Attention NYS Council Hospital Members
& Certain D&TCs re: Health Equity Legislation

June 2, 2021

Bill passed both houses as of yesterday and now moves on to Governor’s desk for final action.

S01451 Summary:





Add 2802-b, Pub Health L

Requires a health equity assessment to be filed with an application for construction, or substantial reduction of, a hospital or health related service; includes a demonstration of whether and how a project will improve or affect access to hospital services and health care with particular reference to members of medically underserved groups in the applicant’s service area.
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S01451 Memo:
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S01451 Text:

            STATE OF NEW YORK

        Cal. No. 110

                           2021-2022 Regular Sessions

                IN SENATE

                                January 12, 2021

      KRUEGER, MAY -- read twice and ordered printed, and when printed to be
      committed to the Committee on Health -- reported favorably  from  said
      committee,  ordered  to  first  and  second report, ordered to a third
      reading, passed by Senate and delivered  to  the  Assembly,  recalled,
      vote  reconsidered,  restored  to  third  reading, amended and ordered
      reprinted, retaining its place in 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:

 1    Section 1. The public health law is amended by adding  a  new  section
 2  2802-b to read as follows:
 3    § 2802-b. Health equity impact assessments. 1. Definitions. As used in
 4  this section:
 5    (a)  "Application"  means  an  application  under this article for the
 6  construction, establishment, change in the establishment, merger, acqui-
 7  sition, closure, or substantial reduction, expansion, or addition  of  a
 8  hospital  service  or health-related service of a hospital that requires
 9  review or approval by the council or the commissioner, where the  appli-
10  cation  is  filed  or  submitted to the council, the commissioner or the
11  department after this section takes effect.
12    (b) "Project" means the construction,  establishment,  change  in  the
13  establishment, merger, acquisition, closure, or substantial reduction of
14  a  hospital  service or health-related service of a hospital that is the
15  subject of an application.
16    (c) "Health equity impact assessment" or "impact assessment" means  an
17  assessment  of  whether, and if so how, a project will improve access to
18  hospital services and health care, health equity and reduction of health
19  disparities, with particular reference to members  of  medically  under-
20  served groups, in the applicant's service area.

     EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                          [ ] is old law to be omitted.
    S. 1451--A                          2

 1    (d) "Medically underserved group" means: low-income people; racial and
 2  ethnic  minorities; immigrants; women; lesbian, gay, bisexual, transgen-
 3  der, or other-than-cisgender people;  people  with  disabilities;  older
 4  adults; persons living with a prevalent infectious disease or condition;
 5  persons  living  in  rural areas; people who are eligible for or receive
 6  public health benefits; people who do not have third-party health cover-
 7  age or have inadequate third-party health coverage; and other people who
 8  are unable to obtain health care.
 9    2. (a) (i) Every application shall  include  a  health  equity  impact
10  assessment of the project. The impact assessment shall be filed together
11  with  the application, and the application shall not be complete without
12  the impact statement. The applicant shall promptly amend or  modify  the
13  impact statement as necessary.
14    (ii)  However,  in the case of a diagnostic and treatment center whose
15  patient population is over fifty percent combined patients  enrolled  in
16  Medicaid or uninsured, a health equity impact assessment is not required
17  unless  the application includes a change in controlling person, princi-
18  pal stockholder, or principal member (as defined in section twenty-eight
19  hundred one-a of this article) of the applicant.
20    (b) In considering whether and on what terms to  approve  an  applica-
21  tion,  the  commissioner  and  the  council,  as  the case may be, shall
22  consider the health equity impact statement.
23    3. Scope and contents of a health equity impact assessment.  A  health
24  equity impact assessment shall include:
25    (a)  A  demonstration  of whether, and if so how, the proposed project
26  will improve access to hospital services and health care, health  equity
27  and  reduction  of  health  disparities,  with  particular  reference to
28  members of medically underserved  groups,  in  the  applicant's  service
29  area.
30    (b)  The  extent  to  which medically underserved groups in the appli-
31  cant's service area  use  the  applicant's  hospital  or  health-related
32  services  or  similar  services  at  the time of the application and the
33  extent to which they are expected to if the project is implemented.
34    (c) The performance of the applicant in meeting  its  obligations,  if
35  any,  under  section  twenty-eight  hundred  seven-k of this article and
36  federal regulations requiring providing  uncompensated  care,  community
37  services,  and  access  by  minorities  and  people with disabilities to
38  programs receiving federal financial assistance, including the existence
39  of any civil rights access complaints against the applicant, and how the
40  applicant's meeting of these obligations will be affected by implementa-
41  tion of the project.
42    (d) How and to what extent the applicant  will  provide  hospital  and
43  health-related  services to the medically indigent, Medicare recipients,
44  Medicaid recipients and members of medically underserved groups  if  the
45  project is implemented.
46    (e)  The  amount of indigent care, both free and below cost, that will
47  be provided by the applicant if the project is approved.
48    (f) Access by public or private transportation,  including  applicant-
49  sponsored  transportation  services,  to  the  applicant's  hospital  or
50  health-related services if the project is implemented.
51    (g) The means of assuring effective communication between  the  appli-
52  cant's  hospital  and health-related service staff and people of limited
53  English-speaking ability  and  those  with  speech,  hearing  or  visual
54  impairments handicaps if the project is implemented.
55    (h)  The  extent  to  which  implementation of the project will reduce
56  architectural barriers for people with mobility impairments.
    S. 1451--A                          3

 1    (i) A review of how the applicant will maintain or improve the quality
 2  of hospital and health-related services including a review of:
 3    (i) demographics of the applicant's service area;
 4    (ii)  economic  status  of  the  population of the applicant's service
 5  area;
 6    (iii) physician  and  professional  staffing  issues  related  to  the
 7  project;
 8    (iv) availability of similar services at other institutions in or near
 9  the applicant's service area; and
10    (v) historical and projected market shares of hospital and health care
11  service providers in the applicant's service area.
12    4.  The  health  equity  impact  assessment  shall be prepared for the
13  applicant by an independent entity and include the meaningful engagement
14  of public health experts, organizations representing  employees  of  the
15  applicant,  stakeholders,  and  community  leaders  and residents of the
16  applicant's service area.
17    5. The department shall publicly post the application and  the  health
18  equity  impact assessment on the department's website within one week of
19  the filing with the department, including any filing with the council.
20    § 2. This act shall take effect on the one hundred eightieth day after
21  it becomes a law.  Effective immediately, the commissioner of health and
22  the public health and health planning council shall make regulations and
23  take other actions reasonably necessary to implement this  act  on  that
24  date.