S T A T E   O F   N E W   Y O R K
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                                  191--A
                                                          Cal. No. 88
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  M. of A. GOTTFRIED, REYES, PAULIN, SIMON, BARRON, STECK,
   EPSTEIN, ENGLEBRIGHT, BICHOTTE HERMELYN, GALEF, ABINANTI, NOLAN, JACK-
   SON, MITAYNES, HEVESI, SOLAGES, L. ROSENTHAL, SAYEGH,  GONZALEZ-ROJAS,
   FORREST  --  read  once  and  referred  to  the Committee on Health --
   reported from committee, advanced to  a  third  reading,  amended  and
   ordered reprinted, retaining its place on the order of third reading
 
 AN  ACT  to  amend  the  public health law, in relation to health equity
   assessments in the establishment or construction of a hospital
 
   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
 2802-b to read as follows:
   § 2802-B. HEALTH EQUITY IMPACT ASSESSMENTS. 1. DEFINITIONS. AS USED IN
 THIS SECTION:
   (A) "APPLICATION" MEANS AN APPLICATION  UNDER  THIS  ARTICLE  FOR  THE
 CONSTRUCTION, ESTABLISHMENT, CHANGE IN THE ESTABLISHMENT, MERGER, ACQUI-
 SITION,  CLOSURE,  OR SUBSTANTIAL REDUCTION, EXPANSION, OR ADDITION OF A
 HOSPITAL SERVICE OR HEALTH-RELATED SERVICE OF A HOSPITAL  THAT  REQUIRES
 REVIEW  OR APPROVAL BY THE COUNCIL OR THE COMMISSIONER, WHERE THE APPLI-
 CATION IS FILED OR SUBMITTED TO THE COUNCIL,  THE  COMMISSIONER  OR  THE
 DEPARTMENT AFTER THIS SECTION TAKES EFFECT.
   (B)  "PROJECT"  MEANS  THE  CONSTRUCTION, ESTABLISHMENT, CHANGE IN THE
 ESTABLISHMENT, MERGER, ACQUISITION, CLOSURE, OR SUBSTANTIAL REDUCTION OF
 A HOSPITAL SERVICE OR HEALTH-RELATED SERVICE OF A HOSPITAL THAT  IS  THE
 SUBJECT OF AN APPLICATION.
   (C)  "HEALTH EQUITY IMPACT ASSESSMENT" OR "IMPACT ASSESSMENT" MEANS AN
 ASSESSMENT OF WHETHER, AND IF SO HOW, A PROJECT WILL IMPROVE  ACCESS  TO
 HOSPITAL SERVICES AND HEALTH CARE, HEALTH EQUITY AND REDUCTION OF HEALTH
 DISPARITIES,  WITH  PARTICULAR  REFERENCE TO MEMBERS OF MEDICALLY UNDER-
 SERVED GROUPS, IN THE APPLICANT'S SERVICE AREA.
 
              

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00607-04-1

 A. 191--A                           2
 
   (D) "MEDICALLY UNDERSERVED GROUP" MEANS: LOW-INCOME PEOPLE; RACIAL AND
 ETHNIC MINORITIES; IMMIGRANTS; WOMEN; LESBIAN, GAY, BISEXUAL,  TRANSGEN-
 DER,  OR  OTHER-THAN-CISGENDER  PEOPLE;  PEOPLE WITH DISABILITIES; OLDER
 ADULTS; PERSONS LIVING WITH A PREVALENT INFECTIOUS DISEASE OR CONDITION;
 PERSONS  LIVING  IN  RURAL AREAS; PEOPLE WHO ARE ELIGIBLE FOR OR RECEIVE
 PUBLIC HEALTH BENEFITS; PEOPLE WHO DO NOT HAVE THIRD-PARTY HEALTH COVER-
 AGE OR HAVE INADEQUATE THIRD-PARTY HEALTH COVERAGE; AND OTHER PEOPLE WHO
 ARE UNABLE TO OBTAIN HEALTH CARE.
   2. (A) (I) EVERY APPLICATION SHALL  INCLUDE  A  HEALTH  EQUITY  IMPACT
 ASSESSMENT OF THE PROJECT. THE IMPACT ASSESSMENT SHALL BE FILED TOGETHER
 WITH  THE APPLICATION, AND THE APPLICATION SHALL NOT BE COMPLETE WITHOUT
 THE IMPACT STATEMENT. THE APPLICANT SHALL PROMPTLY AMEND OR  MODIFY  THE
 IMPACT STATEMENT AS NECESSARY.
   (II)  HOWEVER,  IN THE CASE OF A DIAGNOSTIC AND TREATMENT CENTER WHOSE
 PATIENT POPULATION IS OVER FIFTY PERCENT COMBINED PATIENTS  ENROLLED  IN
 MEDICAID OR UNINSURED, A HEALTH EQUITY IMPACT ASSESSMENT IS NOT REQUIRED
 UNLESS  THE APPLICATION INCLUDES A CHANGE IN CONTROLLING PERSON, PRINCI-
 PAL STOCKHOLDER, OR PRINCIPAL MEMBER (AS DEFINED IN SECTION TWENTY-EIGHT
 HUNDRED ONE-A OF THIS ARTICLE) OF THE APPLICANT.
   (B) IN CONSIDERING WHETHER AND ON WHAT TERMS TO  APPROVE  AN  APPLICA-
 TION,  THE  COMMISSIONER  AND  THE  COUNCIL,  AS  THE CASE MAY BE, SHALL
 CONSIDER THE HEALTH EQUITY IMPACT STATEMENT.
   3. SCOPE AND CONTENTS OF A HEALTH EQUITY IMPACT ASSESSMENT.  A  HEALTH
 EQUITY IMPACT ASSESSMENT SHALL INCLUDE:
   (A)  A  DEMONSTRATION  OF WHETHER, AND IF SO HOW, THE PROPOSED PROJECT
 WILL IMPROVE ACCESS TO HOSPITAL SERVICES AND HEALTH CARE, HEALTH  EQUITY
 AND  REDUCTION  OF  HEALTH  DISPARITIES,  WITH  PARTICULAR  REFERENCE TO
 MEMBERS OF MEDICALLY UNDERSERVED  GROUPS,  IN  THE  APPLICANT'S  SERVICE
 AREA.
   (B)  THE  EXTENT  TO  WHICH MEDICALLY UNDERSERVED GROUPS IN THE APPLI-
 CANT'S SERVICE AREA  USE  THE  APPLICANT'S  HOSPITAL  OR  HEALTH-RELATED
 SERVICES  OR  SIMILAR  SERVICES  AT  THE TIME OF THE APPLICATION AND THE
 EXTENT TO WHICH THEY ARE EXPECTED TO IF THE PROJECT IS IMPLEMENTED.
   (C) THE PERFORMANCE OF THE APPLICANT IN MEETING  ITS  OBLIGATIONS,  IF
 ANY,  UNDER  SECTION  TWENTY-EIGHT  HUNDRED  SEVEN-K OF THIS ARTICLE AND
 FEDERAL REGULATIONS REQUIRING PROVIDING  UNCOMPENSATED  CARE,  COMMUNITY
 SERVICES,  AND  ACCESS  BY  MINORITIES  AND  PEOPLE WITH DISABILITIES TO
 PROGRAMS RECEIVING FEDERAL FINANCIAL ASSISTANCE, INCLUDING THE EXISTENCE
 OF ANY CIVIL RIGHTS ACCESS COMPLAINTS AGAINST THE APPLICANT, AND HOW THE
 APPLICANT'S MEETING OF THESE OBLIGATIONS WILL BE AFFECTED BY IMPLEMENTA-
 TION OF THE PROJECT.
   (D) HOW AND TO WHAT EXTENT THE APPLICANT  WILL  PROVIDE  HOSPITAL  AND
 HEALTH-RELATED  SERVICES TO THE MEDICALLY INDIGENT, MEDICARE RECIPIENTS,
 MEDICAID RECIPIENTS AND MEMBERS OF MEDICALLY UNDERSERVED GROUPS  IF  THE
 PROJECT IS IMPLEMENTED.
   (E)  THE  AMOUNT OF INDIGENT CARE, BOTH FREE AND BELOW COST, THAT WILL
 BE PROVIDED BY THE APPLICANT IF THE PROJECT IS APPROVED.
   (F) ACCESS BY PUBLIC OR PRIVATE TRANSPORTATION,  INCLUDING  APPLICANT-
 SPONSORED  TRANSPORTATION  SERVICES,  TO  THE  APPLICANT'S  HOSPITAL  OR
 HEALTH-RELATED SERVICES IF THE PROJECT IS IMPLEMENTED.
   (G) THE MEANS OF ASSURING EFFECTIVE COMMUNICATION BETWEEN  THE  APPLI-
 CANT'S  HOSPITAL  AND HEALTH-RELATED SERVICE STAFF AND PEOPLE OF LIMITED
 ENGLISH-SPEAKING ABILITY  AND  THOSE  WITH  SPEECH,  HEARING  OR  VISUAL
 IMPAIRMENTS HANDICAPS IF THE PROJECT IS IMPLEMENTED.
   (H)  THE  EXTENT  TO  WHICH  IMPLEMENTATION OF THE PROJECT WILL REDUCE
 ARCHITECTURAL BARRIERS FOR PEOPLE WITH MOBILITY IMPAIRMENTS.

 A. 191--A                           3
 
   (I) A REVIEW OF HOW THE APPLICANT WILL MAINTAIN OR IMPROVE THE QUALITY
 OF HOSPITAL AND HEALTH-RELATED SERVICES INCLUDING A REVIEW OF:
   (I) DEMOGRAPHICS OF THE APPLICANT'S SERVICE AREA;
   (II)  ECONOMIC  STATUS  OF  THE  POPULATION OF THE APPLICANT'S SERVICE
 AREA;
   (III) PHYSICIAN  AND  PROFESSIONAL  STAFFING  ISSUES  RELATED  TO  THE
 PROJECT;
   (IV) AVAILABILITY OF SIMILAR SERVICES AT OTHER INSTITUTIONS IN OR NEAR
 THE APPLICANT'S SERVICE AREA; AND
   (V) HISTORICAL AND PROJECTED MARKET SHARES OF HOSPITAL AND HEALTH CARE
 SERVICE PROVIDERS IN THE APPLICANT'S SERVICE AREA.
   4.  THE  HEALTH  EQUITY  IMPACT  ASSESSMENT  SHALL BE PREPARED FOR THE
 APPLICANT BY AN INDEPENDENT ENTITY AND INCLUDE THE MEANINGFUL ENGAGEMENT
 OF PUBLIC HEALTH EXPERTS, ORGANIZATIONS REPRESENTING  EMPLOYEES  OF  THE
 APPLICANT,  STAKEHOLDERS,  AND  COMMUNITY  LEADERS  AND RESIDENTS OF THE
 APPLICANT'S SERVICE AREA.
   5. THE DEPARTMENT SHALL PUBLICLY POST THE APPLICATION AND  THE  HEALTH
 EQUITY  IMPACT ASSESSMENT ON THE DEPARTMENT'S WEBSITE WITHIN ONE WEEK OF
 THE FILING WITH THE DEPARTMENT, INCLUDING ANY FILING WITH THE COUNCIL.
   § 2. This act shall take effect on the one hundred eightieth day after
 it becomes a law.  Effective immediately, the commissioner of health and
 the public health and health planning council shall make regulations and
 take other actions reasonably necessary to implement this  act  on  that
 date.