NY State Senate Bill 2009-S7429

Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Apr 09, 2010	referred to health

2009-S7429 (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Add §2803-s, Pub Health L

2009-S7429 (ACTIVE) - Summary

Establishes the transition authorization panel demonstration program to evaluate an approach to secure decisions relating to the transition of isolated patients from inpatient care to post-acute care; creates three-person panels which will authorize the transition of eligible patients from participating hospital to post-acute care; authorizes transition-related financial arrangements; sets forth provisions relating to the composition, duties, and powers of such panels

2009-S7429 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S7429

 TITLE OF BILL :

An act to amend the public health law, in relation to establishing a
demonstration program to study transition authorization panels as an
approach to secure decisions regarding the transition of incapable
patients who do not have legally authorized decision makers from
inpatient care to post-acute care; and providing for the repeal of
such provisions upon expiration thereof


 PURPOSE :

To determine whether transition authorization panels will serve the
interests of patients, families, providers and the public by
facilitating the transition of incapable, non-objecting hospital
patients to more appropriate settings.

 SUMMARY OF PROVISIONS :

Section 1 sets forth legislative findings, including findings that:

*in many instances there are hospital patients who are medically ready
to transition to a different level of care, such as nursing home care,
home care or assisted living, but they lack capacity to authorize the

transition, and also lack a family member or other person who can
authorize the transition on their behalf.

*as a result, such patients can be subject to inordinate delays in
accomplishing a needed transition, and can remain as hospital
inpatients for long periods.

*delay is harmful to the interests of those patients, as well as to
other persons who may need the scarce inpatient resources, to
hospitals, to payors and to the public in general.

*it would be valuable to study an alternative, approach to secure
decisions relating to the transition of isolated incapable patients
from inpatient care to post-acute care.

*the transition authorization panel demonstration program shows
promise as means to protect the rights and interests of incapable
patients in the transition decision, while allowing such decisions to
be made within a reasonable timeframe.

Section 2 adds a new section 2803-s to the Public Health Law, called
"Transition authorization panel demonstration program."

Subsection 1 would state that the transition authorization panel (TAP)
program is established at five sites.

Subsection 2 sets forth definitions. Significantly, it defines
"eligible patient" to mean an inpatient at a participating hospital
who, according to the patient's attending physician:

(i) is ready to be discharged as an inpatient, but needs to be
transitioned to post-acute care;

(ii) lacks capacity to consent to the discharge and to admission to
post-acute care;

(iii) does not have a guardian, health care agent or power of
attorney, or a family member, friend or other representative who is
reasonably available and willing to make a transition decision on his

or her behalf, and whose consent would be accepted by a proposed
post-acute care provider;

(iv) has a discharge plan that identifies an appropriate post-acute
care provider that is or may be willing to admit the patient if a
transition authorization panel were to authorize the transition and,
if necessary, make transition-related financial arrangements; and

(v) has not expressed an objection to any of the foregoing findings or
to being transitioned to the proposed post-acute facility or service
or, if applicable, the proposed transition-related financial
arrangements;

This subsection also defines "Participating hospital" to mean any of
the following hospitals: (i) Crouse Hospital, Syracuse NY; (ii) Glens
Falls Hospital, Glens Falls NY; (ii) Memorial Hospital, Albany NY;
(iii) Samaritan Hospital, Troy, NY; (iv) University of Rochester
Medical Center, Rochester NY, and Wyckoff Heights Medical Center,
Brooklyn, NY.

This subsection also defines "Post-acute care," "Transition
authorization," "Transition authorization panel agent," "Transition
authorization panel," "Transition authorization panel pool" and
"Transition-related financial arrangements."

Subsection 3 sets forth the responsibilities of participating
hospitals, including the responsibility to designate a person as
administrator of the program at that site, and to carry out, and bear
the costs of, the administrative responsibilities of the program and
create and maintain records related to requests, panels convened and
actions taken.

Subsection 4 authorizes each participating hospital to create a
transition authorization pool the collection of persons at each site
who can serve on transition authorization panels.

Subsection 5 provides that requests for transition authorization and
for transition-related financial arrangements may be undertaken by
transition authorization panels, and describes the selection and
composition of such panels.

Subsection 6 sets forth the procedure for requesting a panel, and for
notice to involved persons.

Subsection 7 sets forth the procedure for review by a transition
authorization panel.

Subsection 8 specifies what the panel may determine and authorize.

Subsection 9 provides that a participating hospital, the social
services department, and any other person may, but shall not be
required to, enter into an agreement with a post-acute provider for
such hospital, department or other person to petition for the
appointment of a guardian under Mental Hygiene Law Art. 81 for a
patient transitioned pursuant to the order of a panel,

Subsection 10 provides immunity to persons who act in good faith as
panel members, and others who act in good faith pursuant to this Act.

Subsection 11 requires the administrator of each panel to submit an
annual report to the commissioner of health, and specifies the
contents of the report.

Section 3 provides for the Act to take effect immediately.

 EXISTING LAW :
In general, when a hospital, inpatient needs to be transferred to
post-acute care, the patient must consent to the discharge from the
hospital, the admission to the post-acute care provider, and the
financial arrangements with the post-acute care provider. When a
patient lacks capacity, hospitals will often try to turn to a close
family member to make this decision. However:

1. Unless the family member is guardian (e.g., under MHL Article 81)
or a health care agent, the family member will not have clear legal
authority to authorize the patient's discharge from the hospital or
admission to the post-acute care facility. While some post-acute care
facilities will admit incapable patients based on a family member
consent, others will not;

2. Unless the family member is a guardian of the property, or holds a
power of authority of authority from the patient, or jointly owns
property with the patient, the family member is unlikely to be able
make the financial arrangements on behalf of the patient that may be
necessary to secure admission to the post-acute care facility.

3. Many patients do not have family members or close friends. For
those isolated patients, none has the authority to consent to the
patient's discharge from the hospital or admission to the post acute
care setting, or to make the financial arrangements with the post
acute care provider.

The passing of the Family Health Care Decisions Act (S.3164B/A.7729D)
helps with problem
1 above, because it gives clear authority to family members and close
friends to make health care decisions - which would probably encompass
the discharge and admission decision. But it does not help with
problems
2 and
3.

Currently, in many instances when an incapable inpatient is ready to
be discharged, but lacks a health care or financial decision-maker,
the hospital or social services district find it necessary to bring a
guardianship under MHL Article 81 in order to give someone the
authority to accomplish the transition. A guardianship proceeding can
take weeks or months, during which time the patient is unnecessarily
hospitalized.

 JUSTIFICATION :

In many instances there are hospital patients who are medically ready
to transition to a different level of care, such as nursing home care,
home care or assisted living, but they lack capacity to authorize the
transition, and also lack a family member or other person who can
authorize the transition on their behalf As a result, such patients
can be subject to inordinate delays in accomplishing a needed
transition, and can remain as hospital inpatients for long periods.
That delay is harmful to the interests of those patients, as well as
to other persons who may need the scarce inpatient resources, to
hospitals, to payors and to the public in general.

While Article 81 of the Mental Hygiene Law provides a procedure for
the court-appointment of guardians who could be empowered to authorize
transition for such patients, that procedure was designed for
longer-term assistance with an incapacitated person's personal and
property affairs, and includes features that appear to go beyond what
is needed for transition-related decisions alone. As a result, the
guardianship proceeding can require far more time, effort and expense
than is warranted for this limited, non-contested decision.


This bill would test an alternative approach to secure decisions
relating to the transition of isolated incapable patients from
inpatient care to post-acute care. The approach would be tested at six
sites - Crouse Hospital in Syracuse, Glens Falls Hospital, Memorial
Hospital in Albany, Samaritan Hospital in Troy, the University of
Rochester Medical Center in Rochester and Wycoff Heights Medical
Center in Brooklyn. Each participating hospital would establish a
"transition panel pool" - a group of persons qualified to serve on
"transition authorization panels.

When the hospital identifies a person who appears to be an "eligible
patient," it could convene a "transition authorization panel" to make
the transition authorization decision and transition related financial
arrangements.

An eligible patient is a patient who (1) is ready to be discharged as
an inpatient, but needs to be transitioned to post-acute care; (ii)
lacks capacity to consent to the discharge and to admission to
post-acute care; (iii) does not have a guardian, health care agent or
power of attorney, or a family member, friend or other representative
who is willing and legally authorized to make a transition decision on
his or her behalf, and whose consent would be accepted by a proposed
post-acute care provider; (iv) has a discharge plan that identifies an
appropriate post-acute care provider that is or may be willing to
admit the patient if a panel were to authorize the transition and, if
necessary, make transition-related financial arrangements; and (v) has
not expressed an objection to any of the foregoing findings or to
being transitioned to the proposed post-acute facility or service or,
if applicable, the proposed transition-related financial arrangements;

The transition authorization panel, or TAP, would be composed of three
persons -- one person appointed by the hospital, one appointed by the
local social services district, and one jointly appointed. The TAP
could be convened quickly and, while employing basic procedural
protections, could decide whether the patient is in fact eligible. It
could then authorize an appropriate discharge, as well as the
discharge related financial arrangements.

In many cases, the patient will still need a guardian for long term
personal or property management. But the TAP process will make it
possible for the guardianship to occur after the patient has been
discharged to an appropriate care setting, rather than while in the
hospital.

It is hoped that the TAP process will prove to be an ethically sound,
practical approach to facilitate the transition of incapable
inpatients from the hospital to appropriate post-acute settings. If
so, the TAP process will benefit patients, families, providers, and
the public generally.

This is only a demonstration bill; the authority granted by it would
expire in three years and ninety days. Each of the five sites will
collect data on their experience and annually forward that data to the
NYS Department of Health. The Department will compile the data and
forward a report to the Legislature. The Legislature will then be in a
position to decide whether to continue, end, or modify the
demonstration, or apply the model more broadly.

 LEGISLATIVE HISTORY :

New bill.

 FISCAL IMPLICATIONS :

The bill will have no appreciable budgetary impact.

 EFFECTIVE DATE :
Immediately and shall expire 3 years and 90 days after it becomes law.

2009-S7429 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  7429

                            I N  S E N A T E

                              April 9, 2010
                               ___________

Introduced  by  Sen.  DUANE  -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law, in  relation  to  establishing  a
  demonstration  program  to study transition authorization panels as an
  approach to secure decisions regarding  the  transition  of  incapable
  patients  who do not have legally authorized decisionmakers from inpa-
  tient care to post-acute care; and providing for the  repeal  of  such
  provisions upon expiration thereof

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The legislature finds and declares that in  many  instances
there  are  hospital patients who are medically ready to transition to a
different level of care,  such  as  nursing  home  care,  home  care  or
assisted living, but they lack capacity to authorize the transition, and
also  lack a family member or other person who can authorize the transi-
tion on their behalf. As a result, such patients can be subject to inor-
dinate delays in accomplishing a needed transition, and  can  remain  as
hospital  inpatients  for  long  periods.  That  delay is harmful to the
interests of those patients, as well as to other persons  who  may  need
the  scarce  inpatient  resources,  to  hospitals,  to payors and to the
public in general.
  The legislature further finds that while  article  81  of  the  mental
hygiene  law provides a procedure for the court-appointment of guardians
who could be empowered to authorize transition for such  patients,  such
procedure  was designed for longer-term assistance with an incapacitated
person's personal and property affairs, and includes features that often
go beyond what is needed for transition-related decisions  alone.  As  a
result,  the  guardianship  proceeding can require far more time, effort
and expense than is warranted for this limited, non-contested decision.
  Accordingly, the legislature finds that it would be valuable to  study
an  alternative  approach to secure decisions relating to the transition
of isolated incapable patients from inpatient care to  post-acute  care.
Specifically,  the  transition authorization panel demonstration program
shows promise as means to protect the rights and interests of  incapable

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.

                                                           LBD11971-07-0

S. 7429                             2

patients in the transition decision, while allowing such decisions to be
made within a reasonable timeframe.
  S  2.  The public health law is amended by adding a new section 2803-s
to read as follows:
  S 2803-S. TRANSITION AUTHORIZATION PANEL DEMONSTRATION  PROGRAM.    1.
THERE  IS  HEREBY  ESTABLISHED  A  TRANSITION AUTHORIZATION PANEL DEMON-
STRATION PROGRAM, CONDUCTED  AT  FIVE  PROGRAM  SITES,  TO  EVALUATE  AN
APPROACH  TO  SECURE  DECISIONS  RELATING  TO THE TRANSITION OF ISOLATED
PATIENTS FROM INPATIENT CARE TO POST-ACUTE CARE.
  2. AS USED IN THIS SECTION:
  (A) "ELIGIBLE PATIENT" MEANS AN INPATIENT AT A PARTICIPATING  HOSPITAL
WHO, ACCORDING TO THE PATIENT'S ATTENDING PHYSICIAN:
  (I) IS READY TO BE DISCHARGED AS AN INPATIENT, BUT NEEDS TO BE TRANSI-
TIONED TO POST-ACUTE CARE;
  (II)  LACKS  CAPACITY  TO CONSENT TO THE DISCHARGE AND TO ADMISSION TO
POST-ACUTE CARE;
  (III) DOES NOT HAVE A GUARDIAN, HEALTH CARE AGENT OR POWER  OF  ATTOR-
NEY,  OR  A FAMILY MEMBER, FRIEND OR OTHER REPRESENTATIVE WHO IS REASON-
ABLY AVAILABLE AND WILLING TO MAKE A TRANSITION DECISION ON HIS  OR  HER
BEHALF,  WHOSE  CONSENT  WOULD BE ACCEPTED BY A PROPOSED POST-ACUTE CARE
PROVIDER, AND WHO IS LEGALLY AUTHORIZED TO  MAKE  ALL  REQUIRED  TRANSI-
TION-RELATED FINANCIAL ARRANGEMENTS;
  (IV)  HAS  A  DISCHARGE PLAN THAT IDENTIFIES AN APPROPRIATE POST-ACUTE
CARE PROVIDER THAT IS OR MAY BE WILLING TO ADMIT THE PATIENT IF A  TRAN-
SITION  AUTHORIZATION  PANEL  WERE  TO  AUTHORIZE THE TRANSITION AND, IF
NECESSARY, MAKE TRANSITION-RELATED FINANCIAL ARRANGEMENTS; AND
  (V) HAS NOT EXPRESSED AN OBJECTION TO ANY OF THE FOREGOING FINDINGS OR
TO BEING TRANSITIONED TO THE PROPOSED POST-ACUTE FACILITY OR SERVICE OR,
IF APPLICABLE, THE PROPOSED TRANSITION-RELATED FINANCIAL ARRANGEMENTS;
  (B) "PARTICIPATING HOSPITAL" MEANS ANY  OF  THE  FOLLOWING  HOSPITALS,
UPON  THE  CHIEF EXECUTIVE OFFICER OF THE HOSPITAL NOTIFYING THE COMMIS-
SIONER IN WRITING THAT THE HOSPITAL ELECTS TO BE A PARTICIPATING  HOSPI-
TAL,  AND UNTIL THE CHIEF EXECUTIVE OFFICER OF THE HOSPITAL NOTIFIES THE
COMMISSIONER IN WRITING THAT  THE  HOSPITAL  ELECTS  TO  CEASE  BEING  A
PARTICIPATING HOSPITAL:
  (I) CROUSE HOSPITAL, SYRACUSE, NY.
  (II) GLENS FALLS HOSPITAL, GLENS FALLS, NY.
  (III) MEMORIAL HOSPITAL, ALBANY, NY.
  (IV) SAMARITAN HOSPITAL, TROY, NY.
  (V) UNIVERSITY OF ROCHESTER MEDICAL CENTER, ROCHESTER, NY.
  (VI) WYCKOFF HEIGHTS MEDICAL CENTER, BROOKLYN, NY.
  (C)  "POST-ACUTE  CARE" MEANS CARE PROVIDED BY A NURSING HOME, TRANSI-
TIONAL CARE UNIT, HOME HEALTH AGENCY,  ASSISTED  LIVING  PROGRAM,  ADULT
CARE  FACILITY,  AN INPATIENT TREATMENT FACILITY OR RESIDENTIAL FACILITY
LICENSED OR OPERATED BY THE OFFICE OF  ALCOHOLISM  AND  SUBSTANCE  ABUSE
SERVICES,  THE  OFFICE OF MENTAL HEALTH OR THE OFFICE OF MENTAL RETARDA-
TION AND DEVELOPMENTAL DISABILITIES, OR AN INPATIENT TREATMENT  FACILITY
OR  RESIDENTIAL  FACILITY LICENSED BY A HEALTH, MENTAL HYGIENE OR SOCIAL
SERVICES AGENCY OF ANOTHER STATE.
  (D) "TRANSITION AUTHORIZATION" MEANS A DECISION, MADE BY A  TRANSITION
AUTHORIZATION  PANEL  PURSUANT TO THIS ARTICLE, TO AUTHORIZE THE TRANSI-
TION OF AN ELIGIBLE PATIENT FROM A PARTICIPATING HOSPITAL TO A  SPECIFIC
POST-ACUTE CARE PROVIDER.
  (E) "TRANSITION AUTHORIZATION PANEL AGENT" MEANS AN INDIVIDUAL AUTHOR-
IZED  BY  THE  TRANSITION  AUTHORIZATION  PANEL  TO CARRY OUT TRANSITION
RELATED FINANCIAL ARRANGEMENTS.

S. 7429                             3

  (F) "TRANSITION  AUTHORIZATION  PANEL"  MEANS  A  THREE-PERSON  PANEL,
CONVENED  PURSUANT  TO  THIS  ARTICLE, TO AUTHORIZE THE TRANSITION OF AN
ELIGIBLE PATIENT FROM A PARTICIPATING  HOSPITAL  TO  A  POST-ACUTE  CARE
PROVIDER, AND TO MAKE TRANSITION-RELATED FINANCIAL ARRANGEMENTS.
  (G)  "TRANSITION  AUTHORIZATION  PANEL  POOL"  MEANS  THE FULL POOL OF
PERSONS QUALIFIED AND DESIGNATED TO SERVE  ON  TRANSITION  AUTHORIZATION
PANELS AT A PROGRAM SITE.
  (H) "TRANSITION-RELATED FINANCIAL ARRANGEMENTS" MEANS ACTS NECESSARY:
  (I) TO EXPEND THE ELIGIBLE PATIENT'S FUNDS FOR POST-ACUTE CARE FOR ONE
HUNDRED  TWENTY DAYS OR UNTIL THE COURT APPOINTMENT OF A GUARDIAN OF THE
PROPERTY PURSUANT TO ARTICLE  EIGHTY-ONE  OF  THE  MENTAL  HYGIENE  LAW,
WHICHEVER OCCURS FIRST.
  (II)  TO  APPLY  FOR  THE ELIGIBLE PATIENT'S ENROLLMENT IN MEDICAID OR
MEDICARE.
  (III) TO ACCESS FINANCIAL INFORMATION ABOUT THE ELIGIBLE PATIENT  FROM
FINANCIAL  INSTITUTIONS  TO  THE  EXTENT  NECESSARY FOR THE PURPOSES SET
FORTH IN SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH.
  (I) "FINANCIAL INSTITUTION" MEANS A FINANCIAL INSTITUTION  AS  DEFINED
IN SUBDIVISION FIVE OF SECTION 5-1501 OF THE GENERAL OBLIGATIONS LAW.
  (J)  "ADMINISTRATOR"  MEANS  THE  ADMINISTRATOR OF THE PROGRAM FOR THE
PARTICIPATING  HOSPITAL  DESIGNATED  UNDER  SUBDIVISION  THREE  OF  THIS
SECTION.
  3. EACH PARTICIPATING HOSPITAL SHALL:
  (A) DESIGNATE A PERSON AS ADMINISTRATOR OF THE PROGRAM WITH RESPECT TO
THAT PROGRAM SITE;
  (B)  CARRY OUT, AND BEAR THE COSTS OF, THE ADMINISTRATIVE RESPONSIBIL-
ITIES OF THE PROGRAM AS SET FORTH IN THIS SECTION, WITH RESPECT TO  THAT
PROGRAM SITE; AND
  (C)  CREATE  AND MAINTAIN RECORDS OF (I) ALL REQUESTS, PANELS CONVENED
AND ACTIONS TAKEN PURSUANT TO THIS SECTION, AND (II) ALL  TRANSITION-RE-
LATED  FINANCIAL  ARRANGEMENTS  MADE  PURSUANT  TO  THIS SECTION.   SUCH
RECORDS SHALL BE MADE AVAILABLE TO THE DEPARTMENT UPON REQUEST.
  4. (A) A PARTICIPATING HOSPITAL MAY CREATE A TRANSITION  AUTHORIZATION
PANEL POOL AT A PROGRAM SITE, WHICH SHALL HAVE THREE CLASSES OF MEMBERS:
  (I)  ONE CLASS OF MEMBERS SHALL BE QUALIFIED PERSONS DESIGNATED BY THE
HOSPITAL;
  (II) ONE CLASS OF MEMBERS SHALL BE QUALIFIED PERSONS DESIGNATED BY THE
LOCAL SOCIAL SERVICES COMMISSIONER; AND
  (III) ONE CLASS OF MEMBERS SHALL BE QUALIFIED  PERSONS  DESIGNATED  BY
THE NEW YORK STATE OFFICE OF LONG TERM CARE OMBUDSMAN.
  (B)  FOR  THE  PURPOSES  OF  THIS PARAGRAPH, "QUALIFIED PERSONS" MEANS
ADULT PERSONS WITH RECOGNIZED EXPERTISE OR DEMONSTRATED INTEREST IN  THE
CARE AND TREATMENT OF HOSPITAL AND POST-ACUTE CARE PATIENTS, AND WHO CAN
BE  EXPECTED  TO  APPLY  THE STANDARDS OF THIS ARTICLE IN GOOD FAITH AND
WITH SIGNIFICANT SENSITIVITY TO THE INTERESTS OF THE ELIGIBLE PATIENT.
  (C) THE PARTICIPATING HOSPITAL AND THE LOCAL SOCIAL  SERVICES  COMMIS-
SIONER  SHALL  JOINTLY  APPOINT  ONE  MEMBER  AS CHAIR OF THE TRANSITION
AUTHORIZATION PANEL POOL.
  5. (A) THE REVIEW OF REQUESTS FOR  TRANSITION  AUTHORIZATION  AND  FOR
TRANSITION-RELATED  FINANCIAL ARRANGEMENTS SHALL BE UNDERTAKEN BY PANELS
OF THREE MEMBERS DRAWN FROM THE TRANSITION AUTHORIZATION PANEL POOL, ONE
FROM EACH CLASS. THE MEMBER FROM THE JOINTLY APPOINTED CLASS SHALL SERVE
AS PANEL CHAIR.
  (B) NO PERSON WHO IS A HEALTH CARE PROFESSIONAL ACTIVELY  INVOLVED  IN
THE  TREATMENT  OF  THE  PATIENT  WHOSE CASE IS UNDER CONSIDERATION BY A

S. 7429                             4

PANEL MAY SERVE ON THE PANEL WITH  RESPECT  TO  SUCH  PATIENT,  ALTHOUGH
OTHER HOSPITAL PERSONNEL MAY SERVE ON THE PANEL IF OTHERWISE QUALIFIED.
  6. (A) THE ATTENDING PHYSICIAN OF AN ELIGIBLE PATIENT MAY REQUEST THAT
A  PANEL  BE CONVENED BY SUBMITTING A WRITTEN REQUEST TO THE ADMINISTRA-
TOR. THE REQUEST MUST:
  (I) INDICATE THAT IT IS A REQUEST FOR THE PANEL TO AUTHORIZE THE TRAN-
SITION OF THE PATIENT TO POST-ACUTE CARE AND,  IF  APPLICABLE,  TO  MAKE
TRANSITION-RELATED FINANCIAL ARRAIGNMENTS;
  (II) SET FORTH THE REASONS FOR BELIEVING THAT THE PATIENT IS AN ELIGI-
BLE PATIENT; AND
  (III)  SET  FORTH THE PROPOSED POST-ACUTE CARE PROVIDER (OR PROVIDERS,
IF APPLICATIONS HAVE OR WILL BE MADE TO MORE THAN ONE);
  (B) UPON RECEIPT OF THE REQUEST, THE ADMINISTRATOR MAY:
  (I) SET A TIME, DATE AND PLACE FOR THE TRANSITION AUTHORIZATION  PANEL
TO  REVIEW  THE  REQUEST.  SUCH REVIEW MAY BE SCHEDULED FOR ANY TIME AND
DATE AT LEAST THREE DAYS  AFTER  THE  REQUEST  AND  NOTICE  IS  SENT  AS
PROVIDED  BELOW;  HOWEVER,  THE REVIEW MAY BE HELD EARLIER OR LATER THAN
THE DATA SET FORTH IN THE NOTICE IF ALL  PERSONS  WHO  ARE  ENTITLED  TO
NOTICE, AS SET FORTH BELOW, AGREE, IN WRITING OR VERBALLY (AS DOCUMENTED
BY THE ADMINISTRATOR), TO THE TIME, PLACE AND DATE OF THE REVIEW.
  (II)  SEND  A  COPY  OF  THE REQUEST AND NOTICE, BY HAND, MAIL, FAX OR
E-MAIL, TO THE FOLLOWING PERSONS:
  (A) THREE MEMBERS OF THE TRANSITION AUTHORIZATION PANEL POOL, ONE FROM
EACH CLASS, SELECTED BY THE POOL CHAIR, WHO  ARE  WILLING  AND  ABLE  TO
SERVE AS A PANEL FOR THE PURPOSE OF THIS REVIEW;
  (B)  THE  PATIENT, IF THERE IS ANY INDICATION OF THE PATIENT'S ABILITY
TO COMPREHEND SUCH NOTICE;
  (C) TO A FAMILY MEMBER OR FRIEND OF THE PATIENT WHO MAY BE  REASONABLY
AVAILABLE  AND  WILLING  TO  MAKE  A  TRANSITION  DECISION ON HIS OR HER
BEHALF, IF THERE IS ANY SUCH PERSON;
  (D) IF THE PATIENT WAS ADMITTED FROM A FACILITY OR RESIDENCE  LICENSED
BY  THE  OFFICE OF MENTAL HEALTH OR THE OFFICE OR MENTAL RETARDATION AND
DEVELOPMENTAL DISABILITIES, TO  THE FACILITY DIRECTOR AND TO THE  MENTAL
HYGIENE LEGAL SERVICES OFFICE FOR THAT JUDICIAL DEPARTMENT; AND
  (E) TO THE PATIENT'S ATTENDING PHYSICIAN.
  (III)  PROVIDE  NOTICE  TO  THE  PATIENT  AND  TO MENTAL HYGIENE LEGAL
SERVICES WHICH SHALL INFORM THE PATIENT THAT HE OR SHE WILL BE  AFFORDED
AN  OPPORTUNITY  TO  ADDRESS  THE  PANEL,  MAY  BE PRESENT FOR ANY OTHER
ADDRESSES MADE TO THE PANEL, AND MAY BE PRESENT FOR OTHER PARTS  OF  THE
PANEL  REVIEW  AS  THE  CHAIR MAY PERMIT, BUT THAT HE OR SHE WILL NOT BE
PERMITTED TO BE PRESENT DURING THE PANEL'S DELIBERATION.
  (IV) PROVIDE NOTICE TO A PERSON DESCRIBED IN CLAUSES (B)  THROUGH  (E)
OF  SUBPARAGRAPH  (II)  OF  THIS PARAGRAPH WHICH SHALL INFORM THE PERSON
THAT HE OR SHE WILL BE AFFORDED AN OPPORTUNITY TO ADDRESS THE PANEL, AND
MAY BE PRESENT FOR SUCH OTHER PARTS OF THE PANEL REVIEW AS THE CHAIR MAY
PERMIT, THAT THE PATIENT AND MENTAL HYGIENE LEGAL SERVICES (WHEN REPRES-
ENTING A PATIENT) MAY BE PRESENT WHEN ANY  OTHER  PERSON  ADDRESSES  THE
PANEL,  AND  THAT  NO  PERSON  DESCRIBED  IN  CLAUSES (B) THROUGH (E) OF
SUBPARAGRAPH (II) OF THIS PARAGRAPH SHALL BE  PERMITTED  TO  BE  PRESENT
DURING THE PANEL'S DELIBERATION.
  7. (A) PRIOR TO OR DURING THE REVIEW, THE PANEL CHAIR MAY REQUEST AND,
NOTWITHSTANDING  ANY  OTHER  LAW  TO  THE CONTRARY, SHALL BE ENTITLED TO
RECEIVE FROM ANY HEALTH CARE PROVIDER AND  DISCLOSE  TO  THE  PANEL  ANY
INFORMATION  WHICH  IS RELEVANT TO THE PANEL'S REVIEW. INFORMATION WHICH
IS CONFIDENTIAL, AS PROVIDED FOR BY LAW, SHALL BE KEPT  CONFIDENTIAL  BY

S. 7429                             5

THE  PANEL AND ANY LIMITATIONS ON THE FURTHER RELEASE THEREOF IMPOSED BY
LAW UPON THE PARTY FURNISHING THE INFORMATION SHALL APPLY TO THE PANEL.
  (B) THE PANEL SHALL MEET IN PERSON TO CONDUCT ITS REVIEW.
  (C)  THE  PANEL  CHAIR MAY REQUEST THE ATTENDANCE AT THE REVIEW OF ANY
PERSON WHO MIGHT ASSIST THE PANEL IN ITS REVIEW.
  (D) THE PATIENT AND MENTAL HYGIENE LEGAL SERVICES (WHEN REPRESENTING A
PATIENT) MAY BE PRESENT WHEN ANY OTHER PERSON ADDRESSES THE PANEL.
  (E) WHERE PRACTICABLE, THE PANEL MEMBERS  SHALL  PERSONALLY  INTERVIEW
AND OBSERVE THE PATIENT PRIOR TO MAKING THEIR DECISION.
  (F)  NO  PERSON  DESCRIBED  IN CLAUSES (B) THROUGH (E) OF SUBPARAGRAPH
(II) OF PARAGRAPH (B) OF  SUBDIVISION  SIX  OF  THIS  SECTION  SHALL  BE
PERMITTED TO BE PRESENT DURING THE PANEL DELIBERATION.
  (G) THE PANEL CHAIR MAY ADJOURN AND RECONVENE THE PANEL AS NECESSARY.
  (H)  THE  ADMINISTRATOR  SHALL  TAKE AND MAINTAIN MINUTES OF ANY PANEL
MEETING, BUT NO RECORDING OR  TRANSCRIPTION  SHALL  BE  REQUIRED  EXCEPT
WHERE  REQUESTED  BY  A  PERSON  DESCRIBED IN CLAUSES (B) THROUGH (E) OF
SUBPARAGRAPH (II) OF PARAGRAPH (B) OF SUBDIVISION SIX OF THIS SECTION.
  (I) IN ITS REVIEW, THE PANEL SHALL CONSIDER WHETHER THE PROPOSED TRAN-
SITION IS TO A FACILITY OR PROGRAM THAT APPEARS ABLE  (I)  TO  MEET  THE
PATIENT'S  NEEDS,  AND  (II)  TO  DO SO IN THE LEAST RESTRICTIVE SETTING
REASONABLY AVAILABLE TO THE PATIENT.
  8. (A) THE PANEL SHALL MAKE A DETERMINATION, BY MAJORITY VOTE,  AS  TO
WHETHER  THE  PATIENT  IS  AN ELIGIBLE PATIENT, WHETHER TO AUTHORIZE THE
PROPOSED TRANSITION, AND WHETHER TO AUTHORIZE TRANSITION-RELATED  FINAN-
CIAL  ARRANGEMENTS.  THE DETERMINATION SHALL BE SET FORTH IN WRITING AND
SHALL BE SIGNED BY THE CHAIR ON BEHALF OF THE PANEL.
  (B) IF THE PANEL  DETERMINES  TO  AUTHORIZE  THE  PROPOSED  TRANSITION
AND/OR  TRANSITION-RELATED  FINANCIAL  ARRANGEMENTS,  THE  AUTHORIZATION
SHALL BE SET FORTH IN AN ORDER, SIGNED BY THE CHAIR  ON  BEHALF  OF  THE
PANEL.  THE ORDER SHALL DESCRIBE THE SCOPE OF SUCH AUTHORIZATION AND, IF
IT AUTHORIZES TRANSITION-RELATED  FINANCIAL  ARRANGEMENTS,  DESIGNATE  A
TRANSITION AUTHORIZATION PANEL AGENT.
  (C)  THE  DETERMINATION,  AND THE ORDER IF THERE IS ONE, SHALL BE MADE
PART OF THE PATIENT'S MEDICAL RECORD.
  (D) NOTWITHSTANDING ANY LAW TO THE CONTRARY, THE ADMINISTRATOR AND THE
AGENT SHALL DISCLOSE THE ORDER TO SUCH  PERSONS  AS  NECESSARY  FOR  THE
PURPOSE OF CARRYING OUT ITS TERMS.
  (E) THE ORDER AUTHORIZING THE PROPOSED TRANSITION SHALL BE, AND MAY BE
RELIED UPON BY THE PARTICIPATING HOSPITAL, BY POST-ACUTE CARE PROVIDERS,
BY FINANCIAL INSTITUTIONS, AND BY OTHER THIRD-PARTIES AS LEGAL AUTHORITY
FOR  THEM  TO  PERFORM OR COOPERATE IN THE PERFORMANCE OF THE AUTHORIZED
ACTS, INCLUDING LEGAL AUTHORITY:
  (I) FOR THE PARTICIPATING HOSPITAL TO DISCHARGE THE PATIENT;
  (II) FOR THE POST-ACUTE CARE PROVIDER TO ADMIT THE PATIENT;
  (III) FOR THE TRANSITION AUTHORIZATION PANEL  AGENT  TO  MAKE  TRANSI-
TION-RELATED FINANCIAL ARRANGEMENTS; AND
  (IV) FOR MEDICAID, FINANCIAL INSTITUTIONS AND OTHER PARTIES TO PROVIDE
FINANCIAL  AND  OTHER  PERSONAL INFORMATION ABOUT THE PATIENT RELATED TO
THE TRANSITION AND  TRANSITION-RELATED  FINANCIAL  ARRANGEMENTS  TO  THE
ADMINISTRATOR OR AGENT, AND TO OTHERWISE COOPERATE IN THE TRANSITION-RE-
LATED FINANCIAL ARRANGEMENTS.
  SUCH  PARTIES SHALL BE IMMUNE FROM LIABILITY FOR ACTIONS TAKEN IN GOOD
FAITH AND REASONABLE RELIANCE UPON SUCH ORDER.
  9. A PARTICIPATING HOSPITAL, THE LOCAL SOCIAL SERVICES DEPARTMENT, AND
ANY OTHER PERSON MAY, BUT SHALL NOT BE REQUIRED TO, ENTER INTO AN AGREE-
MENT WITH A POST-ACUTE CARE PROVIDER FOR SUCH HOSPITAL,  DEPARTMENT,  OR

S. 7429                             6

OTHER PERSON TO PETITION FOR THE APPOINTMENT OF A GUARDIAN UNDER ARTICLE
EIGHTY-ONE OF THE MENTAL HYGIENE LAW FOR A PATIENT TRANSITIONED PURSUANT
TO THE ORDER OF A TRANSITION AUTHORIZATION PANEL, EITHER BEFORE OR AFTER
THE  TRANSITION,  AS  A WAY TO PROVIDE FOR BROADER AND LONGER TERM DECI-
SIONMAKING AUTHORITY WITH RESPECT TO THE TRANSITIONED PATIENT. THE CHIEF
EXECUTIVE OFFICER OF A PARTICIPATING HOSPITAL, OR HIS OR  HER  DESIGNEE,
THAT  ENTERS  INTO SUCH AGREEMENT PRIOR TO THE PATIENT'S DISCHARGE SHALL
BE DEEMED TO HAVE THE AUTHORITY TO COMMENCE A PETITION  UNDER  PARAGRAPH
SEVEN OF SUBDIVISION (A) OF SECTION 81.06 OF THE MENTAL HYGIENE LAW.
  10. NO PERSON SHALL BE SUBJECT TO CRIMINAL OR CIVIL LIABILITY OR SANC-
TION  BY  A GOVERNMENTAL AGENCY FOR ACTIONS TAKEN REASONABLY AND IN GOOD
FAITH PURSUANT TO THIS ARTICLE (A) AS A MEMBER OR AGENT OF A  TRANSITION
AUTHORIZATION  PANEL,  OR AS ADMINISTRATOR OF A TRANSITION AUTHORIZATION
PROGRAM; (B) DISCHARGING, TRANSFERRING OR ADMITTING A PATIENT FROM OR TO
A FACILITY PURSUANT TO AN ORDER OF A TRANSITION AUTHORIZATION PANEL;  OR
(C)  DISCLOSING  FINANCIAL  INFORMATION  ABOUT  A  PATIENT OR DISBURSING
PATIENT FUNDS PURSUANT TO AN ORDER OF A TRANSITION AUTHORIZATION PANEL.
  11. (A) THE ADMINISTRATOR OF EACH PANEL SHALL SUBMIT AN ANNUAL  REPORT
TO  THE  COMMISSIONER OF HEALTH, DUE WITHIN THIRTY DAYS OF EACH ANNIVER-
SARY OF THE EFFECTIVE DATE OF THIS SECTION.  THE REPORT SHALL SET FORTH:
  (I) WITH RESPECT TO EACH CASE CONSIDERED  BY  A  PANEL,  THE  TYPE  OF
POST-ACUTE  CARE  REQUESTED;    THE  LENGTH OF TIME FROM THE DATE OF THE
REQUEST UNTIL (A) THE PANEL CONVENED, (B) THE PANEL ISSUED ITS  DETERMI-
NATION, AND (C) THE PATIENT WAS DISCHARGED FROM THE PARTICIPATING HOSPI-
TAL  (IF  THE  DETERMINATION APPROVED THE TRANSITION); THE CATEGORIES OF
PERSONS WHO ADDRESSED THE PANEL; THE NUMBER OF UNANIMOUS AND  NON-UNANI-
MOUS PANEL VOTES; WHETHER THE ORDER CALLED FOR TRANSITION-RELATED FINAN-
CIAL ARRANGEMENTS AND IF SO WHETHER THOSE ARRANGEMENTS WERE SUCCESSFULLY
MADE;  AND  ANY DATA OR OTHER INFORMATION AVAILABLE TO THE ADMINISTRATOR
REGARDING THE IMPACT OF THE  DEMONSTRATION  ON  THE  HOSPITAL'S  AVERAGE
INPATIENT LENGTH OF STAY.
  (II) THE PARTICIPATING HOSPITAL AND LOCAL SOCIAL SERVICES DEPARTMENT'S
EVALUATION  OF  THE  SUCCESS  OF  THE  TRANSITION  PLANS APPROVED BY THE
PROGRAM IN MEETING THE NEEDS OF PATIENTS AND THEIR  RECOMMENDATIONS  FOR
AMENDMENTS  TO  THIS SECTION, AND RECOMMENDATIONS REGARDING THE MERIT OF
EXTENDING THIS DEMONSTRATION PROGRAM OR ADOPTING A PERMANENT AND  STATE-
WIDE TRANSITION AUTHORIZATION PROGRAM.
  (B) THE COMMISSIONER SHALL COMPILE THE REPORTS SUBMITTED TO HIM OR HER
AS  REQUIRED  ABOVE,  AND  PROMPTLY SUBMIT SUCH REPORTS TO THE TEMPORARY
PRESIDENT OF THE SENATE, THE SPEAKER OF THE ASSEMBLY, THE MINORITY LEAD-
ER OF THE SENATE AND THE MINORITY LEADER OF THE  ASSEMBLY.  THE  COMMIS-
SIONER MAY ADD HIS OR HER OWN RECOMMENDATIONS TO THAT COMPILATION.
  S  3.  This act shall take effect immediately, and shall expire and be
deemed repealed three years and ninety days after it shall have become a
law.

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Senate Bill S7429

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

2009-S7429 (ACTIVE) - Details

2009-S7429 (ACTIVE) - Summary

2009-S7429 (ACTIVE) - Sponsor Memo

2009-S7429 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S7429

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Sponsored By

Thomas K. Duane

Archive: Last Bill Status - In Senate Committee Health Committee

2009-S7429 (ACTIVE) - Details

2009-S7429 (ACTIVE) - Summary

2009-S7429 (ACTIVE) - Sponsor Memo

2009-S7429 (ACTIVE) - Bill Text download pdf

Comments