S T A T E O F N E W Y O R K
________________________________________________________________________
133
2013-2014 Regular Sessions
I N S E N A T E
(PREFILED)
January 9, 2013
___________
Introduced by Sen. SAMPSON -- read twice and ordered printed, and when
printed to be committed to the Committee on Finance
AN ACT to amend the state finance law, the public health law and the
labor law, in relation to enacting the "New York state community
health care investment fund act"
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Short title. This act shall be known and may be cited as
the "New York state community health care investment fund act".
S 2. Legislative intent. The legislature hereby declares that the
provision of health care in New York state must be affordable, accessi-
ble, and address the multi-faceted needs of its diverse population, from
pre-conception planning through the end of life. The legislature also
finds that many constituencies play an important role in the state's
health care infrastructure: consumers, health care professionals,
communities of faith, state and local governments, businesses, insurance
companies, community based organizations, home care agencies, school
based health clinics, nursing homes, and hospitals.
Health care in New York state also faces many challenges. New York
state is home to world class medical institutions and research centers.
According to the United Health Foundation 2006 America Health Rankings,
New York state has the 4th highest per capita spending on public health
in the nation, a low rate of motor vehicle deaths and a low rate of
cancer deaths. The health care challenges in New York state include a
high incidence of infectious disease, limited access to adequate prena-
tal care, and a low high school graduation rate. Twenty percent of the
state's children under 18 years of age live in poverty. Furthermore, the
state's overall rank among the rest of the country decreased between
2005 and 2006, from 26th place to 29th place. Despite a high per capita
spending on health ($316 per person) almost three million of its resi-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01275-01-3
S. 133 2
dents do not have health insurance. Not surprisingly, health disparities
persist in low-income cities and neighborhoods and where racial and
ethnic minorities comprise a majority of the population. According to a
report released in 2004 by the New York city departments of health and
mental health, "more than 4,000 deaths would be prevented if the all-
cause mortality rate in the poorest neighborhoods were lowered to the
rate in the wealthiest neighborhoods."
Against this backdrop of high public health spending, significant
health care disparities experienced by ethnic and racial minorities and
approximately three million uninsured people in New York state, HMO
profits in New York state have soared in recent years while costs for
members have risen and reimbursement for health care providers has fall-
en. Premium increases statewide have increased about 20 percent, and
revenues have risen from $14.5 billion in 2001 to $17.4 billion in 2005.
In fact, premium rate increases outpaced medical payments from 2001 to
2005 by over $1 billion as New York's HMOs' profits climbed 93 percent,
from $672 million to $1.3 billion. HMOs' administrative and claims
adjustment costs went up by 24 percent from 2001 to 2005, and average
revenue per member increased an average of 8.6 percent annually. During
the same period, enrollments declined 14 percent, provider reimburse-
ments trended downward from 85.3 percent of every dollar to 81.7
percent, and out of pocket costs for members increased by 7.7 percent.
The legislature additionally finds that HMOs that conduct business in
New York state have a responsibility toward improving the health status
of the residents of this state and should assist in providing revenue to
support critical community health and economic development needs.
Definitions. For the purposes of this act, the following terms shall
have the following meanings:
1. New York state stimulus health care investment fund and New York
state health care entrepreneurial stimulus fund refer to the funds
established pursuant to section three of this act.
2. New York state community health care investment fund council refers
to the council established pursuant to section five of this act.
3. New York state community health care investment fund grant program
refers to the grant program established pursuant to section six of this
act.
4. New York state entrepreneurial stimulus investment grant program
refers to the program established pursuant to section seven of this act.
S 3. The state finance law is amended by adding two new sections 99-u
and 99-v to read as follows:
S 99-U. NEW YORK STATE COMMUNITY HEALTH CARE INVESTMENT FUND. 1.
THERE IS HEREBY ESTABLISHED IN THE JOINT CUSTODY OF THE COMPTROLLER AND
THE COMMISSIONER OF HEALTH A FUND TO BE KNOWN AS THE NEW YORK STATE
COMMUNITY HEALTH CARE INVESTMENT FUND.
2. SUCH FUND SHALL CONSIST OF ALL MONEYS APPROPRIATED FOR THE PURPOSE
OF SUCH FUND, ALL OTHER MONEYS CREDITED OR TRANSFERRED TO SUCH FUND
PURSUANT TO LAW, ALL MONEYS REQUIRED BY THE PROVISIONS OF THIS SECTION
OR ANY OTHER LAW TO BE PAID INTO OR CREDITED TO SUCH FUND, AND ALL
MONEYS RECEIVED BY THE FUND OR DONATED TO IT.
3. MONEYS OF SUCH FUND SHALL BE AVAILABLE FOR APPROPRIATION AND ALLO-
CATION TO THE DEPARTMENT OF HEALTH FOR PURPOSES OF DISTRIBUTING SUCH
MONEYS TO QUALIFIED ENTITIES OF THE NEW YORK STATE COMMUNITY HEALTH CARE
INVESTMENT FUND GRANT PROGRAM. FUNDS COLLECTED PURSUANT TO SECTION TWEN-
TY-THREE OF THE PUBLIC HEALTH LAW SHALL BE USED FOR ONE OR MORE OF THE
FOLLOWING:
S. 133 3
(A) PROJECTS THAT ADDRESS THE SIX CLINICAL INDICATORS AS ESTABLISHED
BY THE FEDERAL CENTER FOR DISEASE CONTROL'S GOAL TO ELIMINATE HEALTH
DISPARITIES: INFANT MORTALITY; CANCER SCREENING AND MANAGEMENT; CARDIO-
VASCULAR DISEASE; DIABETES; HIV INFECTION/AIDS; AND IMMUNIZATIONS.
(B) PROJECTS THAT IMPROVE THE CULTURAL COMPETENCE OF THE HEALTH CARE
WORKFORCE.
(C) PROJECTS THAT COLLECT DATA REGARDING (I) ETHNIC AND MINORITY
REPRESENTATION IN THE NEW YORK STATE HEALTH CARE WORKFORCE AND (II)
ETHNIC AND RACIAL MINORITIES SERVED IN HOSPITALS AND NURSING HOMES.
(D) PROJECTS THAT CONDUCT SURVEYS ON RACIAL AND ETHNIC HEALTH DISPARI-
TIES.
(E) SCHOLARSHIPS TO RECRUIT AND TRAIN RACIAL AND ETHNIC MINORITIES IN
THE HEALTH CARE PROFESSIONS.
(F) PROJECTS THAT ADDRESS UNMET HEALTH CARE NEEDS IN RURAL AREAS.
4. MONEYS SHALL BE PAID OUT ON THE AUDIT AND WARRANT OF THE COMP-
TROLLER ON VOUCHERS CERTIFIED OR APPROVED BY THE COMMISSIONER OF HEALTH.
S 99-V. NEW YORK STATE HEALTH CARE ENTREPRENEURIAL STIMULUS FUND. 1.
THERE IS HEREBY ESTABLISHED IN THE JOINT CUSTODY OF THE COMPTROLLER AND
THE COMMISSIONER OF LABOR A FUND TO BE KNOWN AS THE NEW YORK STATE
HEALTH CARE ENTREPRENEURIAL STIMULUS FUND.
2. SUCH FUND SHALL CONSIST OF ALL MONEYS APPROPRIATED FOR THE PURPOSE
OF SUCH FUND, ALL OTHER MONEYS CREDITED OR TRANSFERRED TO SUCH FUND
PURSUANT TO LAW, ALL MONEYS REQUIRED BY THE PROVISIONS OF THIS SECTION
OR ANY OTHER LAW TO BE PAID INTO OR CREDITED TO SUCH FUND, AND ALL
MONEYS RECEIVED BY THE FUND OR DONATED TO IT.
3. MONEYS OF SUCH FUND SHALL BE AVAILABLE FOR APPROPRIATION AND ALLO-
CATION TO THE DEPARTMENT OF LABOR FOR PURPOSES OF DISTRIBUTING SUCH
MONEYS TO QUALIFIED PERSONS OR ENTITIES OF THE NEW YORK STATE ENTREPRE-
NEURIAL STIMULUS INVESTMENT GRANT PROGRAM. FUNDS COLLECTED PURSUANT TO
SECTION FORTY-FOUR OF THE LABOR LAW SHALL BE USED FOR ONE OR MORE OF THE
FOLLOWING:
GRANTS TO NEW INDIVIDUAL ENTREPRENEURS IN THE STATE AND TO PERSONS
QUALIFYING FOR UNEMPLOYMENT INSURANCE IN THE STATE, TO ASSIST WITH THEIR
FIRST-YEAR COSTS OF PURCHASING HEALTH INSURANCE, INCLUDING, BUT NOT
LIMITED TO, PARTICIPATION IN THE HEALTHY NEW YORK OR FAMILY HEALTH PLUS
PROGRAMS, ESTABLISHED PURSUANT TO SECTIONS FOUR THOUSAND THREE HUNDRED
TWENTY-SIX AND FOUR THOUSAND THREE HUNDRED TWENTY-SEVEN OF THE INSURANCE
LAW.
4. MONEYS SHALL BE PAID OUT ON THE AUDIT AND WARRANT OF THE COMP-
TROLLER ON VOUCHERS CERTIFIED OR APPROVED BY THE COMMISSIONER OF LABOR.
S 4. Any health maintenance organization, company or corporation,
certified under article 44 of the public health law or licensed pursuant
to the insurance law shall be subject to the following provisions:
1. On or before each April first, the superintendent of insurance
shall collect from the entities covered by this section all moneys for
deposit into the New York state community health care investment fund
and the New York state health care entrepreneurial stimulus fund.
2. The total amount paid by all entities covered by this section shall
equal:
a. in 2014 the sum of $35,000,000 for deposit into the New York state
community health care investment fund and the sum of $35,000,000 for
deposit into the New York state health care entrepreneurial stimulus
fund;
b. beginning in 2015, and each year thereafter, the total amount to be
collected for deposit into the New York state community health care
investment fund shall equal the total of the prior year deposits into
S. 133 4
the New York state community health care investment fund multiplied by
the sum of one plus any positive percent change in the total annual
profits of all companies and corporations covered by this section;
c. beginning in 2015, and each year thereafter, the total amount to be
collected for deposit into the New York state health care entrepreneuri-
al stimulus fund shall equal the total of the prior year deposits into
the New York state health care entrepreneurial stimulus fund multiplied
by the sum of one plus any positive percent change in the total annual
profits of all companies and corporations covered by this section;
3. The amount paid by each company or corporation covered by this
section shall equal their net income divided by the total net income of
all companies and corporations covered by this section, rounded to four
decimal places, multiplied by the total amount calculated pursuant to
paragraphs a, b and c of subdivision two of this section.
4. For any company or corporation with a net income of less than zero,
their amount shall be calculated based on their net income in the last
year that it was greater than zero. The superintendent of financial
services shall have the authority to grant waivers from this section
when deemed necessary to prevent an undue burden, provided that no
company or corporation may receive a full or partial waiver in any two
successive years.
5. Every not-for-profit health maintenance organization shall be
excluded from the provisions of this section.
S 5. The New York state community health care investment fund council.
1. There is hereby established the New York state community health care
investment fund council consisting of 13 members. The purpose of such
council is to oversee the New York state health care community invest-
ment funds, establish the RFP process, award grants and issue an annual
report. The members of such council shall consist of representatives
from the insurance industry, health care institutions and providers, and
consumer and advocacy groups. The members of the council shall be
appointed in the following manner: six state agency heads or their
representatives: one from the department of health; one from the office
for the aging; one from the office of mental health; one from the office
for people with developmental disabilities; one from the office of alco-
holism and substance abuse services; one from the office of children and
family services; and three members by the governor and one by the speak-
er of the assembly, one by the temporary president of the senate; one by
the minority leader of the assembly; and one by the minority leader of
the senate.
2. The New York state community health care investment fund council
shall issue an annual report to the governor and legislature. Such annu-
al report shall include, but not be limited to, the following: the
dollar amount of HMO investments; the amount of award money granted; the
names of the groups awarded grants; and a description of the projects
for which the grants were awarded.
3. No member shall receive any compensation for his or her services,
but shall be reimbursed for their actual and necessary expenses, includ-
ing travel expenses, incurred in the performance of their duties.
S 6. The public health law is amended by adding a new section 23 to
read as follows:
S 23. NEW YORK STATE COMMUNITY HEALTH CARE INVESTMENT FUND GRANT
PROGRAM. THE COMMISSIONER SHALL ESTABLISH THE NEW YORK STATE COMMUNITY
HEALTH CARE INVESTMENT FUND GRANT PROGRAM WHICH SHALL INCLUDE, BUT NOT
BE LIMITED TO THE FOLLOWING:
S. 133 5
1. PROJECTS THAT ADDRESS THE SIX CLINICAL INDICATORS AS ESTABLISHED BY
THE FEDERAL CENTER FOR DISEASE CONTROL'S GOAL TO ELIMINATE HEALTH
DISPARITIES: INFANT MORTALITY; CANCER SCREENING AND MANAGEMENT; CARDIO-
VASCULAR DISEASE; DIABETES; HIV INFECTION/AIDS; AND IMMUNIZATIONS;
2. PROJECTS THAT IMPROVE THE CULTURAL COMPETENCE OF THE HEALTH CARE
WORKFORCE;
3. PROJECTS THAT COLLECT DATA REGARDING ETHNIC AND MINORITY REPRESEN-
TATION IN THE NEW YORK STATE HEALTH CARE WORKFORCE AND ETHNIC AND RACIAL
MINORITIES SERVED IN HOSPITALS AND NURSING HOMES;
4. PROJECTS THAT CONDUCT SURVEYS ON RACIAL AND ETHNIC HEALTH DISPARI-
TIES;
5. SCHOLARSHIPS TO RECRUIT AND TRAIN RACIAL AND ETHNIC MINORITIES IN
THE HEALTH CARE PROFESSIONS; AND
6. PROJECTS THAT ADDRESS UNMET HEALTH CARE NEEDS IN RURAL AREAS.
S 7. The labor law is amended by adding a new section 44 to read as
follows:
S 44. NEW YORK STATE ENTREPRENEURIAL STIMULUS INVESTMENT GRANT
PROGRAM. 1. THE COMMISSIONER SHALL ESTABLISH WITHIN THE DEPARTMENT A
NEW YORK STATE ENTREPRENEURIAL STIMULUS INVESTMENT GRANT PROGRAM. THE
PURPOSE OF THE PROGRAM IS TO ENCOURAGE STATE RESIDENTS TO DIRECTLY
PARTICIPATE IN THE ECONOMY OF THE STATE BY ESTABLISHING NEW BUSINESS
ENTERPRISES.
2. THE COMMISSIONER SHALL ESTABLISH RULES AND REGULATIONS FOR IDENTI-
FYING QUALIFYING INDIVIDUALS, PROCEDURES FOR OUTREACH, CERTIFYING
PROGRAM PARTICIPATION, AND FOR THE APPLICATION AND AWARDING OF GRANTS
FROM THE NEW YORK STATE ENTREPRENEURIAL STIMULUS FUND.
S 8. This act shall take effect immediately.