S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8834
 
                           I N  A S S E M B L Y
 
                             January 13, 2022
                                ___________
 
 Introduced  by  M.  of  A.  GOTTFRIED  --  read once and referred to the
   Committee on Health
 
 AN ACT to amend the public health law, in relation to  applications  for
   certain  hospital projects; and to amend a chapter of the laws of 2021
   amending the public health law relating to health  equity  assessments
   in  the  establishment  or  construction of a hospital, as proposed in
   legislative bills numbers S. 1451-A and A. 191-A, in relation  to  the
   effectiveness thereof
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 2802-b of the public health  law,  as  added  by  a
 chapter  of  the laws of 2021 amending the public health law relating to
 health equity assessments in the  establishment  or  construction  of  a
 hospital,  as  proposed  in  legislative  bills numbers S. 1451-A and A.
 191-A, is amended 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,]  ELIMINATION 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 application is filed or submitted to the council, the  commis-
 sioner  or  the  department  after  this section takes effect. PROVIDED,
 HOWEVER, THAT AN APPLICATION FOR THE CHANGE IN THE ESTABLISHMENT, MERGER
 OR ACQUISITION OF A HOSPITAL SHALL NOT BE INCLUDED IN THIS DEFINITION IF
 THE APPLICATION WOULD NOT RESULT  IN  THE  ELIMINATION,  OR  SUBSTANTIAL
 REDUCTION,  EXPANSION,  ADDITION  OR  CHANGE  IN  LOCATION OF A HOSPITAL
 SERVICE OR HEALTH RELATED SERVICE OF THE HOSPITAL.
   (b) "Project" means the construction,  establishment,  change  in  the
 establishment,  merger,  acquisition, [closure] ELIMINATION, or substan-
 tial reduction, EXPANSION, OR ADDITION of a hospital service or  health-
 related service of a hospital that is the subject of an application.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00607-06-2
              

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   (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.
   (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 HEALTH EQUITY 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.
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   (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.
   (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] ITS  website  within  one
 week  of  the  filing with the department, including any filing with the
 council.   THE APPLICANT SHALL PUBLICLY POST  THE  APPLICATION  AND  THE
 HEALTH  EQUITY  IMPACT  ASSESSMENT  ON  ITS  WEBSITE  WITHIN ONE WEEK OF
 ACKNOWLEDGEMENT BY THE DEPARTMENT.
   § 2. Section 2 of a chapter of the laws of 2021  amending  the  public
 health law relating to health equity assessments in the establishment or
 construction  of a hospital, as proposed in legislative bills numbers S.
 1451-A and A. 191-A, is amended to read as follows:
   § 2. This act shall take effect [on the  one  hundred  eightieth  day]
 EIGHTEEN  MONTHS  after it [becomes] SHALL HAVE BECOME a law.  Effective
 immediately, the commissioner of health and the public health and health
 planning council shall make regulations and take other  actions  reason-
 ably necessary to implement this act on that date.
   §  3.  This act shall take effect immediately; provided, however, that
 section one of this act shall take effect on the same date  and  in  the
 same  manner as a chapter of the laws of 2021 amending the public health
 law relating to  health  equity  assessments  in  the  establishment  or
 construction  of a hospital, as proposed in legislative bills numbers S.
 1451-A and A. 191-A, takes effect.