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

                                 3198--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             March 12, 2009
                               ___________

Introduced  by  Sen. VALESKY -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health -- reported favora-
  bly from said committee and committed to the Committee on  Finance  --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee

AN ACT to establish the statewide  telemedicine/telehealth  task  force,
  and providing for its powers and duties

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

  Section  1.  Legislative  intent.  The  legislature  recognizes   that
geography,  weather  and  other factors can create barriers to accessing
appropriate health and mental health care in New York State. One way  to
provide  access  to care is through the appropriate use of technology to
allow health care consumers access to qualified  health  care  providers
and  institutions.  In order to better understand the role of technology
in providing access to health care and to ensure that  services  protect
patient  confidentiality,  the  legislature establishes a statewide task
force on telemedicine/telehealth.
  S 2. Statewide telemedicine/telehealth task force.  a. There is hereby
established   within   the   department   of    health    a    statewide
telemedicine/telehealth task force, to be comprised of seventeen members
who shall be appointed in the following manner: three shall be appointed
by  the temporary president of the senate and one by the minority leader
of the senate; three shall be appointed by the speaker of  the  assembly
and  one  by  the  minority  leader  of  the assembly; and nine shall be
appointed by the governor. The members of the task force  shall  include
representatives  of rural hospitals and health systems; community hospi-
tals and health systems; academic medical centers; other  hospitals  and
health  systems;  nursing  homes; home health agencies; hospices; physi-
cians; nurse practitioners; other health care practitioners;  telecommu-
nications  or  related  industries;  health care payors; and health care

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04178-03-9
              

S. 3198--A                          2

consumers. All appointments shall be made in such  a  manner  to  ensure
statewide  geographic representation.  In addition, the task force shall
include the commissioner of education or his or  her  designee  and  the
commissioner of health or his or her designee.
  b.  Members  of  the task force shall not receive any compensation but
shall be reimbursed for their actual, necessary expenditures.
  c. Members of the task force shall serve at the pleasure of the person
who appointed them and may be removed at  anytime,  without  cause.  Any
vacancy  on  the  task  force  shall be filled in the same manner as the
original appointment.
  d. The task force shall make recommendations to the governor  and  the
legislature on the following:
  1.  assessment of existing telehealth programs and recommendations for
expansion;
  2. a plan to develop telemedicine  and  telehealth  systems  including
health  education, preventive and primary care, specialty diagnostic and
clinical services, taking into account access to care by  the  medically
underserved,  residents  of  remote  and  rural areas, and other special
populations;
  3. standards  in  the  application  of  telemedicine,  telehealth  and
medical  informatics including clinical efficacy, cost effectiveness and
quality of care;
  4.  definitions  of  professional  conduct  related  to  telepractice,
including  patient confidentiality and competence in using technology by
licensed professionals;
  5. methods for ensuring patient safety and the  use  of  appropriately
licensed professionals in telemedicine; and
  6.  the  methodology  for determining the payment for telemedicine and
telehealth services under medical assistance services and  other  insur-
ance coverage.
  Such  recommendations  shall also take into account applicable federal
and state regulations governing professional practice and delegation  by
licensed professionals, patient privacy, confidentiality of peer review,
a  licensed  professional's competence to practice using technology, and
quality assurance information.
  e. The task force shall report to the governor and the legislature  on
or before December 1, 2010.
  S 3. This act shall take effect immediately.

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

                                 3198--B

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             March 12, 2009
                               ___________

Introduced  by  Sen. VALESKY -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health -- reported favora-
  bly from said committee and committed to the Committee on  Finance  --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee  --  recommitted  to  the  Committee  on
  Health  in  accordance  with  Senate  Rule  6,  sec.  8  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN ACT to amend the public health law,  in  relation  to  promoting  the
  development,  provision  and  accessibility of telehealth/telemedicine
  services in New York state; and to amend the  state  finance  law,  in
  relation  to  establishing  a  New  York state telehealth/telemedicine
  development and research grant fund

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

  Section  1.  This act shall be known and may be cited as the "New York
state telehealth/telemedicine development act."
  S 2. The public health law is amended by adding a new article 27-M  to
read as follows:
                              ARTICLE 27-M
       NEW YORK STATE TELEHEALTH/TELEMEDICINE DEVELOPMENT PROGRAM
SECTION 2799-T. LEGISLATIVE INTENT.
        2799-U. COORDINATION    OF   DEPARTMENT   RESPONSIBILITIES   FOR
                  TELEHEALTH/TELEMEDICINE; ANNUAL PLAN.
        2799-V. TELEHEALTH/TELEMEDICINE DEVELOPMENT; GRANTS  FOR  UNDER-
                  SERVED AREAS AND POPULATIONS.
        2799-W. TELEHEALTH/TELEMEDICINE RESEARCH.
  S  2799-T.  LEGISLATIVE  INTENT. THE LEGISLATURE RECOGNIZES THE DEMON-
STRATED  COST-EFFECTIVENESS,  IMPROVEMENTS  IN  DISEASE  MANAGEMENT  AND
IMPROVED    PATIENT   OUTCOMES   RESULTING   FROM   THE   PROVISION   OF
TELEHEALTH/TELEMEDICINE SERVICES. TELEHEALTH/TELEMEDICINE  SERVICES  ARE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04178-09-0
              

S. 3198--B                          2

THOSE  SERVICES  WHICH  UTILIZE  ELECTRONIC TECHNOLOGY OVER A GEOGRAPHIC
DISTANCE BETWEEN PATIENTS AND HEALTH CARE PROVIDERS FOR THE PURPOSES  OF
ASSESSMENT,  MONITORING, INTERVENTION, CLINICAL MANAGEMENT AND/OR EDUCA-
TION  WITH  PATIENTS.  STUDIES HAVE CHRONICLED SIGNIFICANT REDUCTIONS IN
HOSPITALIZATIONS AND OTHERWISE NECESSARY MEDICAL CARE  AS  A  RESULT  OF
TELEHEALTH/TELEMEDICINE INTERVENTION. THE LEGISLATURE FURTHER RECOGNIZES
THAT GEOGRAPHY, WEATHER AND OTHER FACTORS CAN CREATE BARRIERS TO ACCESS-
ING  APPROPRIATE  HEALTH  AND  MENTAL  HEALTH CARE IN NEW YORK STATE AND
THAT ONE WAY  TO PROVIDE, ENSURE OR ENHANCE ACCESS TO CARE  GIVEN  THESE
BARRIERS  IS  THROUGH  THE APPROPRIATE USE OF TECHNOLOGY TO ALLOW HEALTH
CARE CONSUMERS ACCESS TO QUALIFIED  HEALTH  CARE  PROVIDERS  AND  INSTI-
TUTIONS.    IN   ORDER   TO   PROMOTE   THE   ROLE   AND   CAPACITY   OF
TELEHEALTH/TELEMEDICINE  TECHNOLOGY  RELATIVE  TO  THESE  PURPOSES,  THE
LEGISLATURE  HEREBY  ENACTS  THE  NEW YORK STATE TELEHEALTH/TELEMEDICINE
DEVELOPMENT  ACT  TO  ESTABLISH  A  TELEHEALTH/TELEMEDICINE  DEVELOPMENT
PROGRAM TO COORDINATE AND FOCUS STATE ADMINISTRATIVE RESPONSIBILITIES AS
WELL  AS  STATE POLICY AND PROGRAM PLANNING FOR TELEHEALTH/TELEMEDICINE,
PROVIDE FOR TELEHEALTH/TELEMEDICINE DEVELOPMENT IN UNDERSERVED GEOGRAPH-
IC AREAS AND FOR NEW POPULATIONS,  PROMOTE  QUALITY  AND  SAFEGUARDS  IN
TELEHEALTH/TELEMEDICINE,   PROMOTE  AND  ASSIST  TELEHEALTH/TELEMEDICINE
RESEARCH AND EVALUATION, ESTABLISH THE TELEHEALTH/TELEMEDICINE  RESEARCH
AND DEVELOPMENT FUND, AND PROVIDE FOR CAPITAL FINANCING.
  S    2799-U.   COORDINATION   OF   DEPARTMENT   RESPONSIBILITIES   FOR
TELEHEALTH/TELEMEDICINE; ANNUAL PLAN. 1. THE COMMISSIONER SHALL  COORDI-
NATE  AND FOCUS THE DEPARTMENT'S DEVELOPMENTAL, ADMINISTRATIVE, RESEARCH
AND EVALUATION RESPONSIBILITIES FOR TELEHEALTH/TELEMEDICINE SERVICES.
  2. THE COMMISSIONER, IN CONSULTATION WITH ELIGIBLE PROVIDERS AS SPECI-
FIED IN SUBDIVISION TWO OF SECTION TWENTY-SEVEN HUNDRED NINETY-NINE-V OF
THIS ARTICLE, SHALL PREPARE AND SUBMIT AN ANNUAL  PLAN  TO  SUPPORT  THE
PROVISION  OF  TELEHEALTH/TELEMEDICINE  SERVICES  PROVIDED  PURSUANT  TO
SUBDIVISION THREE-C OF SECTION THIRTY-SIX HUNDRED FOURTEEN OF THIS CHAP-
TER, AS WELL AS OTHER TELEHEALTH/TELEMEDICINE  SERVICES  FOR  WHICH  THE
DEPARTMENT  HAS  DEVELOPMENTAL  AND  ADMINISTRATIVE  RESPONSIBILITY. THE
ANNUAL PLAN SHALL INCLUDE:
  (A) ANY NECESSARY RECOMMENDATIONS FOR LEGISLATIVE,  ADMINISTRATIVE  OR
BUDGETARY SUPPORT FOR TELEHEALTH/TELEMEDICINE SERVICES;
  (B)  THE  IDENTIFICATION OF BARRIERS TO THE PROVISION OF AND ACCESS TO
TELEHEALTH/TELEMEDICINE,  INCLUDING  EDUCATION  AND  TRAINING  FOR  BOTH
PROVIDERS  AND  CONSUMERS,  ELECTRONIC RECORDS INTERFACE, AND OTHER, AND
THE METHODS BY WHICH THE DEPARTMENT WILL AID IN ADDRESSING  SUCH  BARRI-
ERS; AND
  (C) AN ABSTRACT OF TELEHEALTH/TELEMEDICINE RESEARCH EITHER BEING OR TO
BE  CONDUCTED  BY  THE  DEPARTMENT, OR FACILITATED BY THE DEPARTMENT AND
BEING OR TO BE CONDUCTED BY PROVIDERS OR OTHER ENTITIES.
  3. THE COMMISSIONER SHALL PROVIDE COPIES OF THE  ANNUAL  PLAN  TO  THE
GOVERNOR,  THE TEMPORARY PRESIDENT AND MINORITY LEADER OF THE SENATE AND
THE SPEAKER AND MINORITY LEADER OF THE ASSEMBLY.
  4. (A) THE COMMISSIONER, IN CONSULTATION WITH  ELIGIBLE  PROVIDERS  AS
SPECIFIED   IN   SUBDIVISION   TWO   OF   SECTION  TWENTY-SEVEN  HUNDRED
NINETY-NINE-V OF THIS ARTICLE, SHALL IDENTIFY STANDARDS DETERMINED TO BE
NECESSARY FOR TELEHEALTH/TELEMEDICINE SERVICES UNDER THIS ARTICLE.  SUCH
STANDARDS,  INCLUDING  STANDARDS  FOR THE PROTECTION OF PATIENT INFORMA-
TION, SHALL BE IDENTIFIED FROM:
  (I) THE AMERICAN TELEMEDICINE ASSOCIATION, THE FEDERAL FOOD  AND  DRUG
ADMINISTRATION AND/OR OTHER GENERALLY RECOGNIZED STANDARD-SETTING ORGAN-
IZATIONS AS THE COMMISSIONER MAY DETERMINE;

S. 3198--B                          3

  (II)  TITLE  EIGHT  OF THE EDUCATION LAW AND REGULATIONS THERETO, THIS
CHAPTER AND REGULATIONS THERETO AND, AS  APPLICABLE,  THE  STANDARDS  OF
RELEVANT  PROFESSIONAL  OR  ACCREDITING  BODIES  AS THE COMMISSIONER MAY
DETERMINE,  TO  ENSURE  THAT   TELEHEALTH/TELEMEDICINE   MONITORING   IS
CONDUCTED  BY  INDIVIDUALS  IN  ACCORDANCE  WITH, AND AS LIMITED BY, THE
APPLICABLE SCOPE OF PRACTICE, LICENSURE AND/OR CREDENTIALING  PROVISIONS
OF SUCH LAWS AND STANDARDS.
  (B) THE COMMISSIONER MAY INCORPORATE, WITHIN THE ANNUAL PLAN SUBMITTED
PURSUANT  TO  SUBDIVISION  TWO  OF THIS SECTION, RECOMMENDATIONS FOR ANY
ADDITIONAL  STANDARDS  OR   REQUIREMENTS   FOR   TELEHEALTH/TELEMEDICINE
SERVICES AS MAY BE NECESSARY UNDER THIS ARTICLE.
  S  2799-V. TELEHEALTH/TELEMEDICINE DEVELOPMENT; GRANTS FOR UNDERSERVED
AREAS AND POPULATIONS. 1. SUBJECT TO THE AVAILABILITY  OF  FUNDING  FROM
SECTION  NINETY-NINE-T OF THE STATE FINANCE LAW, FUNDS MADE AVAILABLE IN
THE GENERAL FUND OR ANY OTHER FUNDS MADE AVAILABLE THEREFOR, THE DEPART-
MENT SHALL PROVIDE GRANTS TO ELIGIBLE PROVIDERS FOR:
  (A) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES IN  GEOGRAPHIC
AREAS  OF  THE  STATE  DEEMED BY THE DEPARTMENT TO BE UNDERSERVED ON THE
BASIS OF A LACK OF PROVIDERS PURSUANT TO THIS ARTICLE;
  (B) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES IN  GEOGRAPHIC
AREAS  OF  THE  STATE  DEEMED BY THE DEPARTMENT TO BE UNDERSERVED ON THE
BASIS OF THE LACK OF TELEHEALTH/TELEMEDICINE SERVICES IN THE AREA;
  (C) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES FOR NEW  POPU-
LATIONS,  WHERE  EVIDENCE  SUGGESTS THE PROVISION OF SUCH SERVICES WOULD
FACILITATE THE  MANAGEMENT  OF  PATIENT  CARE,  ACCESS  TO  CARE  AND/OR
COST-EFFECTIVENESS OF CARE;
  (D) THE DEVELOPMENT OF TELEHEALTH/TELEMEDICINE SERVICES FOR NEW CONDI-
TIONS,  WHERE  EVIDENCE  SUGGESTS  THE  PROVISION OF SUCH SERVICES WOULD
FACILITATE THE MANAGEMENT OF SUCH  CONDITIONS,  ACCESS  TO  CARE  AND/OR
COST-EFFECTIVENESS OF CARE;
  (E)  THE  DEVELOPMENT  OF TELEHEALTH/TELEMEDICINE SERVICES TO EVALUATE
THE POTENTIAL BENEFITS OF NEW  TELEHEALTH/TELEMEDICINE  TECHNOLOGY,  FOR
PATIENT CARE, ACCESS TO CARE AND/OR COST-EFFECTIVENESS OF CARE; OR
  (F) SUCH OTHER PURPOSES AS THE DEPARTMENT MAY IDENTIFY.
  2.  ELIGIBLE  PROVIDERS  SHALL  INCLUDE  THOSE  LICENSED, CERTIFIED OR
AUTHORIZED UNDER ARTICLE TWENTY-EIGHT, THIRTY-SIX OR FORTY OF THIS CHAP-
TER OR UNDER SECTION FORTY-FOUR  HUNDRED  THREE-F  OF  THIS  CHAPTER  OR
PHYSICIANS  LICENSED UNDER ARTICLE ONE HUNDRED THIRTY-ONE OF TITLE EIGHT
OF THE EDUCATION LAW;  PROVIDED  HOWEVER  THAT  ELIGIBILITY  UNDER  THIS
SECTION  TO PROVIDE TELEHEALTH/TELEMEDICINE SERVICES SHALL BE CONSISTENT
WITH THE AUTHORITY FOR THE PROVISION OF CARE OTHERWISE PROVIDED PURSUANT
TO ARTICLE TWENTY-EIGHT, THIRTY-SIX OR FORTY OF THIS  CHAPTER  OR  UNDER
SECTION FORTY-FOUR HUNDRED THREE-F OF THIS CHAPTER OR TITLE EIGHT OF THE
EDUCATION LAW.
  3.  THE  DEPARTMENT, IN CONSULTATION WITH ELIGIBLE PROVIDERS AS SPECI-
FIED IN SUBDIVISION TWO OF THIS SECTION, SHALL ESTABLISH THE  FORMS  AND
PROCESS  FOR  THE SUBMISSION AND APPROVAL OF GRANT APPLICATIONS PURSUANT
TO THIS SUBDIVISION.
  S 2799-W. TELEHEALTH/TELEMEDICINE RESEARCH. 1. THE COMMISSIONER  SHALL
PROMOTE  AND SUPPORT CLINICAL AND PROGRAMMATIC RESEARCH BY PROVIDERS AND
OTHER ENTITIES TO FURTHER EVALUATE, REFINE AND/OR DEVELOP EFFECTIVE  AND
EFFICIENT  APPLICATION OF TELEHEALTH/TELEMEDICINE METHODS AND TECHNOLOGY
TO POPULATIONS, CONDITIONS AND  CIRCUMSTANCES.  THE  COMMISSIONER  SHALL
MAKE AVAILABLE DATA AND TECHNICAL ASSISTANCE FOR SUCH RESEARCH, PROVIDED
THAT  ANY  DATA MADE AVAILABLE MUST NOT CONTAIN INDIVIDUALLY IDENTIFYING
INFORMATION.

S. 3198--B                          4

  2. THE COMMISSIONER IS AUTHORIZED  TO  APPLY  FOR  SUCH  GOVERNMENTAL,
PHILANTHROPIC  AND OTHER GRANTS THAT MAY BE AVAILABLE FOR SUCH RESEARCH.
MONIES FROM SUCH GRANTS  SHALL  BE  DEPOSITED  IN  THE  NEW  YORK  STATE
TELEHEALTH/TELEMEDICINE  DEVELOPMENT AND RESEARCH GRANT FUND ESTABLISHED
BY SECTION NINETY-NINE-T OF THE STATE FINANCE LAW.
  3.  THE DEPARTMENT SHALL CONSULT WITH ELIGIBLE PROVIDERS, AS SPECIFIED
IN SUBDIVISION TWO OF SECTION TWENTY-SEVEN HUNDRED NINETY-NINE-V OF THIS
ARTICLE IN THE IMPLEMENTATION OF THIS SECTION.
  S 3. Section 3614 of the public health law is amended by adding a  new
subdivision 3-d to read as follows:
  3-D. CAPITAL REIMBURSEMENT FOR TELEHEALTH/TELEMEDICINE. THE DEPARTMENT
SHALL  INCLUDE  IN  THE REIMBURSEMENT RATES ESTABLISHED PURSUANT TO THIS
SECTION A COST ALLOWANCE FOR THE REIMBURSEMENT OF CAPITAL COSTS FOR  THE
DEVELOPMENT,   OPERATION   AND   PROVISION   OF  TELEHEALTH/TELEMEDICINE
SERVICES, INCLUDING THE LINKAGE OF TELEHEALTH/TELEMEDICINE AND ELECTRON-
IC MEDICAL RECORDS. THE METHODOLOGY FOR THE INCLUSION OF  THE  ALLOWANCE
SHALL  BE  DEVELOPED  IN  CONSULTATION  WITH  THE ELIGIBLE PROVIDERS FOR
TELEHEALTH/TELEMEDICINE PURSUANT TO SECTION TWENTY-SEVEN  HUNDRED  NINE-
TY-NINE-U OF THIS ARTICLE.
  S  4. The state finance law is amended by adding a new section 99-t to
read as follows:
  S  99-T.  NEW  YORK  STATE  TELEHEALTH/TELEMEDICINE  DEVELOPMENT   AND
RESEARCH GRANT FUND. 1. THERE IS HEREBY ESTABLISHED IN THE JOINT CUSTODY
OF  THE  STATE  COMPTROLLER  AND  COMMISSIONER OF TAXATION AND FINANCE A
SPECIAL FUND TO BE KNOWN AS THE "NEW YORK STATE  TELEHEALTH/TELEMEDICINE
DEVELOPMENT AND RESEARCH FUND".
  2.  SUCH FUND SHALL CONSIST OF ALL MONIES APPROPRIATED FOR THE PURPOSE
OF SUCH FUND AND ANY GRANT, GIFT OR BEQUEST MADE FOR PURPOSES OF  DEVEL-
OPMENT  OR  GRANTS  FOR  TELEHEALTH/TELEMEDICINE  SERVICES  PURSUANT  TO
SECTION TWENTY-SEVEN HUNDRED NINETY-NINE-V OF THE PUBLIC HEALTH LAW.
  3. MONIES OF THE FUND SHALL BE AVAILABLE TO THE COMMISSIONER OF HEALTH
FOR THE  PURPOSE  OF  PROVIDING  DEVELOPMENT  AND  RESEARCH  GRANTS  FOR
TELEHEALTH/TELEMEDICINE  PURSUANT  TO SECTION TWENTY-SEVEN HUNDRED NINE-
TY-NINE-V OF THE PUBLIC HEALTH LAW.
  4. THE MONIES OF THE FUND SHALL BE PAID OUT ON THE AUDIT  AND  WARRANT
OF THE COMPTROLLER ON VOUCHERS CERTIFIED OR APPROVED BY THE COMMISSIONER
OF  HEALTH,  OR  BY  AN  OFFICER OR EMPLOYEE OF THE DEPARTMENT OF HEALTH
DESIGNATED BY SUCH COMMISSIONER.
  S 5. This act shall take effect  immediately;  provided  that  section
three  of  this  act  shall  take  effect on the first day of April next
succeeding the date on which this act shall have  become  law;  provided
further  however  that the commissioner of health shall be authorized to
take all necessary steps to implement this section by such date.