Assembly Health Committee Update

Sixty-eight bills approved by the Assembly Health Committee passed both the Assembly and Senate this year.

Bills passed by both Houses include:

The Health Committee also held hearings this spring on rural health care access and the New York Health Act single-payer bill.

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

Hearings

New York Health Act – The Assembly and Senate Health Committees held a joint hearing on May 28 on the New York Health Act, my bill creating a single-payer health care system in New York.Over 50 witnesses testified over 13 hours in Albany speaking as health care patients and providers, labor representatives, small business owners, and others.This was the first of what I expect will be a series of hearings across the State this summer and fall. 

New York Health would replace traditional health insurance coverage and public health coverage programs with comprehensive single-payer health coverage, including long-term care, for all New Yorkers. The program would be publicly funded, including existingfederal support for Medicaid and Medicare. New Yorkers would no longer have to pay premiums, deductibles, co-pays, out-of-network charges, or have limited provider networks.New York Health is the only way to ensure universal access to care, without financial barriers, for all New Yorkers.

Rural Health Care – On May 31, the Assembly Health Committee held a hearing on rural health care services.This broad topic included discussions of facility and provider financing in rural areas; geographic and transportation challenges unique to rural providers; and recruitment and retention strategies.

The hearing featured discussion of several current or potential legislative proposals on rural emergency medical services (EMS), including community paramedicine, the use of EMS personnel in non-emergency settings.Witnesses also discussed potentially diverting ambulances to non-hospital settings for non-emergency care, which could save transport time and prevent expensive and unnecessary hospital admissions.One bill I co-sponsor, which passed both Houses this session (A8058), would make it simpler to re-certify EMS personnel, which will help with staff retention in this critical field.

Bills Passed Both Houses

Reproductive Health Act (RHA) - Described above.Abortion would have the same legal status as other health care procedures, including allowing nurse practitioners, physician assistants and midwives to perform procedures within their ordinary scope of practice.(A21, Glick, signed 1/22/19)

Central Venous Line Patient Information - This bill would require hospitals to determine if family or other caregivers are able and willing to do the tasks involved in maintaining a central venous line for a patient about to be sent home from the hospital. (A212, Galef)

Protecting Patient Health Information - Prohibits emergency medical service providers from selling patient health information without written consent. (A230, Braunstein)

Feminine Hygiene Products in Charter Schools – The enacted budget required that all public schools provide feminine hygiene products free of charge for students in grades 6-12.This bill adds charter schools to that law.(A290, Rosenthal)

Doula certification – Doula support is effective in improving maternal health outcomes.In order to help standardize reimbursement for doula services, this bill provides title protection for certified doulas.(A364B, Paulin) 

Physician Information for Nursing Home Patients – Potential nursing home residents may want to know whether their trusted physicians in the community will be available at certain facilities.This bill requires nursing homes to provide potential residents with information regarding their policies on the granting of physician privileges.(A407, Cahill)

Adding E-Cigarettes to the Tobacco Use and Prevention Program – New York’s tobacco control program uses evidence-based education and outreach programs to reduce tobacco use by youth and help smokers quit.This bill adds electronic cigarettes to tobacco use prevention and control activities.(A481A, Rosenthal)

Menstrual Disorder Education – This bill directs the Commissioner, together with the Commissioner of Education, to create materials to be provided to school districts with information on symptoms and treatment of menstrual disorders.(A484, Rosenthal)

Tobacco 21 – Raises the purchase age for tobacco products from 18 years old to 21 years old.(A558A, Rosenthal)

Obstetrician Risk Management Continuing Education - Grants a medical malpractice premium reduction to obstetricians, other physicians who do deliveries, and midwives who take a continuing education course on risk management and birthing options for patients.(A568, Paulin)

Licensed Mental Health Practitioners (LMHP) Medicaid Coverage – LMHPs provide vital mental health services, including counseling and psychotherapy. Currently, LMHP services are only reimbursable by Medicaid if they are billed through a State mental or behavioral health agency. This bill makes LMHP services reimbursable when provided in other settings, increasing patient access to mental health care.(A648, Bronson)

LHCSA Moratorium Clarification – In response to the proliferation of licensed home care service agencies (LHCSAs), the 2018 enacted budget put a moratorium on new licenses for two years with certain exceptions.This bill clarifies the intent of the budget agreement that licensees whose applications were already in process will not be subject to the moratorium.(A976, Gottfried) 

First Responder Epi-Pens Outside NY City – Authorizes police and firefighters outside of New York City to possess and administer epi-pens.(A1024B, Rosenthal)

Electronic Prescription Exemptions – Current law requires all prescriptions to be done electronically.Since nursing homes may not have physicians or nurse practitioners (NPs) on-site 24/7 to access the electronic prescribing system, the State has allowed registered nurses to take orders for medications to be delivered in nursing home settings as long as the physician or NP signs an order within 48 hours.This bill extends this waiver process through 2021.(A1034A, Gottfried)

Technical Corrections to Hospice Law - Updates references to palliative care in the hospice law.(A1078, Gottfried) 

Adult Home Resident Health Care Autonomy – Protects the rights of adult home residents to make their own health care decisions and choose their health care providers. (A1084, Gottfried)

Isolated Hospice Patient Decision-making - Simplifies the process for decisions about routine care for hospice patients who don't have an appointed health care agent or a family "surrogate;" decisions would be governed by the provisions of the Family Health Care Decisions Act for patients who lack a surrogate. (A1124, Gottfried)

Correctional Health Oversight Expansion – In 2009, a law was enacted giving the Commissioner of Health authority and responsibility to “review any policy or practice” in correctional facilities relating to HIV/AIDS and hepatitis C.Since then, advocates have universally praised the improvement in care in these areas.However, the Health Department’s oversight is only limited to inmates with these particular conditions.This bill expands their oversight powers within State and County correctional settings to additional populations and conditions, such as women and transgender inmates and aging inmates and those with chronic conditions.It also requires a staffing adequacy study in response to evidence of severe health care staffing shortages.(A1130A, Gottfried)

Physician Assistant Decision-making – Laws enacted in 2017 and 2018 authorize attending nurse practitioner (NP) involvement in end of life decisions such as determinations of capacity, orders not to resuscitate, and implementation of health care proxy documents.This bill expands the same power to physician assistants (PAs), recognizing that PAs are often the practitioner with the closest relationship to and knowledge of the wishes of a patient or the patient’s family.(A1162A, Gottfried)

HIV Post-Exposure Prophylaxis - Current law requires hospitals to provide sexual assault victims with a 7-day "starter pack" of HIV post-exposure prophylaxis (PEP). This bill expands it to require provision of a full PEP regiment. The bill also requires that PEP costs be billed directly to the State Office of Victims Services and reimbursed directly to the health care provider, rather than requiring the victim to fill out a formal application.(A1204, Peoples-Stokes)

Temporary Operator Technical Correction – A law enacted in 2018 required that the department provide written notification to resident of adult care facilities when a temporary operator is appointed.This bill makes a minor change to clarify that the temporary operators themselves must notify the residents.(A1615, Wright)

Access to Breastfeeding Counseling Services - Medicaid currently covers lactation counseling by certified lactation consultants only upon referral by a physician, physician assistant, nurse practitioner, or licensed midwife. This bill would authorize Medicaid coverage for these services without requiring such medical orders.(A2345, Solages)

Medical Record Transfer – Establishes requirements for transfer of medical records in the event that a physician closes an office, including notification to patients that they can either receive their own records back or have them transferred to other offices.(A2349, Perry)

Vaccines Religious Exemption Repealer – Repeals the exemption from vaccinations due to religious beliefs.(A2371, Dinowitz)

Medication Synchronization – Medication synchronization enables partial prescription fills so that later refills are coordinated among multiple prescriptions.This bill authorizes, but does not require, partial fills for synchronized dispensing when the patient, prescriber, and pharmacist agree.(A2785A, Gottfried)

Behavioral Health Prompt Pay - Medicaid managed care plans pay behavioral health providers using ambulatory patient group rates, which are occasionally adjusted by the State. When rates go up, the State increases payments to the plans and the plans are supposed to pass the payment increase through to providers. Under current law, however, plans are allowed to delay paying these increases while making administrative changes but are not required to then adjust the payments retroactively to the effective date. This bill requires plans to make retroactive payments as necessary to implement such pay increases on their effective date.(A2787, Gottfried) 

Pharmacy Benefit Manager Accountability – Pharmacy benefit managers (PBMs) are companies that manage prescription drug benefit programs for health plans. PBMs promote themselves as saving health plans and their covered members money, but in reality, their negotiations and discounts or rebates they get from drug companies are very secretive and they commonly pocket payments from drug manufacturers that ought to be used to lower drug prices.This bill requires PBMs to be registered and licensed by the State and establishes a duty and standards for fair dealing with health plans, pharmacists and patients.The State will establish minimum standards for PBM licensees addressing conflicts of interest, deceptive and anti-competitive practices, unfair claims practices, and consumer protections. The bill will also allow patients, prescribers and pharmacists to sue PBMs if a PBM’s fail to meet appropriate standards.(A2836A, Gottfried)

Hospital Identification and Assistance for Domestic Violence Victims - Establishes procedures for hospitals and emergency rooms to properly identify and assist suspected or confirmed cases of domestic violence.(A2850A, Lavine)

Information on Complications from Pregnancy – Current law requires hospitals to provide informational leaflets to maternity patients.This bill requires that such leaflets include information on possible complications from pregnancy.(A2857A, Richardson)

Expedited Partner Therapy for Sexually Transmitted Diseases - Allows for expedited partner therapy for any sexually transmitted diseases for which it is recommended by the Centers for Disease Control and Prevention (CDC.) Current law covers expedited partner therapy for chlamydia but no other STDs. (A2998, Bichotte)

Maternal Mortality Review Board – Establishes a statewide Maternal Mortality Review Board comprised of health care professionals and other experts on the issues affecting women and mothers in communities with high rates of maternal mortality.The board will be tasked with reviewing cases of maternal death and developing recommendations for prevention strategies, policies, and best practices.(A3276, Joyner)

Sepsis Screening and Intervention Initiative – Sepsis is a deadly, often hospital-acquired infection.This bill authorizes the department to support increased screening, intervention, and education programs for health care providers including hospitals and home care agencies, and directs the commissioner to issue guidance to providers on sepsis prevention. (A3839, McDonald)

Window Blind Safety Pamphlets - Requires the Department to produce pamphlets regarding strangulation risks to children posed by window blind cords. The Department will provide these pamphlets to pediatricians for distribution at children's six-month appointments. (A3840, McDonald)

Public Health and Health Planning Council Membership – The Public Health and Health Planning Council (PHHPC) makes decisions and recommendations to the Commissioner regarding facility establishment, construction, transfer, and services.However, of 24 members, just one is required to represent patient advocacy groups and just one to represent organized labor, and all are appointed by the Governor.This bill adds additional labor and consumer representation as well as appointees on the recommendation of legislative leaders.(A4071, Gottfried)

Plant-based Food Options in Hospitals – Plant-based diets are those free of animal products such as meat, seafood, dairy, and eggs.In 2017, the American Medical Association adopted a resolution that calls on hospitals to improve patient health by "providing a variety of healthful food, including plant-based meals.”This bill requires hospitals to offer plant-based options to patients. (A4072, Gottfried)

Leukemia Tax Check-Offs - Provides an income tax check-off for leukemia, lymphoma, and myeloma education and outreach. (A4481, Cusick)

Nursing Home Oversight and Patient Protection – This bill authorizes independent quality monitors, chosen by the department, to ensure nursing home compliance with correction plans for violations.When a violation is caused by a staffing shortfall, DOH can also limit administrative costs for nursing homes in order to free up cash for hiring more direct care workers. The bill also requires disclosure of co-owner or contractor family ties to a nursing home operator, and at least 90 days’ notice before a facility is sold.If a facility is sold as real estate, such as for conversion to condominiums, the facility would have to return a portion of any State building grant money back to the State.(A4757A, Gottfried)

Opioid Information on Death Certificates – Current law requires that when a death is caused by an opioid overdose, it shall be noted on a death certificate.This bill requires that if the specific opioid is known to the person completing the death certificate, it shall also be noted.(A4915, Jean-Pierre)

Informed Consent for Training Procedures – While informed consent is a standard practice in medicine, there have been cases of practitioners instructing medical students to do procedures on unconscious or anesthetized patients without appropriate consent when those procedures are for training purposes only.This bill reaffirms that a procedure being done for the purposes of medical education or training does not diminish informed consent requirements.(A4988, Paulin)

Doctors Across NY Grants Process Workgroup – The Doctors Across New York program provides loan repayment and physician practice support to doctors practicing in high-need areas of the state.Recently, the department changed its electronic application process, causing problems for some applicants.This bill would require the department to form a workgroup to assess the impact of the new system on applicants’ ability to participate in the program.(A5425, Gottfried)

Adoptee Right to Know - Allows adoptees who are at least 18 years old to obtain from the Department of Health a copy of their birth certificates and medical history forms if available.(A5494, Weprin)

Rare Disease Advisory Council – There are nearly 7,000 rare diseases, defined as conditions affecting fewer than 200,000 Americans, which often lack recommended treatment plans or best practices.This bill establishes a Rare Disease Advisory Council to advise the commissioner on policy matters relating to rare diseases.(A5762, Paulin)

Informed Consent for Pelvic Exams – While informed consent is a standard practice in medicine, there have been cases of practitioners performing pelvic exams on unconscious patients without appropriate consent, often for purposes of training medical students.This bill reaffirms that informed consent is necessary for pelvic exams.(It is similar to, but narrower than, A4988, which also passed both Houses.)(A6325C, Solages)

Albany Birth and Death Certificate Fees – Authorizes the Albany Common Council to set the fee charged for birth and death records issued by the City Clerk.Several counties and cities have been given this authority. (A6463, Fahy)

Queens Asthma Study and Remediation – Directs the Commissioner of Health to conduct a study on the high incidence of asthma in the 5th Congressional District (southeastern Queens) and prepare a remedial plan.(A6497, Hyndman)

Emergency Room Bed Study – Overcrowding or local travel conditions may cause patients to wait longer than appropriate for access to emergency room beds.This bill directs the commissioner to study and make recommendations regarding the number of emergency room beds available in relation to travel time.(A6832, DenDekker)

Obstetric Hemorrhage Protocols – Many maternal deaths are linked to inadequate treatment of obstetric hemorrhage.This bill directs the commissioner to work with experts in developing a toolkit for obstetric hemorrhage management, and provide such protocols and guidance to hospitals who are directed to adopt and report on their implementation.(A6962A, Joyner.) 

Concussion Information Packets – Requires schools, leagues, or other entities who organize youth tackle football leagues to provide information to parents regarding concussions and sub-concussive blows.(A6968A, Benedetto)

Anaphylaxis Policies for Day Cares – Current law requires all schools to have in place policies for responding to anaphylaxis.This bill directs the commissioner to create a procedure and treatment plan, including training standards, for day care, and requires day cares to implement such plans including providing appropriate information to parents.(A6971B, Taylor)

Medicaid Coverage for Medication Assisted Treatment – Medication Assisted Treatment (MAT) is an evidence-based treatment method used to treat substance use disorders.Under current law, Medicaid coverage for MAT may require prior authorization, only cover certain medications, or require other barriers to care. This bill ensures Medicaid coverage for all MAT services without prior authorization.(A7246B, Rosenthal)

Opioid Antagonist Good Samaritan Information – Current law requires that opioid antagonist kits (such as Naloxone) include a card with information such as how to recognize an overdose and phone numbers for treatment hotlines.This bill adds information about Good Samaritan protections to the card.(A7277, Rosenthal)

Protecting Access to Complex Rehabilitation Equipment – This bill would have DOH establish qualifications for equipment suppliers to ensure adequate supply, configuration, delivery, and repair of complex rehabilitation equipment as well as to establish minimum reimbursement rates; and have Medicaid apply any new Medicare billing codes for such equipment.(A7492, Steck)

Lead Poisoning Prevention Council Quorum – The Lead Poisoning Prevention Council advises the department on lead poisoning prevention programs.This bill re-defines a quorum on this council as a majority of appointed members (i.e. not the full body counting vacant seats), which will help the Council’s functioning.(A7547, Peoples-Stokes)

Medicaid Recertification Simplification – Medicaid applicants often face delays before they are effectively enrolled.This bill enables auto-assignment in managed long-term care plans if an enrollee has not chosen a plan within 75 days, and provides automatic recertification for certain managed long-term care and other enrollees.(A7578A, Gottfried)

Extender – Hepatitis C testing – Current law establishes a testing and referral requirement for hepatitis C in hospitals for individuals born between 1945 and 1965.The program sunsets in 2019, so this bill extends it for an additional 6 years.(A7671, Zebrowski)

Camp Safety Advisory Council Quorum – The State Camp Safety Advisory Council advises the department on camp safety.This bill re-defines a quorum on this council as a majority of appointed members (i.e. not the full body counting vacant seats), which will help the Council’s functioning.(A7723, Gottfried)

Uniform Anatomical Gift Act – The Uniform Anatomical Gift Act (UAGA) includes processes for individuals and their family members to make anatomical gifts.Forty-eight states have adopted the most recent version of the UAGA, but New York has not.This bill updates New York law to conform to the UAGA, clarifying the anatomical gift process and providing that if there is a group of people authorized to make an anatomical gift decision, such as a patient’s children or siblings, the decision can be made by a simple majority.(New York is currently the only state in which a single objection from a member of a given category can override the preference of two or more others in that category.)Organ donation advocates estimate that these changes will add 200-300 donors a year, for a total of over 1,000 additional organs for transplant.(A7800A, Gottfried)

Home Care Registry Training Verification – The department maintains a home care worker registry that documents work history and completion of initial state-approved training programs.This bill adds a record of each home care worker's required annual in-service training to the registry, which will help track worker qualifications when they change employers.(A7854, Gottfried)

Special Transportation Claiming – The federal government authorizes states to claim Medicaid reimbursement for certain vehicle adaptations for school children with disabilities.However, states vary in what they cover and New York is the most restrictive.This bill directs the commissioner to seek to maximize receipt of all available federal funds for these transportation services, including reviewing policies in other, less restrictive states.(A7962, Gottfried)

Extender – Limited LHCSAs – Current law establishes limited licensed home care services agencies (LHCSA) licenses, but the program expires in 2019.This bill extends the limited LHCSA program through 2021.(A8032, Gottfried)

Extender – Child Health Plus Premiums – The Child Health Plus program provides a full range of health care services for children, with minimal premiums.This bill extends the premium provisions necessary to maintain the program through 2021.(A8053, Reyes)

Extender and Expansion – First Responder Recertification – Current law includes a demonstration program simplifying the recertification process for emergency medical technicians and other first responders in six regions of the state.This bill expands the program statewide and extends the program’s provisions through 2021.(A8058, Sayegh)

Extender – Contract Renewals – Current law requires that if a contract between a health plan and a hospital is terminated or not renewed, the parties must continue to follow the terms of the contract for a limited period in order to protect enrollees.This bill extends these provisions through 2021.(A8084, Buttenschon)

Licensed Clinical Social Worker (LCSW) Medicaid Coverage – LCSWs diagnose and treat people with mental, emotional, and behavioral disorders.However, they are prohibited from directly billing Medicaid, limiting their ability to serve patients in need.This bill authorizes LCSWs to directly bill Medicaid.(A8104, Bronson) 

Human Subject Research Review – Prior to 2019, research institutions were eligible for an exemption from New York human research laws if they were subject to federal regulations.Recent federal policy changes require that the NY exemption be modified so that the thousands of studies being conducted at New York institutions can continue without interruption with the same safety standards as before.(A8125, Gottfried)

Continuing Care Retirement Communities – New York State authorized the creation of Continuing Care Retirement Communities (CCRCs) in 1989.Thirty years later there are just 12 in the entire state, due largely to overly complex state requirements and regulations across multiple agencies, which have made it very challenging to build more.This legislation simplifies the administration of CCRCs, including removing duplicative regulatory requirements and centralizing the licensing process in the Department of Health.(A8193, Schimminger)