§ 2952. Rural health network development grant program. To the extent
of funds available therefor, the sum of seven million dollars shall
annually be available for periods prior to January first, two thousand
three, and up to six million five hundred thirty thousand dollars
annually for the period January first, two thousand three through
December thirty-first, two thousand four, up to seven million sixty-two
thousand dollars for the period January first, two thousand five through
December thirty-first, two thousand six annually, up to seven million
sixty-two thousand dollars annually for the period January first, two
thousand seven through December thirty-first, two thousand ten, up to
one million seven hundred sixty-six thousand dollars for the period
January first, two thousand eleven through March thirty-first, two
thousand eleven, and within amounts appropriated for each state fiscal
year on and after April first, two thousand eleven, shall be available
to the commissioner from funds made available pursuant to section
twenty-eight hundred seven-l of this chapter for grants pursuant to this
section. 1. The commissioner shall establish a rural health network
development grant program for the purpose of assisting community based
health care providers, consumers and organizations in rural areas to
promote more effective health care delivery through the coordination,
development, planning, implementation and operation of rural health
networks pursuant to this title. Such grants shall support activities
and organizational costs including, but not limited to, the recruitment
of qualified health care professionals, the performance of feasibility
studies, the development of affiliation agreements among rural health
providers, the development of managed care capacities, the expansion and
integration of public and preventive health services into community
based primary care systems, the integration and expansion of prehospital
emergency medical services and related consulting and legal fees.

2. To be eligible to receive grant funding pursuant to this section,
the applicant shall submit a network plan to the commissioner for
approval; the network plan shall identify network participants and
indicate how the members or participants of the rural health network
intend to respond to the health care needs of the rural area, improve
access to and the quality of care for residents of the community,
promote the coordination of resources among providers and reduce
duplication of services while achieving cost and other operational
efficiencies.

3. a. The commissioner shall make grants to rural health networks, or
rural health care providers planning to develop a rural health network.
The network plan submitted by a rural health network or rural health
care providers planning to form a network for grant funds pursuant to
this section shall be consistent with guidelines issued by the
commissioner, in consultation with the New York state rural health
council and the legislative commission on the development of rural
resources. Such guidelines shall include, but need not be limited to,
the duration of rural health network grants, appropriate funding levels
and criteria for providing an appropriate geographic distribution of
grantees; provided, however, that the amount of any such grant shall be
based on the scope and nature of the proposed activities described in
such plan and that the quality of any such plan complies with the
conditions for approval pursuant to paragraph b of subdivision three of
this section.

b. The commissioner may require revisions or amendments to the initial
network plan prior to approval for funding, or periodic updates from an
applicant to reflect the current status of a network's development or
operation and to assure that the plan is implemented in accordance with
its approved terms. In approving grants the commissioner shall consider
the following:

(i) The specific objectives and description of the proposed network,
including considerations of the existing health care services currently
being delivered within the rural area, and the unmet health care needs
of the community;

(ii) The degrees to which the plan demonstrates enhanced costs and
service delivery efficiencies and access to necessary and high quality
health care services by rural residents;

(iii) The degree to which stated objectives and the scope of the
network plan may reasonably be implemented and achieved using existing
and projected resources;

(iv) The degree to which information sharing, communication, and
cooperation between health care providers, human service entities and
consumers would be fostered;

(v) The contribution the network would make toward the identification
and development of innovative delivery systems;

(vi) The degree to which management and continuity of care would be
fostered and improved;

(vii) The degree to which participating providers are represented on
governing bodies of the network;

(viii) The degree to which consumers within the area served or to be
served by the network are made aware of and have an effective
opportunity to provide input in the creation and on-going development of
a network plan; and

(ix) The degree to which providers within the area served by the
network are made aware of and have an effective opportunity to
participate in or become a member of the network.

c. The commissioner shall act on such application within ninety days
after its receipt. In the event waivers of any regulations are requested
by an applicant, the commissioner shall have an additional thirty days
to act upon such application.

4. The commissioner or his or her duly authorized representative may
provide or contract to provide technical assistance in the creation and
implementation of rural health networks and to promote community
organization, collaboration and communication in rural network
development across the state. The funding for any such contract shall
not be made available from funds provided for purposes of this section
by section twenty-eight hundred seven-l of this chapter.

5. If the commissioner determines that a grant is being used for
purposes other than those which are in conformity with this title, the
commissioner may withdraw his or her approval of the project and require
repayment of all or part of such grant to the state. The commissioner
shall cause reports to be prepared and submitted for each project by the
grantees at such times and in such manner as are consistent with the
purposes of this title.

6. a. The commissioner or his or her duly authorized representative
may also, promote appropriate active state supervision necessary to
promote state action immunity under the federal antitrust laws, inspect
or request additional documentation to verify that a network plan is
implemented in accordance with its approved terms as they relate to
antitrust activity.

b. The commissioner shall review a network plan and all agreements
between participating providers of a network organized pursuant to the
not-for-profit corporation law at any time with respect to their effect
on competition, access, and quality of care, may seek the advice of the
attorney general and may require amendments to such agreements where he
or she determines that the benefits of anti-competitive activity are
outweighed by any disadvantages.

c. The commissioner may revoke, limit or annul approval to implement a
network plan, or portions thereof, after review and a hearing, for
failure to implement such plan in accordance with its terms as
appropriate for the promotion of state action immunity under the federal
antitrust laws.

d. The commissioner shall, at the request of any rural health network,
review network agreements with respect to their effect on competition,
access and quality of care, may seek the advice of the attorney general,
and may require amendments to such agreements where he or she determines
that the benefits of anticompetitive activity are outweighed by any
disadvantage.

7. For the purpose of promoting maximum effectiveness in the
utilization of state and local monies and innovative approaches, the
commissioner is authorized to waive, modify or suspend the respective
provisions of rules and regulations promulgated pursuant to this chapter
if the commissioner determines that such waiver, modification or
suspension is necessary for the successful implementation of this title
and provided that the commissioner determines that the health, safety
and general welfare of people receiving health care will not be impaired
as a result of such waiver, modification, or suspension. Such waiver,
modification or suspension may be granted for up to two years. In
addition, upon the request of a rural health network organized pursuant
to the not-for-profit corporation law and approved pursuant to
subdivision fourteen of section twenty-eight hundred one-a of this
chapter thereto, through its network plan or its amendments, the
commissioner is authorized to permit such rural health network to make
applications or fulfill regulatory requirements on behalf of members of
the network for purposes of, but not limited to, certificate of need,
quality assurance, reimbursement, and professional credentialing and
privileging.

8. The commissioner shall consult with federal, state, and local
officials with respect to securing their cooperation in coordinating
related programs and regulatory waivers and shall provide the
legislature with recommendations to facilitate such efforts.

9. Notwithstanding any inconsistent provision of law, the commissioner
may approve a rural health network, to receive directly reimbursement
for the planning and coordination of services including but not limited
to such experimental and other payment methods as global budget, pooling
arrangements, or capitation payments for whole or in-part inpatient
hospital services and ambulatory care services provided by the component
entities of the network. Reimbursement including payments made by
governmental agencies shall be subject to the approval of the state
director of the budget and to the availability of federal financial
participation pursuant to title XIX of the federal social security act
in expenditures made for eligible patients. The commissioner may impose
such terms and conditions as necessary and appropriate for receipt of
such funds.