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S01576 Summary:

BILL NOS01576
 
SAME ASSAME AS A00196
 
SPONSORRIVERA
 
COSPNSRBENJAMIN, BROUK, COMRIE, GAUGHRAN, HOYLMAN, KRUEGER, MANNION, MAY, PERSAUD, RAMOS, REICHLIN-MELNICK, SANDERS, SEPULVEDA
 
MLTSPNSR
 
Amd 460-d, 461-c, 461-d, 461-e & 461-a, Soc Serv L; amd 29.15, Ment Hyg L
 
Relates to violations of safety conditions in adult care facilities; provides penalties for safety violations and operating without a valid license; prohibits reductions in fines in certain circumstances where a patient is endangered or harmed.
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S01576 Actions:

BILL NOS01576
 
01/13/2021REFERRED TO HEALTH
03/09/20211ST REPORT CAL.539
03/10/20212ND REPORT CAL.
03/11/2021ADVANCED TO THIRD READING
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S01576 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          1576
 
                               2021-2022 Regular Sessions
 
                    IN SENATE
 
                                    January 13, 2021
                                       ___________
 
        Introduced by Sens. RIVERA, HOYLMAN, KRUEGER, MAY, PERSAUD -- read twice
          and ordered printed, and when printed to be committed to the Committee
          on Health
 
        AN  ACT  to amend the social services law and the mental hygiene law, in
          relation to violations of safety conditions in adult care facilities

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.    Paragraph  (b) of subdivision 4 of section 460-d of the
     2  social services law, as amended by chapter 733 of the laws of  1994,  is
     3  amended to read as follows:
     4    (b)  No  operating  certificate shall be revoked, suspended or limited
     5  without a hearing held in  accordance  with  procedures  established  by
     6  department  regulations,  which  procedures shall require that notice of
     7  the time and place of the hearing, and notice of the charges,  shall  be
     8  served in person or by certified mail addressed to the facility at least
     9  thirty  days  prior  to the date of the hearing. A written answer to the
    10  charges may be filed with the department not less than ten business days
    11  prior to the date of the hearing. An operating certificate  may,  never-
    12  theless,  be  suspended or limited without a hearing for a period not in
    13  excess of sixty days, upon written notice to the  facility  following  a
    14  finding  by  the  department  that the public health, or an individual's
    15  health, safety or welfare, are in imminent  danger;  provided,  however,
    16  that  if  the  department  demonstrates reasonable efforts to commence a
    17  hearing within such sixty day period and to complete such hearing within
    18  a reasonable period of time,  the  hearing  officer  may  authorize  the
    19  department  to  extend  the  period  of  suspension or limitation for an
    20  appropriate period of time, but in no event beyond an additional  thirty
    21  days.
    22    §  2.  Subdivision  7  of section 460-d of the social services law, as
    23  added by chapter 669 of the laws of 1977, paragraph (a)  as  amended  by
    24  chapter 719 of the laws of 1989, paragraph (b) as amended by chapter 524
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00265-01-1

        S. 1576                             2
 
     1  of the laws of 1984, subparagraph 2 of paragraph (b) as amended by chap-
     2  ter 733 of the laws of 1994, is amended to read as follows:
     3    7.  (a)  The  department  shall  adopt  regulations establishing civil
     4  penalties of up to [one] two thousand dollars  per  day  per  violation,
     5  and,  for  repeat violations, under subparagraph two of paragraph (c) of
     6  this subdivision for which a prior penalty was  assessed,  up  to  three
     7  thousand  dollars per day per violation to be assessed against all adult
     8  care facilities except facilities operated by a social services district
     9  for violations of (i) regulations of the department  pertaining  to  the
    10  care  of residents in such facilities, (ii) paragraph (a) of subdivision
    11  three of section four hundred sixty-one-a of this [chapter] article,  or
    12  (iii) an order issued pursuant to subdivision eight of this section. The
    13  regulations  shall  specify  the  violations  subject to penalty and the
    14  amount of the penalty to  be  assessed  in  connection  with  each  such
    15  violation and shall specify that only civil penalties of up to [one] two
    16  thousand  dollars  per  day  per violation shall be assessed pursuant to
    17  this paragraph against an adult care facility found responsible  for  an
    18  act  of retaliation or reprisal against any resident, employee, or other
    19  person for having filed a complaint with or having provided  information
    20  to any long term care [patient] ombudsman functioning in accordance with
    21  section [five hundred forty-four or five hundred forty-five] two hundred
    22  eighteen of the [executive] elder law.
    23    (b)  [(1)] In addition to any other civil or criminal penalty provided
    24  by law, the department shall have the power to assess civil penalties in
    25  accordance with its regulations adopted pursuant  to  paragraph  (a)  of
    26  this  subdivision,  after  a  hearing  conducted  in accordance with the
    27  procedures established by regulations of the department. Such procedures
    28  shall require that notice of the time and place of the hearing, together
    29  with a statement of charges of violations, shall be served in person  or
    30  by  certified  mail addressed to the facility at least thirty days prior
    31  to the date of the hearing. The statement of charges of violations shall
    32  set forth the existence of the violations, the  amount  of  penalty  for
    33  which  it may become liable and the steps which must be taken to rectify
    34  the violation and, where applicable, a  statement  that  the  department
    35  contends  that  a penalty may be imposed under this paragraph regardless
    36  of rectification. An answer to the charges of  violations,  in  writing,
    37  shall  be filed with the department, not less than ten days prior to the
    38  date of hearing. The answer shall notify the department of  the  facili-
    39  ty's  position with respect to each of the charges and shall include all
    40  matters which if not disclosed in the answer would be likely to take the
    41  department by surprise. The commissioner, or a member of his  staff  who
    42  is  designated  and  authorized  by him to hold such hearing, may in his
    43  discretion allow the facility to prove any matter not  included  in  the
    44  answer.
    45    (c)  (1) Where the facility satisfactorily demonstrates that it either
    46  had rectified the violations within thirty  days  of  receiving  written
    47  notification  of  the results of the inspection pursuant to section four
    48  hundred sixty-one-a of this [chapter] article, or had  submitted  within
    49  thirty  days an acceptable plan for rectification and was rectifying the
    50  violations in accordance with the steps and within the additional  peri-
    51  ods of time as accepted by the department in such plan, no penalty shall
    52  be imposed, except as provided in subparagraph two of this paragraph.
    53    (2)  Rectification  shall  not preclude the assessment of a penalty if
    54  the department establishes at a hearing  that  a  particular  violation,
    55  although  corrected[,  endangered or resulted in harm to any resident as
    56  the result of]:

        S. 1576                             3
 
     1    (i) endangered any resident. Endangerment is defined as:
     2    (A)  the total or substantial failure of the facility's fire detection
     3  or prevention systems, or emergency evacuation procedures prescribed  by
     4  department safety standard regulations;
     5    [(ii)] (B) the retention of any resident who has been evaluated by the
     6  resident's physician as being medically or mentally unsuited for care in
     7  the  facility  or  as  requiring  placement in a hospital or residential
     8  health care facility and for whom the operator is not making  persistent
     9  efforts to secure appropriate placement;
    10    [(iii)]  (C)  the  failure  in systemic practices and procedures which
    11  shall be defined as widespread or chronic, and  material,  noncompliance
    12  with  statutory or regulatory requirements, including but not limited to
    13  the rights of residents under section four hundred sixty-one-d  of  this
    14  article;
    15    [(iv)]  (D) the failure of the operator to take actions as required by
    16  department regulations in the event of a resident's illness or accident;
    17    [(v)] (E) the failure of the operator to provide at all  times  super-
    18  vision of residents by numbers of staff at least equivalent to the night
    19  staffing requirement set forth in department regulations; or
    20    [(vi)]  (F) [unreasonable] threats of retaliation or taking reprisals,
    21  including but not limited  to  [unreasonable]  threats  of  eviction  or
    22  hospitalization,  against  any  resident,  employee  or other person who
    23  makes a complaint concerning the operation of an  adult  care  facility,
    24  participates in the investigation of a complaint or is the subject of an
    25  action identified in a complaint[.
    26    The  department  shall specify in its regulations those regulations to
    27  which this subparagraph two shall apply.
    28    (3) In assessing penalties pursuant to this paragraph, the  department
    29  shall  consider  promptness  of  rectification,  delay occasioned by the
    30  department, and the specific circumstances of the violations as mitigat-
    31  ing factors.
    32    (c)];
    33    (ii) resulted in harm to any resident, including but not limited to:
    34    (A) physical harm;
    35    (B) loss or denial of access to  money  or  other  personal  property,
    36  including  but not limited to a violation of section one hundred thirty-
    37  one-o of this chapter; or
    38    (C) being subjected to (I) conduct by an operator, administrator, case
    39  manager, or other employee in a supervisory position that  violates  the
    40  rights  of  a  resident  under  section four hundred sixty-one-d of this
    41  article, or (II) an egregious failure  by  an  operator,  administrator,
    42  case  manager, or other employee in a supervisory position to ensure the
    43  rights of a resident under section  four  hundred  sixty-one-d  of  this
    44  article; or
    45    (iii) is an identical repeat violation. Repeat violation is defined as
    46  a  violation  of the same provision of regulation for which the facility
    47  received notice of a citation issued by the department at  any  time  in
    48  the previous twelve months.
    49    (d)  In assessing penalties pursuant to this paragraph, the department
    50  shall consider promptness of  rectification,  delay  occasioned  by  the
    51  department, and the specific circumstances of the violations as mitigat-
    52  ing factors.
    53    (e)  Upon  the  request  of  the  department, the attorney general may
    54  commence an action in any court of competent  jurisdiction  against  any
    55  facility  subject  to  the  provisions  of this section, and against any
    56  person or corporation operating such facility, for the recovery  of  any

        S. 1576                             4
 
     1  penalty  assessed by the department in accordance with the provisions of
     2  this subdivision.
     3    [(d)]  (f) Any such penalty assessed by the department may be released
     4  or compromised by the department, subject to and consistent  with  para-
     5  graph  (c)  of  this subdivision, before the matter has been referred to
     6  the attorney general, and where such matter has  been  referred  to  the
     7  attorney  general,  any  such penalty may be released or compromised and
     8  any action commenced to recover the same may be settled and discontinued
     9  by the attorney general, after considering paragraph (c) of this  subdi-
    10  vision and with the consent of the department.
    11    §  3.  Paragraphs (a) and (b) of subdivision 9 of section 460-d of the
    12  social services law, paragraph (a) as amended by chapter 558 of the laws
    13  of 1999 and paragraph (b) as added by chapter 848 of the laws  of  1992,
    14  are amended to read as follows:
    15    (a) The department shall have authority to impose a civil penalty [not
    16  exceeding  one  thousand dollars per day] consistent with section twelve
    17  of the public health law against, and to issue an  order  requiring  the
    18  closing of, after notice and opportunity to be heard, any facility which
    19  does  not possess a valid operating certificate issued by the department
    20  and is an adult care facility subject to the provisions of this  article
    21  and  the  regulations of the department. A hearing shall be conducted in
    22  accordance with procedures established by department  regulations  which
    23  procedures  shall  require  that  notice  of  the determination that the
    24  facility is an adult care facility and the  reasons  for  such  determi-
    25  nation  and  notice  of  the  time and place of the hearing be served in
    26  person on the operator, owner or prime lessor, if any, or  by  certified
    27  mail, return receipt requested, addressed to such person and received at
    28  least  twenty  days  prior to the date of the hearing. If such operator,
    29  owner or prime lessor, if any, is not  known  to  the  department,  then
    30  service  may  be  made  by posting a copy thereof in a conspicuous place
    31  within the facility or by sending a  copy  thereof  by  certified  mail,
    32  return receipt requested, addressed to the facility. A written answer to
    33  the  notice  of violation may be filed with the department not less than
    34  five days prior to the date of the hearing.  Demonstration by the facil-
    35  ity that it possessed an operating certificate issued pursuant  to  this
    36  article,  article  twenty-eight  of  the  public  health  law or article
    37  sixteen, [twenty-three,] thirty-one or thirty-two of the mental  hygiene
    38  law  at  the  time the hearing was commenced shall constitute a complete
    39  defense to any charges made pursuant to this subdivision.
    40    (b) [The penalty authorized by this section shall begin to run  thirty
    41  days  after  the  department  provides  the operator, in writing, with a
    42  summary of the inspection of the facility by which the department deter-
    43  mined that he or she is operating an uncertified adult  care  facility.]
    44  The  submission  of  an  application  by  the  operator for an operating
    45  certificate for the facility shall not act as a bar to the imposition of
    46  a penalty against the operator of an unlicensed adult care facility.
    47    § 4. Paragraph (c) of subdivision 9 of section  460-d  of  the  social
    48  services  law  is  amended  by adding a new subparagraph (iv) to read as
    49  follows:
    50    (iv) If the department of health determines, based on a  complaint  or
    51  other  facts  known  to  the department, that there is reason to believe
    52  that an individual or entity is operating an adult home, enriched  hous-
    53  ing  program,  or  residence  for  adults which does not possess a valid
    54  operating certificate issued by the department, and  that  one  or  more
    55  conditions  or  activities  at such facility constitute or are likely to
    56  give rise to an immediate danger to the health  of  the  residents,  and

        S. 1576                             5
 
     1  awaiting  a court order pursuant to subparagraph (iii) of this paragraph
     2  would be seriously detrimental to the  health  of  such  residents,  the
     3  department  of health may, notwithstanding an objection by the operator,
     4  administrator  or  other  person in charge, inspect the entire premises,
     5  which shall include access to all dwellings on the said  property  which
     6  house tenants/occupants as well as access to such tenants/occupants, for
     7  the  purpose  of ascertaining whether such danger exists or is likely to
     8  arise on an immediate basis. The department of health  may  request  the
     9  assistance  of  local  law enforcement for purposes of carrying out such
    10  inspection and may take any appropriate action  if  it  determines  that
    11  such  danger  exists  or is likely to arise, including issuing a written
    12  notice directing the operator, administrator or other person  in  charge
    13  of such facility to cease or correct the condition or activity at issue.
    14  As  promptly  as  possible  thereafter,  within  a  period not to exceed
    15  fifteen days, the commissioner shall provide the operator an opportunity
    16  to be heard and to present any proof that  such  condition  or  activity
    17  does  not  constitute  a  danger  to the health of the residents of such
    18  facility. The attorney  general,  upon  request  of  the  department  of
    19  health,  shall be authorized to apply to the supreme court in the county
    20  in which the facility is located for an order for any appropriate  addi-
    21  tional relief.
    22    §  5.  Subdivision  11 of section 460-d of the social services law, as
    23  amended by section 154 of subpart B of part C of chapter 62 of the  laws
    24  of 2011, is amended to read as follows:
    25    11.  On or before issuance by the department to an adult care facility
    26  operator of official written notice of: the proposed revocation, suspen-
    27  sion or denial of the operator's operating certificate;  the  limitation
    28  of  the  operating certificate with respect to new admissions; the issu-
    29  ance of a department order or commissioner's order; the seeking of equi-
    30  table relief pursuant to this  section;  the  [proposed]  assessment  of
    31  civil  penalties  for  violations of the provisions of [subparagraph two
    32  of] paragraph [(b)] (c) of subdivision seven of this section  or  place-
    33  ment  on the "do not refer list" pursuant to subdivision fifteen of this
    34  section, written notice also shall be given to the appropriate office of
    35  the department of mental hygiene, department of corrections and communi-
    36  ty supervision and local social services districts, and provided further
    37  that the department of health shall notify hospitals, residential health
    38  care facilities and adult care facilities in the locality in which  such
    39  facility is located that such notice has been issued. Upon resolution of
    40  such  enforcement action the department shall within ten days notify the
    41  appropriate office of the department of mental  hygiene,  department  of
    42  corrections  and  community supervision, local social services districts
    43  [and], hospitals, residential health  care  facilities  and  adult  care
    44  facilities.
    45    §  6.  Subdivision  12 of section 460-d of the social services law, as
    46  amended by section 42 of part B of chapter 58 of the laws  of  2004,  is
    47  amended to read as follows:
    48    12. [Social] Hospitals, residential health care facilities, adult care
    49  facilities,  social  services districts and other local government enti-
    50  ties established pursuant to  this  chapter  shall  be  prohibited  from
    51  making  referrals  for  admissions  to  adult  care facilities that have
    52  received official written notice  regarding:  the  proposed  revocation,
    53  suspension  or denial of the operator's operating certificate; the limi-
    54  tation of the operating certificate with respect to new admissions;  the
    55  issuance  of  department  order or commissioner's orders; the seeking of
    56  equitable relief pursuant to this section[; the proposed  assessment  of

        S. 1576                             6

     1  civil  penalties for violations of the provisions of subparagraph two of
     2  paragraph (b) of subdivision seven of this section]; or  the  facility's
     3  placement  on the "do not refer list" pursuant to subdivision fifteen of
     4  this section.
     5    §  7.  Section 460-d of the social services law is amended by adding a
     6  new subdivision 18 to read as follows:
     7    18. When the department of health issues official written notice to an
     8  operator of a proposed action specified in subdivision  eleven  of  this
     9  section,  and  the department determines that there is a condition which
    10  constitutes an imminent danger to the health, safety or welfare  of  any
    11  resident,  the  department may prohibit that operator from admitting any
    12  new resident to the facility until the department determines that  there
    13  is  no longer an imminent danger to the health, safety or welfare of any
    14  resident.
    15    § 8. Section 461-c of the social services law is amended by  adding  a
    16  new subdivision 10 to read as follows:
    17    10. The operator of an adult home or an enriched housing program shall
    18  provide  to prospective residents who inquire about admission, and shall
    19  post   on   its   website,   a   copy   of   the   facility's   approved
    20  admission/residency agreement.
    21    §  9.  The  closing paragraph of subdivision 3 of section 461-d of the
    22  social services law, as added by chapter 601 of the  laws  of  1981,  is
    23  amended to read as follows:
    24    Waiver  of  any  provision [contained within] of this subdivision by a
    25  resident of an adult care facility or by the resident's legal  represen-
    26  tative  or  resident  representative,  with  respect to a resident of an
    27  adult home, residence for adults or enriched housing program,  shall  be
    28  void.
    29    §  10. Section 461-e of the social services law is amended by adding a
    30  new subdivision 3-a to read as follows:
    31    3-a. Every adult home and enriched housing program shall:
    32    (a) Post in a prominent position in the facility so as to be  accessi-
    33  ble to all residents and to the general public:
    34    (i)  a summary of any report of inspection based on a complaint issued
    35  by the department of health to the facility  within  the  previous  year
    36  which resulted in the payment of a fine or penalty by the facility; and
    37    (ii)  notice of residents' right to review reports under paragraph (b)
    38  of this subdivision.
    39    (b) Provide to any resident and each applicant for admission an oppor-
    40  tunity to review any report of inspection based on a complaint issued by
    41  the department of health to the facility within the previous year.
    42    (c) Provide to the  resident  council  a  summary  of  any  report  of
    43  inspection based on a complaint issued by the department of health with-
    44  in fourteen days  of receipt by the facility.
    45    § 11. Paragraphs (a), (b) and (c) of subdivision 2 of section 461-a of
    46  the  social  services  law, paragraphs (a) and (c) as amended by chapter
    47  735 of the laws of 1994 and paragraph (b) as amended by chapter  601  of
    48  the laws of 1981, are amended to read as follows:
    49    (a) With respect to adult care facilities the department shall conduct
    50  a  minimum of one unannounced inspection of each such facility to deter-
    51  mine the  adequacy of care being rendered, pursuant to the following:
    52    (1) Such facilities [receiving the department's highest rating] deter-
    53  mined by the department to be in compliance  or  substantial  compliance
    54  with  applicable  statutes and regulations, based on the facility's most
    55  recent inspection, shall be  inspected  at  least  once  every  eighteen
    56  months on an unannounced basis.

        S. 1576                             7
 
     1    (2)  All  other  such  facilities shall be inspected on an unannounced
     2  basis no less than annually.   The commissioner  may  provide  for  more
     3  frequent  inspections  of any such facilities. Such inspection shall not
     4  be required with respect to any facility for which the commissioner  has
     5  delegated  responsibility  for  inspection  and  supervision to a social
     6  services official pursuant to  section  four  hundred  sixty-c  of  this
     7  [chapter]  article.  Any employee of the department or a social services
     8  district who gives or causes to be given advance notice  of  such  unan-
     9  nounced  inspections  to  any unauthorized persons shall, in addition to
    10  any other penalty provided by law, be suspended by the department or the
    11  social services district from all duties without pay for at  least  five
    12  days  or  for  such  greater  period of time as the department or social
    13  services district shall determine.  Any such suspension shall be made by
    14  the department or social services district in accordance with all  other
    15  applicable provisions of law.
    16    (b)  [The department or a social services district, where appropriate,
    17  shall each year conduct a minimum of one full inspection of  each  adult
    18  care  facility. Such inspection] An inspection of an adult care facility
    19  under this section shall include, but shall not be limited to,  examina-
    20  tion of the medical, dietary and social services records of the facility
    21  as well as the minimum standards of construction, life safety standards,
    22  quality  and  adequacy  of  care,  rights of residents, payments and all
    23  other areas of operation. The purpose of  any  inspection  shall  be  to
    24  determine  compliance  with requirements of applicable provisions of law
    25  and regulations of the department.
    26    (c) (i) An inspection report shall be made of  each  inspection  which
    27  shall  clearly  identify  and indicate in detail each area of operation,
    28  including, but not limited to, the premises, equipment, personnel, resi-
    29  dent care and services, and whether [each] any such area of operation or
    30  any of its component parts is [or is] not in compliance with  the  regu-
    31  lations of the department and all other applicable requirements. It also
    32  shall  identify  those  areas of operation or any of its component parts
    33  found not in compliance as a result of failure in systemic practices and
    34  procedures. The operator  shall  be  notified  of  the  results  of  the
    35  inspection in a manner to be determined by regulations of the department
    36  and  shall  submit a written plan of correction to the department within
    37  thirty calendar days from the date the inspection  report  is  received.
    38  The  department  shall  notify  the operator of the acceptability of the
    39  plan of correction within  thirty  calendar  days  of  the  department's
    40  receipt of such plan.  Such notification shall contain directions as may
    41  be appropriate as to the manner and time in which compliance with appli-
    42  cable  requirements  of  law  or  regulations of the department shall be
    43  effected.
    44    (ii) The department shall also require the operator of an adult  home,
    45  enriched  housing program or residence for adults to develop, biannually
    46  update and implement plans for quality  assurance  activities  for  each
    47  area  of  operation.  Quality  assurance  activities include but are not
    48  limited to, development and maintenance of performance standards,  meas-
    49  urement of adherence to such standards and to applicable state and local
    50  laws  and  regulations,  identification of performance failures, design,
    51  and implementation of corrective action.
    52    § 12. Subparagraphs (I) and (II) of paragraph 2 of subdivision (i)  of
    53  section  29.15  of  the mental hygiene law, as amended by chapter 168 of
    54  the laws of 2010, are amended to read as follows:
    55    (I) A patient about to be discharged or conditionally released from  a
    56  department  facility  licensed or operated by the office for people with

        S. 1576                             8
 
     1  developmental disabilities or from an  inpatient  facility  operated  or
     2  licensed  by  the  office  of [alcoholism and substance abuse] addiction
     3  services and supports or the office of mental health to an  adult  home,
     4  enriched  housing program or residence for adults, as defined in section
     5  two of the social services law, shall be referred only to such  home  or
     6  residence that is consistent with that patient's needs and that operates
     7  pursuant  to  section  four  hundred  sixty  of the social services law,
     8  provided further that: (A) for a department facility licensed  or  oper-
     9  ated  by the office for people with developmental disabilities or for an
    10  inpatient facility operated by the office of [alcoholism  and  substance
    11  abuse]  addiction  services and supports or the office of mental health,
    12  the facility director retains authority to determine whether  the  home,
    13  program  or  residence  is  consistent with that patient's needs and (B)
    14  such referral shall be made to the patient's home county whenever possi-
    15  ble or appropriate.
    16    (II) No patient about to be discharged or conditionally released  from
    17  a department facility licensed or operated by the office for people with
    18  developmental  disabilities  or  from  an inpatient facility operated or
    19  licensed by the office of [alcoholism  and  substance  abuse]  addiction
    20  services  and  supports or the office of mental health shall be referred
    21  to any adult home, enriched housing program or residence for adults,  as
    22  defined in section two of the social services law, which has received an
    23  official  written  notice  from  the  department  of  health of: (A) the
    24  proposed revocation, suspension or denial of its operating  certificate;
    25  (B)  the  limitation  of  its  operating certificate with respect to new
    26  admissions; (C) the issuance of a department of health order or  commis-
    27  sioner  of health's order or the seeking of equitable relief pursuant to
    28  section four hundred  sixty-d  of  the  social  services  law;  (D)  the
    29  proposed  assessment of civil penalties for violations of the provisions
    30  of [subparagraph two of] paragraph [(b)] (c)  of  subdivision  seven  of
    31  section four hundred sixty-d of the social services law; or placement on
    32  the  "do not refer list" pursuant to subdivision fifteen of section four
    33  hundred sixty-d of the social services law. Referrals  may  resume  when
    34  such enforcement actions are resolved.
    35    § 13. Severability clause. If any provision of this act, or any appli-
    36  cation  of  any  provision  of  this  act,  is held to be invalid, or to
    37  violate or be inconsistent with any  federal  law  or  regulation,  that
    38  shall not affect the validity or effectiveness of any other provision of
    39  this  act,  which can be given effect without that provision or applica-
    40  tion; and to that end, the provisions and applications of this  act  are
    41  severable.
    42    §  14.  This act shall take effect on the ninetieth day after it shall
    43  have become a law. Effective immediately,  the  commissioner  of  health
    44  shall  make  regulations  and  take other actions necessary to implement
    45  this act on that date.
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