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

                                  2011

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            January 13, 2015
                               ___________

Introduced  by  M.  of  A. GUNTHER, SCHIMEL, BARRETT, STIRPE, RUSSELL --
  Multi-Sponsored by -- M.  of A. MONTESANO -- read once and referred to
  the Committee on Health

AN ACT to amend the public health law, in  relation  to  establishing  a
  hospital-home care-physician collaboration program

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

  Section 1. The public health law is amended by adding  a  new  section
2805-x to read as follows:
  S  2805-X. HOSPITAL-HOME CARE-PHYSICIAN COLLABORATION PROGRAM.  1. THE
PURPOSE OF THIS SECTION SHALL BE TO FACILITATE INNOVATION  IN  HOSPITAL,
HOME  CARE AGENCY AND PHYSICIAN COLLABORATION IN MEETING THE COMMUNITY'S
HEALTH CARE NEEDS. IT SHALL PROVIDE A  FRAMEWORK  TO  SUPPORT  VOLUNTARY
INITIATIVES  IN COLLABORATION TO IMPROVE PATIENT CARE ACCESS AND MANAGE-
MENT, PATIENT HEALTH OUTCOMES, COST-EFFECTIVENESS IN THE USE  OF  HEALTH
CARE SERVICES AND COMMUNITY POPULATION HEALTH. SUCH COLLABORATIVE INITI-
ATIVES  MAY  ALSO  INCLUDE  PAYORS, SKILLED NURSING FACILITIES AND OTHER
INTERDISCIPLINARY PROVIDERS, PRACTITIONERS AND SERVICE ENTITIES.
  2. FOR PURPOSES OF THIS SECTION:
  (A) "HOSPITAL" SHALL INCLUDE A GENERAL HOSPITAL  AS  DEFINED  IN  THIS
ARTICLE OR OTHER INPATIENT FACILITY FOR REHABILITATION OR SPECIALTY CARE
WITHIN THE DEFINITION OF HOSPITAL IN THIS ARTICLE.
  (B) "HOME CARE AGENCY" SHALL MEAN A CERTIFIED HOME HEALTH AGENCY, LONG
TERM  HOME  HEALTH CARE PROGRAM OR LICENSED HOME CARE SERVICES AGENCY AS
DEFINED IN ARTICLE THIRTY-SIX OF THIS CHAPTER.
  (C) "PAYOR" SHALL MEAN A HEALTH  PLAN  APPROVED  PURSUANT  TO  ARTICLE
FORTY-FOUR  OF THIS CHAPTER, OR ARTICLE THIRTY-TWO OR FORTY-THREE OF THE
INSURANCE LAW.
  (D) "PRACTITIONER" SHALL MEAN ANY OF  THE  HEALTH,  MENTAL  HEALTH  OR
HEALTH  RELATED  PROFESSIONS  LICENSED  PURSUANT  TO  TITLE EIGHT OF THE
EDUCATION LAW.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02049-01-5
              

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  3. THE COMMISSIONER IS AUTHORIZED TO PROVIDE FINANCING INCLUDING,  BUT
NOT  LIMITED  TO,  GRANTS  OR POSITIVE ADJUSTMENTS IN MEDICAL ASSISTANCE
RATES OR PREMIUM PAYMENTS, TO THE EXTENT OF FUNDS  AVAILABLE  AND  ALLO-
CATED  OR  APPROPRIATED  THEREFOR, INCLUDING FUNDS PROVIDED TO THE STATE
THROUGH  FEDERAL  WAIVERS,  FUNDS MADE AVAILABLE THROUGH STATE APPROPRI-
ATIONS AND/OR FUNDING THROUGH SECTION TWENTY-EIGHT  HUNDRED  SEVEN-V  OF
THIS  ARTICLE,  AS WELL AS WAIVERS OF REGULATIONS UNDER TITLE TEN OF THE
NEW YORK CODES, RULES AND REGULATIONS, TO SUPPORT THE  VOLUNTARY  INITI-
ATIVES AND OBJECTIVES OF THIS SECTION.
  4.  HOSPITAL-HOME  CARE-PHYSICIAN COLLABORATIVE INITIATIVES UNDER THIS
SECTION MAY INCLUDE, BUT SHALL NOT BE LIMITED TO:
  (A) HOSPITAL-HOME CARE-PHYSICIAN  INTEGRATION  INITIATIVES,  INCLUDING
BUT NOT LIMITED TO:
  (I)  TRANSITIONS  IN  CARE  INITIATIVES TO HELP EFFECTIVELY TRANSITION
PATIENTS TO POST-ACUTE CARE  AT  HOME,  COORDINATE  FOLLOW-UP  CARE  AND
ADDRESS ISSUES CRITICAL TO CARE PLAN SUCCESS AND READMISSION AVOIDANCE;
  (II)  CLINICAL  PATHWAYS  FOR  SPECIFIED CONDITIONS, GUIDING PATIENTS'
PROGRESS AND OUTCOME GOALS, AS WELL AS EFFECTIVE HEALTH SERVICES USE;
  (III) APPLICATION OF TELEHEALTH/TELEMEDICINE  SERVICES  IN  MONITORING
AND  MANAGING  PATIENT  CONDITIONS,  AND PROMOTING SELF-CARE/MANAGEMENT,
IMPROVED OUTCOMES AND EFFECTIVE SERVICES USE;
  (IV) FACILITATION OF  PHYSICIAN  HOUSE  CALLS  TO  HOMEBOUND  PATIENTS
AND/OR  TO  PATIENTS  FOR WHOM SUCH HOME VISITS ARE DETERMINED NECESSARY
AND EFFECTIVE FOR PATIENT CARE MANAGEMENT;
  (V) ADDITIONAL MODELS FOR PREVENTION OF  AVOIDABLE  HOSPITAL  READMIS-
SIONS AND EMERGENCY ROOM VISITS;
  (VI) HEALTH HOME DEVELOPMENT;
  (VII)  DEVELOPMENT  AND  DEMONSTRATION  OF NEW MODELS OF INTEGRATED OR
COLLABORATIVE CARE AND CARE MANAGEMENT NOT OTHERWISE ACHIEVABLE  THROUGH
EXISTING MODELS; AND
  (VIII)  BUNDLED PAYMENT DEMONSTRATIONS FOR HOSPITAL-TO-POST-ACUTE-CARE
FOR SPECIFIED CONDITIONS OR CATEGORIES  OF  CONDITIONS,  IN  PARTICULAR,
CONDITIONS  PREDISPOSED  TO  HIGH  PREVALENCE  OF READMISSION, INCLUDING
THOSE CURRENTLY SUBJECT TO FEDERAL/STATE PENALTY, AND  OTHER  DISCHARGES
WITH EXTENSIVE POST-ACUTE NEEDS;
  (B)  RECRUITMENT,  TRAINING AND RETENTION OF HOSPITAL/HOME CARE DIRECT
CARE STAFF AND PHYSICIANS, IN GEOGRAPHIC OR  CLINICAL  AREAS  OF  DEMON-
STRATED NEED.  SUCH INITIATIVES MAY INCLUDE, BUT ARE NOT LIMITED TO, THE
FOLLOWING ACTIVITIES:
  (I)  OUTREACH AND PUBLIC EDUCATION ABOUT THE NEED AND VALUE OF SERVICE
IN HEALTH OCCUPATIONS;
  (II) TRAINING/CONTINUING EDUCATION  AND  REGULATORY  FACILITATION  FOR
CROSS-TRAINING  TO  MAXIMIZE  FLEXIBILITY  IN  THE UTILIZATION OF STAFF,
INCLUDING:
  (A) TRAINING OF HOSPITAL NURSES IN HOME CARE;
  (B) DUAL CERTIFIED NURSE AIDE/HOME HEALTH AIDE CERTIFICATION; AND
  (C) DUAL PERSONAL CARE AIDE/HHA CERTIFICATION;
  (III) SALARY/BENEFIT ENHANCEMENT;
  (IV) CAREER LADDER DEVELOPMENT; AND
  (V) OTHER INCENTIVES TO PRACTICE IN SHORTAGE AREAS; AND
  (C)  HOSPITAL - HOME CARE - PHYSICIAN COLLABORATIVES FOR THE CARE  AND
MANAGEMENT OF SPECIAL NEEDS, HIGH-RISK AND HIGH-COST PATIENTS, INCLUDING
BUT  NOT LIMITED TO BEST PRACTICES, AND TRAINING AND EDUCATION OF DIRECT
CARE PRACTITIONERS AND SERVICE EMPLOYEES.
  5. HOSPITALS AND HOME CARE AGENCIES WHICH ARE  PROVIDED  FINANCING  OR
WAIVERS PURSUANT TO THIS SECTION SHALL REPORT TO THE COMMISSIONER ON THE

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PATIENT,  SERVICE AND COST EXPERIENCES PURSUANT TO THIS SECTION, INCLUD-
ING THE EXTENT TO WHICH THE PROJECT GOALS ARE ACHIEVED. THE COMMISSIONER
SHALL COMPILE AND  MAKE  SUCH  REPORTS  AVAILABLE  ON  THE  DEPARTMENT'S
WEBSITE.
  S 2. This act shall take effect immediately.