Assembly Health Committee Update

The Assembly Health Committee favorably reported 31 bills at its first four meetings of the 2018 session. These bills included proposals to expand the medical marijuana program; protect access to emergency contraception; and provide Department of Health (DOH) oversight of correctional health care facilities.

Several of these bills implement agreements made with the Governor when he signed bills in 2017. A governor often raises concerns and wants changes in a bill after it has been passed by the Legislature. It is common for a governor to insist that the leaders of the Legislature agree to pass legislation making changes in a bill as a condition of the governor signing it.

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:

January 16

Long Range Acoustic Devices Study - Long range acoustic devices (LRADs) are increasingly used by police forces at short ranges for crowd control. This bill requires a study to determine the health effects of exposure to LRADs. (A4915, Rosenthal)

Eligible Forms of Medical Marijuana - Current law prohibits smoking of medical marijuana. While smoking is not appropriate for all patients, many patients could benefit from smoking as a much cheaper delivery method than more complex products. This bill authorizes smoking as a delivery method while adding medical marijuana to the Clean Indoor Air Act. (A6009, Gottfried)

Pharmacy Benefit Manager Audit Rules - Pharmacy Benefit Managers (PBMs) manage pharmacy benefits for health plans, employer self-insured plans, and other payers. PBMs may audit pharmacy records, and these audits can be onerous and interfere with the normal functioning of the pharmacy. This bill provides rules for the auditing process and protections for pharmacies such as advance written notice and documentation standards. (A6733, Lavine)

Prescription Drug Stewardship Study - Prescription drug disposal programs ensure that drugs do not end up in the water supply or otherwise damage the environment. This bill directs DOH to study product stewardship programs in which pharmaceutical manufactures fund incentives for consumers to return unused prescription drugs to approved locations. (A8432, Gunther)

Alternative Identification for WIC Benefits - The Women, Infants, and Children (WIC) program provides supplemental nutrition benefits to low-income New Yorkers through redeemable vouchers or checks. Currently, cashiers cannot accept these payments unless the customer presents WIC identification. This bill authorizes DOH to develop an alternate methodology for customers to identify themselves, such as with drivers licenses. There is little risk of fraud since the vouchers or checks have the purchaser's name on them. (A8435, De La Rosa)

Early Intervention Coordinating Council (EICC) Quorum - The Early Intervention program provides services to 0-3 year olds with developmental delays. The EICC advises DOH's work on the program. This bill defines a quorum on the EICC as a majority of appointed members (i.e., not the full body counting vacant seats), which will help the Council's functioning. (A8656, Gottfried)

Prohibiting Mandatory Arbitration in Nursing Home Cases - This bill prohibits mandatory arbitration clauses in contracts between nursing homes and residents or their representatives. Mandatory arbitration clauses prohibit patients from suing in court. People entering a nursing home often sign contracts under physical and emotional duress and without real choice. They or their families should not be forced to sign away their rights in order to access necessary long-term care. (A8697, Titone)

State Veterans' Homes Board of Visitors Vacancies - The Board of Visitors plays an important role in supporting and monitoring State veterans' homes. Unfortunately, the boards have struggled with prolonged vacancies. This bill would authorize each board to appoint interim members if there has been a vacancy for 270 days. (A8703, D'Urso)

Pharmacy Benefit Manager Transparency - Pharmacy Benefit Managers (PBMs) manage pharmacy benefits for health plans, employer-sponsored self-insured plans, and other payers. PBMs too often engage in practices that limit transparency for consumers, including "gag clauses" in contracts with pharmacies that prohibit pharmacists from telling consumers the actual price of medications, or telling customers when drugs would actually cost less if they paid out of pocket. This bill prohibits such language in contracts between PBMs and pharmacies. (A8781, Rosenthal)

Access to Lactation Counseling Services - Breastfeeding has many health benefits to infants and their mothers. 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. (A8788, Solages)

January 23

Prohibiting Smoking in Home Child Care Facilities - Current law prohibits smoking in child care facilities in a private home, but allows it when children are not present. This bill would bar smoking even if no child enrolled in the program is present, except in any room that is not used for child care purposes. (A397A, Gunther)

Prohibiting Distribution of Free E-Cigarettes to Minors - Current law prohibits the sale of electronic cigarettes to minors, but does not specifically prohibit the distribution of free ones by sellers. This bill corrects this oversight. (A8014, Rosenthal)

Large Cities Asthma Study - Directs the Department of Health to conduct a study on asthma incidence in cities greater than 100,000 people. This would include New York City, Buffalo, Syracuse, Rochester, and Yonkers. (A8500, Hyndman)

Medical Marijuana Conditions Expansion - There is no drug other than marijuana for which the State restricts its use to a limited list of medical conditions. The list was added as a requirement for gaining Senate and Executive support, but takes decision-making power away from health care practitioners and their patients. This bill removes the list. However, it leaves in place the requirement that medical marijuana may only be used for a "severe debilitating or life-threatening condition." (A8904, Gottfried)

Medical Marijuana Providers Expansion - The medical marijuana law initially only allowed physicians to certify patients; later, nurse practitioners and physician assistants were added. However, other providers authorized to prescribe controlled substances often have the most substantial knowledge of a patient's condition and appropriate treatment (for example, a dentist or podiatrist treating chronic mouth or foot pain.) This bill allows any practitioner authorized to prescribe controlled substances to certify patients for medical marijuana, when acting within his or her scope of practice and with the same requirements as current practitioners (such as training, registration, and use of the prescription monitoring program.) (A8915, Gottfried)

Medical Marijuana for Opioid Use Disorders - This bill makes opioid use disorders an eligible condition under the medical marijuana law. Patients who may benefit from marijuana substitution for far more dangerous opioids should be able to make that decision with their providers, and not be limited to the current eligible conditions list. (A9016, O'Donnell)

January 30

Emergency Contraception Access - This bill ensures access to emergency contraception (EC) by allowing registered nurses and pharmacists to dispense EC without a patient-specific prescription and requiring commercial health insurance plans to cover EC without cost-sharing. The bill also provides for the Department to conduct education and outreach on the safety, efficacy, appropriate use, and availability of EC. (A2674A, Paulin)

Maternal Depression Provider Education - This bill requires the Commissioner in consultation with the Commissioner of Mental Health to inform health care providers about how to locate appropriate services, peer support, and community resources for patients at risk for maternal depression. Pursuant to an agreement with the Governor, this bill modifies Chapter 463 enacted in 2017 (A.8308). (A8953, Richardson)

Newborn Safe Sleep Study - This bill requires the Commissioner to conduct a study on safe sleep practices, including but not limited to the use of "baby boxes" and other products to encourage safe and healthy sleep practices. Following completion of the study, the Department shall conduct a pilot program aimed at improving safe sleep practices in areas with high infant mortality rates.Pursuant to an agreement with the Governor, this bill modifies Chapter 401 enacted in 2017 (A.6044). (A8957, Simotas)

Restroom Access - In 2017, a bill was signed giving patients with Crohn's disease and other eligible medical conditions the right to use employee restrooms in businesses open to the public that do not have a public restroom. Pursuant to an agreement with the Governor, this bill moves that statute from Public Health Law to General Business Law. (A8989, Paulin)

Lead Hazard Clean-up - In 2017, a bill was signed requiring the Commissioner to take action when an area of lead poisoning has been designated. Previous law had allowed action, but not required it. Pursuant to an agreement with the Governor, this bill clarifies that enforcement actions would not necessarily require formal hearings. (A8992, Dinowitz)

Medicaid Trust Information - Individuals with disabilities whose incomes would be too high to qualify for Medicaid can currently qualify through three excess income programs: by returning money to the Local Social Service Department; by incurring enough medical expenses to lower their income sufficiently ("spend-down"); or by putting money into a trust. In 2017, a bill was signed requiring the Department to notify individuals eligible for the excess income program of the trust option, including information on how to participate. Pursuant to an agreement with the Governor, this bill clarifies the information to be provided. (A9004, Gottfried)

Adult Home Death and Felony Reporting - In 2017, a bill was signed improving reporting by adult care facilities of resident deaths and attempted suicides and any felony in the facility. Pursuant to an agreement with the Governor, this bill clarifies these requirements including in relation to the Justice Center for the Protection of People with Special Needs. (A9034, Gottfried)

Consumer-Directed Home Care Fiscal Intermediary (FI) Authorization Effective Date - The 2017 State budget created a process for registering FIs in the Consumer Directed Personal Assistance Program, but the effective date was inadvertently made immediate, without notice to current FIs or rule-making by the Department. In 2017, a bill was signed moving the effective date to January 1, 2018. Pursuant to an agreement with the Governor, this bill gives the Department an additional 30 days in order to ensure a smooth process. (A9035, Gottfried)

February 6

In-Home Nursing Care By Family Members - Under the consumer-directed personal assistance program (CDPAP), family members can provide certain in-home care services. However, where a patient is eligible for Medicaid-paid in-home private duty nursing, there is no provision allowing the service to be provided by a family member who is a registered nurse. Under this bill, that patient may apply to the Commissioner to authorize services by a nurse family member to be paid at licensed practical nurse rates. (A8916A, Abinanti)

Rural Health Council - In 2017, a bill was signed establishing an advisory council within the Department's Office of Rural Health, to advise the commissioner on rural health issues including the impact of proposed programs and to report on rural health care workforce issues. Pursuant to an agreement with the Governor, this bill makes minor technical changes. (A8988, Jones)

Cancer and Neurological Disease Study - Cancer and neurological disease diagnoses have increased in the past decade. This bill requires the Commissioner, in consultation with the Commissioner of Environmental Conservation, to conduct a study on linkages between cancer and neurological disease and environmental contamination. (A9520, Woerner)

Medicaid Telehealth Expansion - Telehealth technology makes diagnosis, consultation, and services available to patients with transportation and care access difficulties. The law requires commercial insurers to cover telehealth regardless of where the patient is located However, Medicaid currently limits telehealth reimbursement to services delivered in specific settings, not including the patient's home - entirely defeating the point of delivering services without the patient having to travel. This bill requires Medicaid to cover telehealth services regardless of the patient's location, the same as commercial insurance. (A9521, Gottfried)

Assisted Living Bed Certificate of Need - The Assisted Living Program (ALP) provides home care services to residents of an adult home. It is a successful, lower-cost alternative to nursing home care. However, the current process for authorizing ALP slots disadvantages rural and upstate providers, resulting in shortages. This bill would set up a new certificate of need process that awards beds based on demonstrated community need. (A9562, Lupardo)

Correctional Health Facility Regulation - New York has over 50,000 inmates in State custody and another 25,000 in local facilities. Although New York has a moral and constitutional obligation to provide this care, prison and jail health facilities are largely exempt from Health Department oversight and regulation. This bill would include correctional health care facilities under Article 28 of the Public Health Law, which licenses, regulates, and sets standards hospitals, clinics and other health facilities. (A9675, Gottfried)

Correctional Health Oversight Expansion - At an October hearing, advocates widely praised the 2009 law authorizing the Health Department to review state prison and local jail policies on HIV/AIDS and hepatitis C services. Implementation has included policy reviews done by the State's AIDS Institute, site visits, staff interviews, and medical records reviews. This bill expands the 2009 law to additional conditions and categories of inmates, with a focus on populations identified as most at-risk by prison health advocates. The bill also directs DOH to study staffing levels in correctional settings, following testimony of 20%-25% vacancy rates for nurses and physicians. (A9676, Gottfried)