Learning Objectives

Legislative UpdateThe Legislative Process and Lobby Day 2014Presented byMichael Mattia, PT, DPT, MS, MHAChair, Advisory Panel on Legislation NYPTALegislative Liaison Brooklyn – Staten Island District

Learning Objectives • Discuss and learn about the structure of the executive branch of the NY State. • Discuss and learn how a idea can become a law. • Discuss the Legislative process and how it applies to the practice of Physical Therapy in NYS. • Discuss Lobby Day 2014 including current legislation. • Discuss the role of PAC funds and donations. • Become an advocate for our profession.

The Executive Branch of New York State • The Governor – Andrew M. Cuomo • The Lieutenant Governor – Robert J. Duffy • The State Comptroller – Thomas P. DiNapoli • The Attorney General – Eric T. Schneiderman

The Legislative Branch • The NYS Constitution authorizes a two house Legislative Branch composed of the Senate and Assembly. • The number of representatives can vary. • The Third branch is the Judicial Branch which is composed of the State Courts and the Municipal Courts, and their various components.

The Senate • The NYS Senate currently consists of 63 members elected at the district level by their constituents • The Lieutenant Governor is the President of the Senate, currently Robert J. Duffy. • The Senate majority leader is the Temporary President in the absence of the lieutenant governor. • The Senate majority leader is also third in succession from the governor. • The President is mostly ceremonial, but their vote can break a tie in a measure before the house. • Current Majority Co-leaders are Dean Skelos (R) and Jeffrey Klein (IDC) ** Independent Democratic Conference ** • Current minority Leader is Andrea Stewart – Cousins (D)

The Assembly • The “ People’s House” • 150 members elected by their constituents at the district level. • Speaker of the Assembly is the leader of the Assembly. Currently the position is held by Sheldon Silver (D), a downstate Assemblyman. • The Speaker is elected for a 2 year term by the members. • The Speaker makes all of the committee assignments and directs most of the work of the assembly staff. • Majority Leader is Joseph Morelle (D). • Minority Leader is Brian Kolb (R)

How a Bill becomes a LawReviewing the Process • What is the definition of a Law? • In general, a law is a rule of being or of conduct, established by an authority that is able to enforce its will; a controlling regulation; the mode or order according to which an agent or a power acts. • Any edict, decree, order, ordinance, statute, resolution, judicial decision, usage, etc., recognized, and enforced, by the controlling authority.

All NYS Laws start with an Idea • The Idea • This is the starting point in the process, and the first point at which the citizen has a chance to have a say in the writing or rewriting of law. • Subjects of legislation are as varied as the range of human activities. Someone once said that legislation deals with birth and death, and everything in between. • Ideas for legislation come from many sources. A Senator may have an idea. One of his or her constituents may point out a need. A State official may propose a change. An organization may espouse a cause that requires a change in the law. There is no monopoly on ideas for legislation. • Often, one person's idea on how to solve a problem has resulted in good legislation to help solve the problems of many people.

Bill Drafting • Bill DraftingOnce an idea for a new law has been settled on, it must be put into bill form before it can be considered by the Senate. The actual drafting of legislation requires a specialized type of legal training and is usually done by the staff of the Legislative Bill Drafting Commission. • Sometimes, however, an interest group may have its own attorneys draft a bill, and lawyers working in various state agencies and the executive branch often submit their ideas for legislation in bill form.

Sponsorship • A bill must have a sponsor to be introduced. • A main focus and goal of our lobby day activities is to attain support and sponsorship or co-sponsorship for our legislation. • When a bill comes to the floor for a vote, the larger the co-sponsorship and support, the greater the chances for passage.

Introduction of a Bill • IntroductionNo law may be enacted in New York State unless it has been adopted by the Legislature in bill form. And to be adopted, it must first be introduced. With a single exception, bills can be introduced only by legislators or by standing committees of the Senate and Assembly. That exception is the Executive Budget, which is submitted directly by the Governor. • On introduction in the Senate, a bill goes to the Introduction and Revision Office, where it is examined and corrected, given a number, sent to the appropriate standing committee, entered into the Senate computer, deemed to have had its first and second readings and printed. • (Incidentally, "first reading", "second reading" and "third reading" are terms which linger in the legislative vocabulary from the days when each bill was read aloud in full in public session three times before final action could be taken.)

Committee Action • Committee ActionJust as we engage specialists for specialized problems such as legal or medical advice, so does the Senate engage specialists to study legislation. • These specialists are members of Standing Committees who evaluate bills and decide whether to "report" them (send them) to the Senate floor for a final decision by the full membership. • A committee agenda is issued each week listing the bills and issues each Senate committee will handle the following week. Committees often hold public hearings on bills to gather the widest possible range of opinion. • The committee stage is the second point at which the citizen's contribution is important. An expression of opinion on a proposed bill can be sent directly to the committee chairman, or it can be sent to your local Senator for relay to the committee members. • The committee system acts as a funnel through which the large number of bills introduced each session must pass before they can be considered. The system also acts as a sieve to sift out undesirable or unworkable ideas. • After consideration, the committee may report the bill to the full Senate for consideration, it may amend the bill, or it may reject it.

The Calendar • The Daily Calendar is the agenda for Senate sessions and contains those measures which have come through the committee process. • Bills take their place in order as they are reported from committee, and at this point are referred by their Calendar Number. This process allows additional time for reaction against or for a bill. • Each bill has to be on the Senators' desks for three days before it can be voted on, unless the Governor authorizes and the Senate accepts a Message of Necessity for a certain bill. • When bills reach the Order of Third Reading, they become ready for a final vote. If the sponsor of a bill realizes at this point that his bill may not have enough support for passage, or has a defect which may require an amendment, he may ask that it be laid aside, returned to committee for further study, or "starred" (placed in an inactive file). • The Majority Leader also may ask that a bill be starred. Once starred, it cannot be acted on until one day after removal of the star. • When the bill comes up for consideration on the Order of Third Reading, it is subject to debate, discussion or explanation. • By communicating your views on a particular issue to your Senator, you have another opportunity at this point to participate in the lawmaking process.

Conference Committees • Sometimes the Senate and Assembly pass similar bills, but cannot easily reconcile the differences between them in a reasonable time frame. • In such cases, a procedural device called a conference committee can be used to iron out the differences. • The Senate Majority Leader and Assembly Speaker each appoint five members from their respective houses to serve on this committee. • After agreement is reached, a bill is printed and processed like any other bill.

The Senate Insurance Committee • Seward – Chair • Breslin, Carlucci, Espaillat, Flanagan, Golden, Grisanti, Kennedy, Lanza, Larkin, LaValle, Martins, O’Brien, O’Mara, Parker, Peralta, Stavinsky, Valesky, Young

The Assembly Insurance Committee • Cahill – Chair • Abinanti, Barclay, Blankenbush, Braunstein, Butler, Cook, Crespo, Curran, Cymbrowitz, Finch, Hawley, Hevesi, Jacobs, Lavine, Moya, Peoples-Stokes, Perry, Pretlow, Quart, Rivera, Skoufis, Steck, Walter, Weprin

Floor Amendments • Once a bill has been introduced, reported out by a committee and is on the calendar for consideration by the full Senate, it can still be amended. • The sponsor of the bill, for example, can submit the changes to the Bill Drafting Commission; the bill, now in its amended form, retains its original number, but amended versions are denoted by a letter suffix A, B, C, D and so on for each time the bill is altered. • However, beyond this, any Senator may amend a given bill by offering amendments to it on the Senate floor, even if he or she is not one of the bill's sponsors. • This method allows all members access to a bill's language, opening it to the suggestions and opinions of members who may like the essential ideas of the bill, but disagree with the sponsor on one or more of the legislation's details. • Moreover, since the amendments are offered in open session, all members can ask questions and discuss the merits of the proposed amendments.

Passing a Bill • After explanation, discussion or debate, a vote is taken. If a majority of the Senators approve, the bill is sent to the Assembly. • In the Assembly, you again have a chance to influence the bill as it moves through a process basically the same as that in the Senate. It is referred to a committee for discussion, and if approved there, it goes to the full membership for a vote. • If the bill is approved in the Assembly without amendment, it goes on to the Governor. However, if it is changed, it is returned to the Senate for concurrence in the amendments. • (The reverse procedure is followed if the Assembly first passes a bill identical to a Senate measure or if the Senate amends an Assembly bill.)

Signing a bill into Law • If a bill is sent to the Governor when the Legislature is out of session, the rules are a bit different. • At such times, the Governor has 30 days in which to make a decision, and failure to act ("pocket veto") has the same effect as a veto. • Citizen comment is an important part of the legislative process. Public opinion often affects the shape of a bill as well as its eventual success or failure. • Remember, your input can play a crucial role in determining how a bill becomes a law. • This document is your manual to the legislative process as it functions in the New York State Senate. • It is intended to help you understand how an idea is transformed into a law and the part that you as a citizen can play in this process.

The Governor • While the Legislature is in session, the Governor has 10 days (not counting Sundays) to sign or veto bills passed by both houses. • Signed bills become law; vetoed bills do not. • However, the Governor's failure to sign or veto a bill within the 10-day period means that it becomes law automatically. • Vetoed bills are returned to the house that first passed them, together with a statement of the reason for their disapproval. • A vetoed bill can become law if two-thirds of the members of each house vote to override the Governor's veto.

Let’s Review the Process

Political Action Committee NYPT PAC • PAC funds are the sole source of funding for our advocacy program. • Annual membership dues cannot be utilized for advocacy activities. • The NYPTA requires these funds in order to maintain and expand our advocacy program in a rapidly evolving health care system. • Please donate to NYPT PAC today.

Lobbyists • Lobbyists are professionals who are hired to assist an organization in their advocacy efforts. • NYPTA Lobbyist is Brian Lucey, Esq. • His firm is: Whiteman, Osterman, and Hanna, LLC.

NYPTA Legislative Plan - - 2014 • Excessive Co Pays - NYPTA will continue to pursue passage of its legislation which would reduce co-payments for physical therapy care. If passed, the law would require that no visit co-payment would exceed 20% of the total fee for the visit. • S2319 (DeFrancisco) and A1666 (Cahill) were sent to the Insurance committee of each house on 1/8/2014.

NYPTA Legislative Plan - - 2014(cont’d) • Workers Compensation. NYPTA will continue to pursue passage of two bills addressing issues related to the workers’ compensation system. • Our WC PTA bill – A.7293 (Zembrowski) and S.3555(Griffo) have been moved out of the Labor Committees and on to the floor for a vote in both houses. • The WC Bill which calls for a biannual rate review: A.7661 (Titone) and S.4694 (Griffo) was referred to the Labor Committee in both houses on 1/8/2014.

A Victory • NYPTA leadership and the NYS Workers Compensation leadership sat at the table last year to discuss the WC issues that impact our profession. • As a direct result of these discussions, we were given a seat at the table during the re engineering project undertaken by the WC system. • This has resulted in a rate revision in line with the Medicare fee schedule and a yearly review of rates. • When passed, these changes will take effect April 2015.

NYPTA Legislative Plan - 2014 • Health Care Reform. 2014 continues to see implementation of the Affordable Care Act and New York has fully implemented its Health Insurance Exchange. APOL and NYPTA closely monitor activities to position our profession to respond to market changes, regulatory changes, and payment reform. • Early Intervention: NYPTA will continue to engage the Governor’s Office, the Legislature and regulators to advocate for coverage of physical therapy services and affordable access to those services. NYPTA Leadership formed a strategic coalition with other allied health professionals specifically Speech Language Hearing and Occupational Therapy to address the Early Intervention issues in NYS, and the negative impact that the changes to this vital program have had on one of the most vulnerable populations in our state and our colleagues, who provide vital rehabilitative services in this area of practice. Our President, Executive Director, and our legal representatives have been extremely active in this area. APOL is involved in supporting these efforts and participating as necessary. • A bill to address timely payment for services S.6002 (Hannon) and A.8316 (Gottfried) has been introduced as a result of these efforts.

NYPTA Legislative Plan - - 2014(cont’d) • Referral For Profit. NYPTA will be investigating draft legislation that closes existing loopholes in current NYS laws that permit referral-for-profit (POPTS) arrangements. • State Budget. NYPTA will oppose budget proposals that restrict access to physical therapy services or reduce reimbursement. • Practice Issues. NYPTA continues monitor and oppose legislation which would negatively impact the profession. Current examples are the Athletic Training bills and the Naturopathy bills.

Grassroots Initiative 2014 • APOL and the Legislative Liaisons designed and implemented an aggressive grassroots initiative for 2014. • Our goal is to visit with each NYS representative in his or her home office to discuss the issues that concern and impact the practice of Physical Therapy in NYS. • Our goal is to increase awareness and support for our current legislation and to establish productive dialogue and relationships for the future.

Student Advocacy Group • First group has been established at The College of Staten Island as a response to student experiences at The APTA National Student Conclave (NSC). • Leadership and membership from all three levels. • Representation at the District meetings. • Participation in all district legislative activities. • Format to be used as a basis for all NYS PT/PTA programs.

Lobby Day 2014 • The Day: • Arrive at LOB at 8:30 AM. • Check in and receive ID tag. • Report to your assigned Legislator meeting group and its leadership person. • Meetings are scheduled every 30 minutes beginning at as scheduled by your leaders. • Each meeting should be approximately 20 minutes in duration. • The goal of each meeting is to clearly speak to our bills (see talking points in your Lobby Day packet) and request support and sponsorship by the legislator. • 11:00 AM Assemblywoman Schimel will address our group. • Lunch as scheduled by the leader.

Lobby Day 2014 (cont’d) • Afternoon meetings scheduled from 1:00 to 3:30 pm. • After meetings are completed leadership will provide feedback forms to the NYPTA staff in LOB lobby. • We will board the buses by 4:00 pm for return to our home districts.

What can I do ? • We as PTs need to be aware of laws and legislation that effect our daily practice • We DO have a voice in the process and we Do have an active association that monitors the daily activities and protects and brings forth the ideas of our profession. • There is strength in numbers and in people being involved. • Your elected officials are impressed when they greet their constituents in a meeting on the issues. • Meet with your local representatives and ATTEND LOBBY DAY !!

What can I do after Lobby Day? • We as PTs need to be aware of laws and legislation that effect our daily practice. • Today you have learned that we DO have a voice in the process and we Do have an active association that monitors the daily activities and protects and brings forth the ideas of our profession. • There is strength in numbers and in people being involved. • Your elected officials are impressed when they greet their constituents in a meeting on the issues. • Follow up with your local legislator by phone or at the district office to discuss our issues. • Stay involved in the process through attendance and participation at your district meetings. • Stand at the ready to assist in any “call to action” that is published by NYPTA.

Thank You!! • Thank you for taking the time to attend Lobby Day 2014 and for being an advocate for your profession. • The NYPTA looks forward to continuing to work with the members to advance our profession in New York State and nationally.

References • The New York State Senate Website: www.nysenate.gov/How_a-Bill_Becomes_a_Law • The New York State Assembly Website: http://assembly.state.ny.us/ • The New York State Senate Website: http://www.nysenate.gov • NYPTA Website: http://nypta.org

Learning Objectives