A 9264: Establishes a home care services bill of rights for patients of home care services agencies and certified home health agencies; requires training for staff and contractors of such agencies to eliminate certain discriminations; makes related provisions.

  
  STATE OF NEW YORK ________________________________________________________________________ 9264 2025-2026 Regular Sessions  IN ASSEMBLY November 21, 2025 ___________ Introduced by M. of A. ROSENTHAL -- read once and referred to the Committee on Health AN ACT to amend the public health law, in relation to enacting the "protection, respect, inclusion, dignity, and equality (PRIDE) care act" The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Short title. This act shall be known and may be cited as 2 the "protection, respect, inclusion, dignity, and equality (PRIDE) care 3 act". 4 § 2. Section 3602 of the public health law is amended by adding seven 5 new subdivisions 18, 19, 20, 21, 22, 23 and 24 to read as follows: 6 18. "Non-direct patient contact employee or contractor" means an 7 employee or contractor who does not make direct contact with the 8 patient. For the purposes of this subdivision, the term "direct contact" 9 includes, but is not limited to, communications with the patient through 10 in-person interactions, phone calls, text messages, emails, virtual 11 messages, and letters. 12 19. "Direct contact employee or contractor" means any employee or 13 contractor who makes direct contact with the patient. For the purposes 14 of this subdivision, "direct contact" includes, but is not limited to, 15 communications with the patient through in-person interactions, phone 16 calls, text messages, emails, virtual messages, and letters. 17 20. "Gender identity or expression" means a person's actual or 18 perceived gender-related identity, appearance, behavior, expression, or 19 other gender-related characteristic regardless of the sex assigned to 20 the person at birth, including, but not limited to, the status of being 21 transgender. 22 21. "Gender affirming health care" means medical, surgical, behav- 23 ioral, health, psychological, and other services intended to support and 24 affirm a person's self-determined gender identity or expression. The EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD13764-02-5 
 A. 9264 2 1 term "gender affirming health care" does not include sexual orientation, 2 gender identity, and gender expression change efforts. 3 22. "AIDS" means diagnosed acquired immune deficiency syndrome. 4 23. "HIV" means the human immunodeficiency virus. 5 24. "LGBTQ" means lesbian, gay, bisexual, transgender, queer, and/or 6 intersex identities. 7 § 3. The public health law is amended by adding a new section 3604 to 8 read as follows: 9 § 3604. Home care services bill of rights. The provisions of this 10 section shall apply to home care services agencies and certified home 11 health agencies. 12 1. A patient who receives home care services shall not be subject to 13 discrimination on the basis of sexual orientation, gender identity, 14 gender expression, and/or HIV status, and shall have the following 15 rights: 16 (a) to receive written information, in plain language and in a 17 language the patient understands, about such patient's rights under this 18 section before receiving services, including what to do and who to 19 contact if such rights are violated; 20 (b) to receive a nondiscrimination notice, which: 21 (i) shall read "(Name of provider) does not discriminate and does not 22 permit discrimination, including, but not limited to, bullying, abuse, 23 or harassment, on the basis of actual or perceived sexual orientation, 24 gender identity, gender expression, or HIV status, or based on associ- 25 ation with another individual on account of that individual's actual or 26 perceived sexual orientation, gender identity, gender expression, or HIV 27 status. You may file a complaint with the department of health at 28 (provide contact information) if you believe that you have experienced 29 this kind of discrimination"; 30 (ii) the home care services agency or certified home health agency 31 shall obtain a signed copy of from each patient, or the patient's repre- 32 sentative if applicable, and such signed copy shall be included in such 33 patient's record if applicable; 34 (c) to receive care and services according to a suitable and up-to- 35 date plan, and subject to accepted health care, medical or nursing stan- 36 dards and person-centered care, including the right to be treated with 37 respect and be free from discrimination based on LGBTQ and/or HIV status 38 or perceived status, and to take an active part in developing, modify- 39 ing, and evaluating such plan and services; 40 (d) to receive HIV-related treatment as prescribed and be free from 41 discrimination based on receiving the HIV-related treatment; 42 (e) to receive gender affirming health care and related mental health 43 care and be free from discrimination based on receiving such gender 44 affirming health care; 45 (f) to be informed, before receiving services, on the type and disci- 46 plines of staff who will be providing such services, whether such staff 47 have LGBTQ and HIV cultural competency training as defined in subdivi- 48 sion two of this section, the frequency of visits proposed to be 49 furnished, other choices that are available for addressing home care 50 needs, and the potential consequences of refusing such services; 51 (g) to receive medical or nonmedical care that is appropriate to such 52 patient's organs and bodily needs and that does not demean such 53 patient's dignity or cause avoidable discomfort, including being denied 54 or curtailed medical or nonmedical care because of such patient's gender 55 identity or expression, sexual orientation, and/or HIV status; 
 A. 9264 3 1 (h) to be told in advance of any recommended changes by the provider 2 in such patient's home care services plan and to take an active part in 3 any decisions about changes to such home care services plan; 4 (i) to refuse services or treatment, including experimental HIV or 5 gender affirming health care treatment; 6 (j) to know, before receiving services or during the initial visit, 7 any limits to the services available from the home care services agency 8 or certified home health agency; 9 (k) to be told before home care services are initiated what the 10 provider charges for such home care services; to what extent payment may 11 be expected from health insurance, public programs, or other sources, if 12 known; what charges such patient may be responsible for paying; and what 13 charges might be impacted by such patient's gender identity or 14 expression, sexual orientation, and/or HIV status; 15 (l) to be told that there may be other services available to such 16 patient, if applicable, including other home care services and provid- 17 ers, and to be told where to find information about such alternative 18 services, including providing resources to find a LGBTQ and HIV-friendly 19 home care services agency or certified home health agency; 20 (m) to choose freely among available providers and to change providers 21 after home care services have begun, within the limits of health insur- 22 ance, long-term care insurance, medical assistance, other health 23 programs, or public programs; 24 (n) to have personal, financial, and medical information kept private 25 on a need-to-know basis, and to be advised of the provider's policies 26 and procedures regarding disclosure of such information, including the 27 right to privacy of gender identity or expression and sexual orien- 28 tation; 29 (o) to have access to such patient's own records and written informa- 30 tion from such records; 31 (p) to be served by people who meet applicable standards of care, 32 following the training set forth in subdivision two of this section, and 33 be competent to perform their duties; 34 (q) to be treated with courtesy and respect, and to have such 35 patient's property treated with respect, including but not limited to 36 using such patient's preferred name and pronouns, and be free from a 37 willful and repeated failure to use such patient's chosen name and 38 pronouns after being clearly informed of such patient's chosen name and 39 pronouns; 40 (r) to be free from physical, verbal, sexual, and mental abuse, 41 neglect, financial exploitation, and all forms of maltreatment; 42 (s) to be free from discrimination based on race, color, religion, 43 sex, gender identity or expression, actual or perceived sexual orien- 44 tation, marital status, medical condition including HIV status, military 45 or veteran status, national origin, ancestry, disability, genetic infor- 46 mation, or age; 47 (t) to be free from discrimination based on private and personal items 48 belonging to such patient, including but not limited to, photographs, 49 letters, mail, clothing, toiletries, and decorative choices; 50 (u) to be free to have visitors of their choice and be free to 51 restrict or prohibit individuals from visiting such patient, including 52 members of such patient's biological family, and to have such visitors 53 also be free from discrimination based on race, color, religion, sex, 54 gender identity or expression, actual or perceived sexual orientation, 55 marital status, medical condition including HIV status, military or 
 A. 9264 4 1 veteran status, national origin, ancestry, disability, gender informa- 2 tion, or age; 3 (v) to be free to have privacy, with or without a guest of such 4 patient, at times of such patient's choosing; 5 (w) to be free to associate with visitors, including the right to 6 consensual sexual relations with persons of such patient's choosing; 7 (x) to be free to wear or be dressed in clothing, accessories, or 8 cosmetics of such patient's choosing; 9 (y) to receive written notice of changes in services or charges, with 10 at least a thirty-day notice before any increase in charges; 11 (z) to be provided at least ten calendar days' advance written notice 12 of the termination of a service by the home care services agency or 13 certified home health agency, except in cases where: 14 (i) such patient engages in conduct that significantly alters the 15 terms of the service plan with such home care services agency or certi- 16 fied home health agency; 17 (ii) such patient, person who lives with such patient, or others 18 create an abusive or unsafe work environment for the person providing 19 home care services; or 20 (iii) an emergency or a significant change in such patient's condition 21 has resulted in service needs that exceed the current service plan and 22 that cannot be safely met by such home care services agency or certified 23 home health agency; 24 (aa) if the provider terminates home care services, to receive written 25 notice of such provider's reason for termination of such home care 26 services within ten days of termination of such services, including the 27 provider's name, phone number, date that such services will be termi- 28 nated, and a statement that explains why such services are being termi- 29 nated; 30 (bb) to receive a coordinated transfer when there will be a change in 31 the provider of home care services; 32 (cc) to report reasonable grievances to staff and others about the 33 home care services provided, or failed to be provided, any discrimi- 34 nation faced by such patient including but not limited to discrimination 35 based on sex, gender identity or expression, actual or perceived sexual 36 orientation, any lack of courtesy or respect to such patient or such 37 patient's property, and the right to recommend changes in policies and 38 services, or any other problems with such home care services without 39 fear of retaliation or punishment including the threat of termination of 40 such home care services; 41 (dd) to be informed on how to contact an individual associated with 42 the home care services agency or certified home health agency who is 43 responsible for handling problems and to have such home care services 44 agency or certified home health agency investigate and attempt to 45 resolve the grievance or complaint; 46 (ee) to be informed of the name, address, phone number, and email 47 address of the state, county, or city agency to contact for additional 48 information or assistance; and 49 (ff) to assert rights under this subdivision personally, or have such 50 rights asserted by such patient's representative or by anyone on behalf 51 of such patient, without retaliation. 52 2. (a) Each employee and contractor of a home care services agency or 53 certified home health agency shall complete a training designed to elim- 54 inate and prevent discrimination based on actual or perceived sexual 55 orientation, gender identity or expression, and actual or perceived HIV 56 status, within six months of being hired or beginning their contract, 
 A. 9264 5 1 and at least once every two years thereafter. To be in compliance with 2 this paragraph, each direct contact employee or contractor shall receive 3 three hours of training every two years, and each non-direct contact 4 employee or contractor shall engage in two hours of training every two 5 years. A person required to receive training under this paragraph shall 6 receive such training within six months of hire unless the person 7 provides proof of having received training with the prior two years that 8 the home care services agency or certified home health agency determines 9 satisfies the requirements of this paragraph. Such training program 10 shall be completed by: (i) all providers of home care services who 11 contract with or receive funding from the department, New York state 12 Medicaid, any local, county, or city agency, or any other New York state 13 agency, (ii) home care services agencies, and (iii) certified home 14 health agencies. 15 (b) At a minimum, the training required under paragraph (a) of this 16 subdivision shall address the following: 17 (i) the definitions of the terms commonly associated with sexual 18 orientation, gender identity or expression, intersex status, and HIV 19 status; 20 (ii) an understanding of why patients with diverse sexual orientations 21 and gender identities or expressions may hide their identities; 22 (iii) unique needs of patients with diverse sexual orientations and 23 gender identities or expressions, including older adults; 24 (iv) an overview of the various rights and protections for patients 25 with diverse sexual orientation and gender identities or expressions; 26 (v) practical tips from experts about how to ask questions related to 27 sexual orientation and gender identity or expression and understand why 28 such questions are important for all providers of home care services; 29 (vi) how to respectfully respond to questions and concerns that arise 30 in conversations relating to sexual orientation and gender identity or 31 expression; 32 (vii) best practices for providing gender affirming health care; 33 (viii) methods of communicating with or about LGBTQ individuals or 34 persons living with HIV, which shall address the importance of using 35 LGBTQ individuals' preferred terminology when addressing or speaking 36 about them and shall include a segment on the use of suitable vocabulary 37 regarding gender identity or expression, including respecting patients' 38 pronouns; 39 (ix) the health and social challenges historically faced by older 40 LGBTQ persons and persons living with HIV, including discrimination in 41 the home care services, health care, and other settings, and which shall 42 include information on the history of discrimination and hostility 43 directed towards LGBTQ persons and persons living with HIV, information 44 about LGBTQ persons and persons living with HIVs' reluctance to seek 45 medical treatment because of a fear of discrimination, and the discrimi- 46 nation faced by transgender people and the importance of providing and 47 facilitating medical care and treatment because of a fear of discrimi- 48 nation; 49 (x) the importance of professionalism in the medical setting and the 50 ways caretaker attitudes affect health care access and participation and 51 overall physical and mental health outcomes; and 52 (xi) methods to create a safe and affirming environment, the legal and 53 professional obligation to treat all patients in a nondiscriminatory 54 manner, and the penalties for failing to meet legal and professional 55 standards. 
 A. 9264 6 1 (c) The training required under this subdivision shall be taught by an 2 entity with expertise in identifying and addressing the legal and social 3 challenges faced by LGBTQ persons as they age and those faced by LGBTQ 4 persons who reside in long-term-care facilities. 5 (d) (i) The training required under this subdivision shall be in-per- 6 son training or internet-based training. 7 (ii) The use of in-person training shall require proof of participant 8 attendance in the form of a certificate signed by such participant and 9 such participant's supervisor. 10 (iii) The use of internet-based training shall require the following: 11 (1) controls to ensure that the full training is completed; 12 (2) the use of a personal identification number or personal identifi- 13 cation information that confirms the identity of the participant; and 14 (3) a final screen displaying a printable statement, to be signed by 15 the participant and such participant's supervisor, certifying that such 16 identified participant completed the identified training. 17 (iv) Records of each staff development program shall be maintained. 18 Such records shall include name and title of presenter, date of presen- 19 tation, title of subject presented, description of content and the 20 signatures of those attending. 21 3. The rights provided under subdivision one of this section shall 22 provide patients of home care services agencies and certified home 23 health agencies a right to sue for violations of such rights. A home 24 care services agency or certified home health agency shall not request 25 or require a patient to surrender any of such rights as a condition of 26 receiving services. A home care services agency or certified home health 27 agency shall not force a patient or former patient into arbitration 28 regarding such rights. Further, any arbitration clause regarding such 29 rights between a home care services agency or certified home health 30 agency and a patient or former patient of home care services or home 31 health aide services, shall be deemed null and void. If any of such 32 rights are violated, the affected patient may reach out to the New York 33 long-term care ombudsman. The statement of rights under this section 34 shall not replace or diminish any other rights and liberties that may 35 exist relative to patients receiving home care services or persons 36 providing home care services. 37 4. (a) All home care services agencies and certified home health agen- 38 cies shall do all of the following: 39 (i) require all recipients of state funding, including but not limited 40 to funding provided by Medicaid or non profit organizations, or any 41 other providers who receive state funding to satisfy a cultural compe- 42 tency training requirement; 43 (ii) encourage and assist in the fullest possible exercise of the 44 rights provided under this section; 45 (iii) provide the names and telephone numbers of individuals and 46 organizations that provide advocacy and legal services for patients 47 seeking to assert their rights under this section; 48 (iv) make every effort to assist patients in obtaining information 49 regarding whether Medicare, medical assistance, other health programs, 50 or public programs will pay for home care services; 51 (v) make reasonable accommodations for people who have communication 52 disabilities, or those who speak a language other than English; and 53 (vi) provide all information and notices in plain language and in 54 terms patients can understand. 55 (b) No home care services agency or certified home health agency shall 56 require or request a patient to waive any of the rights listed in this 
 A. 9264 7 1 section at any time or for any reasons, including as a condition of 2 initiating services or entering into an assisted living contract. 3 (c) Every home care services agency or certified home health agency 4 with twenty-five or more employees shall provide a name of a chief 5 diversity officer to the department. 6 § 4. This act shall take effect on the ninetieth day after it shall 7 have become a law. Effective immediately, the addition, amendment and/or 8 repeal of any rule or regulation necessary for the implementation of 9 this act on its effective date are authorized to be made and completed 10 on or before such effective date.