to subdivision 1 of section
37 2874-a of the public health law, made by section nineteen of this act,
38 shall not affect the expiration of such section and shall be deemed to
39 expire therewith; and provided, further, that the amendments to section
40 2806-a of the public health law, made by sections twenty-one, twenty-two
41 and twenty-three of this act, shall not affect the expiration and repeal
42 of such section, and shall be deemed repealed therewith.
43 PART L
44 Section 1. Section 230-d of the public health law is amended by adding
45 two new subdivisions 6 and 7 to read as follows:
46 6. THE COMMISSIONER SHALL CONVENE AN OFFICE-BASED SURGERY WORKGROUP TO
47 REVIEW THE SCOPE OF OFFICE-BASED SURGERY. THE WORKGROUP SHALL BE
48 COMPRISED OF STAKEHOLDERS AND EXPERTS IN THE FIELD OF OFFICE-BASED
49 SURGERY, WHICH SHALL AT A MINIMUM INCLUDE NO LESS THAN FIVE PHYSICIANS
50 CURRENTLY ACCREDITED IN OFFICE-BASED SURGERY AND NO LESS THAN TWO
51 LICENSED ANESTHESIOLOGISTS, TWO LICENSED CHIROPRACTORS, AND TWO LICENSED
52 PODIATRISTS. THE WORKGROUP SHALL EXAMINE THE SCOPE OF OFFICE-BASED
53 SURGERY IN NEW YORK AND WHETHER CERTAIN SURGICAL PROCEDURES NOT CURRENT-
54 LY PROVIDED IN THIS SETTING SHOULD BE, WHETHER CERTAIN SURGICAL PROCE-
S. 4207 79
1 DURES CURRENTLY PROVIDED SHOULD NOT BE PROVIDED IN THIS SETTING, AND
2 WHETHER NON-SURGICAL PROCEDURES INVOLVING CERTAIN LEVELS OF ANESTHESIA
3 SHOULD BE PROVIDED WITHIN THIS SETTING. IN EXAMINING THE SCOPE OF
4 OFFICE-BASED SURGERY, THE WORKGROUP SHALL CONSIDER WHAT OTHER STATES
5 COVER UNDER THIS ACCREDITATION AND WHAT MEDICARE COVERS IN THIS SETTING.
6 THE WORKGROUP SHALL REPORT AND RECOMMEND ANY STATUTORY CHANGES THEY DEEM
7 APPROPRIATE TO THE LEGISLATURE. SUCH REPORT SHALL BE SUBMITTED TO THE
8 TEMPORARY PRESIDENT OF THE SENATE, SPEAKER OF THE ASSEMBLY, CHAIR OF THE
9 SENATE STANDING COMMITTEE ON HEALTH AND CHAIR OF THE ASSEMBLY HEALTH
10 COMMITTEE BY DECEMBER FIRST, TWO THOUSAND FIFTEEN.
11 7. EVERY OFFICE-BASED SURGERY PRACTICE WITH FULL ACCREDITED STATUS
12 SHALL BE ELIGIBLE TO SEEK PAYMENT FROM A HEALTH PLAN FOR COSTS RELATED
13 TO THE USE OF SUCH SURGERY LOCATION OR SETTING. SUCH FEE IS IN ADDITION
14 TO THE FEE CHARGED BY THE LICENSEE FOR THE PERFORMANCE OF THE COVERED
15 OFFICE-BASED SURGERY INVOLVING AN INSURED OR A HEALTH PLAN ENROLLEE;
16 PROVIDED THAT THE HEALTH PLAN ALSO REIMBURSES FOR COSTS RELATED TO THE
17 USE OF A SURGERY LOCATION OR SETTING CHARGED IN CONNECTION WITH THE SAME
18 COVERED PROCEDURE PERFORMED AT A HOSPITAL OR AMBULATORY SURGERY CENTER
19 ORGANIZED PURSUANT TO ARTICLE TWENTY-EIGHT OF THIS CHAPTER. WHEN CALCU-
20 LATING THE APPROPRIATE RATE OF OFFICE-BASED SURGERY RELATED REIMBURSE-
21 MENT, A HEALTH PLAN MAY ALSO TAKE INTO CONSIDERATION CERTAIN COMPARABLE
22 AND NON-COMPARABLE COSTS AND OBLIGATIONS OF AMBULATORY SURGERY CENTERS
23 AND HOSPITALS AND ADJUST RATES ACCORDINGLY AND IN A REASONABLE MANNER.
24 S 2. Paragraph (b) of subdivision 1 of section 230-d of the public
25 health law, as added by chapter 365 of the laws of 2007, is amended to
26 read as follows:
27 (b) "Adverse event" means (i) patient death within thirty days; (ii)
28 unplanned transfer to a hospital OR EMERGENCY DEPARTMENT VISIT WITHIN
29 SEVENTY-TWO HOURS OF OFFICE-BASED SURGERY; (iii) unscheduled hospital
30 admission OR ASSIGNMENT TO OBSERVATION SERVICES, within seventy-two
31 hours of the office-based surgery, for longer than twenty-four hours; or
32 (iv) any other serious or life-threatening event.
33 S 3. The section heading and subdivisions 1 and 2 of section 2998-e of
34 the public health law, as added by chapter 365 of the laws of 2007, are
35 amended to read as follows:
36 Reporting [of adverse events] in office based surgery. 1. The commis-
37 sioner shall enter into agreements with accrediting agencies pursuant to
38 which the accrediting agencies shall REQUIRE ALL OFFICE-BASED SURGICAL
39 PRACTICES TO CONDUCT QUALITY IMPROVEMENT AND QUALITY ASSURANCE ACTIV-
40 ITIES AND UTILIZE AMERICAN BOARD OF MEDICAL SPECIALTIES (ABMS) OR EQUIV-
41 ALENT CERTIFICATION, HOSPITAL PRIVILEGING OR OTHER EQUIVALENT METHODS TO
42 DETERMINE COMPETENCY OF PRACTITIONERS TO PERFORM OFFICE-BASED SURGERY.
43 THE ACCREDITING AGENCY SHALL report[, at a minimum, aggregate] data [on
44 adverse events] for all office-based surgical practices accredited by
45 the accrediting agencies to the department. The department may disclose
46 reports of aggregate data to the public.
47 2. The information required to be collected, maintained and reported
48 directly to the department AND THE ACCREDITING AGENCIES, AND MAINTAINED
49 BY OFFICE-BASED SURGERY PRACTICES UNDER QUALITY IMPROVEMENT AND QUALITY
50 ASSURANCE ACTIVITIES pursuant to section two hundred thirty-d of this
51 chapter shall be kept confidential and shall not be released, except to
52 the department and except as required or permitted under subdivision
53 nine-a and subparagraph (v) of paragraph (a) of subdivision ten of
54 section two hundred thirty of this chapter. Notwithstanding any other
55 provision of law, none of [such information] THE INFORMATION COLLECTED,
56 MAINTAINED AND REPORTED TO THE DEPARTMENT OR THE ACCREDITING AGENCIES,
S. 4207 80
1 AND MAINTAINED BY THE OFFICE-BASED SURGERY PRACTICES UNDER QUALITY
2 IMPROVEMENT AND QUALITY ASSURANCE ACTIVITIES PURSUANT TO THIS SECTION
3 shall be subject to disclosure under article six of the public officers
4 law or article thirty-one of the civil practice law and rules.
5 S 4. Section 2806 of the public health law is amended by adding a new
6 subdivision 1-a to read as follows:
7 1-A. ANY AMBULATORY SURGERY CENTER THAT MAINTAINS AN ACCREDITATION
8 STATUS IN ADDITION TO ITS LICENSURE UNDER THIS ARTICLE SHALL BE SUBJECT
9 TO A HEARING PURSUANT TO THIS SECTION IN ORDER TO DETERMINE WHETHER ITS
10 OPERATING CERTIFICATION SHOULD BE SUSPENDED OR REVOKED UPON THE REMOVAL
11 OF ACCREDITATION BY ANY ACCREDITING BODY.
12 S 5. This act shall take effect immediately, except that section three
13 of this act shall take effect on the ninetieth day after it shall have
14 become a law.
15 PART M
16 Section 1. Subdivisions 1 and 2 of section 1100-a of the public health
17 law, as added by chapter 258 of the laws of 1996, are amended and two
18 new subdivisions 3 and 4 are added to read as follows:
19 1. Notwithstanding any contrary provision of law, rule, regulation or
20 code, any county, city, town or village that owns both its public water
21 system and the water supply for such system may by local law provide
22 whether a fluoride compound shall [or shall not] be added to such public
23 water supply.
24 2. Any county, wherein a public authority owns both its public water
25 system and the water supply for such system, may by local law provide
26 whether a fluoride compound shall [or shall not] be added to such public
27 water supply.
28 3. NO COUNTY, CITY, TOWN OR VILLAGE, INCLUDING A COUNTY WHEREIN A
29 PUBLIC AUTHORITY OWNS BOTH ITS PUBLIC WATER SYSTEM AND THE WATER SUPPLY
30 FOR SUCH SYSTEM, THAT FLUORIDATES A PUBLIC WATER SUPPLY OR CAUSES A
31 PUBLIC WATER SUPPLY TO BE FLUORIDATED, SHALL DISCONTINUE THE ADDITION OF
32 A FLUORIDE COMPOUND TO SUCH PUBLIC WATER SUPPLY UNLESS IT HAS FIRST
33 COMPLIED WITH THE FOLLOWING REQUIREMENTS:
34 (A) ISSUE A NOTICE TO THE PUBLIC OF THE PRELIMINARY DETERMINATION TO
35 DISCONTINUE FLUORIDATION FOR COMMENT, WHICH SHALL INCLUDE THE JUSTIFICA-
36 TION FOR THE PROPOSED DISCONTINUANCE, ALTERNATIVES TO FLUORIDATION
37 AVAILABLE, AND A SUMMARY OF CONSULTATIONS WITH HEALTH PROFESSIONALS AND
38 THE DEPARTMENT CONCERNING THE PROPOSED DISCONTINUANCE. SUCH NOTICE MAY,
39 BUT IS NOT REQUIRED TO, INCLUDE PUBLICATION IN LOCAL NEWSPAPERS.
40 "CONSULTATIONS WITH HEALTH PROFESSIONALS" MAY INCLUDE FORMAL STUDIES BY
41 HIRED PROFESSIONALS, INFORMAL CONSULTATIONS WITH LOCAL PUBLIC HEALTH
42 OFFICIALS OR OTHER HEALTH PROFESSIONALS, OR OTHER CONSULTATIONS,
43 PROVIDED THAT THE NATURE OF SUCH CONSULTATIONS AND THE IDENTITY OF SUCH
44 PROFESSIONALS SHALL BE IDENTIFIED IN THE PUBLIC NOTICE. "ALTERNATIVES TO
45 FLUORIDATION" MAY INCLUDE FORMAL ALTERNATIVES PROVIDED BY OR AT THE
46 EXPENSE OF THE COUNTY, CITY, TOWN OR VILLAGE, OR OTHER ALTERNATIVES
47 AVAILABLE TO THE PUBLIC. ANY PUBLIC COMMENTS RECEIVED IN RESPONSE TO
48 SUCH NOTICE SHALL BE ADDRESSED BY THE COUNTY, CITY, TOWN OR VILLAGE IN
49 THE ORDINARY COURSE OF BUSINESS; AND
50 (B) PROVIDE THE DEPARTMENT AT LEAST NINETY DAYS PRIOR WRITTEN NOTICE
51 OF THE INTENT TO DISCONTINUE AND SUBMIT A PLAN FOR DISCONTINUANCE THAT
52 INCLUDES BUT IS NOT LIMITED TO THE NOTICE THAT WILL BE PROVIDED TO THE
53 PUBLIC, CONSISTENT WITH PARAGRAPH (A) OF THIS SUBDIVISION, OF THE DETER-
54 MINATION TO DISCONTINUE FLUORIDATION OF THE WATER SUPPLY, INCLUDING THE
S. 4207 81
1 DATE OF SUCH DISCONTINUANCE AND ALTERNATIVES TO FLUORIDATION, IF ANY,
2 THAT WILL BE MADE AVAILABLE IN THE COMMUNITY, AND THAT INCLUDES INFORMA-
3 TION AS MAY BE REQUIRED UNDER THE SANITARY CODE.
4 4. THE COMMISSIONER IS HEREBY AUTHORIZED, WITHIN AMOUNTS APPROPRIATED
5 THEREFOR, TO MAKE GRANTS TO COUNTIES, CITIES, TOWNS OR VILLAGES THAT OWN
6 THEIR PUBLIC WATER SYSTEM AND THE WATER SUPPLY FOR SUCH SYSTEM, INCLUD-
7 ING A COUNTY WHEREIN A PUBLIC AUTHORITY OWNS BOTH ITS PUBLIC WATER
8 SYSTEM AND THE WATER SUPPLY FOR SUCH SYSTEM, FOR THE PURPOSE OF PROVID-
9 ING ASSISTANCE TOWARDS THE COSTS OF INSTALLATION, INCLUDING BUT NOT
10 LIMITED TO TECHNICAL AND ADMINISTRATIVE COSTS ASSOCIATED WITH PLANNING,
11 DESIGN AND CONSTRUCTION, AND START-UP OF FLUORIDATION SYSTEMS, AND
12 REPLACING, REPAIRING OR UPGRADING OF FLUORIDATION EQUIPMENT FOR SUCH
13 PUBLIC WATER SYSTEMS. GRANT FUNDING SHALL NOT BE AVAILABLE FOR ASSIST-
14 ANCE TOWARDS THE COSTS AND EXPENSES OF OPERATION OF THE FLUORIDATION
15 SYSTEM, AS DETERMINED BY THE DEPARTMENT. THE GRANT APPLICATIONS SHALL
16 INCLUDE SUCH INFORMATION AS REQUIRED BY THE COMMISSIONER. IN MAKING THE
17 GRANT AWARDS, THE COMMISSIONER SHALL CONSIDER THE DEMONSTRATED NEED FOR
18 INSTALLATION OF NEW FLUORIDATION EQUIPMENT OR REPLACING, REPAIRING OR
19 UPGRADING OF EXISTING FLUORIDATION EQUIPMENT, AND SUCH OTHER CRITERIA AS
20 DETERMINED BY THE COMMISSIONER. GRANT AWARDS SHALL BE MADE ON A COMPET-
21 ITIVE BASIS AND BE SUBJECT TO SUCH CONDITIONS AS MAY BE DETERMINED BY
22 THE COMMISSIONER.
23 S 2. This act shall take effect immediately.
24 PART N
25 Intentionally Omitted
26 PART O
27 Section 1. Section 1 of part D of chapter 111 of the laws of 2010
28 relating to the recovery of exempt income by the office of mental health
29 for community residences and family-based treatment programs as amended
30 by section 1 of part C of chapter 58 of the laws of 2014, is amended to
31 read as follows:
32 Section 1. The office of mental health is authorized to recover fund-
33 ing from community residences and family-based treatment providers
34 licensed by the office of mental health, consistent with contractual
35 obligations of such providers, and notwithstanding any other inconsist-
36 ent provision of law to the contrary, in an amount equal to 50 percent
37 of the income received by such providers which exceeds the fixed amount
38 of annual Medicaid revenue limitations, as established by the commis-
39 sioner of mental health. Recovery of such excess income shall be for the
40 following fiscal periods: for programs in counties located outside of
41 the city of New York, the applicable fiscal periods shall be January 1,
42 2003 through December 31, 2009 and January 1, 2011 through December 31,
43 [2015] 2016; and for programs located within the city of New York, the
44 applicable fiscal periods shall be July 1, 2003 through June 30, 2010
45 and July 1, 2011 through June 30, [2015] 2016.
46 S 2. This act shall take effect immediately.
47 PART P
S. 4207 82
1 Section 1. Subparagraph 9 of paragraph h of subdivision 4 of section
2 1950 of the education law, as added by section 1 of part M of chapter 56
3 of the laws of 2012, is amended to read as follows:
4 (9) To enter into contracts with the commissioner of the office of
5 mental health, to provide special education [and], related services AND
6 ANY ALTERNATIVE EDUCATION PROGRAMS PROVIDED BY THE BOARD OF COOPERATIVE
7 EDUCATIONAL SERVICES TO COMPONENT SCHOOL DISTRICTS, in accordance with
8 subdivision six-b of section thirty-two hundred two of this chapter to
9 patients hospitalized in hospitals operated by the office of mental
10 health who are between the ages of five and twenty-one who have not
11 received a high school diploma. Any such proposed contract shall be
12 subject to the review by the commissioner and his [and] OR her determi-
13 nation that it is an approved cooperative educational service. Services
14 provided pursuant to such contracts shall be provided at cost and
15 approved by the commissioner of the office of mental health and the
16 director of the division of the budget, and the board of cooperative
17 educational services shall not be authorized to charge any costs
18 incurred in providing such services to its component school districts.
19 S 2. The opening paragraph of subdivision 6-b of section 3202 of the
20 education law, as added by section 2 of part M of chapter 56 of the laws
21 of 2012, is amended to read as follows:
22 The commissioner of mental health may meet his or her obligations
23 under section 33.11 of the mental hygiene law by contracting pursuant to
24 this subdivision for educational services for children between the ages
25 of five and twenty-one who do not hold a high school diploma and who are
26 hospitalized in hospitals operated by the office of mental health with
27 the trustees or board of education of any school district for educa-
28 tional services or with a board of cooperative educational services for
29 the provision of special education [and], related services AND ANY
30 ALTERNATIVE EDUCATION PROGRAMS PROVIDED BY THE BOARD OF COOPERATIVE
31 EDUCATIONAL SERVICES TO COMPONENT SCHOOL DISTRICTS to such children in
32 accordance with their individualized education programs. The costs of
33 such education shall not be a charge upon a school district pursuant to
34 section 33.11 of the mental hygiene law.
35 S 3. Section 4 of part M of chapter 56 of the laws of 2012 amending
36 the education law, relating to authorizing contracts for the provision
37 of special education and related services for certain patients hospital-
38 ized in hospitals operated by the office of mental health, is amended to
39 read as follows:
40 S 4. This act shall take effect July 1, 2012 and shall expire June 30,
41 [2015] 2018, when upon such date the provisions of this act shall be
42 deemed repealed.
43 S 4. This act shall take effect immediately and shall be deemed to
44 have been in full force and effect on and after April 1, 2015, provided,
45 however, that:
46 a. The amendments to subparagraph 9 of paragraph h of subdivision 4 of
47 section 1950 of the education law made by section one of this act shall
48 not affect the repeal of such subparagraph and shall be deemed repealed
49 therewith; and
50 b. The amendments to the opening paragraph of subdivision 6-b of
51 section 3202 of the education law made by section two of this act shall
52 not affect the repeal of such subdivision and shall be deemed repealed
53 therewith.
54 PART Q
S. 4207 83
1 Section 1. Section 2801-a of the public health law is amended by
2 adding a new subdivision 17 to read as follows:
3 17. (A) THE COMMISSIONER IS AUTHORIZED TO ESTABLISH A PILOT PROGRAM TO
4 ASSIST IN RESTRUCTURING HEALTH CARE DELIVERY SYSTEMS BY ALLOWING FOR
5 INCREASED CAPITAL INVESTMENT. PURSUANT TO THE PILOT PROGRAM, THE PUBLIC
6 HEALTH AND HEALTH PLANNING COUNCIL SHALL APPROVE THE ESTABLISHMENT, IN
7 ACCORDANCE WITH THE PROVISIONS OF PARAGRAPHS (F), (G) AND (H) OF THIS
8 SUBDIVISION AND SUBDIVISION THREE OF THIS SECTION, OF NO MORE THAN TEN
9 BUSINESS CORPORATIONS FORMED UNDER THE BUSINESS CORPORATION LAW. SUCH
10 BUSINESS CORPORATIONS SHALL AFFILIATE, THE EXTENT OF THE AFFILIATION TO
11 BE DETERMINED BY THE COMMISSIONER, WITH AT LEAST ONE ACADEMIC MEDICAL
12 INSTITUTION OR TEACHING HOSPITAL APPROVED BY THE COMMISSIONER. A BUSI-
13 NESS CORPORATION SHALL NOT BE ELIGIBLE TO PARTICIPATE IN THIS PROGRAM IF
14 ANY OF ITS STOCK, OR THAT OF ANY OF ITS DIRECT OR INDIRECT OWNERS, IS OR
15 WILL BE TRADED ON A PUBLIC STOCK EXCHANGE OR ON AN OVER-THE-COUNTER
16 MARKET.
17 (B) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, BUSINESS
18 CORPORATIONS ESTABLISHED PURSUANT TO THIS SUBDIVISION SHALL BE DEEMED
19 ELIGIBLE TO PARTICIPATE IN DEBT FINANCING PROVIDED BY THE DORMITORY
20 AUTHORITY OF THE STATE OF NEW YORK, LOCAL DEVELOPMENT CORPORATIONS AND
21 ECONOMIC DEVELOPMENT CORPORATIONS.
22 (C) THE FOLLOWING PROVISIONS OF THIS CHAPTER SHALL NOT APPLY TO BUSI-
23 NESS CORPORATIONS ESTABLISHED PURSUANT TO THIS SUBDIVISION: (I) PARA-
24 GRAPH (B) OF SUBDIVISION THREE OF THIS SECTION, RELATING TO STOCKHOLD-
25 ERS, OTHER THAN PRINCIPAL STOCKHOLDERS; (II) PARAGRAPH (C) OF
26 SUBDIVISION FOUR OF THIS SECTION, RELATING TO THE DISPOSITION OF STOCK
27 OR VOTING RIGHTS; (III) PARAGRAPHS (D) AND (E) OF SUBDIVISION FOUR OF
28 THIS SECTION, RELATING TO THE OWNERSHIP OF STOCK; AND (IV) PARAGRAPH (A)
29 OF SUBDIVISION THREE OF SECTION FOUR THOUSAND FOUR OF THIS CHAPTER,
30 RELATING TO THE OWNERSHIP OF STOCK. NOTWITHSTANDING THE FOREGOING, THE
31 PUBLIC HEALTH AND HEALTH PLANNING COUNCIL MAY REQUIRE THE DISCLOSURE OF
32 THE IDENTITY OF STOCKHOLDERS.
33 (D) THE CORPORATE POWERS AND PURPOSES OF A BUSINESS CORPORATION ESTAB-
34 LISHED AS AN OPERATOR PURSUANT TO THIS SUBDIVISION SHALL BE LIMITED TO
35 THE OWNERSHIP AND OPERATION, OR OPERATION, OF A HOSPITAL OR HOSPITALS
36 SPECIFICALLY NAMED AND THE LOCATION OR LOCATIONS OF WHICH ARE SPECIF-
37 ICALLY DESIGNATED BY STREET ADDRESS, CITY, TOWN, VILLAGE OR LOCALITY AND
38 COUNTY; PROVIDED, HOWEVER, THAT THE CORPORATE POWERS AND PURPOSES MAY
39 ALSO INCLUDE THE OWNERSHIP AND OPERATION, OR OPERATION, OF A CERTIFIED
40 HOME HEALTH AGENCY OR LICENSED HOME CARE SERVICES AGENCY OR AGENCIES AS
41 DEFINED IN ARTICLE THIRTY-SIX OF THIS CHAPTER OR A HOSPICE OR HOSPICES
42 AS DEFINED IN ARTICLE FORTY OF THIS CHAPTER, IF THE CORPORATION HAS
43 RECEIVED ALL APPROVALS REQUIRED UNDER SUCH LAW TO OWN AND OPERATE, OR
44 OPERATE, SUCH HOME CARE SERVICES AGENCY OR AGENCIES OR HOSPICE OR
45 HOSPICES. SUCH CORPORATE POWERS AND PURPOSES SHALL NOT BE MODIFIED,
46 AMENDED OR DELETED WITHOUT THE PRIOR APPROVAL OF THE COMMISSIONER.
47 (E)(1) IN DISCHARGING THE DUTIES OF THEIR RESPECTIVE POSITIONS, THE
48 BOARD OF DIRECTORS, COMMITTEES OF THE BOARD AND INDIVIDUAL DIRECTORS AND
49 OFFICERS OF A BUSINESS CORPORATION ESTABLISHED PURSUANT TO THIS SUBDIVI-
50 SION SHALL CONSIDER THE EFFECTS OF ANY ACTION UPON:
51 (A) THE ABILITY OF THE BUSINESS CORPORATION TO ACCOMPLISH ITS PURPOSE;
52 (B) THE SHAREHOLDERS OF THE BUSINESS CORPORATION;
53 (C) THE EMPLOYEES AND WORKFORCE OF THE HOSPITAL OR HOSPITALS;
54 (D) THE INTERESTS OF PATIENTS OF THE HOSPITAL OR HOSPITALS;
S. 4207 84
1 (E) COMMUNITY AND SOCIETAL CONSIDERATIONS, INCLUDING THOSE OF ANY
2 COMMUNITY IN WHICH FACILITIES OF THE HOSPITAL OR HOSPITALS ARE LOCATED;
3 AND
4 (F) THE SHORT-TERM AND LONG-TERM INTERESTS OF THE BUSINESS CORPO-
5 RATION, INCLUDING BENEFITS THAT MAY ACCRUE TO THE BUSINESS CORPORATION
6 FROM ITS LONG-TERM PLANS.
7 (2) THE CONSIDERATION OF INTERESTS AND FACTORS IN THE MANNER REQUIRED
8 BY SUBPARAGRAPH ONE OF THIS PARAGRAPH:
9 (A) SHALL NOT CONSTITUTE A VIOLATION OF THE PROVISIONS OF SECTION
10 SEVEN HUNDRED FIFTEEN OR SEVEN HUNDRED SEVENTEEN OF THE BUSINESS CORPO-
11 RATION LAW; AND
12 (B) IS IN ADDITION TO THE ABILITY OF DIRECTORS TO CONSIDER INTERESTS
13 AND FACTORS AS PROVIDED IN SECTION SEVEN HUNDRED SEVENTEEN OF THE BUSI-
14 NESS CORPORATION LAW.
15 (F) WHILE ANY DECISION TO APPROVE A BUSINESS CORPORATION UNDER THIS
16 SECTION MUST WEIGH AND BALANCE A NUMBER OF FACTORS, IN DETERMINING
17 WHETHER TO APPROVE A BUSINESS CORPORATION UNDER THIS SECTION, THE PUBLIC
18 HEALTH AND HEALTH PLANNING COUNCIL, IN CONSULTATION WITH THE COMMISSION-
19 ER, SHALL CONSIDER THE EXTENT TO WHICH THE BUSINESS CORPORATION:
20 (1) PROVIDES FOR EITHER EQUAL OR MAJORITY GOVERNANCE RIGHTS OF THE
21 NOT-FOR-PROFIT HOSPITAL PARTNER, REGARDLESS OF EQUITY STAKES, THROUGH
22 WEIGHTED CLASS VOTING STRUCTURE OR OTHERWISE;
23 (2) INCORPORATES A REPRESENTATIVE GOVERNANCE MODEL THAT:
24 (A) CLEARLY DELINEATES AUTHORITY AND RESPONSIBILITY FOR THE HOSPITAL'S
25 OPERATIONS; AND
26 (B) DEFINES MECHANISMS FOR APPROVAL OF DESIGNATED SHAREHOLDERS OR
27 INVESTORS;
28 (3) IS INCORPORATED AS A BENEFIT CORPORATION UNDER THE BUSINESS CORPO-
29 RATION LAW;
30 (4) COMMITS TO MAINTAINING OR ENHANCING EXISTING LEVELS OF SERVICES,
31 CHARITY CARE AND CORE COMMUNITY BENEFITS;
32 (5) IDENTIFIES AN ACTIONABLE STRATEGY TO MONITOR AND MAINTAIN OR
33 IMPROVE QUALITY OF CARE;
34 (6) EXPLAINS THE LEVEL OF CAPITAL COMMITMENT AND THE MECHANISM OR
35 MECHANISMS FOR INFUSING CAPITAL INTO THE NOT-FOR-PROFIT HOSPITAL PART-
36 NER;
37 (7) EXPLAINS HOW IT WILL RETAIN THE WORKFORCE, EITHER IN EXISTING JOBS
38 OR THROUGH RETRAINING, AND ADDRESSES OBLIGATIONS OWED TO EMPLOYEE BENE-
39 FIT PLANS AND PENSIONS;
40 (8) WILL CREATE A FOUNDATION TO ADDRESS THE PUBLIC HEALTH NEEDS OF THE
41 COMMUNITY; AND
42 (9) IDENTIFIES HOW PROFIT DISTRIBUTIONS SHALL BE MADE IN A WAY TO
43 ENSURE THAT THE COMMUNITY'S ACCESS TO QUALITY CARE AND CORE COMMUNITY
44 BENEFITS ARE NOT COMPROMISED AND ACCESS TO CAPITAL IS NOT COMPROMISED.
45 NONE OF THE FOREGOING FACTORS SHALL BE DISPOSITIVE IN THE APPROVAL OR
46 DISAPPROVAL OF THE BUSINESS CORPORATION.
47 (G) NO BUSINESS CORPORATION SHALL BE APPROVED UNDER THIS SECTION THAT
48 FAILS TO ATTEST THAT IT WILL PROVIDE THE NOT-FOR-PROFIT HOSPITAL PARTNER
49 WITH THE EXCLUSIVE AUTHORITY OVER FUNCTIONS RELATING TO ITS EXEMPT
50 STATUS.
51 (H) THE BOARD OF DIRECTORS OF A BUSINESS CORPORATION ESTABLISHED
52 PURSUANT TO THIS SUBDIVISION SHALL BE DEEMED A "GOVERNING BODY" FOR THE
53 PURPOSES OF SECTION TWENTY-EIGHT HUNDRED THREE-L OF THIS ARTICLE AND
54 SHALL COMPLY WITH THE PROVISIONS OF SUCH SECTION, REGARDLESS OF THE
55 CORPORATION'S PROFIT-MAKING STATUS.
S. 4207 85
1 (I) A SALE, LEASE, CONVEYANCE, EXCHANGE, TRANSFER, OR OTHER DISPOSI-
2 TION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE BUSINESS CORPO-
3 RATION SHALL NOT BE EFFECTIVE UNLESS THE TRANSACTION IS APPROVED BY THE
4 COMMISSIONER.
5 NO SUCH TRANSACTION MAY OCCUR WITHIN THREE YEARS OF THE COMMISSIONER'S
6 APPROVAL OF THE BUSINESS CORPORATION'S PARTICIPATION IN THE DEMON-
7 STRATION PROJECT. IN APPROVING SUCH A TRANSACTION, THE COMMISSIONER
8 SHALL CONSIDER, AMONG OTHER THINGS, WHETHER THE TRANSACTION:
9 (1) IMPOSES SAFEGUARDS TO PROTECT QUALITY AND ACCESS TO CORE COMMUNITY
10 SERVICES DURING THE TRANSITION TO THE NEW INVESTOR;
11 (2) REQUIRES THE SUBSEQUENT INVESTOR TO GUARANTEE ALL OBLIGATIONS,
12 INCLUDING THOSE DESCRIBED IN SUBPARAGRAPH SEVEN OF PARAGRAPH (F) OF THIS
13 SUBDIVISION;
14 (3) WILL MAINTAIN THE HOSPITAL GOVERNANCE STRUCTURE; AND
15 (4) IMPOSES MINIMUM CAPITALIZATION CRITERIA POST-TRANSACTION.
16 (J) NO LATER THAN THREE YEARS AFTER THE ESTABLISHMENT OF A BUSINESS
17 CORPORATION UNDER THIS SUBDIVISION, THE COMMISSIONER SHALL PROVIDE THE
18 GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE
19 ASSEMBLY WITH A WRITTEN EVALUATION OF THE PILOT PROGRAM. SUCH EVALUATION
20 SHALL ADDRESS THE OVERALL EFFECTIVENESS OF THE PROGRAM IN ALLOWING FOR
21 ACCESS TO CAPITAL INVESTMENT AND THE IMPACT SUCH ACCESS MAY HAVE ON THE
22 QUALITY OF CARE PROVIDED BY HOSPITALS OPERATED BY BUSINESS CORPORATIONS
23 ESTABLISHED UNDER THIS SUBDIVISION.
24 S 2. Paragraph (b) of subdivision 2 of section 1676 of the public
25 authorities law is amended by adding a new undesignated paragraph to
26 read as follows:
27 SUCH BUSINESS CORPORATIONS AS ARE ESTABLISHED PURSUANT TO SUBDIVISION
28 SEVENTEEN OF SECTION TWENTY-EIGHT HUNDRED ONE-A OF THE PUBLIC HEALTH LAW
29 FOR THE ACQUISITION, CONSTRUCTION, RECONSTRUCTION, REHABILITATION AND
30 IMPROVEMENT, OR OTHERWISE PROVIDING, FURNISHING AND EQUIPPING OF A
31 HOSPITAL OR HOSPITALS.
32 S 3. Subdivision 1 of section 1680 of the public authorities law is
33 amended by adding a new undesignated paragraph to read as follows:
34 SUCH BUSINESS CORPORATIONS AS ARE ESTABLISHED PURSUANT TO SUBDIVISION
35 SEVENTEEN OF SECTION TWENTY-EIGHT HUNDRED ONE-A OF THE PUBLIC HEALTH LAW
36 FOR THE ACQUISITION, CONSTRUCTION, RECONSTRUCTION, REHABILITATION AND
37 IMPROVEMENT, OR OTHERWISE PROVIDING, FURNISHING AND EQUIPPING OF A
38 HOSPITAL OR HOSPITALS.
39 S 4. This act shall take effect immediately.
40 PART R
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 B of chapter 58 of the laws of 2014, is amended to
46 read as follows:
47 S 3. This act shall take effect immediately; and shall expire and be
48 deemed repealed June 30, [2015] 2018.
49 S 2. This act shall take effect immediately.
50 PART S
51 Section 1. Section 366 of the social services law is amended by adding
52 a new subdivision 7-a to read as follows:
S. 4207 86
1 7-A. A. THE COMMISSIONER OF HEALTH IN CONSULTATION WITH THE COMMIS-
2 SIONER OF DEVELOPMENTAL DISABILITIES SHALL APPLY FOR A HOME AND COMMUNI-
3 TY-BASED WAIVER, PURSUANT TO SUBDIVISION (C) OF SECTION NINETEEN HUNDRED
4 FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT, IN ORDER TO PROVIDE HOME AND
5 COMMUNITY-BASED SERVICES FOR A POPULATION OF PERSONS WITH DEVELOPMENTAL
6 DISABILITIES, AS SUCH TERM IS DEFINED IN SECTION 1.03 OF THE MENTAL
7 HYGIENE LAW.
8 B. PERSONS ELIGIBLE FOR PARTICIPATION IN THE WAIVER PROGRAM SHALL:
9 (I) HAVE A DEVELOPMENTAL DISABILITY AS SUCH TERM IS DEFINED IN SUBDI-
10 VISION TWENTY-TWO OF SECTION 1.03 OF THE MENTAL HYGIENE LAW;
11 (II) MEET THE LEVEL OF CARE CRITERIA PROVIDED BY AN INTERMEDIATE CARE
12 FACILITY FOR THE DEVELOPMENTALLY DISABLED;
13 (III) BE ELIGIBLE FOR MEDICAID;
14 (IV) LIVE AT HOME OR IN AN INDIVIDUALIZED RESIDENTIAL ALTERNATIVE,
15 COMMUNITY RESIDENCE OR FAMILY CARE HOME, OPERATED, FUNDED OR LICENSED BY
16 THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES OR OTHER APPROPRI-
17 ATE COMMUNITY SETTING AS DEFINED IN REGULATION BY THE COMMISSIONER OF
18 DEVELOPMENTAL DISABILITIES;
19 (V) BE CAPABLE OF BEING CARED FOR IN THE COMMUNITY IF PROVIDED WITH
20 SUCH SERVICES AS RESPITE, HOME ADAPTATION, OR OTHER HOME AND COMMUNITY-
21 BASED SERVICES, OTHER THAN ROOM AND BOARD, AS MAY BE APPROVED BY THE
22 SECRETARY OF THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES, IN
23 ADDITION TO OTHER SERVICES PROVIDED UNDER THIS TITLE, AS DETERMINED BY
24 THE ASSESSMENT REQUIRED BY PARAGRAPH C OF THIS SUBDIVISION;
25 (VI) HAVE A DEMONSTRATED NEED FOR HOME AND COMMUNITY BASED WAIVER
26 SERVICES; AND
27 (VII) MEET SUCH OTHER CRITERIA AS MAY BE ESTABLISHED BY THE COMMIS-
28 SIONER OF HEALTH AND THE COMMISSIONER OF DEVELOPMENTAL DISABILITIES, AS
29 MAY BE NECESSARY TO ADMINISTER THE PROVISIONS OF THIS SUBDIVISION.
30 C. THE COMMISSIONER OF DEVELOPMENTAL DISABILITIES SHALL ASSESS THE
31 ELIGIBILITY OF PERSONS ENROLLED, OR SEEKING TO ENROLL, IN THE WAIVER
32 PROGRAM. THE ASSESSMENT SHALL INCLUDE, BUT NEED NOT BE LIMITED TO, AN
33 EVALUATION OF THE HEALTH, PSYCHO-SOCIAL, DEVELOPMENTAL, HABILITATION AND
34 ENVIRONMENTAL NEEDS OF THE PERSON AND SHALL SERVE AS THE BASIS FOR THE
35 DEVELOPMENT AND PROVISION OF AN APPROPRIATE PERSON CENTERED PLAN OF CARE
36 FOR SUCH PERSON. THE ASSESSMENT SHALL EMPLOY A VALID MEASURE.
37 D. THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES SHALL UNDER-
38 TAKE OR ARRANGE FOR THE DEVELOPMENT OF A WRITTEN PERSON CENTERED PLAN OF
39 CARE FOR EACH PERSON ENROLLED IN THE WAIVER. SUCH PERSON CENTERED PLAN
40 OF CARE SHALL DESCRIBE THE PROVISION OF HOME AND COMMUNITY BASED WAIVER
41 SERVICES CONSISTENT WITH THE ASSESSMENT FOR EACH PERSON.
42 E. THE OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES SHALL REVIEW
43 THE PLAN OF CARE AND AUTHORIZE THOSE HOME AND COMMUNITY BASED SERVICES
44 TO BE INCLUDED IN THE PLAN OF CARE, TAKING INTO ACCOUNT THE PERSON'S
45 ASSESSED NEEDS, VALUED OUTCOMES AND AVAILABLE RESOURCES USING A VALID
46 MEASURE.
47 F. THE COMMISSIONERS OF DEVELOPMENTAL DISABILITIES AND HEALTH SHALL
48 DETERMINE QUALITY STANDARDS FOR ORGANIZATIONS PROVIDING SERVICES UNDER
49 SUCH WAIVER AND SHALL AUTHORIZE ORGANIZATIONS THAT MEET SUCH STANDARDS
50 TO PROVIDE SUCH SERVICES.
51 G. THE COMMISSIONERS OF DEVELOPMENTAL DISABILITIES AND HEALTH SHALL
52 PROMULGATE RULES AND REGULATIONS AS NECESSARY TO EFFECTUATE THE
53 PROVISIONS OF THIS SECTION.
54 H. THIS SUBDIVISION SHALL BE EFFECTIVE ONLY IF, AND AS LONG AS, FEDER-
55 AL FINANCIAL PARTICIPATION IS AVAILABLE FOR EXPENDITURES INCURRED UNDER
56 THIS SUBDIVISION.
S. 4207 87
1 S 2. Paragraph (a) of subdivision 4 of section 488 of the social
2 services law, as added by section 1 of part B of chapter 501 of the laws
3 of 2012, is amended to read as follows:
4 (a) a facility or program in which services are provided and which is
5 operated, licensed or certified by the office of mental health, the
6 office for people with developmental disabilities or the office of alco-
7 holism and substance abuse services, including but not limited to
8 psychiatric centers, inpatient psychiatric units of a general hospital,
9 developmental centers, intermediate care facilities, community resi-
10 dences, group homes and family care homes, provided, however, that such
11 term shall not include a secure treatment facility as defined in section
12 10.03 of the mental hygiene law, SERVICES DEFINED IN SUBPARAGRAPH FOUR
13 OF SUBDIVISION (A) OF SECTION 16.03 OF THE MENTAL HYGIENE LAW, or
14 services provided in programs or facilities that are operated by the
15 office of mental health and located in state correctional facilities
16 under the jurisdiction of the department of corrections and community
17 supervision;
18 S 3. Subdivision 2 of section 550 of the executive law, as added by
19 section 3 of part A of chapter 501 of the laws of 2012, is amended to
20 read as follows:
21 2. "Mental hygiene facility" shall mean a facility as defined in
22 subdivision six of section 1.03 of the mental hygiene law and facilities
23 for the operation of which an operating certificate is required pursuant
24 to article sixteen or thirty-one of the mental hygiene law and including
25 family care homes. "Mental hygiene facility" also means a secure treat-
26 ment facility as defined by article ten of the mental hygiene law. THIS
27 TERM SHALL NOT INCLUDE SERVICES DEFINED IN SUBPARAGRAPH FOUR OF SUBDIVI-
28 SION (A) OF SECTION 16.03 OF THE MENTAL HYGIENE LAW.
29 S 4. Subdivisions 3, 4, 5 and 22 of section 1.03 of the mental hygiene
30 law, subdivision 3 as amended by chapter 223 of the laws of 1992, subdi-
31 vision 4 as added by chapter 978 of the laws of 1977, subdivision 5 as
32 amended by chapter 75 of the laws of 2006, and subdivision 22 as amended
33 by chapter 255 of the laws of 2002, are amended to read as follows:
34 3. "Mental disability" means mental illness, [mental retardation]
35 INTELLECTUAL DISABILITY, developmental disability, alcoholism, substance
36 dependence, or chemical dependence. [A mentally disabled person is one
37 who has a mental disability.]
38 4. "Services for [the mentally disabled] PERSONS WITH A MENTAL DISA-
39 BILITY" means examination, diagnosis, care, treatment, rehabilitation,
40 SUPPORTS, HABILITATION or training of the mentally disabled.
41 5. "Provider of services" means an individual, association, corpo-
42 ration, partnership, limited liability company, or public or private
43 agency, other than an agency or department of the state, which provides
44 services for [the mentally disabled] PERSONS WITH A MENTAL DISABILITY.
45 It shall not include any part of a hospital as defined in article twen-
46 ty-eight of the public health law which is not being operated for the
47 purpose of providing services for the mentally disabled. No provider of
48 services shall be subject to the regulation or control of the department
49 or one of its offices except as such regulation or control is provided
50 for by other provisions of this chapter.
51 22. "Developmental disability" means a disability of a person which:
52 (a) (1) is attributable to [mental retardation] INTELLECTUAL DISABILI-
53 TY, cerebral palsy, epilepsy, neurological impairment, familial dysauto-
54 nomia or autism;
55 (2) is attributable to any other condition of a person found to be
56 closely related to [mental retardation] INTELLECTUAL DISABILITY because
S. 4207 88
1 such condition results in similar impairment of general intellectual
2 functioning or adaptive behavior to that of [mentally retarded] INTEL-
3 LECTUALLY DISABLED persons or requires treatment and services similar to
4 those required for such person; or
5 (3) is attributable to dyslexia resulting from a disability described
6 in subparagraph (1) or (2) of this paragraph;
7 (b) originates before such person attains age twenty-two;
8 (c) has continued or can be expected to continue indefinitely; and
9 (d) constitutes a substantial handicap to such person's ability to
10 function normally in society.
11 S 5. Intentionally omitted.
12 S 6. Subdivision (a) of section 16.03 of the mental hygiene law is
13 amended by adding a new paragraph 4 to read as follows:
14 (4) THE PROVISION OF HOME AND COMMUNITY BASED SERVICES APPROVED UNDER
15 A WAIVER PROGRAM AUTHORIZED PURSUANT TO SUBDIVISION (C) OF SECTION NINE-
16 TEEN HUNDRED FIFTEEN OF THE FEDERAL SOCIAL SECURITY ACT AND SUBDIVISIONS
17 SEVEN AND SEVEN-A OF SECTION THREE HUNDRED SIXTY-SIX OF THE SOCIAL
18 SERVICES LAW.
19 S 7. Section 16.03 of the mental hygiene law is amended by adding a
20 new subdivision (f) to read as follows:
21 (F) NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, THE
22 PROVISION OF LICENSED NURSING SERVICES SHALL BE AUTHORIZED AS PART OF
23 THE PROGRAMS CERTIFIED PURSUANT TO THIS ARTICLE.
24 S 8. Subdivision (a), paragraphs 2, 3, and 6 of subdivision (c), para-
25 graphs 1 and 4 of subdivision (d), subdivision (e), and subdivision (i)
26 of section 16.05 of the mental hygiene law, subdivision (a), paragraphs
27 2, 3, and 6 of subdivision (c), paragraphs 1 and 4 of subdivision (d)
28 and subdivision (e) as added by chapter 786 of the laws of 1983, para-
29 graph 6 of subdivision (c) and paragraph 4 of subdivision (d) as renum-
30 bered by chapter 618 of the laws of 1990, and subdivision (i) as amended
31 by chapter 37 of the laws of 2011, are amended to read as follows:
32 (a)(1) Application for an operating certificate shall be made upon
33 forms prescribed by the commissioner.
34 (2) Application shall be made by the person or entity responsible for
35 operation of the facility OR PROVISION OF SERVICES AS DESCRIBED IN
36 SUBDIVISION FOUR OF SECTION 16.03 OF THIS ARTICLE. Applications shall
37 be in writing, shall be verified and shall contain such information as
38 required by the commissioner.
39 (2) The character, competence and standing in the community of the
40 person or entity responsible for operating the facility OR PROVIDING
41 SERVICES;
42 (3) The financial resources of the proposed facility OR PROVIDER OF
43 SERVICES and its sources of future revenues;
44 (6) In the case of residential facilities, that arrangements have been
45 made with other providers of services for the provision of health,
46 habilitation, day treatment, education, sheltered workshop, transporta-
47 tion or other services as may be necessary to meet the needs of
48 [clients] INDIVIDUALS who will reside in the facility; and
49 (1) the financial resources of the proposed facility OR PROVIDER OF
50 SERVICES and its sources of future revenues;
51 (4) in the case of residential facilities, that arrangements have been
52 made with other providers of services for the provision of health,
53 habilitation, day treatment, education, sheltered workshop, transporta-
54 tion or other services as may be necessary to meet the needs of
55 [clients] INDIVIDUALS who will reside in the facility; and
S. 4207 89
1 (e) The commissioner may disapprove an application for an operating
2 certificate, may authorize fewer services than applied for, and may
3 place limitations or conditions on the operating certificate including,
4 but not limited to compliance with a time limited plan of correction of
5 any deficiency which does not threaten the health or well-being of any
6 [client] INDIVIDUALS. In such cases the applicant shall be given an
7 opportunity to be heard, at a public hearing if requested by the appli-
8 cant.
9 (i) In the event that the holder of an operating certificate for a
10 residential facility issued by the commissioner pursuant to this article
11 wishes to cease the operation or conduct of any of the activities, as
12 defined in paragraph one OR FOUR of subdivision (a) of section 16.03 of
13 this article, for which such certificate has been issued or to cease
14 operation of any one or more of facilities for which such certificate
15 has been issued; wishes to transfer ownership, possession or operation
16 of the premises and facilities upon which such activities are being
17 conducted or to transfer ownership, possession or operation of any one
18 or more of the premises or facilities for which such certificate has
19 been issued; or elects not to apply to the commissioner for re-certifi-
20 cation upon the expiration of any current period of certification, it
21 shall be the duty of such certificate holder to give to the commissioner
22 written notice of such intention not less than sixty days prior to the
23 intended effective date of such transaction. Such notice shall set forth
24 a detailed plan which makes provision for the safe and orderly transfer
25 of each person with a developmental disability served by such certif-
26 icate holder pursuant to such certificate into a program of services
27 appropriate to such person's on-going needs and/or for the continuous
28 provision of a lawfully operated program of such activities and services
29 at the premises and facilities to be conveyed by the certificate holder.
30 Such certificate holder shall not cease to provide any such services to
31 any such person with a developmental disability under any of the circum-
32 stances described in this section until the notice and plan required
33 hereby are received, reviewed and approved by the commissioner. For the
34 purposes of this paragraph, the requirement of prior notice and contin-
35 uous provision of programs and services by the certificate holder shall
36 not apply to those situations and changes in circumstances directly
37 affecting the certificate holder that are not reasonably foreseeable at
38 the time of occurrence, including, but not limited to, death or other
39 sudden incapacitating disability or infirmity. Written notice shall be
40 given to the commissioner as soon as reasonably possible thereafter in
41 the manner set forth within this subdivision.
42 S 9. Paragraph 1 of subdivision (a) of section 16.09 of the mental
43 hygiene law, as added by chapter 786 of the laws of 1983, is amended to
44 read as follows:
45 (1) "Facility" is limited to a facility in which services are offered
46 for which an operating certificate is required by this article. For the
47 purposes of this section facility shall include family care homes BUT
48 SHALL NOT INCLUDE THE PROVISION OF SERVICES, AS DEFINED IN PARAGRAPH
49 FOUR OF SUBDIVISION (A) OF SECTION 16.03 OF THIS ARTICLE, OUTSIDE OF A
50 FACILITY.
51 S 10. The section heading and subdivision (a) of section 16.11 of the
52 mental hygiene law are REPEALED and a new section heading and subdivi-
53 sion (a) are added to read as follows:
54 OVERSIGHT OF FACILITIES AND SERVICES. (A) THE COMMISSIONER SHALL
55 PROVIDE FOR THE OVERSIGHT OF FACILITIES AND PROVIDERS OF SERVICES HOLD-
56 ING OPERATING CERTIFICATES PURSUANT TO SECTION 16.03 OF THIS ARTICLE AND
S. 4207 90
1 SHALL PROVIDE FOR THE ANNUAL REVIEW OF SUCH FACILITIES AND PROVIDERS IN
2 IMPLEMENTING THE REQUIREMENTS OF THE OFFICE AND IN PROVIDING QUALITY
3 CARE AND PERSON CENTERED AND COMMUNITY BASED SERVICES.
4 (1) THE REVIEW OF FACILITIES ISSUED AN OPERATING CERTIFICATE PURSUANT
5 TO THIS ARTICLE SHALL INCLUDE A SITE VISIT TO OCCUR AT LEAST TWICE
6 DURING EACH CALENDAR YEAR AND SHALL BE WITHOUT PRIOR NOTICE. AREAS OF
7 REVIEW SHALL INCLUDE, BUT NOT BE LIMITED TO, A REVIEW OF A FACILITY'S:
8 PHYSICAL PLANT, FIRE SAFETY PROCEDURES, HEALTH CARE, PROTECTIVE OVER-
9 SIGHT, ABUSE AND NEGLECT PREVENTION, AND REPORTING PROCEDURES.
10 (2) THE REVIEW OF PROVIDERS OF SERVICES, AS DEFINED IN PARAGRAPH FOUR
11 OF SUBDIVISION (A) OF SECTION 16.03 OF THIS ARTICLE, SHALL ENSURE THAT
12 THE PROVIDER OF SERVICES COMPLIES WITH ALL THE REQUIREMENTS OF THE
13 APPLICABLE FEDERAL HOME AND COMMUNITY BASED SERVICES WAIVER PROGRAM AND
14 APPLICABLE FEDERAL REGULATION, SUBDIVISIONS SEVEN AND SEVEN-A OF SECTION
15 THREE HUNDRED SIXTY-SIX OF THE SOCIAL SERVICES LAW AND RULES AND REGU-
16 LATIONS ADOPTED BY THE COMMISSIONER.
17 S 11. Subdivisions (b), (c), (d), and (e) of section 16.11 of the
18 mental hygiene law, subdivision (b) as amended by chapter 37 of the laws
19 of 2011, and subdivisions (c), (d) and (e) as added by chapter 786 of
20 the laws of 1983, are amended to read as follows:
21 (b) The commissioner shall have the power to conduct investigations
22 into the operations of any PROVIDER OF SERVICE, person or entity which
23 holds an operating certificate issued by the office, into the operation
24 of any facility, SERVICE or program issued an operating certificate by
25 the office and into the operations, related to the provision of services
26 regulated by this chapter, of any person or entity providing a residence
27 for one or more unrelated persons with developmental disabilities.
28 (c) In conducting an inspection or investigation, the commissioner or
29 his OR HER authorized representative shall have the power to inspect
30 facilities, conduct interviews of clients, interview personnel, examine
31 and copy all records, including financial and medical records of the
32 facility OR PROVIDER OF SERVICES, and obtain such other information as
33 may be required in order to carry out his OR HER responsibilities under
34 this chapter.
35 (d) In conducting any inspection or investigation under this chapter,
36 the commissioner or his OR HER authorized representative is empowered to
37 subpoena witnesses, compel their attendance, administer oaths to
38 witnesses, examine witnesses under oath, and require the production of
39 any books or papers deemed relevant to the investigation, inspection, or
40 hearing. A subpoena issued under this section shall be regulated by the
41 civil practice law and rules.
42 (e) The supreme court may enjoin persons or entities subject to
43 inspection or investigation pursuant to this article to cooperate with
44 the commissioner and to allow the commissioner access to PROVIDERS OF
45 SERVICES, facilities, records, clients and personnel as necessary to
46 enable the commissioner to conduct the inspection or investigation.
47 S 12. Section 16.17 of the mental hygiene law, as added by chapter 786
48 of the laws of 1983, subdivision (a) and paragraph 2 and subparagraph b
49 of paragraph 1 of subdivision (b) as amended and subparagraph d of para-
50 graph 1 of subdivision (b) as relettered by chapter 169 of the laws of
51 1992, subdivision (b) as amended by chapter 856 of the laws of 1985, the
52 opening paragraph and subparagraph c of paragraph 1 of subdivision (b)
53 as amended by chapter 37 of the laws of 2011, subparagraph d of para-
54 graph 1 of subdivision (b) as added by chapter 618 of the laws of 1990,
55 paragraph 4 of subdivision (b) as amended by chapter 168 of the laws of
56 2010, paragraph 1 of subdivision (f) as amended by chapter 601 of the
S. 4207 91
1 laws of 2007, subdivision (g) as amended by chapter 24 of the laws of
2 2007, and subdivision (h) as amended by chapter 306 of the laws of 1995,
3 is amended to read as follows:
4 S 16.17 Suspension, revocation, or limitation of an operating certif-
5 icate.
6 (a) The commissioner may revoke, suspend, or limit an operating
7 certificate or impose the penalties described in subparagraph a, b, c or
8 d of paragraph one of subdivision (b) or in subdivision (g) of this
9 section upon a determination that the holder of the certificate has
10 failed to comply with the terms of its operating certificate or with the
11 provisions of any applicable statute, rule or regulation. The holder of
12 the certificate shall be given notice and an opportunity to be heard
13 prior to any such determination except that no such notice and opportu-
14 nity to be heard shall be necessary prior to an emergency suspension or
15 limitation of the facility's OR PROVIDER OF SERVICES' operating certif-
16 icate imposed pursuant to paragraph one of subdivision (b) of this
17 section, nor shall such notice and opportunity to be heard be necessary
18 should the commissioner, in his OR HER discretion, decide to issue sepa-
19 rate operating certificates to each facility OR PROVIDER OF SERVICES
20 formerly included under the services authorized by one operating certif-
21 icate to the provider of services.
22 (b) (1) An operating certificate may be temporarily suspended or
23 limited without a prior hearing for a period not in excess of sixty days
24 upon written notice to the facility OR PROVIDER OF SERVICES following a
25 finding by the office for people with developmental disabilities that a
26 [client's] INDIVIDUAL'S health or safety is in imminent danger. Upon
27 such finding and notice, the power of the commissioner temporarily to
28 suspend or limit an operating certificate shall include, but shall not
29 be limited to, the power to:
30 a. Prohibit or limit the placement of new [clients] INDIVIDUALS in the
31 facility OR SERVICES;
32 b. Remove or cause to be removed some or all of the [clients] INDIVID-
33 UALS in the facility OR SERVICES;
34 c. Suspend or limit or cause to be suspended or limited the payment of
35 any governmental funds to the facility OR PROVIDER OF SERVICES provided
36 that such action shall not in any way jeopardize the health, safety and
37 welfare of any person with a developmental disability in such program or
38 facility OR SERVICES;
39 d. Prohibit or limit the placement of new [clients] INDIVIDUALS,
40 remove or cause to be removed some or all [clients] INDIVIDUALS, or
41 suspend or limit or cause to be suspended or limited the payment of any
42 governmental funds, in or to any one or more of the facilities OR
43 PROVIDER OF SERVICES authorized pursuant to an operating certificate
44 [issued to a provider of services].
45 (2) At any time subsequent to the suspension or limitation of any
46 operating certificate pursuant to paragraph one of this subdivision
47 where said suspension or limitation is the result of correctable phys-
48 ical plant, staffing or program deficiencies, the facility OR PROVIDER
49 OF SERVICES may request the office to [reinspect] REVIEW the facility OR
50 PROVIDER OF SERVICES to redetermine whether a physical plant, staffing
51 or program deficiency continues to exist. After the receipt of such a
52 request, the office shall [reinspect] REVIEW the facility OR PROVIDER OF
53 SERVICES within ten days and in the event that the previously found
54 physical plant, staffing or program deficiency has been corrected, the
55 suspension or limitation shall be withdrawn. If the physical plant,
56 staffing or program deficiency has not been corrected, the commissioner
S. 4207 92
1 shall not thereafter be required to [reinspect] REVIEW the facility OR
2 PROVIDER OF SERVICES during the emergency period of suspension or limi-
3 tation.
4 (3) During the sixty day suspension or limitation period provided for
5 in paragraph one of this subdivision the commissioner shall determine
6 whether to reinstate or remove the limitations on the facility's OR
7 PROVIDER OF SERVICES' operating certificate or to revoke, suspend or
8 limit the operating certificate pursuant to subdivision (a) of this
9 section. Should the commissioner choose to revoke, suspend or limit the
10 operating certificate, then the emergency suspension or limitation
11 provided for in this subdivision shall remain in effect pending the
12 outcome of an administrative hearing on the revocation, suspension or
13 limitation.
14 (4) The facility operator OR PROVIDER OF SERVICES, within ten days of
15 the date when the emergency suspension or limitation pursuant to para-
16 graph one of this subdivision is first imposed, may request an evidenti-
17 ary hearing to contest the validity of the emergency suspension or limi-
18 tation. Such an evidentiary hearing shall commence within ten days of
19 the facility operator's OR PROVIDER'S request and no request for an
20 adjournment shall be granted without the concurrence of the facility
21 operator OR PROVIDER OF SERVICE, office for people with developmental
22 disabilities, and the hearing officer. The evidentiary hearing shall be
23 limited to those violations of federal and state law and regulations
24 that existed at the time of the emergency suspension or limitation and
25 which gave rise to the emergency suspension or limitation. The emergency
26 suspension or limitation shall be upheld upon a determination that the
27 office for people with developmental disabilities had reasonable cause
28 to believe that a [client's] INDIVIDUAL'S health or safety was in immi-
29 nent danger. A record of such hearing shall be made available to the
30 facility operator OR PROVIDER OF SERVICE upon request. Should the
31 commissioner determine to revoke, suspend or limit [the facility's] AN
32 operating certificate pursuant to subdivision (a) of this section, no
33 administrative hearing on that action shall commence prior to the
34 conclusion of the evidentiary hearing. The commissioner shall issue a
35 ruling within ten days after the receipt of the hearing officer's
36 report.
37 (c) When the holder of an operating certificate shall request an
38 opportunity to be heard, the commissioner shall fix a time and place for
39 the hearing. A copy of the charges, together with the notice of the time
40 and place of the hearing, shall be served in person or mailed by regis-
41 tered or certified mail to the facility OR PROVIDER OF SERVICES at least
42 ten days before the date fixed for the hearing. The facility OR PROVIDER
43 OF SERVICES shall file with the office, not less than three days prior
44 to the hearing, a written answer to the charges.
45 (d) (1) When a hearing must be afforded pursuant to this section or
46 other provisions of this article, the commissioner, acting as hearing
47 officer, or any person designated by him OR HER as hearing officer,
48 shall have power to:
49 a. administer oaths and affirmations;
50 b. issue subpoenas, which shall be regulated by the civil practice law
51 and rules;
52 c. take testimony; or
53 d. control the conduct of the hearing.
54 (2) The rules of evidence observed by courts need not be observed
55 except that the rules of privilege recognized by law shall be respected.
56 Irrelevant or unduly repetitious evidence may be excluded.
S. 4207 93
1 (3) All parties shall have the right of counsel and be afforded an
2 opportunity to present evidence and cross-examine witnesses.
3 (4) If evidence at the hearing relates to the identity, condition, or
4 clinical record of [a client] AN INDIVIDUAL, the hearing officer may
5 exclude all persons from the room except parties to the proceeding,
6 their counsel and the witness. The record of such proceeding shall not
7 be available to anyone outside the office, other than a party to the
8 proceeding or his counsel, except by order of a court of record.
9 (5) The commissioner may establish regulations to govern the hearing
10 procedure and the process of determination of the proceeding.
11 (6) The commissioner shall issue a ruling within ten days after the
12 termination of the hearing or, if a hearing officer has been designated,
13 within ten days from the hearing officer's report.
14 (e) All orders or determinations hereunder shall be subject to review
15 as provided in article seventy-eight of the civil practice law and
16 rules.
17 (f) (1) Except as provided in paragraph two of this subdivision,
18 anything contained in this section to the contrary notwithstanding, an
19 operating certificate of a facility OR PROVIDER OF SERVICE shall be
20 revoked upon a finding by the office that any individual, member of a
21 partnership or shareholder of a corporation to whom or to which an oper-
22 ating certificate has been issued, has been convicted of a class A, B or
23 C felony or a felony related in any way to any activity or program
24 subject to the regulations, supervision, or administration of the office
25 or of the office of temporary and disability assistance, the department
26 of health, or another office of the department of mental hygiene, or in
27 violation of the public officers law in a court of competent jurisdic-
28 tion of the state, or in a court in another jurisdiction for an act
29 which would have been a class A, B or C felony in this state or a felony
30 in any way related to any activity or program which would be subject to
31 the regulations, supervision, or administration of the office or of the
32 office of temporary and disability assistance, the department of health,
33 or another office of the department of mental hygiene, or for an act
34 which would be in violation of the public officers law. The commissioner
35 shall not revoke or limit the operating certificate of any facility OR
36 PROVIDER OF SERVICE, solely because of the conviction, whether in the
37 courts of this state or in the courts of another jurisdiction, more than
38 ten years prior to the effective date of such revocation or limitation,
39 of any person of a felony, or what would amount to a felony if committed
40 within the state, unless the commissioner makes a determination that
41 such conviction was related to an activity or program subject to the
42 regulations, supervision, and administration of the office or of the
43 office of temporary and disability assistance, the department of health,
44 or another office of the department of mental hygiene, or in violation
45 of the public officers law.
46 (2) In the event one or more members of a partnership or shareholders
47 of a corporation shall have been convicted of a felony as described in
48 paragraph one of this subdivision, the commissioner shall, in addition
49 to his OR HER other powers, limit the existing operating certificate of
50 such partnership or corporation so that it shall apply only to the
51 remaining partner or shareholders, as the case may be, provided that
52 every such convicted person immediately and completely ceases and with-
53 draws from participation in the management and operation of the facility
54 OR PROVIDER OF SERVICES and further provided that a change of ownership
55 or transfer of stock is completed without delay, and provided that such
56 partnership or corporation shall immediately reapply for a certificate
S. 4207 94
1 of operation pursuant to subdivision (a) of section 16.05 of this arti-
2 cle.
3 (g) The commissioner may impose a fine upon a finding that the holder
4 of the certificate has failed to comply with the terms of the operating
5 certificate or with the provisions of any applicable statute, rule or
6 regulation. The maximum amount of such fine shall be one thousand
7 dollars per day or fifteen thousand dollars per violation.
8 Such penalty may be recovered by an action brought by the commissioner
9 in any court of competent jurisdiction OR BY OFFSETTING SUCH PENALTY
10 AGAINST A FUTURE MEDICAID OR OFFICE PAYMENT TO SUCH PROVIDER.
11 Such penalty may be released or compromised by the commissioner before
12 the matter has been referred to the attorney general. Any such penalty
13 may be released or compromised and any action commenced to recover the
14 same may be settled or discontinued by the attorney general with the
15 consent of the commissioner.
16 (h) Where a proceeding has been brought pursuant to section 16.27 of
17 this article, and a receiver appointed pursuant thereto, the commission-
18 er may assume operation of the facility subject to such receivership,
19 upon termination of such receivership, and upon showing to the court
20 having jurisdiction over such receivership that no voluntary associ-
21 ation, not-for-profit corporation or other appropriate provider is will-
22 ing to assume operation of the facility subject to receivership and is
23 capable of meeting the requirements of this article; provided that the
24 commissioner notifies the chairman of the assembly ways and means
25 committee, the chairman of the senate finance committee and the director
26 of the budget of his intention to assume operation of such facility upon
27 service of the order to show cause upon the owner or operator of the
28 facility, pursuant to subdivision (b) of section 16.27 of this article.
29 S 13. Paragraph 5 of subdivision (a) of section 16.29 of the mental
30 hygiene law, as amended by section 9 of part C of chapter 501 of the
31 laws of 2012, is amended to read as follows:
32 (5) removing a service recipient when it is determined that there is a
33 risk to such person if he or she continues to remain in a facility OR
34 SERVICE PROGRAM; and
35 S 14. Paragraph (ii) of subdivision (c) of section 16.29 of the mental
36 hygiene law, as amended by section 9 of part C of chapter 501 of the
37 laws of 2012, is amended to read as follows:
38 (ii) development and implementation of a plan of prevention and reme-
39 diation, in the event an investigation of a report of an alleged report-
40 able incident exists and such reportable incident may be attributed in
41 whole or in part to noncompliance by the facility OR PROVIDER OF
42 SERVICES with the provisions of this chapter or regulations of the
43 office applicable to the operation of such facility OR PROVIDER OF
44 SERVICES. Any plan of prevention and remediation required to be devel-
45 oped pursuant to this subdivision by a facility supervised by the office
46 shall be submitted to and approved by such office in accordance with
47 time limits established by regulations of such office. Implementation of
48 the plan shall be monitored by such office. In reviewing the continued
49 qualifications of a residential facility OR PROVIDER OF SERVICES or
50 program for an operating certificate, the office shall evaluate such
51 facility's OR PROVIDER OF SERVICE'S compliance with plans of prevention
52 and remediation developed and implemented pursuant to this subdivision.
53 S 15. This act shall take effect immediately.
54 PART T
S. 4207 95
1 Section 1. Subdivision (a) of section 41.35 of the mental hygiene law,
2 as amended by chapter 658 of the laws of 1977, is amended to read as
3 follows:
4 (a) The commissioners of the offices in the department shall cause to
5 be developed plans for three or more time-limited demonstration
6 programs, the purpose of which shall be to test and evaluate new methods
7 or arrangements for organizing, financing, staffing and providing
8 services for the mentally disabled in order to determine the desirabil-
9 ity of such methods or arrangements. Subject to regulations established
10 by the commissioners and notwithstanding SECTIONS ONE HUNDRED TWELVE AND
11 ONE HUNDRED SIXTY-THREE OF THE STATE FINANCE LAW, SECTION ONE HUNDRED
12 FORTY-TWO OF THE ECONOMIC DEVELOPMENT LAW, OR any other provision of
13 law, such programs may include but shall not be limited to comprehensive
14 organizational structures to serve all mentally disabled persons within
15 the purview of a local governmental unit, innovative financing and
16 staffing arrangements and specific programs to serve the mentally disa-
17 bled. Such demonstration programs shall be consistent with established
18 statewide goals and objectives and local comprehensive plans, shall be
19 developed in conjunction with the local comprehensive planning process,
20 and shall be submitted to the single agent jointly designated by the
21 commissioners of the department for review and approval by the commis-
22 sioner or commissioners having jurisdiction of the services.
23 S 2. This act shall take effect immediately.
24 PART U
25 Section 1. Short title. This act shall be known and may be cited as the
26 "employment first choice act".
27 S 2. Legislative intent. The legislature hereby supports increasing
28 access to integrated employment settings for individuals with develop-
29 mental disabilities. The legislature additionally finds, however, that
30 the policy to increase integrated employment opportunities shall not
31 preclude an individual's right to choose either an integrated or nonin-
32 tegrated setting in accordance with such individual's personal wishes.
33 Furthermore, the legislature supports an individual's wish to remain in
34 a nonintegrated setting in order to, among other personal priorities,
35 retain friendships, continue their participation in their community as
36 they so choose, and, in some instances, maintain their ability to earn a
37 paycheck.
38 The legislature, therefore, finds that individuals with developmental
39 disabilities, who currently participate in a nonintegrated setting,
40 should be allowed to choose to remain in such a setting. To require such
41 individuals to transition out of this chosen environment undermines the
42 guiding Supreme Court decision in Olmstead v. L.C., which held that the
43 Americans with Disabilities Act of 1990 requires placement of individ-
44 uals with developmental disabilities in integrated settings rather than
45 nonintegrated settings, but only when such a transfer is not opposed by
46 the affected individual. The legislature, therefore, declares this act
47 to be a priority of the state's actions affecting individuals with
48 developmental disabilities.
49 S 3. The mental hygiene law is amended by adding a new section 16.02
50 to read as follows:
51 S 16.02 INDIVIDUAL'S RIGHT OF CHOICE.
52 ANY INDIVIDUAL WITH A DEVELOPMENTAL DISABILITY WHO IS PARTICIPATING IN
53 A NONINTEGRATED SETTING INCLUDING, BUT NOT LIMITED TO, A SHELTERED WORK-
54 SHOP, AND WHO CHOOSES TO REMAIN IN A NONINTEGRATED SETTING MAY SEEK
S. 4207 96
1 ACCOMMODATION FROM THE COMMISSIONER TO ALLOW SUCH PLACEMENT, PROVIDED
2 THAT PENDING SUCH REQUEST THE INDIVIDUAL MAY REMAIN IN THE NONINTEGRATED
3 SETTING.
4 (A) ACCOMMODATIONS SHALL BE GRANTED AT THE DISCRETION OF THE COMMIS-
5 SIONER, WHO MAY ALSO REQUIRE THAT THE INDIVIDUAL HAS COMPLETED AT LEAST
6 ONE OF THE FOLLOWING:
7 (1) PARTICIPATION IN AT LEAST ONE VOCATIONAL ASSESSMENT EVERY FIVE
8 YEARS IN ACCORDANCE WITH REGULATIONS PROMULGATED BY THE COMMISSIONER.
9 THE PRIMARY PURPOSE OF A VOCATIONAL ASSESSMENT SHALL BE TO DETERMINE AN
10 INDIVIDUAL'S INTERESTS, STRENGTHS AND ABILITIES, IN ORDER TO IDENTIFY A
11 SUITABLE MATCH BETWEEN THE INDIVIDUAL AND A COMPETITIVE INTEGRATED
12 EMPLOYMENT SETTING;
13 (2) COMPLETION OF ONE TRIAL INTEGRATED WORK EXPERIENCE EVERY FIVE
14 YEARS, WHICH CAN INCLUDE ANY WORK EXPERIENCE WITH OR WITHOUT PAY IN
15 WHICH THE INDIVIDUAL WORKS ALONGSIDE NON-DISABLED COWORKERS, CUSTOMERS
16 OR PEERS, WITH THE APPROPRIATE SERVICES AND SUPPORTS FOR A SUFFICIENT
17 PERIOD OF TIME TO ESTABLISH WHETHER AN INDIVIDUAL'S INTERESTS, SKILLS
18 AND ABILITIES ARE WELL-SUITED FOR THE PARTICULAR JOB. THE TRIAL INTE-
19 GRATED WORK EXPERIENCE SHALL BE SELECTED THROUGH A PERSON-CENTERED PLAN-
20 NING PROCESS AND SHALL BE INDIVIDUALLY TAILORED TO EACH PERSON. ALTERNA-
21 TIVELY, THE COMMISSIONER SHALL CONSIDER THE INDIVIDUAL'S DEMONSTRATION
22 OF AN INABILITY TO PARTICIPATE IN AN INTEGRATED WORK SETTING DUE TO A
23 DOCUMENTED MEDICAL CONDITION THAT POSES AN IMMEDIATE AND SERIOUS THREAT
24 TO THE INDIVIDUAL'S HEALTH OR SAFETY, OR THE HEALTH OR SAFETY OF OTHERS
25 IN AN INTEGRATED WORK SETTING;
26 (3) RECEIPT OF OUTREACH, EDUCATION AND SUPPORT SERVICES IN ACCORDANCE
27 WITH REGULATIONS PROMULGATED BY THE COMMISSIONER. OUTREACH, EDUCATION
28 AND SUPPORT SERVICES ARE SERVICES DESIGNED TO EXPLAIN THE BENEFITS OF
29 SUPPORTED EMPLOYMENT, AS DEFINED IN SUBDIVISION ELEVEN OF SECTION ONE
30 THOUSAND TWO OF THE EDUCATION LAW, THAT ADDRESS CONCERNS OF FAMILIES AND
31 PERCEIVED OBSTACLES TO PARTICIPATION, AND ARE DESIGNED TO ENCOURAGE
32 INDIVIDUALS IN DAY ACTIVITY SERVICE PROGRAMS, INCLUDING IN SHELTERED
33 WORKSHOPS AND FACILITY-BASED DAY PROGRAMS, AND THEIR FAMILIES TO SEEK
34 SUPPORTED EMPLOYMENT SERVICES, AS DEFINED UNDER SUBDIVISION TWELVE OF
35 SECTION ONE THOUSAND TWO OF THE EDUCATION LAW; OR
36 (4) INVOLVEMENT IN A BENEFITS COUNSELING CONSULTATION IN ACCORDANCE
37 WITH REGULATIONS PROMULGATED BY THE COMMISSIONER. A BENEFIT COUNSELING
38 CONSULTATION SHALL PROVIDE INFORMATION TO THE INDIVIDUAL AND HIS OR HER
39 FAMILY OR GUARDIAN ABOUT THE IMPACT OF EARNED INCOME ON THE INDIVIDUAL'S
40 PUBLIC BENEFITS.
41 (B) THE OFFICE SHALL ENSURE THAT INDIVIDUALS WHO ARE GRANTED ACCOMMO-
42 DATION TO PARTICIPATE IN A NONINTEGRATED SETTING SHALL CONTINUE TO
43 RECEIVE SERVICES AND ANY ADDITIONAL SERVICES THE OFFICE DETERMINES ARE
44 NECESSARY TO ENABLE THE INDIVIDUAL'S MEANINGFUL PARTICIPATION IN THE
45 CHOSEN SETTING.
46 (C) THE PROCEDURES FOR OBTAINING ACCOMMODATION TO REMAIN IN A NONINTE-
47 GRATED SETTING SHALL NOT SUPERSEDE NOR BAR THE INDIVIDUAL'S CHOICE TO
48 REMAIN IN A NONINTEGRATED SETTING.
49 (D) THE ACCOMMODATION TO REMAIN IN A NONINTEGRATED SETTING SHALL NOT
50 DIMINISH THE INDIVIDUAL'S ELIGIBILITY FOR RECEIPT OF SERVICES UNDER
51 TITLE ELEVEN OF ARTICLE FIVE OF THE SOCIAL SERVICES LAW, AND SUCH INDI-
52 VIDUAL'S ELIGIBILITY TO RECEIVE SUCH SERVICES SHALL BE SUBSTANTIALLY
53 SIMILAR TO BENEFITS THAT WOULD HAVE BEEN RECEIVED HAD THE INDIVIDUAL
54 CHOSEN TO PARTICIPATE IN AN INTEGRATED SETTING.
S. 4207 97
1 (E) THE COMMISSIONER IS AUTHORIZED TO ISSUE, AMEND OR REPEAL ANY REGU-
2 LATIONS AS HE OR SHE SHALL DEEM NECESSARY TO IMPLEMENT THE PROVISIONS OF
3 THIS SECTION.
4 S 4. The commissioner of developmental disabilities shall amend and
5 resubmit to the Federal Centers for Medicare and Medicaid Services the
6 final New York plan to increase competitive employment opportunities for
7 people with developmental disabilities, as approved on May 1, 2014, in
8 order to secure the continued federal financial participation for prevo-
9 cational services and any other necessary federal funds for those indi-
10 viduals choosing a sheltered workshop setting pursuant to section 16.02
11 of the mental hygiene law. The plan, as amended according to this
12 section, shall stipulate that facility-based prevocational services
13 shall continue to be eligible for federal funding, as allowed by such
14 centers' stated policy that its regulations do not prohibit individuals
15 from receiving prevocational services in a facility-based setting, such
16 as a sheltered workshop, as referenced in its Informational Bulletin on
17 Employment Services dated September 16, 2011, and its related document
18 titled "HCBS Final Regulations 42 C.F.R. Part 441: Questions and Answers
19 Regarding Home and Community-Based Settings; Public Notice and
20 Comments".
21 S 5. This act shall take effect immediately.
22 PART V
23 Section 1. Section 13.17 of the mental hygiene law is amended by
24 adding a new subdivision (d) to read as follows:
25 (D) 1. THE COMMISSIONER SHALL ENSURE FOR CONTINUITY OF CARE FOR INDI-
26 VIDUALS WITH A DEVELOPMENTAL DISABILITY TRANSITIONING TO LESS RESTRIC-
27 TIVE SETTINGS PURSUANT TO ANY CLOSURE, CONSOLIDATION, MERGER OR ANY
28 OTHER ACTION THAT DIMINISHES CURRENT STATE OPERATED SERVICES. THE
29 COMMISSIONER SHALL ENSURE THAT INDIVIDUALS WITH A DEVELOPMENTAL DISABIL-
30 ITY SO AFFECTED ARE GIVEN THE OPTION OF TRANSITIONING TO STATE OPERATED
31 SERVICES WITHIN THE DEVELOPMENTALLY DISABLED SERVICE OFFICES REGION
32 WHERE THEY ARE CURRENTLY RECEIVING SERVICES. IF NO SUCH STATE SERVICE AS
33 REQUESTED BY THE INDIVIDUALS WITH A DEVELOPMENTAL DISABILITY OR THEIR
34 PARENT, GUARDIAN OR ADVOCATE ARE AVAILABLE THEN SUCH INDIVIDUAL SHALL
35 REMAIN IN THE FACILITY OR RESIDENCE UNTIL SAID SERVICES ARE AVAILABLE.
36 THE COMMISSIONER SHALL DOCUMENT EACH OFFER OF STATE OPERATED OPPORTU-
37 NITIES AND SHALL RETAIN A RECORD OF THE SERVICES OFFERED.
38 2. IN THE EVENT NO SERVICES DESIRED BY THE INDIVIDUALS THAT ARE DEVEL-
39 OPMENTALLY DISABLED ARE EITHER AVAILABLE OR EXIST WITHIN CURRENT STATE
40 OPERATED SERVICES, THE OFFICE SHALL RECORD THE NAME, PARENT, GUARDIAN OR
41 ADVOCATE AND SERVICES THEY ARE SEEKING. THE COMMISSIONER SHALL DEVELOP A
42 RECORD OF SERVICES FOR STATE OPERATED SUPPORTIVE PLACEMENT OPTIONS THAT
43 ARE NOT AVAILABLE WITH A PLAN TO ADDRESS THE UNMET NEEDS FOR THE FOLLOW-
44 ING FISCAL YEAR. SUCH COMMISSIONER SHALL SUBMIT THE PLAN TO THE TEMPO-
45 RARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY NO LATER
46 THAN DECEMBER THIRTY-FIRST OF EACH YEAR.
47 S 2. This act shall take effect immediately.
48 PART W
49 Section 1. Section 7.17 of the mental hygiene law is amended by adding
50 a new subdivision (g) to read as follows:
51 (G) THE COMMISSIONER SHALL PROVIDE MONTHLY STATUS REPORTS ON COMMUNITY
52 INVESTMENTS AND THE IMPACT ON INPATIENT CENSUS TO THE CHAIRS OF THE
S. 4207 98
1 SENATE FINANCE COMMITTEE AND THE ASSEMBLY WAYS AND MEANS COMMITTEE. SUCH
2 REPORT SHALL INCLUDE, BUT NOT BE LIMITED TO:
3 (1) A STATE OPERATED PSYCHIATRIC FACILITY CENSUS;
4 (2) LOW TO HIGH CENSUS RANGE;
5 (3) AVERAGE DAILY CENSUS;
6 (4) ADMISSIONS AND DISCHARGES;
7 (5) PSYCHIATRIC READMISSIONS TO HOSPITALS AND EMERGENCY ROOMS FOR
8 STATE PC DISCHARGES;
9 (6) PSYCHIATRIC READMISSIONS TO HOSPITALS AND EMERGENCY ROOMS FOR
10 ARTICLE TWENTY-EIGHT AND ARTICLE THIRTY-ONE HOSPITALS PSYCHIATRIC UNIT
11 DISCHARGES;
12 (7) MEDICAID EMERGENCY ROOM PSYCHIATRIC VISITS;
13 (8) DESCRIPTIONS OF NEW COMMUNITY SERVICE REINVESTMENTS;
14 (9) AN EXPLANATION OF ANY MATERIAL CENSUS REDUCTIONS;
15 (10) MEDIAN LENGTH OF STAY AT EACH FACILITY;
16 (11) THE NUMBER OF INDIVIDUALS WHO ARE LONG STAY AT EACH FACILITY;
17 (12) THE NUMBER OF INDIVIDUALS OUT OF THE CATCHMENT AREA ADMITTED INTO
18 FACILITIES IN THE CATCHMENT AREA;
19 (13) THE NUMBER OF INDIVIDUALS IN THE CATCHMENT AREA ADMITTED INTO
20 FACILITIES OUT OF THE CATCHMENT AREA;
21 (14) ARTICLE TWENTY-EIGHT AND THIRTY-ONE HOSPITAL REINVESTMENT SUMMA-
22 RIES PURSUANT TO CHAPTER FIFTY-THREE OF THE LAWS OF TWO THOUSAND FOUR-
23 TEEN FOR SERVICES AND EXPENSES OF THE MEDICAL ASSISTANCE PROGRAM TO
24 ADDRESS COMMUNITY MENTAL HEALTH SERVICE NEEDS RESULTING FROM THE
25 REDUCTION OF PSYCHIATRIC INPATIENT SERVICES; AND
26 (15) A GLOSSARY OF SERVICES.
27 S 2. Section 13.17 of the mental hygiene law, as amended by section 1
28 of part J of chapter 56 of the laws of 2012, is amended to read as
29 follows:
30 S 13.17 Programs, services, and operations in the office for people with
31 developmental disabilities.
32 (a) The commissioner shall establish policy and procedures for the
33 organization, administration, and service delivery system under his or
34 her jurisdiction and shall make provision for the effective rendition of
35 supports and services to individuals with developmental disabilities.
36 (b) There shall be, within the state operations offices of the office,
37 the developmental disabilities services offices named below serving the
38 areas either currently or previously served by a school, for the care
39 and treatment of persons with developmental disabilities and for
40 research and teaching in the science and skills required for the care
41 and treatment of such persons with developmental disabilities:
42 Bernard M. Fineson Developmental Disabilities Services Office
43 Brooklyn Developmental Disabilities Services Office
44 Broome Developmental Disabilities Services Office
45 Capital District Developmental Disabilities Services Office
46 Central New York Developmental Disabilities Services Office
47 Finger Lakes Developmental Disabilities Services Office
48 Institute for Basic Research in Developmental Disabilities
49 Hudson Valley Developmental Disabilities Services Office
50 Metro New York Developmental Disabilities Services Office
51 Long Island Developmental Disabilities Services Office
52 Sunmount Developmental Disabilities Services Office
53 Taconic Developmental Disabilities Services Office
54 Western New York Developmental Disabilities Services Office
55 Staten Island Developmental Disabilities Services Office
S. 4207 99
1 The New York State Institute for Basic Research in Developmental Disa-
2 bilities is designated as an institute for the conduct of medical
3 research and other scientific investigation directed towards furthering
4 knowledge of the etiology, diagnosis, treatment and prevention of devel-
5 opmental disabilities.
6 (c) The commissioner shall establish, at his or her discretion, devel-
7 opmental disabilities regional offices and shall establish state oper-
8 ations offices that provide for the direct delivery of supports and
9 services by the office for people with developmental disabilities.
10 [(c)] (D) The commissioner may authorize other offices of the depart-
11 ment and any public or private non-profit organization or political
12 subdivision of the state to deliver supports and services to individuals
13 with developmental disabilities, not inconsistent with the programs and
14 objectives of the office in any facility under his jurisdiction. The
15 commissioner may permit any facility under his jurisdiction to operate
16 programs for persons with mental disabilities, not inconsistent with
17 programs and objectives of the department, under contracts or agreements
18 with other offices within the department.
19 (E) THE COMMISSIONER SHALL PROVIDE MONTHLY STATUS REPORTS TO THE
20 CHAIRS OF THE SENATE FINANCE COMMITTEE AND THE ASSEMBLY WAYS AND MEANS
21 COMMITTEE. SUCH REPORT SHALL INCLUDE, BUT NOT BE LIMITED TO:
22 (1) CURRENT CENSUS BY FACILITY;
23 (2) ADMISSIONS AND DISCHARGES;
24 (3) THE NUMBER OF INDIVIDUALS WHO ARE LONG STAY AT EACH FACILITY;
25 (4) AN EXPLANATION OF ANY SIGNIFICANT CENSUS REDUCTIONS; AND
26 (5) COMMUNITY SERVICES PROVIDED TO INDIVIDUALS LEAVING FACILITIES,
27 INCLUDING THOSE INDIVIDUALS WITH COMPLEX NEEDS.
28 S 3. This act shall take effect immediately.
29 PART X
30 Section 1. The commissioner of the office for people with develop-
31 mental disabilities, in collaboration with the developmental disabili-
32 ties advisory council established pursuant to section 13.05 of the
33 mental hygiene law, shall develop a plan for implementing the front door
34 process. Such commissioner shall submit the plan to the temporary presi-
35 dent of the senate and the speaker of the assembly no later than January
36 1, 2016 and implement guidelines putting the plan into effect on or
37 after April 1, 2016, but no later than July 1, 2016. The plan shall:
38 (a) Provide clear and specific guidelines outlining the criteria for
39 when self-direction is and is not appropriate for individuals.
40 (b) Provide guidelines for a clear, expeditious and transparent proc-
41 ess for allocating residential placements and other critical services to
42 persons based on their individual needs. Such process shall be consist-
43 ent across the state and where exceptions are made such exceptions shall
44 be made in explicit recognition of clear and rational factors. Such
45 guidelines shall:
46 (1) Ensure that critical needs are met in a timely fashion;
47 (2) Provide an expedited appeals process to review and finally deter-
48 mine authorized requests for critical services when the state has not
49 granted such a request promptly considering the circumstances, provided,
50 however, that such appeal must be authorized if the request has not been
51 granted within ten business days;
52 (3) Provide linguistically and culturally appropriate information on
53 services and access to services in a universally clear and transparent
54 manner;
S. 4207 100
1 (4) Provide designated staff which may include a Medicaid service
2 coordinator to assist prospective service recipients and their families
3 with navigating the front door process;
4 (5) Provide a process to ensure that people in crisis are not subject
5 to the front door process and receive immediate services;
6 (6) Report on the extent to which the front door policy, as it has
7 been implemented, is consistent with applicable requirements for the
8 home and community based waiver regarding timeliness of decisions,
9 comprehensiveness of necessary services, choice, persons centered plan-
10 ning and other matters affecting the appropriateness and adequacy of
11 services for people with developmental disabilities.
12 (7) Provide guidelines to facilitate and support the evaluation of
13 post-secondary options for individuals with developmental disabilities
14 consistent with subparagraph 5 of paragraph b of subdivision 1 of
15 section 4402 of the education law.
16 S 2. This act shall take effect immediately.
17 PART Y
18 Section 1. Section 13.15 of the mental hygiene law is amended by
19 adding a new subdivision (c) to read as follows:
20 (C) (1) FOR PURPOSES OF THIS SUBDIVISION, THE FOLLOWING TERMS SHALL
21 HAVE THE FOLLOWING MEANINGS:
22 (A) "DIRECT SUPPORT PROFESSIONALS" MEANS DIRECT SUPPORT WORKERS,
23 DIRECT CARE WORKERS, PERSONAL ASSISTANTS, PERSONAL ATTENDANTS, AND PARA-
24 PROFESSIONALS THAT PROVIDE ASSISTANCE TO INDIVIDUALS WITH DEVELOPMENTAL
25 DISABILITIES IN THE FORM OF DAILY LIVING, AND PROVIDE THE HABILITATION,
26 REHABILITATION, AND VOCATIONAL AND EDUCATIONAL NEEDS OF THESE INDIVID-
27 UALS.
28 (B) "LICENSED PROFESSIONALS" MEANS PHYSICIANS, DENTISTS, DENTAL
29 HYGIENISTS, DENTAL ASSISTANTS, NURSE PRACTITIONERS, LICENSED PRACTICAL
30 NURSES, REGISTERED NURSES, PSYCHIATRISTS, PSYCHOLOGISTS, LICENSED MASTER
31 SOCIAL WORKERS, OR LICENSED CLINICAL SOCIAL WORKERS, LICENSED TO PRAC-
32 TICE PURSUANT TO THE EDUCATION LAW AND OTHER QUALIFIED MENTAL HEALTH
33 PROFESSIONALS.
34 (C) "SUPPORTS AND SERVICES" MEANS DIRECT SUPPORT PROFESSIONALS,
35 LICENSED PROFESSIONALS, EMPLOYMENT, TRANSPORTATION, DAY AND RESIDENTIAL
36 SERVICES, INCLUDING, BUT NOT LIMITED TO, PRIVATE RESIDENCES, COMMUNITY-
37 INTEGRATED LIVING ARRANGEMENTS, SUPPORTED RESIDENTIAL PROGRAMS, SUPER-
38 VISED RESIDENTIAL PROGRAMS, OR SUPPORTIVE HOUSING PROGRAMS.
39 (2) THE COMMISSIONER SHALL CONDUCT AN ANNUAL GEOGRAPHIC ANALYSIS OF
40 SUPPORTS AND SERVICES IN COMMUNITY SETTINGS FOR INDIVIDUALS WITH DEVEL-
41 OPMENTAL DISABILITIES IN EACH COUNTY OF THE STATE IN ORDER TO IDENTIFY
42 GAPS BETWEEN SUPPORTS AND SERVICES CURRENTLY PROVIDED AND SUPPORTS AND
43 SERVICES BEING REQUESTED BY INDIVIDUALS IN EACH COUNTY OF THE STATE. THE
44 ANALYSIS SHALL BE BASED UPON INFORMATION CURRENTLY MAINTAINED BY THE
45 OFFICE.
46 (A) THE COMMISSIONER SHALL CATEGORIZE THE NEEDS FOR DEVELOPMENTAL
47 DISABILITY SERVICES WITHIN A FRAMEWORK THAT ENCOMPASSES THREE LEVELS OF
48 URGENCY OF NEEDS. THESE LEVEL OF SUPPORT NEEDS ARE: (I) EMERGENCY NEED,
49 FOR THOSE PERSONS WITH DEVELOPMENTAL DISABILITIES IN NEED OF IMMEDIATE
50 SUPPORT EITHER DAY SUPPORT OR IN-HOME OR OUT-OF-HOME PLACEMENT; (II)
51 CRITICAL NEED FOR THOSE INDIVIDUALS WHO WILL HAVE A NEED FOR SUPPORTS OR
52 SERVICES WITHIN ONE YEAR; AND (III) PLANNING FOR NEED, FOR THOSE INDI-
53 VIDUALS WHOSE SUPPORT NEEDS ARE ONE TO FIVE YEARS AWAY, OR WHERE THE
54 CAREGIVER'S PHYSICAL AND MENTAL WELL-BEING OR ABILITY IS COMPROMISED.
S. 4207 101
1 (B) THE GEOGRAPHIC ANALYSIS SHALL INCLUDE:
2 (I) THE STATEWIDE NUMBER OF INDIVIDUALS SEEKING SERVICES;
3 (II) INDIVIDUALS WHO HAVE REGISTERED FOR RESIDENTIAL PLACEMENT, RESI-
4 DENTIAL SUPPORTS IN THE COMMUNITY, DAY SERVICE SUPPORT, HOME AND COMMU-
5 NITY-BASED WAIVER SUPPORT, EMPLOYMENT SUPPORT, BEHAVIORAL HEALTH
6 SERVICES AND SUPPORTS, OR OTHER COMMUNITY-BASED SUPPORT;
7 (III) RESIDENTIAL REGISTRY DATA SUCH AS:
8 (I) THE TYPE OF SUPPORTS AND SERVICES SUCH INDIVIDUALS ARE SEEKING AND
9 THE TYPES OF SUPPORTS AND SERVICES SUCH INDIVIDUAL IS EXPECTED TO
10 REQUIRE BASED UPON INDIVIDUAL SERVICES PLANNING MODEL (ISPM) GROUPING
11 SCORES DIVIDED INTO CERTIFIED OUT-OF-HOME, SUPERVISED, SUPPORTIVE PLACE-
12 MENT NEEDS AND OTHER NON-PLACEMENT NEEDS AND THE NUMBER OF SUCH PERSONS
13 WHO ARE MEDICALLY FRAIL REQUIRING INTENSIVE MEDICAL CARE;
14 (II) NON-CERTIFIED RESIDENTIAL PLACEMENTS OUTSIDE THE PARENT'S OR
15 PARENTS' OR OTHER FAMILY CAREGIVER'S HOME;
16 (III) THE NUMBER OF INDIVIDUALS EXPECTED TO REQUIRE HOME AND COMMUNITY
17 SERVICES WAIVER-FUNDED HABILITATION SERVICES AT HOME;
18 (IV) THE TOTAL NUMBER OF INDIVIDUALS, WHO HAVE BEEN IDENTIFIED AS IN
19 NEED OF SUPPORTS AND SERVICES WHO HAVE RECEIVED THESE SUPPORTS AND
20 SERVICES AND ANY GAP BETWEEN SUPPORTS AND SERVICES REQUESTED AND THE
21 SUPPORTS AND SERVICES PROVIDED;
22 (V) THE NUMBER OF EMERGENCY NEED RESIDENTIAL PLACEMENTS FOR THE PAST
23 YEAR AND OTHER SUPPORTS AND SERVICES PROVIDED ON AN EMERGENCY BASIS;
24 (VI) THE NUMBER OF INDIVIDUALS WHO ARE CURRENTLY RECEIVING SUPPORTS
25 AND SERVICES, INCLUDING RESIDENTIAL SERVICES, WHO ARE AWAITING AN ALTER-
26 NATIVE PLACEMENT OR ALTERNATIVE SUPPORT AND SERVICE DELIVERY OPTIONS;
27 (VII) THE NUMBER OF INDIVIDUALS THE COMMISSIONER HAS IDENTIFIED AS
28 HAVING AN EMERGENCY NEED, FOR THOSE PERSONS WITH DEVELOPMENTAL DISABILI-
29 TIES IN NEED OF IMMEDIATE SUPPORT EITHER DAY SUPPORT OR IN-HOME OR OUT-
30 OF-HOME PLACEMENT; CRITICAL NEED FOR THOSE INDIVIDUALS WHO WILL HAVE A
31 NEED FOR SUPPORTS OR SERVICES WITHIN ONE YEAR; AND PLANNING FOR NEED,
32 FOR THOSE INDIVIDUALS WHOSE SUPPORT NEEDS ARE ONE TO FIVE YEARS AWAY, OR
33 WHERE THE CAREGIVER'S PHYSICAL AND MENTAL WELL-BEING OR ABILITY IS
34 COMPROMISED; AND
35 (VIII) ANY OTHER INFORMATION DEEMED NECESSARY BY THE COMMISSIONER.
36 (3) IN ORDER TO PERFORM THE GEOGRAPHIC ANALYSIS OR TO GATHER DATA FOR
37 PURPOSES OF PERFORMING THE GEOGRAPHIC ANALYSIS, THE COMMISSIONER MAY
38 WORK IN COOPERATION AND AGREEMENT WITH OTHER OFFICES, DEPARTMENTS OR
39 AGENCIES OF THE STATE, LOCAL OR FEDERAL GOVERNMENT, OR OTHER ORGANIZA-
40 TIONS AND INDIVIDUALS, WHICH MAY INCLUDE PROVIDERS OF SERVICES FOR
41 PERSONS WITH DEVELOPMENTAL DISABILITIES, REPRESENTATIVES FROM EMPLOYEE
42 ORGANIZATIONS REPRESENTING DIRECT CARE WORKERS, CONSUMER REPRESENTATIVES
43 INCLUDING PERSONS WITH DEVELOPMENTAL DISABILITIES, OR THEIR PARENTS OR
44 GUARDIANS.
45 (4) THE COMMISSIONER SHALL MAKE PUBLIC EACH ANNUAL ANALYSIS NO LATER
46 THAN THE FIRST DAY OF THE FIRST MONTH FOLLOWING THE END OF THE PRECEDING
47 YEAR, BY POSTING THE DATA ON THE OFFICE WEBSITE.
48 S 2. This act shall take effect immediately.
49 PART Z
50 Section 1. Section 6801-a of the education law, as added by chapter 21
51 of the laws of 2011, is amended to read as follows:
52 S 6801-a. Collaborative drug therapy management [demonstration
53 program]. 1. As used in this section, the following terms shall have the
54 following meanings:
S. 4207 102
1 a. "Collaborative drug therapy management" shall mean the performance
2 of services by a pharmacist relating to the review, evaluation and
3 management of drug therapy to a patient, who is being treated by a
4 physician OR NURSE PRACTITIONER for a specific disease or disease state,
5 in accordance with a written agreement or protocol with a voluntarily
6 participating physician OR NURSE PRACTITIONER and in accordance with the
7 policies, procedures, and protocols of the facility. Such agreement or
8 protocol as entered into by the physician OR NURSE PRACTITIONER and a
9 pharmacist, may include, and shall be limited to:
10 (i) [adjusting or managing] PRESCRIBING IN ORDER TO ADJUST OR MANAGE a
11 drug regimen of a patient, pursuant to a patient specific written order
12 or protocol made by the patient's physician OR NURSE PRACTITIONER, which
13 may include adjusting drug strength, frequency of administration or
14 route of administration. Adjusting the drug regimen shall not include
15 substituting or selecting a different drug which differs from that
16 initially prescribed by the patient's physician OR NURSE PRACTITIONER
17 unless such substitution is expressly authorized in the written order or
18 protocol. The pharmacist shall be required to immediately enter into the
19 patient record any change or changes made to the patient's drug therapy
20 and shall use any reasonable means or method established by the facility
21 or the department to notify any of the patient's other treating physi-
22 cians OR NURSE PRACTITIONERS with whom he or she does not have a written
23 agreement or protocol regarding such changes. The patient's physician OR
24 NURSE PRACTITIONER may prohibit, by written instruction, any adjustment
25 or change in the patient's drug regimen by the pharmacist;
26 (ii) evaluating and, only if specifically authorized by the protocol
27 and only to the extent necessary to discharge the responsibilities set
28 forth in this section, ordering clinical laboratory tests related to the
29 drug therapy management for the specific disease or disease state speci-
30 fied within the protocol; and
31 (iii) only if specifically authorized by the protocol and only to the
32 extent necessary to discharge the responsibilities set forth in this
33 section, ordering or performing routine patient monitoring functions as
34 may be necessary in the drug therapy management, including the collect-
35 ing and reviewing of patient histories, and ordering or checking patient
36 vital signs, including pulse, temperature, blood pressure and respira-
37 tion.
38 b. "Written agreement or protocol" shall mean a written document,
39 pursuant to and consistent with any applicable state or federal require-
40 ments, that addresses a specific disease or disease state and that
41 describes the nature and scope of collaborative drug therapy management
42 to be undertaken by the pharmacist, in collaboration with the partic-
43 ipating physician OR NURSE PRACTITIONER, in accordance with the
44 provisions of this section.
45 c. "Physician OR NURSE PRACTITIONER" shall mean the physician OR NURSE
46 PRACTITIONER, selected by or assigned to a patient, who has primary
47 responsibility for the treatment and care of the patient for the disease
48 or disease state that is the subject of the collaborative drug therapy
49 management.
50 d. "Facility" shall mean a [teaching] hospital, [including any diag-
51 nostic center, treatment center, or hospital-based outpatient depart-
52 ment, however, for the purposes of this section, residential health care
53 facilities and nursing homes shall be excluded] AS DEFINED BY SUBDIVI-
54 SION ONE OF SECTION TWENTY-EIGHT HUNDRED ONE OF THE PUBLIC HEALTH LAW.
55 [For the purposes of this section, a "teaching hospital" shall mean a
56 hospital licensed pursuant to article twenty-eight of the public health
S. 4207 103
1 law that is eligible to receive direct or indirect graduate medical
2 education payments pursuant to article twenty-eight of the public health
3 law.] IN ADDITION, A FACILITY MAY ALSO INCLUDE UP TO FIFTEEN COMMUNITY-
4 PRACTICE SITES, SELECTED BY THE DEPARTMENT IN CONSULTATION WITH THE
5 DEPARTMENT OF HEALTH, WHERE PHARMACISTS AND PHYSICIANS OR NURSE PRACTI-
6 TIONERS MAY PROPOSE TO ENTER INTO COLLABORATIVE ARRANGEMENTS, PURSUANT
7 TO THE PROVISIONS OF THIS SECTION. SUCH SITES SHALL BE SELECTED BASED
8 UPON A REVIEW OF APPLICATIONS SUBMITTED TO THE DEPARTMENT BY SUCH PHAR-
9 MACISTS AND PHYSICIANS OR NURSE PRACTITIONERS, WHICH DEMONSTRATE THAT
10 THE APPLICANTS CAN SATISFY THE REQUIREMENTS OF THIS SECTION.
11 2. a. A pharmacist who meets the experience requirements of paragraph
12 b of this subdivision and who is EITHER employed by or otherwise affil-
13 iated with a facility OR IS PARTICIPATING WITH A COMMUNITY-PRACTICE SITE
14 SELECTED PURSUANT TO PARAGRAPH D OF SUBDIVISION ONE OF THIS SECTION
15 shall be permitted to enter into a written agreement or protocol with a
16 physician OR NURSE PRACTITIONER authorizing collaborative drug therapy
17 management, subject to the limitations set forth in this section, within
18 the scope of such employment [or], affiliation OR PARTICIPATION.
19 b. A participating pharmacist must:
20 (i)(A) have been awarded either a master of science in clinical phar-
21 macy or a doctor of pharmacy degree;
22 (B) maintain a current unrestricted license; and
23 (C) have a minimum of two years experience, of which at least one year
24 of such experience shall include clinical experience in a health facili-
25 ty, which involves consultation with physicians OR NURSE PRACTITIONERS
26 with respect to drug therapy and may include a residency at a facility
27 involving such consultation; or
28 (ii)(A) have been awarded a bachelor of science in pharmacy;
29 (B) maintain a current unrestricted license; and
30 (C) within the last seven years, have a minimum of three years experi-
31 ence, of which at least one year of such experience shall include clin-
32 ical experience in a health facility, which involves consultation with
33 physicians OR NURSE PRACTITIONERS with respect to drug therapy and may
34 include a residency at a facility involving such consultation.
35 c. Notwithstanding any provision of this section, nothing herein shall
36 authorize the pharmacist to diagnose disease. In the event that a treat-
37 ing physician OR NURSE PRACTITIONER may disagree with the exercise of
38 professional judgment by the pharmacist, the judgment of the treating
39 physician OR NURSE PRACTITIONER shall prevail.
40 3. The physician OR NURSE PRACTITIONER who is a party to a written
41 agreement or protocol authorizing collaborative drug therapy management
42 IN A FACILITY SETTING shall be employed by or otherwise affiliated with
43 the same facility with which the pharmacist is also employed or affil-
44 iated.
45 4. The existence of a written agreement or protocol on collaborative
46 drug therapy management and the patient's right to choose to not partic-
47 ipate in collaborative drug therapy management shall be disclosed to any
48 patient who is eligible to receive collaborative drug therapy manage-
49 ment. Collaborative drug therapy management shall not be utilized unless
50 the patient or the patient's authorized representative consents, in
51 writing, to such management. If the patient or the patient's authorized
52 representative consents, it shall be noted on the patient's medical
53 record. If the patient or the patient's authorized representative who
54 consented to collaborative drug therapy management chooses to no longer
55 participate in such management, at any time, it shall be noted on the
56 patient's medical record. In addition, the existence of the written
S. 4207 104
1 agreement or protocol and the patient's consent to such management shall
2 be disclosed to the patient's primary physician OR NURSE PRACTITIONER
3 and any other treating physician OR NURSE PRACTITIONER or healthcare
4 provider.
5 5. Participation in a written agreement or protocol authorizing colla-
6 borative drug therapy management shall be voluntary, and no patient,
7 physician, NURSE PRACTITIONER, pharmacist, or facility shall be required
8 to participate.
9 6. Nothing in this section shall be deemed to limit the scope of prac-
10 tice of pharmacy nor be deemed to limit the authority of pharmacists and
11 physicians OR NURSE PRACTITIONERS to engage in medication management
12 prior to the effective date of this section and to the extent authorized
13 by law.
14 S 2. Section 5 of chapter 21 of the laws of 2011 amending the educa-
15 tion law relating to authorizing pharmacists to perform collaborative
16 drug therapy management with physicians in certain settings, as amended
17 by chapter 125 of the laws of 2014, is amended to read as follows:
18 S 5. This act shall take effect on the one hundred twentieth day after
19 it shall have become a law [and shall expire 4 years after such effec-
20 tive date when upon such date the provisions of this act shall be deemed
21 repealed]; provided, however, that the amendments to subdivision 1 of
22 section 6801 of the education law made by section one of this act shall
23 be subject to the expiration and reversion of such subdivision pursuant
24 to section 8 of chapter 563 of the laws of 2008, when upon such date the
25 provisions of section one-a of this act shall take effect; provided,
26 further, that effective immediately, the addition, amendment and/or
27 repeal of any rule or regulation necessary for the implementation of
28 this act on its effective date is authorized and directed to be made and
29 completed on or before such effective date.
30 S 3. This act shall take effect immediately; provided, however, that
31 section two of this act shall take effect on the one hundred twentieth
32 day after it shall have become a law; provided that, effective imme-
33 diately, the addition, amendment and/or repeal of any rule or regulation
34 necessary for the implementation of this act on its effective date is
35 authorized and directed to be made and completed on or before such
36 effective date.
37 PART AA
38 Section 1. Section 7.17 of the mental hygiene law is amended by adding
39 a new subdivision (g) to read as follows:
40 (G) THE COMMISSIONER SHALL ESTABLISH THE SINGLE POINT OF ACCESS WAIT
41 LIST FOR INDIVIDUALS SEEKING HOUSING AND RELATED SERVICES WITHIN THE
42 OFFICE OF MENTAL HEALTH SERVICES SYSTEM.
43 (1) THE COMMISSIONER SHALL USE THE DATA REPORTED TO THE OFFICE BY
44 COUNTIES AND THIRD PARTY ENTITIES CONTRACTED TO PROVIDE SINGLE POINT OF
45 ACCESS SUPPORT SERVICES AS REQUIRED BY PARAGRAPH SEVENTEEN OF SUBDIVI-
46 SION (A) OF SECTION 41.13 OF THIS CHAPTER, TO GENERATE THE SINGLE POINT
47 OF ACCESS WAIT LIST FOR INDIVIDUALS SEEKING HOUSING AND RELATED SERVICES
48 WITHIN THE OFFICE OF MENTAL HEALTH SERVICES SYSTEM.
49 (2) THE INFORMATION PROVIDED IN THE SINGLE POINT OF ACCESS WAIT LIST
50 SHALL INCLUDE BUT NOT BE LIMITED TO:
51 (I) THE NAME OF EACH PERSON WHO IS REFERRED TO, APPLIES FOR, IS ADMIT-
52 TED TO, WITHDRAWS AN APPLICATION FOR OR IS DENIED ACCESS TO HOUSING
53 PROGRAMS OR RELATED SERVICES THROUGH EACH COUNTY'S SINGLE POINT OF
54 ACCESS PROGRAM;
S. 4207 105
1 (II) THE NAMES OF PERSONS REFERRED TO A HOUSING SERVICES PROVIDER BY
2 THE COUNTY OR THIRD PARTY ENTITY CONTRACTED TO PROVIDE SINGLE POINT OF
3 ACCESS SUPPORT SERVICES VIA THE SINGLE POINT OF ACCESS PROGRAM;
4 (III) THE NAME OF EACH PERSON RECEIVING MENTAL HEALTH RESIDENTIAL
5 SERVICES OR PLACED IN HOUSING VIA THE SINGLE POINT OF ACCESS PROGRAM;
6 AND
7 (IV) ANY OTHER INFORMATION AS THE COMMISSIONER MAY REQUIRE.
8 (3) THE COMMISSIONER SHALL MAKE PUBLIC THE SINGLE POINT OF ACCESS WAIT
9 LIST BY POSTING THE DATA, ABSENT PERSONAL IDENTIFICATION INFORMATION ON
10 THE OFFICE OF MENTAL HEALTH WEBSITE. THE COMMISSIONER SHALL REGULARLY
11 UPDATE THE OFFICE OF MENTAL HEALTH WEBSITE TO ACCURATELY REFLECT CHANGES
12 TO THE SINGLE POINT OF ACCESS WAIT LIST AS NEW DATA IS REPORTED BUT
13 SHALL NOT EXCEED A PERIOD LONGER THAN SEVENTY DAYS BETWEEN UPDATES.
14 (4) THE COMMISSIONER SHALL ESTABLISH POLICIES, PROCEDURES AND FORMS
15 FOR THE SINGLE POINT OF ACCESS WAIT LIST IN ORDER TO ENSURE COUNTIES AND
16 THIRD PARTY ENTITIES CONTRACTED TO PROVIDE SINGLE POINT OF ACCESS
17 SUPPORT SERVICES ARE ABLE TO SUBMIT WAIT LIST INFORMATION, AS OUTLINED
18 BY PARAGRAPHS SEVENTEEN, EIGHTEEN AND NINETEEN OF SUBDIVISION (A) OF
19 SECTION 41.13 OF THIS CHAPTER, DIRECTLY TO THE OFFICE VIA ELECTRONIC
20 MEANS. SUCH POLICIES, PROCEDURES AND FORMS SHALL SAFEGUARD THE CONFIDEN-
21 TIALITY OF INFORMATION CONCERNING PERSONS SEEKING HOUSING, AND ACCORD
22 EACH PERSON ON THE WAIT LIST AN OPPORTUNITY TO RECEIVE A WRITTEN COPY OF
23 HIS OR HER PERSONAL INFORMATION MAINTAINED ON THE WAIT LIST. SUCH POLI-
24 CIES AND PROCEDURES SHALL PROVIDE FOR THE SINGLE POINT OF ACCESS WAIT
25 LIST TO INCLUDE ALL PERSONS ON ANY LOCAL WAIT LIST FOR HOUSING BEFORE
26 THE EFFECTIVE DATE OF THIS SUBDIVISION AND THE DATE UPON WHICH EACH SUCH
27 PERSON WAS FIRST PLACED ON SUCH WAIT LIST. SUCH LIST SHALL ALSO INCLUDE
28 PERSONS WHO ARE PLACED ON ANY SUCH LOCAL WAIT LIST ON OR AFTER THE
29 EFFECTIVE DATE OF THIS SUBDIVISION.
30 (5) THE COMMISSIONER SHALL PREPARE A REPORT ON THE SINGLE POINT OF
31 ACCESS WAIT LIST OF PERSONS SEEKING HOUSING WITHIN THE MENTAL HEALTH
32 SYSTEM. THE REPORT SHALL INCLUDE BUT NOT BE LIMITED TO: (I) THE NUMBER
33 OF ADULTS REFERRED TO THE SINGLE POINT OF ACCESS WAIT LIST; (II) THE
34 NUMBER OF ADULTS THAT APPLIED FOR EACH CATEGORY OF RESIDENTIAL SERVICE;
35 (III) THE NUMBER OF ADULTS ADMITTED TO EACH CATEGORY OF RESIDENTIAL
36 SERVICE; (IV) THE NUMBER OF ADULTS DENIED ADMISSION FOR EACH CATEGORY OF
37 RESIDENTIAL SERVICE; (V) THE NUMBER OF ADULTS WHO WITHDREW APPLICATIONS
38 FOR EACH CATEGORY OF RESIDENTIAL SERVICE; AND (VI) THE NUMBER OF ADULTS
39 ON THE SINGLE POINT OF ACCESS WAIT LIST FOR EACH CATEGORY OF RESIDENTIAL
40 SERVICE. SUCH REPORT SHALL INCLUDE FOR EACH CATEGORY AND COUNTY, THE
41 NUMBER OF MONTHS ON THE SINGLE POINT OF ACCESS WAIT LIST FOR EACH
42 PERSON. SUCH REPORT SHALL INCLUDE THE TYPES, CAPACITIES AND VACANCY
43 RATES OF RESIDENTIAL SERVICES OFFERED IN EACH COUNTY. THE REPORTS SHALL
44 INCLUDE ANY ACTIONS TAKEN BY THE OFFICE TO REDUCE THE LENGTH OF THE
45 SINGLE POINT OF ACCESS WAIT LIST FOR EACH CATEGORY OF RESIDENTIAL
46 SERVICES, INCLUDING THE METHODS BY WHICH THE OFFICE PRIORITIZES THE
47 PROVISIONS OF SERVICES TO PERSONS ON THE SINGLE POINT OF ACCESS WAIT
48 LIST AND THE ACTIONS OF THE OFFICE TO INFORM THE PUBLIC ABOUT THE SINGLE
49 POINT OF ACCESS WAIT LIST AND THE AVAILABILITY OF COMMUNITY HOUSING AND
50 SERVICES FOR ADULTS WITH A DOCUMENTED MENTAL ILLNESS. THE OFFICE SHALL
51 SUBMIT THE REPORT TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE
52 AND THE SPEAKER OF THE ASSEMBLY ON OR BEFORE JANUARY FIRST, TWO THOUSAND
53 SEVENTEEN AND QUARTERLY THEREAFTER.
54 S 2. Subdivision (a) of section 41.13 of the mental hygiene law is
55 amended by adding three new paragraphs 17, 18 and 19 to read as follows:
S. 4207 106
1 17. USING DATA CONTAINED IN THE SINGLE POINT OF ACCESS DATABASE,
2 REPORT EVERY SIXTY DAYS TO THE OFFICE THE NAME OF EACH PERSON WHO IS
3 REFERRED TO, APPLIES FOR, IS ADMITTED TO, WITHDRAWS AN APPLICATION FOR
4 OR IS DENIED ACCESS TO HOUSING PROGRAMS OR RELATED SERVICES THROUGH THE
5 COUNTY'S SINGLE POINT OF ACCESS PROGRAM, ALONG WITH SUCH OTHER INFORMA-
6 TION AS THE COMMISSIONER MAY REQUIRE.
7 18. USING DATA CONTAINED IN THE SINGLE POINT OF ACCESS DATABASE,
8 REPORT THE NAMES OF PERSONS REFERRED TO A HOUSING SERVICES PROVIDER BY
9 THE COUNTY OR THIRD PARTY ENTITY CONTRACTED TO PROVIDE SINGLE POINT OF
10 ACCESS SUPPORT SERVICES VIA THE SINGLE POINT OF ACCESS PROGRAM TO THE
11 OFFICE, ALONG WITH SUCH OTHER INFORMATION AS THE COMMISSIONER MAY
12 REQUIRE.
13 19. USING DATA CONTAINED IN THE SINGLE POINT OF ACCESS DATABASE,
14 REPORT THE NAME OF EACH PERSON RECEIVING MENTAL HEALTH RESIDENTIAL
15 SERVICES OR PLACED IN HOUSING, ALONG WITH SUCH OTHER INFORMATION AS THE
16 COMMISSIONER MAY REQUIRE.
17 S 3. This act shall take effect on the one hundred twentieth day after
18 it shall have become a law; provided, however, that effective immediate-
19 ly, the addition, amendment and/or repeal of any rule or regulation
20 necessary for the implementation of this act on its effective date are
21 authorized and directed to be made and completed on or before such
22 effective date.
23 PART BB
24 Section 1. Subparagraph (iv) of paragraph (a) of subdivision 3 of
25 section 3309 of the public health law, as added by chapter 42 of the
26 laws of 2014, is amended to read as follows:
27 (iv) "Opioid antagonist recipient" or "recipient" means a person at
28 risk of experiencing an opioid-related overdose, or a family member,
29 friend or other person in a position to assist a person experiencing or
30 at risk of experiencing an opioid-related overdose, or an organization
31 registered as an opioid overdose prevention program pursuant to this
32 section, OR A SCHOOL DISTRICT, BOARD OF COOPERATIVE EDUCATIONAL
33 SERVICES, COUNTY VOCATIONAL EDUCATION AND EXTENSION BOARD, CHARTER
34 SCHOOL, NON-PUBLIC ELEMENTARY AND/OR SECONDARY SCHOOL IN THE STATE OR
35 ANY PERSON EMPLOYED BY SUCH DISTRICT, BOARD OR SCHOOL.
36 S 2. Subdivision 4 of section 3309 of the public health law, as
37 amended by chapter 42 of the laws of 2014, is amended to read as
38 follows:
39 4. Use of an opioid antagonist pursuant to this section shall be
40 considered first aid or emergency treatment for the purpose of any stat-
41 ute relating to liability.
42 A recipient, opioid overdose prevention program, SCHOOL DISTRICT,
43 BOARD OF COOPERATIVE EDUCATIONAL SERVICES, COUNTY VOCATIONAL EDUCATION
44 AND EXTENSION BOARD, CHARTER SCHOOL, NON-PUBLIC ELEMENTARY AND/OR
45 SECONDARY SCHOOL IN THE STATE, OR ANY PERSON EMPLOYED BY SUCH DISTRICT,
46 BOARD OR SCHOOL under this section, acting reasonably and in good faith
47 in compliance with this section, shall not be subject to criminal, civil
48 or administrative liability solely by reason of such action.
49 S 3. Subdivision 3 of section 3309 of the public health law, as added
50 by chapter 34 of the laws of 2014, is renumbered subdivision 3-a.
51 S 4. The education law is amended by adding a new section 922 to read
52 as follows:
53 S 922. OPIOID OVERDOSE PREVENTION. 1. SCHOOL DISTRICTS, BOARDS OF
54 COOPERATIVE EDUCATIONAL SERVICES, COUNTY VOCATIONAL EDUCATION AND EXTEN-
S. 4207 107
1 SION BOARDS, CHARTER SCHOOLS, AND NON-PUBLIC ELEMENTARY AND SECONDARY
2 SCHOOLS IN THIS STATE MAY PROVIDE AND MAINTAIN ON-SITE IN EACH INSTRUC-
3 TIONAL SCHOOL FACILITY OPIOID ANTAGONISTS, AS DEFINED IN SECTION THREE
4 THOUSAND THREE HUNDRED NINE OF THE PUBLIC HEALTH LAW, IN QUANTITIES AND
5 TYPES DEEMED BY THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER
6 OF HEALTH, TO BE ADEQUATE TO ENSURE READY AND APPROPRIATE ACCESS FOR USE
7 DURING EMERGENCIES TO ANY STUDENT OR STAFF HAVING OPIOID OVERDOSE WHETH-
8 ER OR NOT THERE IS A PREVIOUS HISTORY OF OPIOID ABUSE.
9 2. SCHOOL DISTRICTS, BOARDS OF COOPERATIVE EDUCATIONAL SERVICES, COUN-
10 TY VOCATIONAL EDUCATION AND EXTENSION BOARDS, CHARTER SCHOOLS, AND NON-
11 PUBLIC ELEMENTARY AND SECONDARY SCHOOLS IN THIS STATE OR ANY PERSON
12 EMPLOYED BY ANY SUCH ENTITY MAY ADMINISTER AN OPIOID ANTAGONIST IN THE
13 EVENT OF AN EMERGENCY PURSUANT TO THE REQUIREMENTS OF SECTION THREE
14 THOUSAND THREE HUNDRED NINE OF THE PUBLIC HEALTH LAW.
15 S 5. Subdivision 4 of section 6909 of the education law is amended by
16 adding a new paragraph (f) to read as follows:
17 (F) THE URGENT OR EMERGENCY TREATMENT OF OPIOID RELATED OVERDOSE OR
18 SUSPECTED OPIOID RELATED OVERDOSE.
19 S 6. Subdivision 6 of section 6527 of the education law is amended by
20 adding a new paragraph (f) to read as follows:
21 (F) THE URGENT OR EMERGENCY TREATMENT OF OPIOID RELATED OVERDOSE OR
22 SUSPECTED OPIOID RELATED OVERDOSE.
23 S 7. This act shall take effect immediately.
24 PART CC
25 Section 1. Section 48-a of part A of chapter 56 of the laws of 2013
26 amending chapter 59 of the laws of 2011 amending the public health law
27 and other laws relating to general hospital reimbursement for annual
28 rates relating to the cap on local Medicaid expenditures, as amended by
29 section 13 of part C of chapter 60 of the laws of 2014, is amended to
30 read as follows:
31 S 48-a. Notwithstanding any contrary provision of law, the commission-
32 ers of the office of alcoholism and substance abuse services and the
33 office of mental health are authorized, subject to the approval of the
34 director of the budget, to transfer to the commissioner of health state
35 funds to be utilized as the state share for the purpose of increasing
36 payments under the medicaid program to managed care organizations
37 licensed under article 44 of the public health law or under article 43
38 of the insurance law. Such managed care organizations shall utilize such
39 funds for the purpose of reimbursing providers licensed pursuant to
40 article 28 of the public health law or article 31 or 32 of the mental
41 hygiene law for ambulatory behavioral health services, as determined by
42 the commissioner of health, in consultation with the commissioner of
43 alcoholism and substance abuse services and the commissioner of the
44 office of mental health, provided to medicaid eligible outpatients. Such
45 reimbursement shall be in the form of fees for such services which are
46 equivalent to the payments established for such services under the ambu-
47 latory patient group (APG) rate-setting methodology as utilized by the
48 department of health, the office of alcoholism and substance abuse
49 services, or the office of mental health for rate-setting purposes;
50 provided, however, that the increase to such fees that shall result from
51 the provisions of this section shall not, in the aggregate and as deter-
52 mined by the commissioner of health, in consultation with the commis-
53 sioner of alcoholism and substance abuse services and the commissioner
54 of the office of mental health, be greater than the increased funds made
S. 4207 108
1 available pursuant to this section. The increase of such ambulatory
2 behavioral health fees to providers available under this section shall
3 be for all rate periods on and after the effective date of the chapter
4 of the laws of [2014] 2015 which amended this section through [December
5 31, 2016] JUNE 30, 2018 for patients in the city of New York, for all
6 rate periods on and after the effective date of the chapter of the laws
7 of [2014] 2015 which amended this section through [June 30, 2017]
8 SEPTEMBER 30, 2018 for patients outside the city of New York, and for
9 all rate periods on and after the effective date of such chapter of the
10 laws of [2014] 2015 which amended this section through December 31,
11 [2017] 2018 for all services provided to persons under the age of twen-
12 ty-one; provided, however, that managed care organizations and providers
13 may negotiate different rates and methods of payment during such periods
14 described above, subject to the approval of the department of health.
15 The department of health shall consult with the office of alcoholism and
16 substance abuse services and the office of mental health in determining
17 whether such alternative rates shall be approved. The commissioner of
18 health may, in consultation with the commissioner of alcoholism and
19 substance abuse services and the commissioner of the office of mental
20 health, promulgate regulations, including emergency regulations promul-
21 gated prior to October 1, 2015 to establish rates for ambulatory behav-
22 ioral health services, as are necessary to implement the provisions of
23 this section. Rates promulgated under this section shall be included in
24 the report required under section 45-c of part A of this chapter.
25 S 2. Subdivision 8 of section 84 of part A of chapter 56 of the laws
26 of 2013, amending chapter 59 of the laws of 2011 amending the public
27 health law and other laws relating to general hospital reimbursement for
28 annual rates relating to the cap on local Medicaid expenditures, as
29 amended by section 14 of part C of chapter 60 of the laws of 2014, is
30 amended to read as follows:
31 8. section forty-eight-a of this act shall expire and be deemed
32 repealed January 1, [2018] 2019;
33 S 3. Section 1 of part H of chapter 111 of the laws of 2010 relating
34 to increasing Medicaid payments to providers through managed care organ-
35 izations and providing equivalent fees through an ambulatory patient
36 group methodology, as amended by section 15 of part C of chapter 60 of
37 the laws of 2014, is amended to read as follows:
38 Section 1. Notwithstanding any contrary provision of law, the commis-
39 sioners of mental health and alcoholism and substance abuse services are
40 authorized, subject to the approval of the director of the budget, to
41 transfer to the commissioner of health state funds to be utilized as the
42 state share for the purpose of increasing payments under the medicaid
43 program to managed care organizations licensed under article 44 of the
44 public health law or under article 43 of the insurance law. Such managed
45 care organizations shall utilize such funds for the purpose of reimburs-
46 ing providers licensed pursuant to article 28 of the public health law,
47 or pursuant to article 31 or article 32 of the mental hygiene law for
48 ambulatory behavioral health services, as determined by the commissioner
49 of health in consultation with the commissioner of mental health and
50 commissioner of alcoholism and substance abuse services, provided to
51 medicaid eligible outpatients. Such reimbursement shall be in the form
52 of fees for such services which are equivalent to the payments estab-
53 lished for such services under the ambulatory patient group (APG) rate-
54 setting methodology as utilized by the department of health or by the
55 office of mental health or office of alcoholism and substance abuse
56 services for rate-setting purposes; provided, however, that the increase
S. 4207 109
1 to such fees that shall result from the provisions of this section shall
2 not, in the aggregate and as determined by the commissioner of health in
3 consultation with the commissioners of mental health and alcoholism and
4 substance abuse services, be greater than the increased funds made
5 available pursuant to this section. The increase of such behavioral
6 health fees to providers available under this section shall be for all
7 rate periods on and after the effective date of the chapter of the laws
8 of [2014] 2015 which amended this section through [December 31, 2016]
9 JUNE 30, 2018 for patients in the city of New York, for all rate periods
10 on and after the effective date of the chapter of the laws of [2014]
11 2015 which amended this section through [June 30, 2017] SEPTEMBER 30,
12 2018 for patients outside the city of New York, and for all rate periods
13 on and after the effective date of the chapter of the laws of [2014]
14 2015 which amended this section through December 31, [2017] 2018 for all
15 services provided to persons under the age of twenty-one; provided,
16 however, that managed care organizations and providers may negotiate
17 different rates and methods of payment during such periods described,
18 subject to the approval of the department of health. The department of
19 health shall consult with the office of alcoholism and substance abuse
20 services and the office of mental health in determining whether such
21 alternative rates shall be approved. The commissioner of health may, in
22 consultation with the commissioners of mental health and alcoholism and
23 substance abuse services, promulgate regulations, including emergency
24 regulations promulgated prior to October 1, 2013 that establish rates
25 for behavioral health services, as are necessary to implement the
26 provisions of this section. Rates promulgated under this section shall
27 be included in the report required under section 45-c of part A of chap-
28 ter 56 of the laws of 2013.
29 S 4. Section 2 of part H of chapter 111 of the laws of 2010, relating
30 to increasing Medicaid payments to providers through managed care organ-
31 izations and providing equivalent fees through an ambulatory patient
32 group methodology, as amended by section 16 of part C of chapter 60 of
33 the laws of 2014, is amended to read as follows:
34 S 2. This act shall take effect immediately and shall be deemed to
35 have been in full force and effect on and after April 1, 2010, and shall
36 expire on January 1, [2018] 2019.
37 S 5. Subdivision 7-a of section 84 of part A of chapter 56 of the laws
38 of 2013, amending the public health law and other laws relating to state
39 health mental hygiene budget for the 2013-14 state fiscal year, as added
40 by section 16-b of part C of chapter 60 of the laws of 2014, is amended
41 to read as follows:
42 7-a. section forty-five-c of this act shall expire and be deemed
43 repealed January 1, [2018] 2019;
44 S 6. This act shall take effect immediately.
45 PART DD
46 Section 1. The mental hygiene law is amended by adding a new section
47 13.43 to read as follows:
48 S 13.43 INTEGRATED HOUSING PLAN.
49 (A) THE COMMISSIONER, IN CONSULTATION WITH THE DEVELOPMENTAL DISABILI-
50 TIES ADVISORY COUNCIL, THE DEPARTMENT OF HEALTH, THE DIVISION OF HOUSING
51 AND COMMUNITY RENEWAL, THE MOST INTEGRATED SETTINGS COORDINATING COUNCIL
52 AND OTHER AGENCIES AS DETERMINED APPROPRIATE BY THE COMMISSIONER, SHALL
53 ESTABLISH A PLAN TO INCREASE HOUSING OPPORTUNITIES FOR PEOPLE WITH
S. 4207 110
1 DEVELOPMENTAL DISABILITIES. THE PLAN SHALL INCLUDE, BUT NOT BE LIMITED
2 TO:
3 (1) THE CREATION AND MAINTENANCE OF A LIST OF AFFORDABLE AND ACCESSI-
4 BLE RENTAL UNITS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES; AND
5 (2) IDENTIFICATION OF STRATEGIES TO FACILITATE INDIVIDUALS RECEIVING
6 OR ELIGIBLE FOR HOME AND COMMUNITY BASED (HCBS) WAIVERS TO LIVE IN THEIR
7 OWN HOME, LEASED APARTMENT OR FAMILY'S HOME, WHEN SUCH A PLACEMENT IS
8 THEIR INFORMED CHOICE AND THE MOST INTEGRATED SETTING APPROPRIATE TO
9 THEIR NEEDS. ANY SUCH STRATEGIES AT A MINIMUM SHALL ADDRESS:
10 (I) FACILITATING OPPORTUNITIES FOR INDIVIDUALS WITH DEVELOPMENTAL
11 DISABILITIES, INCLUDING STUDENTS TRANSITIONING FROM EDUCATIONAL PROGRAMS
12 TO LIVE INDEPENDENTLY IN THEIR OWN HOME OR APARTMENT AND AWAY FROM THEIR
13 PARENTAL HOME;
14 (II) INCREASING AFFORDABLE AND ACCESSIBLE RENTAL UNITS FOR INDIVIDUALS
15 WITH DEVELOPMENTAL DISABILITIES;
16 (III) INCREASING AND EXPANDING ACCESS TO RENTAL SUBSIDIES FOR INDIVID-
17 UALS WITH DEVELOPMENTAL DISABILITIES;
18 (IV) DEVELOPING AN EDUCATIONAL PROGRAM ABOUT INDIVIDUAL LIVING OPTIONS
19 FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, FAMILIES, PUBLIC AND
20 PRIVATE ORGANIZATIONS, DEVELOPERS AND MEDICAID SERVICE COORDINATORS;
21 (V) ANALYZING POTENTIAL FEDERAL AND STATE POLICY CHANGES THAT WILL
22 FACILITATE INCREASED ACCESS AND AVAILABILITY OF SERVICES AND SUPPORTS
23 THAT PERMIT INDIVIDUALS TO CHOOSE MORE INDEPENDENT LIVING OPTIONS; AND
24 (VI) ASSESSING AND ADVANCING COORDINATED PLAN IMPLEMENTATION.
25 (B) THE COMMISSIONER, IN CONSULTATION WITH THE DEVELOPMENTAL DISABILI-
26 TIES ADVISORY COUNCIL, THE DEPARTMENT OF HEALTH, THE DIVISION OF HOUSING
27 AND COMMUNITY RENEWAL, THE MOST INTEGRATED SETTINGS COORDINATING COUNCIL
28 AND OTHER AGENCIES AS DETERMINED APPROPRIATE BY THE COMMISSIONER, SHALL
29 DEVELOP THE PLAN WITH INPUT FROM STAKEHOLDERS, INCLUDING INDIVIDUALS
30 WITH DEVELOPMENTAL DISABILITIES, PARENTS AND GUARDIANS OF INDIVIDUALS
31 WITH DEVELOPMENTAL DISABILITIES, ADVOCATES AND PROVIDERS OF SERVICES FOR
32 INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES.
33 (C) THE PLAN REQUIRED PURSUANT TO THIS SECTION SHALL BE DEVELOPED AND
34 SUBMITTED TO THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF
35 THE ASSEMBLY AND POSTED ON THE WEBSITE OF THE OFFICE ON OR BEFORE APRIL
36 FIRST, TWO THOUSAND SIXTEEN. SUCH PLAN SHALL BE REASSESSED AND UPDATED
37 AT LEAST ANNUALLY THEREAFTER, ON OR BEFORE THE THIRTY-FIRST DAY OF JANU-
38 ARY, TO ENSURE RESPONSIVENESS TO CHANGING NEEDS AND GOALS, TO REFLECT
39 THE DEVELOPMENT OF NEW INFORMATION, AND TO REFLECT ACHIEVEMENT OF HOUS-
40 ING TRANSFORMATION GOALS, EVALUATION OF SUCCESSFUL INTEGRATED HOUSING
41 STRATEGIES AND MILESTONES TO MEET INTEGRATED HOUSING GOALS. SUCH UPDATED
42 PLAN SHALL BE POSTED ON THE WEBSITE OF THE OFFICE, AND SUBMITTED TO THE
43 TEMPORARY PRESIDENT OF THE SENATE AND SPEAKER OF THE ASSEMBLY.
44 S 2. This act shall take effect immediately.
45 PART EE
46 Section 1. The mental hygiene law is amended by adding a new section
47 31.38 to read as follows:
48 S 31.38 TEMPORARY ADJUSTMENT TO REIMBURSEMENT RATES FOR BEHAVIORAL
49 HEALTH.
50 (A) NOTWITHSTANDING ANY PROVISION OF LAW TO THE CONTRARY, WITHIN FUNDS
51 APPROPRIATED AND SUBJECT TO THE AVAILABILITY OF FEDERAL FINANCIAL
52 PARTICIPATION, THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER
53 OF HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE
54 ABUSE SERVICES, MAY GRANT APPROVAL OF A TEMPORARY ADJUSTMENT TO THE
S. 4207 111
1 NON-CAPITAL COMPONENTS OF RATES, OR MAKE TEMPORARY LUMP-SUM MEDICAID
2 PAYMENTS, TO ELIGIBLE PROVIDERS LICENSED UNDER THIS ARTICLE OR ARTICLE
3 THIRTY-TWO OF THIS CHAPTER, PROVIDED HOWEVER, THAT SHOULD FEDERAL FINAN-
4 CIAL PARTICIPATION NOT BE AVAILABLE FOR ANY ELIGIBLE PROVIDER, THEN
5 PAYMENTS PURSUANT TO THIS SUBDIVISION MAY BE MADE AS GRANTS AND SHALL
6 NOT BE DEEMED TO BE MEDICAL ASSISTANCE PAYMENTS.
7 (B) ELIGIBLE PROVIDERS SHALL INCLUDE:
8 (I) PROVIDERS UNDERGOING CLOSURE;
9 (II) PROVIDERS IMPACTED BY THE CLOSURE OF OTHER HEALTH CARE PROVIDERS;
10 (III) PROVIDERS SUBJECT TO MERGERS, ACQUISITIONS, CONSOLIDATIONS OR
11 RESTRUCTURING; OR
12 (IV) PROVIDERS IMPACTED BY THE MERGER, ACQUISITION, CONSOLIDATION OR
13 RESTRUCTURING OF OTHER HEALTH CARE PROVIDERS.
14 (C) PROVIDERS SEEKING TEMPORARY RATE ADJUSTMENTS UNDER THIS SECTION
15 SHALL DEMONSTRATE THROUGH SUBMISSION OF A WRITTEN PROPOSAL TO THE
16 COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH AND THE
17 COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES,
18 THAT THE ADDITIONAL RESOURCES PROVIDED BY A TEMPORARY RATE ADJUSTMENT
19 WILL ACHIEVE ONE OR MORE OF THE FOLLOWING:
20 (I) PROTECT OR ENHANCE ACCESS TO CARE;
21 (II) PROTECT OR ENHANCE QUALITY OF CARE;
22 (III) IMPROVE THE COST EFFECTIVENESS OF THE DELIVERY OF HEALTH CARE
23 SERVICES; OR
24 (IV) OTHERWISE PROTECT OR ENHANCE THE HEALTH CARE DELIVERY SYSTEM, AS
25 DETERMINED BY THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF
26 HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE
27 ABUSE SERVICES.
28 (D) (I) SUCH WRITTEN PROPOSAL SHALL BE SUBMITTED TO THE COMMISSIONER,
29 THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCO-
30 HOLISM AND SUBSTANCE ABUSE SERVICES, AT LEAST SIXTY DAYS PRIOR TO THE
31 REQUESTED EFFECTIVE DATE OF THE TEMPORARY RATE ADJUSTMENT, AND SHALL
32 INCLUDE A PROPOSED BUDGET TO ACHIEVE THE GOALS OF THE PROPOSAL. ANY
33 MEDICAID PAYMENT ISSUED PURSUANT TO THIS SECTION SHALL BE IN EFFECT FOR
34 A SPECIFIED PERIOD OF TIME AS DETERMINED BY THE COMMISSIONER, IN CONSUL-
35 TATION WITH THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE
36 OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, OF UP TO THREE YEARS.
37 AT THE END OF THE SPECIFIED TIMEFRAME SUCH PAYMENTS OR ADJUSTMENTS TO
38 THE NON-CAPITAL COMPONENT OF RATES SHALL CEASE, AND THE PROVIDER SHALL
39 BE REIMBURSED IN ACCORDANCE WITH THE OTHERWISE APPLICABLE RATE-SETTING
40 METHODOLOGY AS SET FORTH IN APPLICABLE STATUTES AND REGULATIONS. THE
41 COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH AND THE
42 COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES,
43 MAY ESTABLISH, AS A CONDITION OF RECEIVING SUCH TEMPORARY RATE ADJUST-
44 MENTS OR GRANTS, BENCHMARKS AND GOALS TO BE ACHIEVED IN CONFORMITY WITH
45 THE PROVIDER'S WRITTEN PROPOSAL AS APPROVED BY THE COMMISSIONER, IN
46 CONSULTATION WITH THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE
47 OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, AND MAY ALSO REQUIRE
48 THAT THE FACILITY SUBMIT SUCH PERIODIC REPORTS CONCERNING THE ACHIEVE-
49 MENT OF SUCH BENCHMARKS AND GOALS AS THE COMMISSIONER, IN CONSULTATION
50 WITH THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE OFFICE OF
51 ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, DEEMS NECESSARY. FAILURE TO
52 ACHIEVE SATISFACTORY PROGRESS, AS DETERMINED BY THE COMMISSIONER, IN
53 CONSULTATION WITH THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE
54 OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES, IN ACCOMPLISHING SUCH
55 BENCHMARKS AND GOALS SHALL BE A BASIS FOR ENDING THE FACILITY'S TEMPO-
56 RARY RATE ADJUSTMENT OR GRANT PRIOR TO THE END OF THE SPECIFIED TIME-
S. 4207 112
1 FRAME. (II) THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF
2 HEALTH AND THE COMMISSIONER OF THE OFFICE OF ALCOHOLISM AND SUBSTANCE
3 ABUSE SERVICES, MAY REQUIRE THAT APPLICATIONS SUBMITTED PURSUANT TO THIS
4 SECTION BE SUBMITTED IN RESPONSE TO AND IN ACCORDANCE WITH A REQUEST FOR
5 APPLICATIONS OR A REQUEST FOR PROPOSALS ISSUED BY THE COMMISSIONER, IN
6 CONSULTATION WITH THE COMMISSIONER OF HEALTH AND THE COMMISSIONER OF THE
7 OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES.
8 (E) NOTWITHSTANDING ANY LAW TO THE CONTRARY, ANY PROGRAMS AND FACILI-
9 TIES ISSUED OPERATING CERTIFICATES UNDER THIS ARTICLE OR ARTICLE THIR-
10 TY-TWO OF THIS CHAPTER SHALL BE ALLOCATED NO LESS THAN THIRTY MILLION
11 DOLLARS ANNUALLY PURSUANT TO THIS SECTION.
12 S 2. This act shall take effect immediately.
13 PART FF
14 Section 1. Subdivision 2 of section 2807-y of the public health law,
15 as added by section 67 of part B of chapter 58 of the laws of 2005, is
16 amended to read as follows:
17 2. In the event contracts with the article forty-three insurance law
18 plans or other commissioner's designees are effectuated, the commission-
19 er shall conduct annual audits of the receipt and distribution of the
20 funds AND SHALL PROVIDE RECORDS OF ALL REVENUES AND DISBURSEMENTS MADE
21 FROM ALLOWANCES AND ASSESSMENTS LISTED IN SUBDIVISION ONE OF THIS
22 SECTION TO THE TEMPORARY PRESIDENT OF THE SENATE AND SPEAKER OF THE
23 ASSEMBLY ON AN ANNUAL BASIS BEGINNING JANUARY FIRST, TWO THOUSAND
24 SIXTEEN.
25 S 2. HCRA modernization task force: The commissioner of health shall
26 convene a task force to evaluate and make recommendations related to
27 increasing the transparency and accountability of the health care reform
28 act resources fund (HCRA fund), to evaluate and modernize the provisions
29 of law related to the health care reform act (HCRA), and to restore
30 integrity and purpose to the HCRA program. The task force shall: be
31 provided a detailed accounting of revenues and disbursements made
32 through HCRA and the HCRA fund; assess the extent to which HCRA revenues
33 are expended toward their originally intended purpose; evaluate and
34 recommend a timeframe by which any state costs associated with Medicaid
35 shall be wholly funded by the general fund; assess the impact any feder-
36 al law enacted since 2009 has had on indigent care costs in the state,
37 and make recommendations for updating and modernizing the HCRA statute.
38 The task force shall be composed of the commissioner of health, and
39 stakeholders with institutional knowledge regarding the provisions of
40 HCRA and the disbursements from the HCRA fund, including but not limited
41 to representatives of health plans, managed care plans, hospitals,
42 physicians, other health care providers, the HCRA pool administrator,
43 and the office of the state comptroller. At least one such stakeholder
44 shall be appointed to the task force by the temporary president of the
45 senate and one by the speaker of the assembly. The task force shall be
46 convened not later than June 30, 2015 and shall submit its report to the
47 governor, the temporary president of the senate and the speaker of the
48 assembly no later than December 31, 2015.
49 S 3. Subdivision 10 of section 2807-m of the public health law is
50 amended by adding two new paragraphs (g) and (h) to read as follows:
51 (G) NO LATER THAN JULY FIRST, TWO THOUSAND FIFTEEN, THE COMMISSIONER
52 SHALL ISSUE A NEW REQUEST FOR APPLICATIONS FOR PHYSICIAN LOAN REPAYMENT
53 AWARDS, AND NO LATER THAN JULY FIRST, TWO THOUSAND SIXTEEN, THE COMMIS-
54 SIONER SHALL ISSUE ANOTHER REQUEST FOR SUCH APPLICATIONS.
S. 4207 113
1 (H) THE COMMISSIONER SHALL APPOINT A WORK GROUP OF INTERESTED PARTIES
2 BY SEPTEMBER FIRST, TWO THOUSAND FIFTEEN, TO EVALUATE WHETHER CHANGES
3 ARE NECESSARY IN ORDER TO ENHANCE THE PROGRAM, AND TO MAKE RECOMMENDA-
4 TIONS FOR ANY CHANGES. A REPORT, CONTAINING THE RECOMMENDATIONS OF THE
5 WORK GROUP, SHALL BE SUBMITTED TO THE GOVERNOR, THE CHAIRS OF THE SENATE
6 HEALTH AND FINANCE COMMITTEES, AND THE CHAIRS OF THE ASSEMBLY HEALTH AND
7 WAYS AND MEANS COMMITTEES BY OCTOBER FIRST, TWO THOUSAND SIXTEEN.
8 S 4. Subdivision 1 of section 2807-v of the public health law is
9 amended by adding a new paragraph (iii) to read as follows:
10 (III) NOTWITHSTANDING ANY CONTRARY PROVISION OF LAW, AND IN ADDITION
11 TO FUNDS PROVIDED PURSUANT TO PARAGRAPH (D) OF SUBDIVISION FIVE-A OF
12 SECTION TWENTY-EIGHT HUNDRED SEVEN-M OF THIS ARTICLE, FUNDS SHALL BE
13 RESERVED AND ACCUMULATED FROM YEAR TO YEAR AND SHALL BE AVAILABLE FOR
14 THE PURPOSE OF FUNDING THE PHYSICIAN LOAN REPAYMENT PROGRAM PURSUANT TO
15 SUBDIVISION TEN OF SECTION TWENTY-EIGHT HUNDRED SEVEN-M OF THIS ARTICLE
16 IN THE FOLLOWING AMOUNTS:
17 (I) TWO MILLION DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND
18 FIFTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND SIXTEEN; AND
19 (II) FOUR MILLION FIVE HUNDRED THOUSAND DOLLARS FOR THE PERIOD APRIL
20 FIRST, TWO THOUSAND SIXTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND
21 SEVENTEEN.
22 THE ADDITIONAL FUNDS OF TWO MILLION DOLLARS FOR THE PERIOD APRIL
23 FIRST, TWO THOUSAND FIFTEEN THROUGH MARCH THIRTY-FIRST, TWO THOUSAND
24 SIXTEEN SHALL FUND THE FIRST YEAR LOAN REPAYMENT FOR ONE HUNDRED NEW
25 AWARDS, AND THE ADDITIONAL FUNDS OF FOUR MILLION FIVE HUNDRED THOUSAND
26 DOLLARS FOR THE PERIOD APRIL FIRST, TWO THOUSAND SIXTEEN THROUGH MARCH
27 THIRTY-FIRST, TWO THOUSAND SEVENTEEN SHALL FUND THE FIRST YEAR LOAN
28 REPAYMENT FOR ANOTHER ONE HUNDRED NEW AWARDS AND THE SECOND YEAR LOAN
29 REPAYMENT FOR THE PRIOR YEAR AWARDS. NOTWITHSTANDING ANY CONTRARY
30 PROVISION OF LAW AND SUBJECT TO THE EXTENSION OF THE HEALTH CARE REFORM
31 ACT OF 1996, SUFFICIENT FUNDS SHALL BE SET ASIDE AND RESERVED BY THE
32 COMMISSIONER FOR STATE FISCAL YEARS ON AND AFTER APRIL FIRST, TWO THOU-
33 SAND SEVENTEEN, AND SHALL BE AVAILABLE FOR PURPOSES OF PHYSICIAN LOAN
34 REPAYMENT IN ACCORDANCE WITH SUBDIVISION TEN OF SECTION TWENTY-EIGHT
35 HUNDRED SEVEN-M OF THIS ARTICLE IN AMOUNTS SUFFICIENT TO AT LEAST FUND
36 THE REMAINING YEAR COMMITMENTS FOR AWARDS MADE PRIOR TO APRIL FIRST, TWO
37 THOUSAND SEVENTEEN.
38 S 5. Subdivision 2 of section 2807-g of the public health law, as
39 added by chapter 1 of the laws of 1999, is amended to read as follows:
40 2. Grants shall be made on a competitive basis by region, in accord-
41 ance with the amount raised in the region, PROVIDED THAT NO LESS THAN
42 TWO AND ONE-HALF PERCENT OF THE TOTAL FUNDS MADE AVAILABLE IN ANY
43 REQUEST FOR PROPOSALS SHALL BE MADE AVAILABLE IN ANY REGION, with pref-
44 erence within regions given to areas and eligible organizations that
45 have experienced or are likely to experience job loss because of changes
46 in the health care system. If, at the conclusion of the regional compet-
47 itive contract award process, there are excess funds available within
48 any regional allocation, such funds shall be redistributed to regions
49 where there is a shortage of funds available for programs which other-
50 wise qualify for funding pursuant to this section. IF A GRANT RECIPIENT
51 HAS RECEIVED GRANT AWARDS FOR THE SAME WORKFORCE RETRAINING PROJECT IN
52 MULTIPLE REGIONS, SUCH GRANT RECIPIENT, WITH THE APPROVAL OF THE COMMIS-
53 SIONER, MAY REDISTRIBUTE FUNDS AMONG SAID REGIONS.
54 S 6. Subdivision 6 of section 2807-s of the public health law is
55 amended by adding a new paragraph (g) to read as follows:
S. 4207 114
1 (G) A FURTHER GROSS ANNUAL AMOUNT ALLOCATED TO THE ROCHESTER REGION
2 BEGINNING JANUARY FIRST, TWO THOUSAND SIXTEEN SHALL BE ONE HUNDRED TEN
3 MILLION DOLLARS. SUCH AMOUNT SHALL BE EXCLUDED FROM ALL COMPUTATIONS AND
4 ADJUSTMENTS MADE PURSUANT TO PARAGRAPH (B) OF SUBDIVISION SIX OF SECTION
5 TWO THOUSAND EIGHT HUNDRED SEVEN-T OF THIS ARTICLE.
6 S 7. Subdivision 7 of section 2807-s of the public health law is
7 amended by adding a new paragraph (d) to read as follows:
8 (D)(I) FIVE MILLION DOLLARS OF THE FUNDS ALLOCATED PURSUANT TO PARA-
9 GRAPH (G) OF SUBDIVISION SIX OF THIS SECTION SHALL BE DISTRIBUTED TO A
10 REGIONAL HEALTH PLANNING ORGANIZATION FOR USE IN FUNDING REGIONAL HEALTH
11 CARE IMPROVEMENT PROJECTS. THE REGIONAL HEALTH PLANNING ORGANIZATION
12 SHALL DISBURSE THOSE FUNDS IN ACCORDANCE WITH THIS PARAGRAPH, OR PURSU-
13 ANT TO GRANTS MADE BY THE ORGANIZATION IN ACCORDANCE WITH THIS PARA-
14 GRAPH. DISTRIBUTION OF ANY GRANT FUNDS ADMINISTERED BY THE REGIONAL
15 HEALTH PLANNING ORGANIZATION SHALL BE PURSUANT TO A MULTI-STAKEHOLDER
16 PROCESS. THE REGIONAL HEALTH CARE IMPROVEMENT GRANT FUND PROJECTS SHALL
17 INCLUDE THREE MILLION DOLLARS PER YEAR FOR A SHARED COMMUNITY HEALTH
18 INFRASTRUCTURE DESIGNED ON THE BASIS OF COLLABORATIVE COMMUNITY EFFORTS,
19 INCLUDING COMMUNITY-WIDE PATIENT SAFETY AND QUALITY IMPROVEMENT
20 PROGRAMS, ELIMINATION OF HEALTH DISPARITIES, HEALTH INFORMATION TECHNOL-
21 OGY, AND TWO MILLION DOLLARS TO FUND THE REGIONAL HEALTH PLANNING ORGAN-
22 IZATION. THE HEALTH PLANNING ORGANIZATION SHALL USE REASONABLE EFFORTS
23 TO GENERATE MATCHING FUND CONTRIBUTIONS IN THE FORM OF GRANTS, DONATIONS
24 AND OTHER CONTRIBUTIONS.
25 (II) ONE HUNDRED FIVE MILLION DOLLARS OF THE FUNDS ALLOCATED PURSUANT
26 TO PARAGRAPH (G) OF SUBDIVISION SIX OF THIS SECTION SHALL BE ALLOCATED
27 TO A NOT-FOR-PROFIT ORGANIZATION OR ASSOCIATION THAT HAS BEEN DESIGNATED
28 THROUGH A MULTI-STAKEHOLDER PROCESS, WHICH SHALL DISTRIBUTE THOSE FUNDS
29 TO ALL OF THE HOSPITALS IN THE REGION ENGAGED IN GRADUATE MEDICAL EDUCA-
30 TION IN ORDER TO FUND GRADUATE MEDICAL EDUCATION. ONE HUNDRED MILLION
31 DOLLARS OF SUCH FUNDING SHALL BE DISTRIBUTED PROPORTIONALLY TO EACH OF
32 THE HOSPITALS IN AMOUNTS WHICH REFLECT EACH HOSPITAL'S CURRENT COSTS FOR
33 GRADUATE MEDICAL EDUCATION, AND FIVE MILLION DOLLARS OF UNREIMBURSED
34 ADMINISTRATIVE AND OTHER GRADUATE MEDICAL EDUCATION RELATED COSTS SHALL
35 BE ALLOCATED IN THE SAME PROPORTIONS. ONE HUNDRED MILLION DOLLARS OF THE
36 DISTRIBUTED FUNDS SHALL BE IN LIEU OF CURRENT FUNDING OF SUCH COSTS AS
37 CURRENTLY INCLUDED IN CLAIMS PAYMENTS BY SPECIFIED THIRD PARTY PAYORS IN
38 THE REGION RESULTING IN A REDUCTION IN THE AMOUNT PAID BY SUCH THIRD
39 PARTY PAYORS IN AN AMOUNT EQUAL TO THE ONE HUNDRED MILLION DOLLARS.
40 PRIOR TO THE ALLOCATION OF FUNDS PURSUANT TO THIS SUBDIVISION, THE
41 PARTICIPATING HOSPITALS AND SUCH THIRD PARTY PAYORS SHALL DEVELOP A
42 PROCESS FOR THE DISTRIBUTION OF SUCH FUNDS AND A MECHANISM TO ENSURE
43 THAT THE REQUIRED REDUCTION OF PAYMENTS BY SUCH THIRD PARTY PAYORS TO
44 THE HOSPITALS OCCURS. THE AFFECTED HOSPITALS AND THE THIRD PARTY PAYORS
45 IN THE REGION SHALL SELECT AN INDEPENDENT THIRD PARTY TO DETERMINE THE
46 REDUCTIONS WHICH SHALL OCCUR FROM PREVIOUSLY NEGOTIATED RATES FOR CLAIMS
47 PAYMENTS TO SUCH HOSPITALS BY SPECIFIED THIRD PARTY PAYORS IN ORDER TO
48 AVOID DUPLICATE FUNDING PURSUANT TO THIS PARAGRAPH. PRIOR TO THE IMPLE-
49 MENTATION OF THESE PROVISIONS, A REPORT SHALL BE PREPARED BY SUCH INDE-
50 PENDENT THIRD PARTY TO ANALYZE THE ANTICIPATED IMPACT OF THESE
51 PROVISIONS ON GRADUATE MEDICAL EDUCATION AND THE PROMOTION OF COMMUNITY
52 HEALTH IN THE ROCHESTER REGION. THE REPORT WILL CONSIDER: THE IMPACT OF
53 THE PROPOSAL ON THE DEVELOPMENT AND RETENTION OF THE PHYSICIAN WORKFORCE
54 IN ROCHESTER AND THE SURROUNDING REGION AS A RESULT OF ITS EFFECTS ON
55 THE SUPPORT OF GRADUATE MEDICAL EDUCATION; THE IMPACT OF THE PROPOSAL ON
56 THE HEALTHCARE COMMUNITY (INCLUDING HOSPITALS AND OTHER HEALTHCARE
S. 4207 115
1 PROVIDERS), THIRD PARTY PAYORS, THE BUSINESS COMMUNITY AND CONSUMERS;
2 AND THE OVERALL IMPACT OF THE PROPOSAL ON THE HEALTHCARE DELIVERY SYSTEM
3 IN THE ROCHESTER REGION, INCLUDING ITS SUPPORT FOR COMMUNITY HEALTH
4 INITIATIVES AND HEALTHCARE PLANNING. THE REPORT WILL BE SUBMITTED TO THE
5 SPEAKER OF THE ASSEMBLY, THE TEMPORARY PRESIDENT OF THE SENATE AND TO
6 THE COMMISSIONER OF HEALTH NO LATER THAN OCTOBER 1, 2015.
7 S 8. This act shall take effect immediately; provided, however, that
8 the amendments made to section 2807-s of the public health law made by
9 sections six and seven of this act shall not affect the expiration of
10 such section and shall be deemed to expire therewith.
11 PART GG
12 Section 1. Section 2825 of the public health law, as added by section
13 8 of part A of chapter 60 of the laws of 2014, is amended to read as
14 follows:
15 S 2825. Capital restructuring financing program. 1. A capital restruc-
16 turing financing program is hereby established under the joint adminis-
17 tration of the commissioner and the president of the dormitory authority
18 of the state of New York, SUBJECT TO AN APPROPRIATION, for the purpose
19 of enhancing the quality, financial viability and efficiency of New
20 York's health care delivery system by transforming the system into a
21 more rational patient-centered care system that promotes population
22 health and improved well-being for all New Yorkers. The issuance of any
23 bonds or notes hereunder shall further be subject to the approval of the
24 director of the division of the budget, and any projects funded through
25 the issuance of bonds or notes hereunder shall be approved by the New
26 York state public authorities control board, as required under section
27 fifty-one of the public authorities law.
28 2. For the period April first, two thousand [fourteen] FIFTEEN through
29 March thirty-first, two thousand twenty-one, funds made available [for
30 expenditure] pursuant to this section [may] SHALL be distributed by the
31 commissioner and the president of the authority, in consultation with
32 the commissioners of the office of mental health, office for people with
33 developmental disabilities and office for alcoholism and substance abuse
34 services, as applicable, [for:
35 (a) capital grants to general hospitals, residential health care
36 facilities, diagnostics and treatment centers, and clinics licensed
37 pursuant to this chapter or the mental hygiene law, assisted living
38 programs, primary care providers, and home care providers certified or
39 licensed pursuant to article thirty-six of this chapter (collectively
40 "applicants") that qualify for payments under the delivery system reform
41 incentive payment program (DSRIP), in which case funding under this
42 paragraph shall be requested in such applicant's DSRIP application. Such
43 capital grant projects include, but are not limited to; closures, merg-
44 ers, restructuring, improvements to infrastructure, development of
45 primary care service capacity, development of telehealth infrastructure,
46 the promotion of integrated delivery systems that strengthen and protect
47 continued access to essential health care services and other transforma-
48 tional projects as determined by the commissioner and the president of
49 the authority.
50 (b) capital grants to general hospitals, residential health care
51 facilities, diagnostic and treatment centers, and clinics licensed
52 pursuant to this chapter or the mental hygiene law, assisted living
53 programs, primary care providers, home care providers, certified or
54 licensed pursuant to article thirty-six of this chapter (collectively
S. 4207 116
1 "applicants") that are non-qualifying and non-participating applicants
2 under paragraph (a) of this subdivision, for capital non-operational
3 works or purposes that support the purposes set forth in this section.
4 Such capital grant projects include, but are not limited to;] PURSUANT
5 TO A PROCESS AND PLAN APPROVED BY THE GOVERNOR, TEMPORARY PRESIDENT OF
6 THE SENATE AND THE SPEAKER OF THE ASSEMBLY.
7 (A) I. UPON APPROVAL OF A PROCESS AND PLAN, FUNDS SHALL BE DISTRIBUTED
8 TO SUPPORT DEBT RETIREMENT, NON-OPERATIONAL CAPITAL PROJECTS AND NON-CA-
9 PITAL PROJECTS, INCLUDING BUT NOT LIMITED TO PROJECTS RELATED TO
10 closures, mergers, restructuring, improvements to infrastructure, devel-
11 opment of primary care service capacity, development of telehealth
12 infrastructure, [the promotion of integrated delivery systems that
13 strengthen and protect continued access to essential health care
14 services] ESTABLISHMENT OR EXPANSION OF HEALTH INFORMATION TECHNOLOGY,
15 ESTABLISHMENT OF THE STATEWIDE HEALTH INFORMATION NETWORK OF NEW YORK,
16 AND THE ESTABLISHMENT OF AN ALL PAYER DATABASE WITH THE DEPARTMENT.
17 II. CRITERIA ESTABLISHED FOR APPLICANTS INTENDING TO RETIRE DEBT MUST
18 INCLUDE REQUIREMENTS TO DEMONSTRATE A REASONABLE RESTRUCTURING PLAN,
19 WHICH DEMONSTRATES LONG TERM SUSTAINABILITY OF THE APPLICANT.
20 (B) ELIGIBLE FUNDING RECIPIENTS SHALL INCLUDE GENERAL HOSPITALS, RESI-
21 DENTIAL HEALTH CARE FACILITIES, DIAGNOSTIC AND TREATMENT CENTERS, CLIN-
22 ICS LICENSED PURSUANT TO THIS CHAPTER OR THE MENTAL HYGIENE LAW,
23 ASSISTED LIVING PROGRAMS, PRIMARY CARE PROVIDERS, HOME CARE PROVIDERS
24 CERTIFIED OR LICENSED PURSUANT TO ARTICLE THIRTY-SIX OF THIS CHAPTER,
25 COMMUNITY HEALTH CARE PROVIDERS, AND FACILITIES AND PROVIDERS THAT ARE
26 AFFILIATED WITH OR LEADS OF A PERFORMING PROVIDER SYSTEM (PPS) IN THE
27 DELIVERY SYSTEM REFORM INCENTIVE PROGRAM (DSRIP), AND REGIONAL HEALTH
28 INFORMATION ORGANIZATIONS.
29 3. The commissioner and the president of the authority shall enter
30 into an agreement, subject to approval by the director of the budget and
31 subject to section sixteen hundred eighty-r of the public authorities
32 law, as added by [a] chapter FIFTY-FIVE of the laws of two thousand
33 fourteen, for the purposes of awarding, distributing, and administering
34 the funds made available pursuant to this section.
35 [(a) For capital grant projects under paragraph (a) of subdivision two
36 of this section, the evaluation of applications shall be submitted
37 pursuant to the process described in paragraph (b) of subdivision twenty
38 of section twenty-eight hundred seven of this article; provided, howev-
39 er, that such capital grant projects shall not be subject to review by
40 the federal Centers for Medicare and Medicaid services.
41 (b)] For monies allocated under [paragraph (b) of] subdivision two of
42 this section:
43 [(i)] (A) the department shall post on its website, for a period of no
44 less than thirty days:
45 [(A)] (I) the process by which such applications shall be reviewed;
46 [(B)] (II) the criteria by which such applications shall be judged;
47 and
48 [(C)] (III) a list of approved and denied applications subsequent to
49 such determination.
50 [(ii)] (B) the evaluation of applications shall be reviewed by the
51 department, pursuant to a process to be determined by the department[.
52 Applications shall then be subject to review by the panel established
53 pursuant to paragraph (b) of subdivision twenty of section twenty-eight
54 hundred seven of this article, which shall submit its recommendations to
55 the commissioner for final determination. Determination of awards for
56 funds allocated under paragraph (b) of subdivision two of this section,
S. 4207 117
1 shall include] INCLUDING, but not [be] limited to the following crite-
2 ria:
3 [(A)] (I) eligibility requirements for applicants;
4 [(B)] (II) statewide geographic distribution of funds;
5 [(C)] (III) minimum and maximum amounts of funding to be awarded under
6 the program;
7 [(D)] (IV) the relationship between the project proposed by an appli-
8 cant and identified community need;
9 [(E)] (V) the extent to which the applicant has access to alternative
10 financing;
11 [(F)] (VI) the extent to which the proposed project furthers the
12 purposes set forth [in this section;
13 (G) the extent that the proposed project furthers the development of
14 primary care;
15 (H) the extent to which the proposed project benefits Medicaid enrol-
16 lees and uninsured individuals;
17 (I) the extent to which the proposed project addresses potential risk
18 to patient safety and welfare;
19 (J) the extent that the proposed project involves an applicant that
20 receives or has applied for a temporary rate adjustment pursuant to
21 applicable regulations; and
22 (K) the extent to which the proposed project will contribute to the
23 long term sustainability of the applicant] BY THE PLAN APPROVED TO ALLO-
24 CATE FUNDS.
25 The commissioner shall provide a report on a quarterly basis to the
26 chairs of the senate finance, assembly ways and means, senate health and
27 assembly health committees. Such reports shall be submitted no later
28 than sixty days after the close of the quarter, and shall conform to the
29 reporting requirements of subdivision twenty of section twenty-eight
30 hundred seven of this article, as applicable.
31 S 2. Paragraphs (b) and (e) of subdivision 20 of section 2807 of the
32 public health law, as added by section 8-a of part A of chapter 60 of
33 the laws of 2014, are amended to read as follows:
34 (b) The commissioner shall establish an advisory panel to provide
35 assistance with regard to the DSRIP program. The panel shall be charged
36 with reviewing recommendations for DSRIP funding made by the state's
37 contracted DSRIP assessor and advising the commissioner regarding the
38 results of such review. [Such panel shall also review applications under
39 paragraph (b) of subdivision two of section twenty-eight hundred twen-
40 ty-five of this article.] Panel membership shall be comprised of indi-
41 viduals with significant health care system experience. Members may not
42 be elected officials or employed by providers that would benefit from
43 DSRIP funding, and must not have any conflict of interest that would
44 prevent them from providing an impartial review of DSRIP assessor recom-
45 mendations. The panel shall consist of members appointed by the commis-
46 sioner and shall in addition consist of one member appointed by the
47 [majority leader] TEMPORARY PRESIDENT of the New York state senate, and
48 one member appointed by the speaker of the New York state assembly. The
49 panel shall carry out the review of DSRIP recommendations in strict
50 accordance with all requirements set forth in the state's federal 1115
51 Medicaid waiver standard terms and conditions. The panel shall submit
52 its recommendations to the commissioner for final determination, in
53 accordance with all requirements set forth in the state's federal 1115
54 Medicaid waiver standard terms and conditions. The commissioner may
55 modify the requirements of this paragraph and paragraph (c) of this
56 subdivision if such modifications are required by the federal CMS.
S. 4207 118
1 (e) Notwithstanding any provision of law to the contrary, the commis-
2 sioners of the department of health, the office of mental health, the
3 office for people with developmental disabilities, and the office of
4 alcoholism and substance abuse services are authorized to waive any
5 regulatory requirements as are necessary, consistent with applicable
6 law, to allow applicants under this subdivision [and paragraph (a) of
7 subdivision two of section twenty-eight hundred twenty-five of this
8 article] to avoid duplication of requirements and to allow the efficient
9 implementation of the proposed project; provided, however, that regu-
10 lations pertaining to patient safety may not be waived, nor shall any
11 regulations be waived if such waiver would risk patient safety. Such
12 waiver shall not exceed the life of the project or such shorter time
13 periods as the authorizing commissioner may determine. Any regulatory
14 relief granted pursuant to this subdivision shall be described, includ-
15 ing each regulations waived and the project it relates to, in the report
16 provided pursuant to paragraph (c) of this subdivision.
17 S 3. This act shall take effect immediately.
18 S 2. Severability clause. If any clause, sentence, paragraph, subdivi-
19 sion, section or part of this act shall be adjudged by any court of
20 competent jurisdiction to be invalid, such judgment shall not affect,
21 impair, or invalidate the remainder thereof, but shall be confined in
22 its operation to the clause, sentence, paragraph, subdivision, section
23 or part thereof directly involved in the controversy in which such judg-
24 ment shall have been rendered. It is hereby declared to be the intent of
25 the legislature that this act would have been enacted even if such
26 invalid provisions had not been included herein.
27 S 3. This act shall take effect immediately provided, however, that
28 the applicable effective date of Parts A through GG of this act shall be
29 as specifically set forth in the last section of such Parts.