S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6761
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                May 8, 2023
                                ___________
 
 Introduced  by M. of A. REYES -- read once and referred to the Committee
   on Health
 
 AN ACT to amend the public health  law,  the  mental  hygiene  law,  the
   social  services  law,  and the insurance law, in relation to allowing
   certain youth to give effective consent to  medical,  dental,  health,
   and/or hospital services and immunizations

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subdivisions 2, 4, 5, and 6 of section 2504 of  the  public
 health law, subdivision 2 as amended by chapter 119 of the laws of 2005,
 subdivision 4 as amended by chapter 623 of the laws of 2019, subdivision
 5 as added and subdivision 6 as renumbered by chapter 521 of the laws of
 1994  and subdivision 6 as added by chapter 769 of the laws of 1972, are
 amended and a new subdivision 8 is added to read as follows:
   2. Any person who has been married or who has borne a child  may  give
 effective  consent for medical, dental, health and hospital services for
 his [or], her, OR THEIR child. Any person who has been designated pursu-
 ant to title fifteen-A of article five of the general obligations law as
 a person in parental relation to a child may  consent  to  any  medical,
 dental, health and hospital services for such child for which consent is
 otherwise  required  [which  are  not:  (a)  major  medical treatment as
 defined in subdivision (a) of section 80.03 of the mental  hygiene  law;
 (b)  electroconvulsive  therapy; or (c) the withdrawal or discontinuance
 of medical treatment which is sustaining life functions].
   4. Medical, dental, health and hospital services may  be  rendered  to
 persons  of  any  age without the consent of a parent, legal guardian or
 person possessing a lawful order of custody when, in  the  [physician's]
 PRACTITIONER'S  judgment, an emergency exists and the person is in imme-
 diate need of medical attention and an attempt to secure  consent  would
 result  in  delay  of  treatment  which  would  increase the risk to the
 person's life or health.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD10800-01-3
              

 A. 6761                             2
 
   5. Where not otherwise already authorized by law to do so, any  person
 in  a  parental  relation  to  a  child as defined in section twenty-one
 hundred sixty-four of this chapter and,  (i)  a  grandparent,  an  adult
 brother  or sister, an adult aunt or uncle, any of whom has assumed care
 of  the child and, (ii) an adult who has care of the child and has writ-
 ten authorization to consent from a person in a parental relation  to  a
 child  as defined in section twenty-one hundred sixty-four of this chap-
 ter, may give effective consent for the immunization of a child.  Howev-
 er,  a  person  other than one in a parental relation to the child shall
 not give consent under this subdivision if [he or  she  has]  THEY  HAVE
 reason  to  believe  that  a person in parental relation to the child as
 defined in section twenty-one hundred sixty-four of this chapter objects
 to the immunization. HOWEVER, A CHILD WHO MAY GIVE EFFECTIVE CONSENT  TO
 MEDICAL,  DENTAL, HEALTH, AND HOSPITAL SERVICES PURSUANT TO THIS SECTION
 MAY GIVE SUCH CONSENT TO THEIR OWN IMMUNIZATION, AND THE CONSENT  OF  NO
 OTHER PERSON SHALL BE NECESSARY.
   6.  Anyone  who  acts  in  good faith based on the representation by a
 person that [he is] THEY ARE eligible to consent pursuant to  the  terms
 of this section shall be deemed to have received effective consent.
   8.  ANY  PERSON,  INCLUDING A MINOR, WHO COMPREHENDS THE NEED FOR, THE
 NATURE OF, AND THE REASONABLY FORESEEABLE RISKS AND BENEFITS INVOLVED IN
 ANY CONTEMPLATED MEDICAL, DENTAL, HEALTH, AND/OR HOSPITAL SERVICES,  AND
 ANY  ALTERNATIVES  THERETO,  MAY GIVE EFFECTIVE CONSENT TO SUCH SERVICES
 FOR THEMSELF, AND THE CONSENT OF NO OTHER PERSON SHALL BE NECESSARY. THE
 COMMISSIONER IS AUTHORIZED TO PROMULGATE RULES AND REGULATIONS NECESSARY
 TO EFFECTUATE THE PROVISIONS OF THIS SUBDIVISION.
   § 2. Subdivision (a) of section 9.13 of the  mental  hygiene  law,  as
 amended  by  chapter  465  of  the  laws  of 1992, is amended to read as
 follows:
   (a) The director of any hospital may receive as  a  voluntary  patient
 any suitable person in need of care and treatment, who voluntarily makes
 written  application  therefor.  If the person is under sixteen years of
 age, the person may be received as a voluntary  patient  [only]  on  the
 application  of  the  parent,  legal  guardian,  or  next-of-kin of such
 person[, or,]; subject to the terms of any court order or any instrument
 executed pursuant to section three hundred eighty-four-a of  the  social
 services  law, a social services official or authorized agency with care
 and custody of such person pursuant to  SECTION  THREE  HUNDRED  EIGHTY-
 FOUR-A  OF  the  social  services  law, the director of the division for
 youth, acting in accordance with section five hundred nine of the execu-
 tive law, or a person or entity having custody of the person pursuant to
 an order issued pursuant to section seven hundred fifty-six or one thou-
 sand fifty-five of the family court act; OR ON SUCH PERSON'S OWN  APPLI-
 CATION,  IF  THEY MAY GIVE EFFECTIVE CONSENT PURSUANT TO SECTION TWENTY-
 FIVE HUNDRED FOUR OF THE PUBLIC  HEALTH  LAW.  If  the  person  is  over
 sixteen  and  under  eighteen  years  of age, the director may, in [his]
 THEIR discretion, admit such person either as  a  voluntary  patient  on
 [his]  THEIR  own  application  or  on  the  application of the person's
 parent, legal guardian, next-of-kin, or, subject to  the  terms  of  any
 court order or any instrument executed pursuant to section three hundred
 eighty-four-a  of the social services law, a social services official or
 authorized agency with care and  custody  of  such  person  pursuant  to
 SECTION  THREE  HUNDRED  EIGHTY-FOUR-A  OF  the social services law, the
 director of the division for youth, acting in  accordance  with  section
 five  hundred nine of the executive law, provided that such person know-
 ingly and voluntarily consented to such application in  accordance  with
 A. 6761                             3
 
 such  section, or a person or entity having custody of the person pursu-
 ant to an order issued pursuant to section seven  hundred  fifty-six  or
 one thousand fifty-five of the family court act.
   §  3.  Subdivision  (b)  and  paragraphs 1 and 3 of subdivision (c) of
 section 22.11 of the mental hygiene law, as added by chapter 558 of  the
 laws of 1999, are amended to read as follows:
   (b) In treating a minor for chemical dependence on an inpatient, resi-
 dential, or outpatient basis, the important role of the parents or guar-
 dians  shall  be recognized. Steps shall be taken to involve the parents
 or guardians in the course of treatment, and consent from such a  person
 for  inpatient, residential, or outpatient treatment for minors shall be
 required, except as  otherwise  provided  by  subdivision  (c)  of  this
 section OR SECTION TWENTY-FIVE HUNDRED FOUR OF THE PUBLIC HEALTH LAW.
   1. If, in the judgment of a [physician] QUALIFIED HEALTH PROFESSIONAL,
 parental  or  guardian  involvement and consent would have a detrimental
 effect on the course of treatment of a minor who is voluntarily  seeking
 treatment  for chemical dependence or if a parent or guardian refuses to
 consent to such treatment and the [physician] QUALIFIED  HEALTH  PROFES-
 SIONAL  believes that such treatment is necessary for the best interests
 of the child, such treatment may be provided to the minor by a [licensed
 physician] QUALIFIED HEALTH PROFESSIONAL on an inpatient, residential or
 outpatient basis, a staff [physician] HEALTH PROFESSIONAL in a hospital,
 or persons operating under their supervision,  without  the  consent  or
 involvement of the parent or guardian. Such [physician] QUALIFIED HEALTH
 PROFESSIONAL  shall  fully  document the reasons why the requirements of
 subdivision (b) of  this  section  were  dispensed  within  the  minor's
 medical record[, provided, however, that for providers of services which
 are not required to include physicians on staff, pursuant to regulations
 promulgated  by  the  commissioner,  a qualified health professional, as
 defined in such regulations, shall fulfill the role of a  physician  for
 purposes of this paragraph].
   3.  IF  THE MINOR MAY GIVE EFFECTIVE CONSENT PURSUANT TO SECTION TWEN-
 TY-FIVE HUNDRED FOUR OF THE PUBLIC HEALTH LAW,  SUCH  TREATMENT  MAY  BE
 PROVIDED  TO  THE  MINOR  BY A QUALIFIED HEALTH PROFESSIONAL ON AN INPA-
 TIENT, RESIDENTIAL OR OUTPATIENT BASIS, A STAFF HEALTH PROFESSIONAL IN A
 HOSPITAL, OR PERSONS OPERATING  UNDER  THEIR  SUPERVISION,  WITHOUT  THE
 CONSENT OR INVOLVEMENT OF THE PARENT OR GUARDIAN.
   4.  Admission  and  discharge  for  inpatient or residential treatment
 shall be made in accordance with subdivision (d) of this section.
   § 4. Subdivisions (a), (b), (c), and  (e)  of  section  33.21  of  the
 mental hygiene law, subdivisions (a), (b), and (c) as amended and subdi-
 vision  (e)  as added by chapter 461 of the laws of 1994, are amended to
 read as follows:
   (a) For the purposes of this section:
   (1) "minor" shall mean a person under eighteen years of age, but shall
 not include a person who is the parent  of  a  child,  emancipated,  has
 married  or is on voluntary status on [his or her] THEIR own application
 pursuant to section 9.13 of this chapter;
   (2) "mental health practitioner" shall mean a  physician,  a  licensed
 psychologist,  or  persons  providing  MENTAL  HEALTH services under the
 supervision of a physician in a facility operated  or  licensed  by  the
 office of mental health OR PROVIDING OUTPATIENT MENTAL HEALTH SERVICES;
   (3) "outpatient  mental  health  services"  shall  mean [those] MENTAL
 HEALTH services provided TO A PERSON THAT OCCUR in A COMMUNITY  LOCATION
 AND/OR  IN an [outpatient program licensed] AMBULATORY CARE SETTING SUCH
 AS A MENTAL HEALTH CENTER or [operated pursuant to  the  regulations  of
 A. 6761                             4

 the commissioner of mental health] SUBSTANCE USE DISORDER CLINIC, HOSPI-
 TAL  OUTPATIENT  DEPARTMENT,  COMMUNITY HEALTH CENTER, OR PRACTITIONER'S
 OFFICE, OR VIA TELEHEALTH, OR AT A PERSON'S HOME  OR  SCHOOL,  INCLUDING
 PSYCHOTHERAPY  AND/OR MEDICATION MANAGEMENT, DELIVERED IN AN INDIVIDUAL,
 FAMILY, OR GROUP SETTING;
   (4) "reasonably available" shall mean a  parent  or  guardian  can  be
 contacted with diligent efforts by a mental health practitioner; and
   (5) "capacity" shall mean the minor's ability to understand and appre-
 ciate  the  nature and consequences of the proposed treatment, including
 the benefits and risks of, and alternatives to, such proposed treatment,
 and to reach an informed decision.
   (b) In providing outpatient mental health services  to  a  minor,  [or
 psychotropic  medications to a minor residing in a hospital,] the impor-
 tant role of the parents or guardians shall be recognized. As clinically
 appropriate, steps shall be taken to actively  involve  the  parents  or
 guardians,  and  the  consent of such persons shall be required for such
 treatment in non-emergency situations, except as  provided  in  subdivi-
 sions  (c),  (d)  and  (e)  of this section or section two thousand five
 hundred four of the public health law.
   (c) A mental health practitioner may provide outpatient mental  health
 services[,  other than those treatments and procedures for which consent
 is specifically required by section 33.03 of this article,] to  a  minor
 voluntarily  seeking  such services without parental or guardian consent
 if the mental health practitioner determines that:
   (1) THE MINOR MAY GIVE EFFECTIVE CONSENT PURSUANT TO  SECTION  TWENTY-
 FIVE HUNDRED FOUR OF THE PUBLIC HEALTH LAW; OR
   (2)  (I) the minor is knowingly and voluntarily seeking such services;
 and
   [(2)] (II) provision of such  services  is  clinically  indicated  and
 necessary to the minor's well-being; and
   [(3)  (i)] (III) (A) a parent or guardian is not reasonably available;
 or
   [(ii)] (B) requiring parental or guardian consent or involvement would
 have a detrimental effect on the course of outpatient treatment; or
   [(iii)] (C) a parent or guardian has refused to give such consent  and
 a [physician] PRACTITIONER determines that treatment is necessary and in
 the best interests of the minor.
   The  mental  health  practitioner shall fully document the reasons for
 [his or her] THEIR determinations. Such documentation shall be  included
 in the minor's clinical record, along with a written statement signed by
 the  minor  indicating  that [he or she is] THEY ARE voluntarily seeking
 services. As clinically appropriate,  notice  of  a  determination  made
 pursuant  to  subparagraph  (iii) of paragraph three of this subdivision
 shall be provided to the parent or guardian.
   (e) (1) Subject to the  regulations  of  the  commissioner  of  mental
 health governing the patient's right to object to treatment, subdivision
 (b)  of  this section and paragraph two of this subdivision, the consent
 of a parent or guardian  or  the  authorization  of  a  court  shall  be
 required  for  the  non-emergency administration of psychotropic medica-
 tions to a minor residing in a hospital UNLESS THE MINOR MAY GIVE EFFEC-
 TIVE CONSENT PURSUANT TO SECTION TWENTY-FIVE HUNDRED FOUR OF THE  PUBLIC
 HEALTH LAW.
   (2) A minor [sixteen years of age or older] who consents may be admin-
 istered  psychotropic  medications  without  the  consent of a parent or
 guardian or the authorization of a court where[:
 A. 6761                             5

   (i) a parent or guardian is not  reasonably  available,  provided  the
 treating  physician  determines that (A) the minor has capacity; and (B)
 such medications are in the minor's best interests; or
   (ii)  requiring  consent  of  a parent or guardian would have a detri-
 mental effect on the minor, provided the treating physician and a second
 physician who specializes in psychiatry and is not an  employee  of  the
 hospital determine that (A) such detrimental effect would occur; (B) the
 minor  has  capacity;  and  (C) such medications are in the minor's best
 interests; or
   (iii) the parent  or  guardian  has  refused  to  give  such  consent,
 provided  the  treating physician and a second physician who specializes
 in psychiatry and is not an employee of the hospital determine that  (A)
 the minor has capacity; and (B) such medications are in the minor's best
 interests. Notice of the decision to administer psychotropic medications
 pursuant to this subparagraph shall be provided to the parent or guardi-
 an] THE MINOR MAY GIVE EFFECTIVE CONSENT PURSUANT TO SECTION TWENTY-FIVE
 HUNDRED FOUR OF THE PUBLIC HEALTH LAW.
   (3)  The reasons for an exception authorized pursuant to paragraph two
 of this subdivision shall be fully  documented  and  such  documentation
 shall be included in the minor's clinical record.
   §  5.  Subdivisions  1,  2, and 3 of section 2305 of the public health
 law, subdivisions 1 and 2 as amended by section 35 of part E of  chapter
 56  of  the  laws of 2013 and subdivision 3 as amended by chapter 878 of
 the laws of 1980, are amended to read as follows:
   1. No person, other than a [licensed physician, or, in a  hospital,  a
 staff  physician,]  HEALTH  CARE  PRACTITIONER  shall diagnose, treat or
 prescribe for a person who  is  infected  with  a  sexually  transmitted
 disease,  or who has been exposed to infection with a sexually transmit-
 ted disease, or dispense or sell a drug,  medicine  or  remedy  for  the
 treatment  of  such  person  except  on  prescription of a duly licensed
 [physician] HEALTH CARE PRACTITIONER.
   2. A [licensed physician, or in a hospital, a staff physician,] HEALTH
 CARE PRACTITIONER may diagnose, treat or prescribe for  a  person  under
 the  age  of  twenty-one  years  without the consent or knowledge of the
 parents or guardian of said person, where such person is infected with a
 sexually transmitted disease, [or] has been exposed to infection with  a
 sexually  transmitted disease, OR MAY GIVE EFFECTIVE CONSENT PURSUANT TO
 SECTION TWENTY-FIVE HUNDRED FOUR OF THIS CHAPTER.
   3. For the purposes of this section[, the]:
   (A) THE term "hospital" shall mean a hospital as  defined  in  article
 twenty-eight of this chapter.
   (B)  THE TERM "HEALTH CARE PRACTITIONER" SHALL MEAN A PERSON LICENSED,
 CERTIFIED, OR OTHERWISE AUTHORIZED TO PRACTICE UNDER TITLE EIGHT OF  THE
 EDUCATION LAW, ACTING WITHIN THEIR LAWFUL SCOPE OF PRACTICE.
   §  6.  Subdivision  8  of  section  372 of the social services law, as
 amended by chapter 684 of the laws  of  1996,  is  amended  to  read  as
 follows:
   8.  In  any case where a child is to be placed with or discharged to a
 relative or other person legally responsible  pursuant  to  section  ten
 hundred  seventeen  or  ten  hundred fifty-five of the family court act,
 such relative or other person shall be provided with such information by
 an authorized agency as is provided to foster parents pursuant  to  this
 section and applicable regulations of the department; PROVIDED, HOWEVER,
 THAT  NO  INFORMATION ABOUT ANY MEDICAL, DENTAL, HEALTH, AND/OR HOSPITAL
 SERVICE THAT A CHILD HAS CONSENTED TO THEMSELF SHALL BE INCLUDED WITHOUT
 A. 6761                             6
 
 THE CHILD'S AUTHORIZATION. A CHILD MAY CONSENT TO DISCLOSURE  GENERALLY,
 OR ONLY IN AN EMERGENCY, OR MAY WITHHOLD CONSENT ALL TOGETHER.
   §  7.  Section 373-a of the social services law, as amended by chapter
 305 of the laws of 2008, is amended to read as follows:
   § 373-a. Medical histories. Notwithstanding any other provision of law
 to the contrary, to the extent they are available, the medical histories
 of a child legally freed for adoption or of a  child  to  be  placed  in
 foster  care and of his or her birth parents, with information identify-
 ing such birth parents eliminated, shall be provided  by  an  authorized
 agency  to such child's prospective adoptive parent or foster parent and
 upon request to the adoptive parent or foster parent when such child has
 been adopted or placed in foster care; PROVIDED, HOWEVER, THAT NO INFOR-
 MATION ABOUT ANY MEDICAL, DENTAL, HEALTH, AND/OR HOSPITAL SERVICE THAT A
 CHILD HAS CONSENTED TO THEMSELF SHALL BE INCLUDED  WITHOUT  THE  CHILD'S
 AUTHORIZATION.  A  CHILD MAY CONSENT TO DISCLOSURE GENERALLY, OR ONLY IN
 AN EMERGENCY, OR MAY WITHHOLD CONSENT ALL TOGETHER. To the  extent  they
 are  available,  the  medical histories of a child in foster care and of
 his or her birth parents shall be provided by an  authorized  agency  to
 such  child  when  discharged to his or her own care and upon request to
 any adopted former foster child; provided, however, medical histories of
 birth parents shall be provided to an adoptee with information identify-
 ing such birth parents eliminated. Such medical histories shall  include
 all  available information setting forth conditions or diseases believed
 to be hereditary, any drugs or medication taken during pregnancy by  the
 child's birth mother and any other information, including any psycholog-
 ical  information  in  the case of a child legally freed for adoption or
 when such child has been adopted, or in the case of a child to be placed
 in foster care or placed in foster care which may be a factor  influenc-
 ing  the  child's present or future health. The department shall promul-
 gate and may alter or amend regulations governing the release of medical
 histories pursuant to this section.
   § 8. The social services law is amended by adding a new section  373-b
 to read as follows:
   § 373-B. REPRODUCTIVE AND SEXUAL HEALTH CARE SERVICES AND INFORMATION.
 1.  EACH FOSTER PARENT MUST BE ADVISED, IN WRITING, BY MEANS OF A LETTER
 OR  BROCHURE DESIGNED FOR SUCH PURPOSE, INITIALLY UPON BECOMING A FOSTER
 PARENT TO A CHILD  AND  ANNUALLY  THEREAFTER,  OF  THE  AVAILABILITY  OF
 SOCIAL,  EDUCATIONAL,  AND  MEDICAL  REPRODUCTIVE AND SEXUAL HEALTH CARE
 SERVICES AND INFORMATION FOR SUCH CHILD.
   2. A CHILD-CARING AGENCY SHALL OFFER AGE-  AND  DEVELOPMENTALLY-APPRO-
 PRIATE  REPRODUCTIVE  AND SEXUAL HEALTH CARE SERVICES AND INFORMATION TO
 ALL FOSTER CHILDREN WHO ARE OR MAY BE SEXUALLY  ACTIVE  OR  WHO  REQUEST
 SUCH  SERVICES  OR  INFORMATION THROUGH SUCH AGENCY'S CASEWORKER CONTACT
 AND AS PART OF THE COMPREHENSIVE SERVICE PLAN FOR EACH  CHILD.  SUCH  AN
 OFFER  MAY  BE MADE ORALLY TO THE CHILD AND SHALL BE MADE IN WRITING, BY
 MEANS OF A LETTER OR BROCHURE DESIGNED FOR SUCH PURPOSE. IF SUCH A  PLAN
 IS  DEVELOPED BY A SOCIAL SERVICES DISTRICT, SUCH DISTRICT MUST CONTINUE
 TO MONITOR THE CHILD-CARING AGENCY'S PROGRAM  IMPLEMENTATION  TO  ASSURE
 THAT  THE OFFER IS BEING MADE IN WRITING AND THAT REQUESTED SERVICES ARE
 PROVIDED WITHIN THIRTY DAYS, AND TO REQUIRE AND COLLECT REPORTS AND DATA
 FROM SUCH AGENCY.
   3. SERVICES  AND  INFORMATION  OFFERED  UNDER  THIS  SECTION  MUST  BE
 RESPECTFUL  AND INCLUSIVE OF ALL FOSTER CHILDREN REGARDLESS OF ACTUAL OR
 PERCEIVED RACE, COLOR, WEIGHT, NATIONAL ORIGIN, ETHNIC GROUP,  RELIGION,
 RELIGIOUS  PRACTICE,  DISABILITY,  SEXUAL  ORIENTATION,  OR  GENDER,  AS
 DEFINED BY SECTION ELEVEN OF THE EDUCATION LAW.
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   § 9. Paragraph (c) of subdivision 1  of  section  366  of  the  social
 services is amended by adding a new subparagraph 11 to read as follows:
   (11)  A  MINOR  WHO  IS  NOT OTHERWISE ELIGIBLE FOR MEDICAL ASSISTANCE
 UNDER THIS SECTION WHO CONSENTS TO THEIR OWN  MEDICAL,  DENTAL,  HEALTH,
 AND/OR HOSPITAL SERVICES PURSUANT TO SECTION TWENTY-FIVE HUNDRED FOUR OF
 THE  PUBLIC  HEALTH  LAW  IS ELIGIBLE FOR STANDARD COVERAGE ONLY FOR THE
 SPECIFIC SERVICES CONSENTED TO BY SUCH MINOR;  PROVIDED,  HOWEVER,  THAT
 THIS  SUBPARAGRAPH  ONLY  APPLIES IF SUCH MINOR IS UNABLE TO USE ANOTHER
 SOURCE OF HEALTH INSURANCE TO PAY FOR THE SERVICES CONSENTED TO BY  SUCH
 MINOR.    THE  COMMISSIONER  OF  HEALTH SHALL PROMULGATE RULES AND REGU-
 LATIONS NECESSARY TO CARRY OUT THE PROVISIONS OF THIS SUBPARAGRAPH.
   § 10. The first undesignated paragraph of section  17  of  the  public
 health law, as amended by chapter 322 of the laws of 2017, is amended to
 read as follows:
   Upon  the written request of any competent patient, parent or guardian
 of an infant, a guardian appointed pursuant to article eighty-one of the
 mental hygiene law, or  conservator  of  a  conservatee,  an  examining,
 consulting  or  treating physician or hospital must release and deliver,
 exclusive of personal notes of the said physician or hospital, copies of
 all x-rays, medical records and test records  including  all  laboratory
 tests regarding that patient to any other designated physician or hospi-
 tal; provided, however, that such records concerning the treatment of an
 infant patient for venereal disease [or], the performance of an abortion
 operation  upon  such  infant  patient,  OR ANY MEDICAL, DENTAL, HEALTH,
 AND/OR HOSPITAL SERVICES THAT SUCH INFANT PATIENT HAS CONSENTED TO THEM-
 SELF PURSUANT TO SECTION TWENTY-FIVE HUNDRED FOUR OF THIS CHAPTER  shall
 not  be  released  or  in  any manner be made available to the parent or
 guardian of such infant[,]; PROVIDED, FURTHER, THAT ANY  INFANT  PATIENT
 WHO  MAY  GIVE EFFECTIVE CONSENT PURSUANT TO SECTION TWENTY-FIVE HUNDRED
 FOUR OF THIS CHAPTER MAY REQUEST RELEASE OF THEIR OWN RECORDS,  AND  THE
 REQUEST  OF  NO  OTHER PERSON SHALL BE NECESSARY; and provided, further,
 that original mammograms, rather than copies thereof, shall be  released
 and delivered. Either the physician or hospital incurring the expense of
 providing  copies  of x-rays, medical records and test records including
 all laboratory tests pursuant to the  provisions  of  this  section  may
 impose  a  reasonable  charge  to  be  paid by the person requesting the
 release and deliverance  of  such  records  as  reimbursement  for  such
 expenses,  provided,  however,  that  the  physician or hospital may not
 impose a charge for copying an original mammogram when the original  has
 been  released or delivered to any competent patient, parent or guardian
 of an infant, a guardian appointed pursuant to article eighty-one of the
 mental hygiene law, or a conservator  of  a  conservatee  and  provided,
 further,  that  any charge for delivering an original mammogram pursuant
 to this section shall not exceed the documented costs associated  there-
 with.  However,  the reasonable charge for paper copies shall not exceed
 seventy-five cents per page. A release of  records  under  this  section
 shall not be denied solely because of inability to pay. No charge may be
 imposed  under  this  section  for  providing,  releasing, or delivering
 medical records or copies of medical records  where  requested  for  the
 purpose of supporting an application, claim or appeal for any government
 benefit  or  program,  provided that, where a provider maintains medical
 records in electronic form, it shall provide the copy  in  either  elec-
 tronic  or paper form, as required by the government benefit or program,
 or at the patient's request.
 A. 6761                             8
 
   § 11. Paragraph (c) of subdivision 3  of  section  18  of  the  public
 health  law,  as added by chapter 497 of the laws of 1986, is amended to
 read as follows:
   (c)  A subject [over the age of twelve years may] SHALL be notified of
 any request by a qualified person  to  review  [his/her]  THEIR  patient
 information,  and,  if  [the]  SUCH  subject  objects to disclosure, the
 provider may deny the request. In the case of a facility,  the  treating
 practitioner shall be consulted.  A PROVIDER SHALL NOT DISCLOSE INFORMA-
 TION ABOUT ANY MEDICAL, DENTAL, HEALTH, AND/OR HOSPITAL SERVICES THAT AN
 INFANT  HAS  CONSENTED  TO  THEMSELF TO SUCH INFANT'S PARENT OR GUARDIAN
 WITHOUT SUCH INFANT'S AUTHORIZATION.  AN INFANT MAY CONSENT  TO  DISCLO-
 SURE  TO THEIR PARENT OR GUARDIAN GENERALLY, OR ONLY IN AN EMERGENCY, OR
 MAY WITHHOLD CONSENT ALL TOGETHER.   AN INFANT WHO  MAY  GIVE  EFFECTIVE
 CONSENT TO MEDICAL, DENTAL, HEALTH, AND/OR HOSPITAL SERVICES PURSUANT TO
 SECTION TWENTY-FIVE HUNDRED FOUR OF THIS CHAPTER MAY ALSO GIVE EFFECTIVE
 CONSENT TO RELEASE THEIR PATIENT INFORMATION TO ANY PERSON.
   §  12.  Paragraph  2 of subdivision (c) of section 33.16 of the mental
 hygiene law, as added by chapter 498 of the laws of 1986, is amended  to
 read as follows:
   2.  A patient or client [over the age of twelve may] SHALL be notified
 of any request by a qualified person to review  [his/her]  THEIR  record
 and if [the] SUCH patient or client objects to disclosure, the facility,
 in consultation with the treating practitioner, may deny the request.  A
 FACILITY,  PRACTITIONER,  OR  TREATING  PRACTITIONER  SHALL NOT DISCLOSE
 CLINICAL RECORDS PERTAINING TO  TREATMENT  THAT  AN  INFANT  PATIENT  OR
 CLIENT CONSENTED TO THEMSELF TO SUCH INFANT'S PARENT OR GUARDIAN WITHOUT
 SUCH  INFANT'S AUTHORIZATION. AN INFANT PATIENT OR CLIENT MAY CONSENT TO
 DISCLOSURE TO THEIR PARENT OR GUARDIAN GENERALLY, OR ONLY IN AN EMERGEN-
 CY, OR MAY WITHHOLD CONSENT ALL TOGETHER. AN INFANT WHO MAY GIVE  EFFEC-
 TIVE CONSENT TO MEDICAL, DENTAL, HEALTH, AND/OR HOSPITAL SERVICES PURSU-
 ANT  TO  SECTION  TWENTY-FIVE HUNDRED FOUR OF THIS CHAPTER MAY ALSO GIVE
 EFFECTIVE CONSENT TO RELEASE THEIR CLINICAL RECORD TO ANY PERSON.
   § 13. Section 3244 of the insurance law is amended  by  adding  a  new
 subsection (f) to read as follows:
   (F) (1) AN INSURER, INCLUDING HEALTH MAINTENANCE ORGANIZATIONS OPERAT-
 ING  UNDER ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW OR ARTICLE FORTY-
 THREE OF THIS CHAPTER, AND ANY OTHER CORPORATION OPERATING UNDER ARTICLE
 FORTY-THREE OF THIS CHAPTER, SHALL TAKE THE FOLLOWING STEPS  TO  PROTECT
 THE  CONFIDENTIALITY  OF  AN  INSURED'S,  INCLUDING  A  SUBSCRIBER'S  OR
 ENROLLEE'S, MEDICAL INFORMATION:
   (A) INSURERS SHALL  PERMIT  AN  INSURED  WHO  CONSENTS  TO  THEIR  OWN
 MEDICAL,  DENTAL,  HEALTH,  AND/OR HOSPITAL SERVICES PURSUANT TO SECTION
 TWENTY-FIVE HUNDRED FOUR OF THE PUBLIC HEALTH LAW TO CHOOSE A METHOD  OF
 RECEIVING EXPLANATION OF BENEFIT FORMS THAT CONTAIN INFORMATION RELATING
 TO  THE  RECEIPT  OF  THE  SPECIFIC  SERVICES  CONSENTED TO, WHICH SHALL
 INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING: SENDING THE FORM  TO  THE
 ADDRESS  OF  THE  SUBSCRIBER;  SENDING  THE  FORM  TO THE ADDRESS OF THE
 INSURED; SENDING THE FORM TO AN  ALTERNATE  ADDRESS  DESIGNATED  BY  THE
 INSURED;  OR  SENDING  THE FORM THROUGH ELECTRONIC MEANS WHEN AVAILABLE.
 WHEN AN INSURED HAS SUBMITTED A REQUEST  FOR  RECEIVING  EXPLANATION  OF
 BENEFIT  FORMS  UNDER THIS SECTION AN INSURER IS THEREBY PROHIBITED FROM
 SENDING DUPLICATIVE EXPLANATION OF  BENEFIT  FORMS  TO  A  NON-SPECIFIED
 RECIPIENT OR IN A MANNER INCONSISTENT WITH THE REQUEST OF SUCH INSURED.
   (B)  INSURERS  SHALL NOT IN ANY WAY IDENTIFY THE DIAGNOSIS OR SERVICES
 RECEIVED IN AN EXPLANATION OF BENEFITS FORM OR IN ANY ONLINE PORTAL THAT
 ALLOWS SUBSCRIBERS TO ACCESS CLAIM  INFORMATION  IF  SUCH  DIAGNOSIS  OR
 A. 6761                             9
 
 SERVICES  WERE CONSENTED TO PURSUANT TO SECTION TWENTY-FIVE HUNDRED FOUR
 OF THE PUBLIC HEALTH LAW.
   (2)  THE  DEPARTMENT  SHALL  DEVELOP AND MAKE AVAILABLE A STANDARDIZED
 FORM FOR AN INSURED TO USE TO REQUEST CONFIDENTIAL  COMMUNICATIONS  THAT
 SHALL BE ACCEPTED BY ALL INSURERS.
   (3)  FOR  THE  PURPOSES OF THIS SECTION, AN ALTERNATIVE COMMUNICATIONS
 REQUEST AS DESCRIBED IN  SUBPARAGRAPH  (A)  OF  PARAGRAPH  ONE  OF  THIS
 SUBSECTION SHALL BE IMPLEMENTED BY AN INSURER WITHIN SEVEN CALENDAR DAYS
 OF RECEIPT OF AN ELECTRONIC TRANSMISSION OR TELEPHONIC REQUEST OR WITHIN
 FOURTEEN  CALENDAR  DAYS OF RECEIPT OF SUCH REQUEST BY FIRST-CLASS MAIL.
 AN INSURER SHALL ACKNOWLEDGE RECEIPT OF SUCH ALTERNATIVE  COMMUNICATIONS
 REQUEST  AND  ADVISE THE INSURED OF THE STATUS OF IMPLEMENTATION OF SUCH
 REQUEST IF SUCH INSURED CONTACTS SUCH INSURER.
   (4) AN INSURER SHALL NOT CONDITION THE ENROLLMENT OR COVERAGE  ON  THE
 WAIVER OF RIGHTS PROVIDED IN THIS SUBSECTION.
   (5)  THIS  SUBSECTION SHALL NOT BE CONSTRUED TO LIMIT ACCEPTANCE BY AN
 INSURER OF ANY OTHER FORM OF WRITTEN REQUEST FROM AN INSURED FOR  CONFI-
 DENTIAL  COMMUNICATIONS  FROM  A  CARRIER UNDER PARAGRAPH (B) OF SECTION
 164.522 OF PART 164 OF TITLE 45 OF THE CODE OF FEDERAL REGULATIONS.
   § 14. Paragraph (c) and subparagraph (vi) of paragraph (d) of subdivi-
 sion 8 and subdivision 10 of section 2168  of  the  public  health  law,
 paragraph  (c) of subdivision 8 as amended by chapter 829 of the laws of
 2022, subparagraph (vi) of paragraph (d) of subdivision 8 as amended  by
 chapter 532 of the laws of 2022 and subdivision 10 as amended by section
 7  of  part  A of chapter 58 of the laws of 2009, are amended to read as
 follows:
   (c) health care providers and their designees, registered professional
 nurses, and pharmacists authorized to administer immunizations  pursuant
 to  subdivision  two of section sixty-eight hundred one of the education
 law shall have access to the statewide immunization  information  system
 and  the  blood  lead  information  in  such system only for purposes of
 submission of information about  vaccinations  received  by  a  specific
 registrant,  determination  of  the  immunization  status  of a specific
 registrant, determination of the blood lead testing status of a specific
 registrant, submission of the results from a blood lead  analysis  of  a
 sample  obtained from a specific registrant in accordance with paragraph
 (h) of subdivision two of this section,  review  of  practice  coverage,
 generation  of reminder notices, quality improvement and accountability,
 including professional  responsibility  proceedings  of  the  office  of
 professional  medical  conduct  and  the state education department, and
 printing a copy of the immunization  or  lead  testing  record  for  the
 registrant's medical record, for the registrant's parent or guardian, or
 other  person  in  parental  or  custodial relation to a child, or for a
 registrant [upon reaching eighteen years  of  age];  PROVIDED,  HOWEVER,
 THAT  ANY IMMUNIZATION RECORD PRINTED FOR A REGISTRANT'S PARENT, GUARDI-
 AN, OR OTHER PERSON IN A CUSTODIAL RELATION  TO  SUCH  REGISTRANT  SHALL
 EXCLUDE  INFORMATION  ABOUT  ANY  IMMUNIZATION  THAT SUCH REGISTRANT HAS
 CONSENTED TO THEMSELF PURSUANT TO SECTION TWENTY-FIVE  HUNDRED  FOUR  OF
 THIS CHAPTER.
   (vi) commissioners of local social services districts with regard to a
 child in [his/her] THEIR legal custody;
   10.  The  person  to  whom any immunization record relates, or [his or
 her] THEIR parent, or guardian, or other person in parental or custodial
 relation to such person may request a copy of an  immunization  or  lead
 testing  record from the registrant's healthcare provider, the statewide
 immunization information system or the  citywide  immunization  registry
 A. 6761                            10
 
 according  to procedures established by the commissioner or, in the case
 of the citywide immunization registry, by the city of New  York  commis-
 sioner  of the department of health and mental hygiene; PROVIDED, HOWEV-
 ER,  THAT  ANY  IMMUNIZATION  RECORD  PROVIDED TO THE PERSON'S PARENT OR
 GUARDIAN OR OTHER PERSON IN A PARENTAL OR  CUSTODIAL  RELATION  TO  SUCH
 PERSON SHALL EXCLUDE INFORMATION ABOUT ANY IMMUNIZATION THAT SUCH PERSON
 HAS  CONSENTED  TO THEMSELF PURSUANT TO SECTION TWENTY-FIVE HUNDRED FOUR
 OF THIS CHAPTER.
   § 15. This act shall take effect on  the  one  hundred  eightieth  day
 after  it  shall have become a law. Effective immediately, the addition,
 amendment and/or repeal of any rule  or  regulation  necessary  for  the
 implementation  of  this  act on its effective date are authorized to be
 made and completed on or before such effective date.