Bill Text: NY A04416 | 2019-2020 | General Assembly | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: 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.

Spectrum: Partisan Bill (Democrat 24-0)

Status: (Introduced - Dead) 2020-07-13 - reported referred to codes [A04416 Detail]

Download: New_York-2019-A04416-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         4416--A

                               2019-2020 Regular Sessions

                   IN ASSEMBLY

                                    February 4, 2019
                                       ___________

        Introduced  by  M.  of  A.  GOTTFRIED,  JAFFEE,  BRONSON,  STECK, GALEF,
          L. ROSENTHAL, ABINANTI, MOSLEY, BENEDETTO,  DINOWITZ,  BLAKE,  D'URSO,
          HYNDMAN, LUPARDO, SAYEGH, SALKA, BARRON -- Multi-Sponsored by -- M. of
          A.  ARROYO,  COOK,  SIMON,  THIELE  --  read  once and referred to the
          Committee on Health -- committee  discharged,  bill  amended,  ordered
          reprinted as amended and recommitted to said committee

        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.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04051-06-9
        A. 4416--A                          2

     1    §  2.  Subdivision  7  of section 460-d of the social services law, as
     2  added by chapter 669 of the laws of 1977, paragraph (a)  as  amended  by
     3  chapter 719 of the laws of 1989, paragraph (b) as amended by chapter 524
     4  of the laws of 1984, subparagraph 2 of paragraph (b) as amended by chap-
     5  ter 733 of the laws of 1994, is amended to read as follows:
     6    7.  (a)  The  department  shall  adopt  regulations establishing civil
     7  penalties of up to [one] two thousand dollars  per  day  per  violation,
     8  and, for identical repeat violations occurring within twelve months of a
     9  violation for which a penalty was assessed, up to three thousand dollars
    10  per  day  per violation to be assessed against all adult care facilities
    11  except facilities operated by a social services district for  violations
    12  of (i) regulations of the department pertaining to the care of residents
    13  in  such  facilities, (ii) paragraph (a) of subdivision three of section
    14  four hundred sixty-one-a of this [chapter] article, or  (iii)  an  order
    15  issued  pursuant  to  subdivision eight of this section. The regulations
    16  shall specify the violations subject to penalty and the  amount  of  the
    17  penalty  to be assessed in connection with each such violation and shall
    18  specify that only civil penalties of up to [one]  two  thousand  dollars
    19  per  day  per  violation  shall  be  assessed pursuant to this paragraph
    20  against an adult care facility found responsible for an act  of  retali-
    21  ation  or  reprisal  against any resident, employee, or other person for
    22  having filed a complaint with or having provided information to any long
    23  term care [patient] ombudsman functioning  in  accordance  with  section
    24  [five  hundred  forty-four or five hundred forty-five] two hundred eigh-
    25  teen of the [executive] elder law.
    26    (b) [(1)] In addition to any other civil or criminal penalty  provided
    27  by law, the department shall have the power to assess civil penalties in
    28  accordance  with  its  regulations  adopted pursuant to paragraph (a) of
    29  this subdivision, after a  hearing  conducted  in  accordance  with  the
    30  procedures established by regulations of the department. Such procedures
    31  shall require that notice of the time and place of the hearing, together
    32  with  a statement of charges of violations, shall be served in person or
    33  by certified mail addressed to the facility at least thirty  days  prior
    34  to the date of the hearing. The statement of charges of violations shall
    35  set  forth  the  existence  of the violations, the amount of penalty for
    36  which it may become liable and the steps which must be taken to  rectify
    37  the  violation  and,  where  applicable, a statement that the department
    38  contends that a penalty may be imposed under this  paragraph  regardless
    39  of  rectification.  An  answer to the charges of violations, in writing,
    40  shall be filed with the department, not less than ten days prior to  the
    41  date  of  hearing. The answer shall notify the department of the facili-
    42  ty's position with respect to each of the charges and shall include  all
    43  matters which if not disclosed in the answer would be likely to take the
    44  department  by  surprise. The commissioner, or a member of his staff who
    45  is designated and authorized by him to hold such  hearing,  may  in  his
    46  discretion  allow  the  facility to prove any matter not included in the
    47  answer.
    48    (c) (1) Where the facility satisfactorily demonstrates that it  either
    49  had  rectified  the  violations  within thirty days of receiving written
    50  notification of the results of the inspection pursuant to  section  four
    51  hundred  sixty-one-a  of this [chapter] article, or had submitted within
    52  thirty days an acceptable plan for rectification and was rectifying  the
    53  violations  in accordance with the steps and within the additional peri-
    54  ods of time as accepted by the department in such plan, [no] the depart-
    55  ment shall determine that  the  penalty  under  this  section  shall  be
    56  reduced  from  what  otherwise  would  be  imposed, or waived, except as
        A. 4416--A                          3

     1  provided in subparagraph two of this paragraph.   The  department  shall
     2  reduce  the penalty under this paragraph, if it finds two of the follow-
     3  ing mitigating circumstances, and it may waive the  penalty  under  this
     4  paragraph if it finds three of the following mitigating circumstances:
     5    (i)  the  cause  of  the violation is not a widespread or chronic, and
     6  material, noncompliance with statutory or regulatory requirements;
     7    (ii) fewer than three residents were materially and directly  affected
     8  by the violation;
     9    (iii)  the  facility  has  not  been assessed a civil penalty nor been
    10  cited for more than fifteen violations in the  thirty  months  preceding
    11  the violation; or
    12    (iv)  the facility corrected the violation within fourteen days, or if
    13  delay of rectification was occasioned by the department or was  not  the
    14  fault of the facility, it corrected the violation promptly thereafter.
    15    (2)  [Rectification  shall not preclude the assessment of a penalty if
    16  the department establishes at a hearing  that  a  particular  violation,
    17  although  corrected,  endangered  or resulted in harm to any resident as
    18  the result of:
    19    (i)] No fine shall be reduced or waived for a violation that:
    20    (i) endangered any resident.  Endangerment is defined as:
    21    (A) the total or substantial failure of the facility's fire  detection
    22  or  prevention systems, or emergency evacuation procedures prescribed by
    23  department safety standard regulations;
    24    [(ii)] (B) the retention of any resident who has been evaluated by the
    25  resident's physician as being medically or mentally unsuited for care in
    26  the facility or as requiring placement  in  a  hospital  or  residential
    27  health  care facility and for whom the operator is not making persistent
    28  efforts to secure appropriate placement;
    29    [(iii)] (C) the failure in systemic  practices  and  procedures  which
    30  shall  be  defined as widespread or chronic, and material, noncompliance
    31  with statutory or regulatory requirements;
    32    [(iv)] (D) the failure of the operator to protect the  safety  of  the
    33  residents,  or take actions as required by department regulations in the
    34  event of a resident's illness or accident;
    35    [(v)] (E) the failure of the operator to provide at all  times  super-
    36  vision of residents by numbers of staff at least equivalent to the night
    37  staffing requirement set forth in department regulations; or
    38    [(vi)]  (F)  unreasonable  threats of retaliation or taking reprisals,
    39  including but not limited to unreasonable threats of eviction or  hospi-
    40  talization  against  any  resident, employee or other person who makes a
    41  complaint concerning the operation of an adult  care  facility,  partic-
    42  ipates  in  the  investigation  of  a  complaint or is the subject of an
    43  action identified in a complaint[.
    44    The department shall specify in its regulations those  regulations  to
    45  which this subparagraph two shall apply.
    46    (3)  In assessing penalties pursuant to this paragraph, the department
    47  shall consider promptness of  rectification,  delay  occasioned  by  the
    48  department, and the specific circumstances of the violations as mitigat-
    49  ing factors.
    50    (c)];
    51    (ii) resulted in harm to any resident, including but not limited to:
    52    (A) physical harm;
    53    (B) loss or denial of access to money or other personal property; or
    54    (C)  being  the  object  of words or conduct that constitute bullying,
    55  harassment, humiliation, infantilization, intimidation, taunt, ridicule,
    56  or a threat; or
        A. 4416--A                          4

     1    (iii) is  a  repeat  violation.  Repeat  violation  is  defined  as  a
     2  violation for which the facility was cited by the department at any time
     3  in the previous twelve months.
     4    (d)  Upon  the  request  of  the  department, the attorney general may
     5  commence an action in any court of competent  jurisdiction  against  any
     6  facility  subject  to  the  provisions  of this section, and against any
     7  person or corporation operating such facility, for the recovery  of  any
     8  penalty  assessed by the department in accordance with the provisions of
     9  this subdivision.
    10    [(d)] (e) Any such penalty assessed by the department may be  released
    11  or  compromised  by the department, subject to and consistent with para-
    12  graph (c) of this subdivision, before the matter has  been  referred  to
    13  the  attorney  general,  and  where such matter has been referred to the
    14  attorney general, any such penalty may be released  or  compromised  and
    15  any action commenced to recover the same may be settled and discontinued
    16  by  the attorney general, after considering paragraph (c) of this subdi-
    17  vision and with the consent of the department.
    18    § 3. Paragraphs (a) and (b) of subdivision 9 of section 460-d  of  the
    19  social services law, paragraph (a) as amended by chapter 558 of the laws
    20  of  1999  and paragraph (b) as added by chapter 848 of the laws of 1992,
    21  are amended to read as follows:
    22    (a) The department shall have authority to impose a civil penalty [not
    23  exceeding one thousand dollars per day] consistent with  section  twelve
    24  of  the  public  health law against, and to issue an order requiring the
    25  closing of, after notice and opportunity to be heard, any facility which
    26  does not possess a valid operating certificate issued by the  department
    27  and  is an adult care facility subject to the provisions of this article
    28  and the regulations of the department. A hearing shall be  conducted  in
    29  accordance  with  procedures established by department regulations which
    30  procedures shall require that  notice  of  the  determination  that  the
    31  facility  is  an  adult  care facility and the reasons for such determi-
    32  nation and notice of the time and place of  the  hearing  be  served  in
    33  person  on  the operator, owner or prime lessor, if any, or by certified
    34  mail, return receipt requested, addressed to such person and received at
    35  least twenty days prior to the date of the hearing.  If  such  operator,
    36  owner  or  prime  lessor,  if  any, is not known to the department, then
    37  service may be made by posting a copy thereof  in  a  conspicuous  place
    38  within  the  facility  or  by  sending a copy thereof by certified mail,
    39  return receipt requested, addressed to the facility. A written answer to
    40  the notice of violation may be filed with the department not  less  than
    41  five days prior to the date of the hearing.  Demonstration by the facil-
    42  ity  that  it possessed an operating certificate issued pursuant to this
    43  article, article twenty-eight  of  the  public  health  law  or  article
    44  sixteen,  [twenty-three,] thirty-one or thirty-two of the mental hygiene
    45  law at the time the hearing was commenced shall  constitute  a  complete
    46  defense to any charges made pursuant to this subdivision.
    47    (b)  [The penalty authorized by this section shall begin to run thirty
    48  days after the department provides the  operator,  in  writing,  with  a
    49  summary of the inspection of the facility by which the department deter-
    50  mined  that  he or she is operating an uncertified adult care facility.]
    51  The submission of an  application  by  the  operator  for  an  operating
    52  certificate for the facility shall not act as a bar to the imposition of
    53  a penalty against the operator of an unlicensed adult care facility.
    54    §  4.  Paragraph  (c)  of subdivision 9 of section 460-d of the social
    55  services law is amended by adding a new subparagraph  (iv)  to  read  as
    56  follows:
        A. 4416--A                          5

     1    (iv)  If  the department of health determines, based on a complaint or
     2  other facts known to the department, that there  is  reason  to  believe
     3  that  an individual or entity is operating an adult home, enriched hous-
     4  ing program, or residence for adults which  does  not  possess  a  valid
     5  operating  certificate  issued  by  the department, and that one or more
     6  conditions or activities at such facility constitute or  are  likely  to
     7  give  rise  to  an  immediate danger to the health of the residents, and
     8  awaiting a court order pursuant to subparagraph (iii) of this  paragraph
     9  would  be  seriously  detrimental  to  the health of such residents, the
    10  department of health may, notwithstanding an objection by the  operator,
    11  administrator  or  other  person in charge, inspect the entire premises,
    12  which shall include access to all dwellings on the said  property  which
    13  house tenants/occupants as well as access to such tenants/occupants, for
    14  the  purpose  of ascertaining whether such danger exists or is likely to
    15  arise on an immediate basis. The department of health  may  request  the
    16  assistance  of  local  law enforcement for purposes of carrying out such
    17  inspection and may take any appropriate action  if  it  determines  that
    18  such  danger  exists  or is likely to arise, including issuing a written
    19  notice directing the operator, administrator or other person  in  charge
    20  of such facility to cease or correct the condition or activity at issue.
    21  As  promptly  as  possible  thereafter,  within  a  period not to exceed
    22  fifteen days, the commissioner shall provide the operator an opportunity
    23  to be heard and to present any proof that  such  condition  or  activity
    24  does  not  constitute  a  danger  to the health of the residents of such
    25  facility. The attorney  general,  upon  request  of  the  department  of
    26  health,  shall be authorized to apply to the supreme court in the county
    27  in which the facility is located for an order for any appropriate  addi-
    28  tional relief.
    29    §  5.  Subdivision  11 of section 460-d of the social services law, as
    30  amended by section 154 of subpart B of part C of chapter 62 of the  laws
    31  of 2011, is amended to read as follows:
    32    11.  On or before issuance by the department to an adult care facility
    33  operator of official written notice of: the proposed revocation, suspen-
    34  sion or denial of the operator's operating certificate;  the  limitation
    35  of  the  operating certificate with respect to new admissions; the issu-
    36  ance of a department order or commissioner's order; the seeking of equi-
    37  table relief pursuant to this  section;  the  [proposed]  assessment  of
    38  civil  penalties  for  violations of the provisions of [subparagraph two
    39  of] paragraph [(b)] (c) of subdivision seven of this section  or  place-
    40  ment  on the "do not refer list" pursuant to subdivision fifteen of this
    41  section, written notice also shall be given to the appropriate office of
    42  the department of mental hygiene, department of corrections and communi-
    43  ty supervision and local social services districts, and provided further
    44  that the department of health shall notify hospitals, residential health
    45  care facilities and adult care facilities in the locality in which  such
    46  facility is located that such notice has been issued. Upon resolution of
    47  such  enforcement action the department shall within ten days notify the
    48  appropriate office of the department of mental  hygiene,  department  of
    49  corrections  and  community supervision, local social services districts
    50  [and], hospitals, residential health  care  facilities  and  adult  care
    51  facilities.
    52    §  6.  Subdivision  12 of section 460-d of the social services law, as
    53  amended by section 42 of part B of chapter 58 of the laws  of  2004,  is
    54  amended to read as follows:
    55    12. [Social] Hospitals, residential health care facilities, adult care
    56  facilities,  social  services districts and other local government enti-
        A. 4416--A                          6

     1  ties established pursuant to  this  chapter  shall  be  prohibited  from
     2  making  referrals  for  admissions  to  adult  care facilities that have
     3  received official written notice  regarding:  the  proposed  revocation,
     4  suspension  or denial of the operator's operating certificate; the limi-
     5  tation of the operating certificate with respect to new admissions;  the
     6  issuance  of  department  order or commissioner's orders; the seeking of
     7  equitable relief pursuant to this section[; the proposed  assessment  of
     8  civil  penalties for violations of the provisions of subparagraph two of
     9  paragraph (b) of subdivision seven of this section]; or  the  facility's
    10  placement  on the "do not refer list" pursuant to subdivision fifteen of
    11  this section.
    12    § 7. Section 460-d of the social services law is amended by  adding  a
    13  new subdivision 18 to read as follows:
    14    18. When the department of health issues official written notice to an
    15  operator  of  a  proposed action specified in subdivision eleven of this
    16  section, and the department determines that there is a  condition  which
    17  constitutes  an  imminent danger to the health, safety or welfare of any
    18  resident, the department may prohibit that operator from  admitting  any
    19  new  resident to the facility until the department determines that there
    20  is no longer an imminent danger to the health, safety or welfare of  any
    21  resident.
    22    §  8.  Section 461-c of the social services law is amended by adding a
    23  new subdivision 10 to read as follows:
    24    10. The operator of an adult home or an enriched housing program shall
    25  provide to prospective residents who inquire about admission, and  shall
    26  post   on   its   website,   a   copy   of   the   facility's   approved
    27  admission/residency agreement.
    28    § 9. The closing paragraph of subdivision 3 of section  461-d  of  the
    29  social  services  law,  as  added by chapter 601 of the laws of 1981, is
    30  amended to read as follows:
    31    Waiver of any provision [contained within] of this  subdivision  by  a
    32  resident  of an adult care facility or by the resident's legal represen-
    33  tative or resident representative, with respect  to  a  resident  of  an
    34  adult  home,  residence for adults or enriched housing program, shall be
    35  void.
    36    § 10. Section 461-e of the social services law is amended by adding  a
    37  new subdivision 3-a to read as follows:
    38    3-a. Every adult home and enriched housing program shall:
    39    (a)  Post in a prominent position in the facility so as to be accessi-
    40  ble to all residents and to the general public:
    41    (i) a summary of any report of inspection based on a complaint  issued
    42  by  the  department  of  health to the facility within the previous year
    43  which resulted in the payment of a fine or penalty by the facility; and
    44    (ii) notice of residents' right to review reports under paragraph  (b)
    45  of this subdivision.
    46    (b) Provide to any resident and each applicant for admission an oppor-
    47  tunity to review any report of inspection based on a complaint issued by
    48  the department of health to the facility within the previous year.
    49    (c)  Provide  to  the  resident  council  a  summary  of any report of
    50  inspection based on a complaint issued by the department of health with-
    51  in fourteen days  of receipt by the facility.
    52    § 11. Paragraphs (a), (b) and (c) of subdivision 2 of section 461-a of
    53  the social services law, paragraphs (a) and (c) as  amended  by  chapter
    54  735  of  the laws of 1994 and paragraph (b) as amended by chapter 601 of
    55  the laws of 1981, are amended to read as follows:
        A. 4416--A                          7

     1    (a) With respect to adult care facilities the department shall conduct
     2  a minimum of one unannounced inspection of each such facility to  deter-
     3  mine the  adequacy of care being rendered, pursuant to the following:
     4    (1) Such facilities [receiving the department's highest rating] deter-
     5  mined  by  the  department to be in compliance or substantial compliance
     6  with applicable statutes and regulations, based on the  facility's  most
     7  recent  inspection,  shall  be  inspected  at  least once every eighteen
     8  months on an unannounced basis.
     9    (2) All other such facilities shall be  inspected  on  an  unannounced
    10  basis  no  less  than  annually.   The commissioner may provide for more
    11  frequent inspections of any such facilities. Such inspection  shall  not
    12  be  required with respect to any facility for which the commissioner has
    13  delegated responsibility for inspection  and  supervision  to  a  social
    14  services  official  pursuant  to  section  four  hundred sixty-c of this
    15  [chapter] article.  Any employee of the department or a social  services
    16  district  who  gives  or causes to be given advance notice of such unan-
    17  nounced inspections to any unauthorized persons shall,  in  addition  to
    18  any other penalty provided by law, be suspended by the department or the
    19  social  services  district from all duties without pay for at least five
    20  days or for such greater period of time  as  the  department  or  social
    21  services district shall determine.  Any such suspension shall be made by
    22  the  department or social services district in accordance with all other
    23  applicable provisions of law.
    24    (b) [The department or a social services district, where  appropriate,
    25  shall  each  year conduct a minimum of one full inspection of each adult
    26  care facility. Such inspection] An inspection of an adult care  facility
    27  under  this section shall include, but shall not be limited to, examina-
    28  tion of the medical, dietary and social services records of the facility
    29  as well as the minimum standards of construction, life safety standards,
    30  quality and adequacy of care, rights  of  residents,  payments  and  all
    31  other  areas  of  operation.  The  purpose of any inspection shall be to
    32  determine compliance with requirements of applicable provisions  of  law
    33  and regulations of the department.
    34    (c)  (i)  An  inspection report shall be made of each inspection which
    35  shall clearly identify and indicate in detail each  area  of  operation,
    36  including, but not limited to, the premises, equipment, personnel, resi-
    37  dent care and services, and whether [each] any such area of operation or
    38  any  of  its component parts is [or is] not in compliance with the regu-
    39  lations of the department and all other applicable requirements. It also
    40  shall identify those areas of operation or any of  its  component  parts
    41  found not in compliance as a result of failure in systemic practices and
    42  procedures.  The  operator  shall  be  notified  of  the  results of the
    43  inspection in a manner to be determined by regulations of the department
    44  and shall submit a written plan of correction to the  department  within
    45  thirty  calendar  days  from the date the inspection report is received.
    46  The department shall notify the operator of  the  acceptability  of  the
    47  plan  of  correction  within  thirty  calendar  days of the department's
    48  receipt of such plan.  Such notification shall contain directions as may
    49  be appropriate as to the manner and time in which compliance with appli-
    50  cable requirements of law or regulations  of  the  department  shall  be
    51  effected.
    52    (ii)  The department shall also require the operator of an adult home,
    53  enriched housing program or residence for adults to develop,  biannually
    54  update  and  implement  plans  for quality assurance activities for each
    55  area of operation. Quality assurance  activities  include  but  are  not
    56  limited  to, development and maintenance of performance standards, meas-
        A. 4416--A                          8

     1  urement of adherence to such standards and to applicable state and local
     2  laws and regulations, identification of  performance  failures,  design,
     3  and implementation of corrective action.
     4    §  12. Subparagraphs (I) and (II) of paragraph 2 of subdivision (i) of
     5  section 29.15 of the mental hygiene law, as amended by  chapter  168  of
     6  the laws of 2010, are amended to read as follows:
     7    (I)  A patient about to be discharged or conditionally released from a
     8  department facility licensed or operated by the office for  people  with
     9  developmental  disabilities  or  from  an inpatient facility operated or
    10  licensed by the office of alcoholism and substance abuse services or the
    11  office of mental health to an adult home, enriched  housing  program  or
    12  residence  for  adults, as defined in section two of the social services
    13  law, shall be referred only to such home or residence that is consistent
    14  with that patient's needs and that operates  pursuant  to  section  four
    15  hundred sixty of the social services law, provided further that: (A) for
    16  a department facility licensed or operated by the office for people with
    17  developmental  disabilities or for an inpatient facility operated by the
    18  office of alcoholism and substance  abuse  services  or  the  office  of
    19  mental  health,  the  facility  director  retains authority to determine
    20  whether the home, program or residence is consistent with that patient's
    21  needs and (B) such referral shall be made to the patient's  home  county
    22  whenever possible or appropriate.
    23    (II)  No patient about to be discharged or conditionally released from
    24  a department facility licensed or operated by the office for people with
    25  developmental disabilities or from an  inpatient  facility  operated  or
    26  licensed by the office of alcoholism and substance abuse services or the
    27  office  of  mental  health shall be referred to any adult home, enriched
    28  housing program or residence for adults, as defined in  section  two  of
    29  the  social  services law, which has received an official written notice
    30  from the department of health of: (A) the proposed  revocation,  suspen-
    31  sion  or  denial of its operating certificate; (B) the limitation of its
    32  operating certificate with respect to new admissions; (C)  the  issuance
    33  of a department of health order or commissioner of health's order or the
    34  seeking  of equitable relief pursuant to section four hundred sixty-d of
    35  the social services law; (D) the proposed assessment of civil  penalties
    36  for  violations  of  the  provisions  of [subparagraph two of] paragraph
    37  [(b)] (c) of subdivision seven of section four hundred  sixty-d  of  the
    38  social services law; or placement on the "do not refer list" pursuant to
    39  subdivision  fifteen  of  section  four  hundred  sixty-d  of the social
    40  services law. Referrals may resume when  such  enforcement  actions  are
    41  resolved.
    42    § 13. Severability clause. If any provision of this act, or any appli-
    43  cation  of  any  provision  of  this  act,  is held to be invalid, or to
    44  violate or be inconsistent with any  federal  law  or  regulation,  that
    45  shall not affect the validity or effectiveness of any other provision of
    46  this  act,  which can be given effect without that provision or applica-
    47  tion; and to that end, the provisions and applications of this  act  are
    48  severable.
    49    §  14.  This act shall take effect on the ninetieth day after it shall
    50  have become a law. Effective immediately,  the  commissioner  of  health
    51  shall  make  regulations  and  take other actions necessary to implement
    52  this act on that date.