Senate Bill S7193

2009-2010 Legislative Session

Establishes the New York state home care quality of care innovations initiative and the New York State Home Care Quality Innovations Initiative Fund

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Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Mar 19, 2010	referred to health

2009-S7193 (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Add §3616-b, Pub Health L; add §99-t, St Fin L

2009-S7193 (ACTIVE) - Summary

Establishes the New York state home care quality of care innovations initiative and the New York State Home Care Quality Innovations Initiative Fund.

2009-S7193 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S7193

 TITLE OF BILL :

An act to amend the public health law, in relation to establishing the
New York state home care quality of care innovations initiative; and
to amend the state finance law, in relation to establishing New York
state home care quality innovations initiative fund


 PURPOSE :

Establishes the New York State Home Care Quality of Care Innovations
Initiative. The purpose of this initiative is to promote quality
innovations in the care of patients at home to enhance overall care
management, patient outcomes, patient/caregiver self-management of
chronic conditions and cost-effectiveness of care.

 SUMMARY OF PROVISIONS :

Declares legislative findings and intent and creates a new section
3616-b of the public health law establishing the New York State Home
Care Quality of Care Innovations Initiative; sets forth its purposes,
participating providers/organizations and the State Health
Department's collaborative and administrative role.

The Home Care Quality of Care Innovations Initiative would include,
but not be limited to:

a. Promoting the development, application, utilization and research of
clinical guidelines and evidenced based practices in connection with
the care of patients at home;

b. Promoting the use of technology in conjunction with clinical
criteria and evidence based practice for the advancement of quality
care;

c. Promoting quality transitions in care, including but not limited to
transitions to and from home-based care and to hospitals, nursing
homes, rehabilitation centers and other settings, as well as
transitions to and from different home care programs;

d. Identifying gaps and other elements of the system which contribute
to avoidable hospital readmissions, including medication
reconciliation, and targeting intervention to prevent and reduce such
readmissions;

e. Identifying the cost-effectiveness of the application of such
quality innovations for governmental and nongovernmental payers; and

f. Researching clinical protocols, programs, practices and outcomes to
identify additional areas and methods for developing and promoting
quality innovations.

Participating entities would include voluntarily participating
certified home health agencies, long term home health care programs,
licensed home care services agencies, AIDS home care programs,
agencies/programs under managed long term care plans, collaborative
initiatives with physicians, hospitals and other providers or
entities, as well as entities with expertise in quality review, home
health agency accreditation, and statewide home care representation.

The bill establishes an advisory group to consult on program
implementation. The Health Department would work with the advisory
group to:

a. Identify clinical guidelines and evidence based practices to be
researched and/or promoted through the initiative, which would include
the consideration of nationally developed guidelines and practices as
well as those developed or evidenced on a provider-specific basis;

b. Identify types of technology and areas where the application and
coverage of such technology would be considered as a standard of care;

c. Identify elements to be addressed in improving transitions of care
as well as for preventing avoidable rehospitalizations, and the
corresponding methods for addressing such elements;

d. Conduct provider/consumer education, including that of provider
quality improvement personnel, relative to the utilization of clinical
guidelines, evidence based practices, application of technology, the
implementation of strategies to improve transitions in care and
interventions to prevent or reduce hospital readmissions;

e. Determine data to be shared with providers which would further the
goals of clinical guideline identification, development and/or use and
improvement in transitions in care;

f. Identify and respond as practicable to the technical assistance
needs of providers participating in the initiative;

g. Implement a grant program to support the quality initiative;

h. Determine and recommend positive adjustments in the Medicaid rate
methodology to enable and encourage desired provider behavior and
goals with regard to quality innovation and enhancement pursuant to
this section;

i. Identify areas for research and foster such other activities as the
Department in conjunction with the workgroup deem necessary,
appropriate and consistent with the goals of the program.

A grant program would be established to support the home care quality
innovations initiatives, with funding also set aside to support the
administrative and implementation expenses of the Health Department.

A New York State Home Care Quality of Care Innovations Fund would be
established under the state finance law to include appropriations as
well as any grants, gifts or other philanthropic, private or
governmental sources of funding to support the program.

The Commissioner of Health would be provided with waiver authority for
purposes of promoting the implementation and goals of the program.
The legislation would exclude costs associated with the provision of
home care quality of care innovations from the calculation of
providers' administrative and general cost cap under section 3614 of
the public health law.

The Department would report experiences and recommendations to the
Governor and Legislature on or before December 1, 2011.

 JUSTIFICATION :

With the advancement of clinical techniques and the improvements in
data, technology and measurement of clinical practices and outcomes,
new and significant opportunities exist for quality of care
innovation, with consequent benefits for patients, the health care
system and potential for cost-savings for all payers. Given home
care's increasing, central role in the total care of all types of
patients, the support of quality innovation in connection with care in
the home should be a vital focus for advancing these opportunities.
Many critical elements that affect patient health and the functioning
of the system, including transitions in care, avoidable hospital
admissions and readmissions and other critical problems and needs, can
be address through such innovations.

The ability to impact the system, patients' lives and health care
costs through such innovations necessitates the state's support for
and investment in the engagement of home care agencies, their patients
and collaborating providers and entities. The creation of the proposed
New York State Home Care Quality of Care Innovations Initiative would
break new ground in health care, and serve the strong interests of the
state and its citizens.

 LEGISLATIVE HISTORY :

New bill.

 FISCAL IMPLICATIONS :

Creates opportunities for cost savings to Medicaid and other payors.
The program would be financed through both external sources of funds
(private, philanthropic, federal grants) and any state appropriations
that might be provided in the budget.

 EFFECTIVE DATE :
Immediately.

2009-S7193 (ACTIVE) - Bill Text download pdf

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

                                  7193

                            I N  S E N A T E

                             March 19, 2010
                               ___________

Introduced  by  Sen.  DUANE  -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law, in relation to  establishing  the
  New  York  state home care quality of care innovations initiative; and
  to amend the state finance law, in relation to establishing  New  York
  state home care quality innovations initiative fund

  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
3616-b to read as follows:
  S  3616-B. NEW YORK STATE HOME CARE QUALITY OF CARE INNOVATIONS INITI-
ATIVE. 1. THE LEGISLATURE  HEREBY  FINDS  AND  DECLARES  THAT  WITH  THE
ADVANCEMENT  OF  CLINICAL TECHNIQUES AND THE IMPROVEMENTS IN DATA, TECH-
NOLOGY AND MEASUREMENT OF  CLINICAL  PRACTICES  AND  OUTCOMES,  NEW  AND
SIGNIFICANT  OPPORTUNITIES  EXIST  FOR  QUALITY OF CARE INNOVATION, WITH
CONSEQUENT BENEFITS FOR PATIENTS, THE HEALTH CARE SYSTEM  AND  POTENTIAL
FOR COST-SAVINGS FOR ALL PAYERS. THE LEGISLATURE FURTHER FINDS THAT WITH
THE INCREASING, CENTRAL ROLE OF HOME CARE IN THE TOTAL CARE OF ALL TYPES
OF  PATIENTS,  THE SUPPORT OF QUALITY INNOVATION IN CONNECTION WITH CARE
IN THE HOME SHOULD BE A VITAL FOCUS FOR ADVANCING THESE OPPORTUNITIES.
  THE LEGISLATURE FINDS THAT METHODS OF  ADVANCING  THESE  OPPORTUNITIES
THROUGH  HOME CARE, BOTH DIRECTLY THROUGH HOME CARE AGENCIES AND THROUGH
HOME CARE'S COLLABORATION WITH HOSPITALS, PHYSICIANS AND OTHERS, INCLUDE
BUT ARE NOT LIMITED TO: (A) THE DEVELOPMENT,  TARGETED  APPLICATION  AND
UTILIZATION OF CLINICAL GUIDELINES AND EVIDENCE BASED PRACTICES TAILORED
TO  SPECIFIC  CONDITIONS, POPULATIONS AND CIRCUMSTANCES OF CARE; (B) THE
APPLICATION OF SPECIFIC TECHNOLOGY AS  A  BASIC  STANDARD  OF  CARE  FOR
CERTAIN  CONDITIONS;  (C)  IDENTIFYING  AND  ADDRESSING  GAPS  AND OTHER
ASPECTS AFFECTING TRANSITIONS IN CARE,  ESPECIALLY  TRANSITIONS  TO  AND
FROM  HOME CARE AND HOSPITALS, NURSING HOMES, REHABILITATION CENTERS AND
OTHER SETTINGS; AND (D) TARGETING THE CONTRIBUTING FACTORS  TO  HOSPITAL
READMISSIONS  AND  PROMOTING  APPROPRIATE  INTERVENTIONS  TO PREVENT AND
REDUCE SUCH READMISSIONS.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD16497-01-0

S. 7193                             2

  THE LEGISLATURE FINDS THAT SUCH INNOVATIONS  NECESSITATE  THE  STATE'S
INVESTMENT  IN  AND  VOLUNTARY  ENGAGEMENT  OF HOME CARE AGENCIES, THEIR
PATIENTS AND COLLABORATIVE PROVIDERS, AND THAT THE  ACTIVE  SUPPORT  AND
PARTNERSHIP  OF  THE  DEPARTMENT IS CONDUCIVE TO THE GOAL OF THESE INNO-
VATIONS  AND,  AS  SUCH,  IN  THE STRONG INTEREST OF THE CITIZENS OF THE
STATE.
  THE LEGISLATURE THEREFORE CONCLUDES THAT THE STATE ESTABLISH THE "HOME
CARE QUALITY OF CARE INNOVATIONS  INITIATIVE"  TO  PROMOTE  AND  SUPPORT
THESE ACTIVITIES AND INTERVENTIONS.
  2.  THERE  IS  HEREBY  CREATED THE NEW YORK STATE HOME CARE QUALITY OF
CARE INNOVATIONS INITIATIVE, WHICH HEREINAFTER MAY  BE  REFERRED  TO  AS
"INITIATIVE."  SUCH  INITIATIVE  IS CREATED FOR THE PURPOSE OF PROMOTING
QUALITY INNOVATIONS IN THE CARE OF PATIENTS AT HOME TO  IMPROVE  OVERALL
CARE  MANAGEMENT, PATIENT OUTCOMES, PATIENT/CAREGIVER SELF-MANAGEMENT OF
CHRONIC CONDITIONS AND POTENTIAL COST-EFFECTIVENESS OF CARE. SUCH INITI-
ATIVE SHALL BE UNDERTAKEN TO INFORM AND SUPPORT, AND NOT BE EMPLOYED  TO
SUPERSEDE CLINICAL JUDGMENT ABOUT THE PROVISION OR MANAGEMENT OF CARE.
  3.  SUCH INITIATIVE SHALL INCLUDE BUT NOT BE LIMITED TO: (A) PROMOTING
THE DEVELOPMENT,  APPLICATION,  UTILIZATION  AND  RESEARCH  OF  CLINICAL
GUIDELINES  AND  EVIDENCE BASED PRACTICES IN CONNECTION WITH THE CARE OF
PATIENTS AT HOME;
  (B) PROMOTING THE USE  OF  TECHNOLOGY  IN  CONJUNCTION  WITH  CLINICAL
CRITERIA  AND  EVIDENCE  BASED  PRACTICES FOR THE ADVANCEMENT OF QUALITY
CARE;
  (C) PROMOTING QUALITY TRANSITIONS IN CARE, INCLUDING BUT  NOT  LIMITED
TO  TRANSITIONS  TO  AND  FROM HOME-BASED CARE AND TO HOSPITALS, NURSING
HOMES, REHABILITATION CENTERS AND OTHER SETTINGS, AS WELL AS TRANSITIONS
TO AND FROM DIFFERENT HOME CARE PROGRAMS;
  (D) IDENTIFYING GAPS AND OTHER ELEMENTS OF THE SYSTEM WHICH CONTRIBUTE
TO AVOIDABLE HOSPITAL READMISSIONS, INCLUDING MEDICATION RECONCILIATION,
AND TARGETING INTERVENTION TO PREVENT AND REDUCE SUCH READMISSIONS;
  (E) IDENTIFYING THE COST-EFFECTIVENESS  OF  THE  APPLICATION  OF  SUCH
QUALITY INNOVATIONS FOR GOVERNMENTAL AND NONGOVERNMENTAL PAYERS; AND
  (F)  RESEARCHING  CLINICAL PROTOCOLS, PROGRAMS, PRACTICES AND OUTCOMES
TO IDENTIFY ADDITIONAL AREAS AND METHODS FOR  DEVELOPING  AND  PROMOTING
QUALITY INNOVATIONS.
  4.  (A)  SUCH  INITIATIVE SHALL BE UNDERTAKEN WITH VOLUNTARILY PARTIC-
IPATING CERTIFIED HOME HEALTH  AGENCIES,  LONG  TERM  HOME  HEALTH  CARE
PROGRAMS,  LICENSED  HOME  CARE  SERVICES  AGENCIES  AND  AIDS HOME CARE
PROGRAMS, AND SHALL INCLUDE SUCH AGENCIES OR PROGRAMS  CONTAINED  WITHIN
OR  UNDER  CONTRACT  WITH MANAGED LONG TERM CARE PLANS. SUCH INITIATIVES
MAY INCLUDE SUCH AGENCIES' AND PROGRAMS' COLLABORATION WITH  PHYSICIANS,
HOSPITALS AND OTHER PROVIDERS OR ENTITIES.
  (B)  SUCH INITIATIVE MAY ALSO INCLUDE THE PARTICIPATION OF: A NON-PRO-
VIDER ENTITY WITH EXPERTISE IN PERFORMING QUALITY AND UTILIZATION REVIEW
FOR HOME HEALTH CARE AS WELL AS STUDIES OR DEMONSTRATIONS  FOR  IMPROVED
TRANSITIONS  IN  CARE;  AN ENTITY WHICH SERVES AS A NATIONAL ACCREDITING
BODY FOR HOME HEALTH AGENCIES; AND, A STATEWIDE TRADE  ASSOCIATION  MOST
BROADLY  REPRESENTATIVE  OF HOME CARE AGENCIES AND PROGRAMS CERTIFIED BY
MEDICARE AND MEDICAID IN THE  STATE,  INCLUDING  CERTIFIED  HOME  HEALTH
AGENCIES AND LONG TERM HOME HEALTH CARE PROGRAMS.
  5.  THE  DEPARTMENT SHALL CONVENE AN ADVISORY GROUP OF REPRESENTATIVES
OF PARTICIPATING PROVIDERS AND PROGRAMS AS  WELL  AS  STATEWIDE  ASSOCI-
ATIONS REPRESENTATIVE OF SUCH PROVIDERS AND THEIR CONSUMERS TO GUIDE THE
IMPLEMENTATION  OF  EACH COMPONENT OF THE INITIATIVE. THE ADVISORY GROUP
MAY ALSO INCLUDE REPRESENTATIVES OF PHYSICIANS, HOSPITALS AND THIRD-PAR-

S. 7193                             3

TY PAYORS AND OTHERS WHICH THE DEPARTMENT DEEMS APPROPRIATE AND CONSIST-
ENT WITH THE PURPOSES OF THIS SECTION.
  6.  THE DEPARTMENT SHALL WORK WITH THE ADVISORY GROUP TO: (A) IDENTIFY
CLINICAL GUIDELINES AND EVIDENCE BASED PRACTICES TO BE RESEARCHED AND/OR
PROMOTED THROUGH THE INITIATIVE, WHICH SHALL INCLUDE  THE  CONSIDERATION
OF NATIONALLY DEVELOPED GUIDELINES AND PRACTICES AS WELL AS THOSE DEVEL-
OPED OR EVIDENCED ON A PROVIDER-SPECIFIC BASIS;
  (B)  IDENTIFY  TYPES OF TECHNOLOGY AND AREAS WHERE THE APPLICATION AND
COVERAGE OF SUCH TECHNOLOGY SHOULD BE CONSIDERED AS A STANDARD OF CARE;
  (C) IDENTIFY ELEMENTS TO BE ADDRESSED IN IMPROVING TRANSITIONS OF CARE
AS WELL AS FOR PREVENTING AVOIDABLE REHOSPITALIZATIONS, AND  THE  CORRE-
SPONDING METHODS FOR ADDRESSING SUCH ELEMENTS;
  (D)  CONDUCT  PROVIDER/CONSUMER  EDUCATION, INCLUDING THAT OF PROVIDER
QUALITY IMPROVEMENT PERSONNEL, RELATIVE TO THE UTILIZATION  OF  CLINICAL
GUIDELINES,  EVIDENCE  BASED  PRACTICES,  APPLICATION OF TECHNOLOGY, THE
IMPLEMENTATION OF STRATEGIES TO IMPROVE TRANSITIONS IN CARE  AND  INTER-
VENTIONS TO PREVENT OR REDUCE HOSPITAL READMISSIONS;
  (E) DETERMINE DATA TO BE SHARED WITH PROVIDERS WHICH WOULD FURTHER THE
GOALS  OF  CLINICAL GUIDELINE IDENTIFICATION, DEVELOPMENT AND/OR USE AND
IMPROVEMENT IN TRANSITIONS IN CARE;
  (F) IDENTIFY AND RESPOND AS PRACTICABLE TO  THE  TECHNICAL  ASSISTANCE
NEEDS OF PROVIDERS PARTICIPATING IN THE INITIATIVE;
  (G)  IMPLEMENT  THE GRANT PROGRAM PROVIDED FOR IN SUBDIVISION SEVEN OF
THIS SECTION;
  (H) DETERMINE AND RECOMMEND POSITIVE ADJUSTMENTS IN THE MEDICAID  RATE
METHODOLOGY  TO ENABLE AND ENCOURAGE DESIRED PROVIDER BEHAVIOR AND GOALS
WITH REGARD TO QUALITY  INNOVATION  AND  ENHANCEMENT  PURSUANT  TO  THIS
SECTION; AND
  (I)  IDENTIFY  AREAS  FOR RESEARCH PURSUANT TO THIS SECTION AND FOSTER
SUCH OTHER ACTIVITIES AS THE DEPARTMENT IN CONJUNCTION  WITH  THE  WORK-
GROUP DEEM TO BE NECESSARY, APPROPRIATE AND CONSISTENT WITH THE GOALS OF
THIS SECTION.
  7.  (A)  THE DEPARTMENT IS HEREBY AUTHORIZED, FROM ANY FUNDS APPROPRI-
ATED THEREFOR, INCLUDING FUNDS FROM THE NEW YORK STATE HOME CARE QUALITY
OF CARE INNOVATIONS INITIATIVE FUND PURSUANT TO SECTION NINETY-NINE-T OF
THE STATE FINANCE LAW, TO ISSUE GRANTS TO  PROVIDERS  AND  PARTICIPATING
ENTITIES  TO  ASSIST  IN  MEETING  THE  COSTS OF PLANNING, IMPLEMENTING,
AND/OR CONDUCTING QUALITY INNOVATIONS PURSUANT TO THIS SECTION.
  (B) THE DEPARTMENT SHALL AWARD  SUCH  GRANTS  BASED  ON  CRITERIA  AND
PRIORITIES  ESTABLISHED  IN  CONSULTATION WITH THE ADVISORY GROUP ESTAB-
LISHED PURSUANT TO SUBDIVISION FOUR OF THIS SECTION.
  (C) GRANTS AWARDED UNDER THIS SECTION MAY BE RENEWED  SUBJECT  TO  THE
AVAILABILITY OF FUNDS.
  (D)  NOTWITHSTANDING  THE  PROVISIONS OF SECTION ONE HUNDRED TWELVE OR
ONE HUNDRED THIRTEEN OF THE STATE FINANCE LAW, THE DEPARTMENT MAY  ISSUE
GRANTS TO PARTICIPANTS SPECIFIED IN PARAGRAPH (B) OF SUBDIVISION FOUR OF
THIS SECTION WITHOUT A COMPETITIVE BID PROCESS.
  8. NOTWITHSTANDING THE PROVISIONS OF SUBDIVISIONS SEVEN AND SEVEN-A OF
SECTION  THREE THOUSAND FOURTEEN OF THIS ARTICLE, PROVIDER COSTS ASSOCI-
ATED WITH THE PARTICIPATION IN THE QUALITY INNOVATIONS INITIATIVE PURSU-
ANT TO THIS SECTION SHALL NOT BE INCLUDED IN OR SUBJECT TO THE STATEWIDE
AVERAGE ADMINISTRATIVE AND GENERAL COST LIMITATION APPLIED  PURSUANT  TO
SUCH SUBDIVISIONS.
  9.  THE  COMMISSIONER IS AUTHORIZED TO WAIVE PROVISIONS OF THE DEPART-
MENT'S RULES AND REGULATIONS, AS WELL AS RULES AND  REGULATIONS  PROMUL-
GATED  PURSUANT  TO  THE  SOCIAL  SERVICES  LAW, AS MAY BE NECESSARY AND

S. 7193                             4

APPROPRIATE TO FACILITATE THE IMPLEMENTATION AND GOALS OF THIS  SECTION,
INCLUDING  THE  GOAL  OF  IMPROVING  THE  COST-EFFECTIVENESS  TO PAYERS;
PROVIDED HOWEVER THAT NO RULES OR  REGULATIONS  SHALL  BE  WAIVED  WHICH
WOULD  REMOVE  OR  DIMINISH RIGHTS AFFORDED TO PROVIDERS OR CONSUMERS OF
CARE.
  10. THE DEPARTMENT  SHALL  REPORT  TO  THE  GOVERNOR  AND  LEGISLATURE
REGARDING  THE EFFECTS ON QUALITY, COST AND UTILIZATION UNDER THE INITI-
ATIVE. SUCH REPORT SHALL BE FILED ON OR BEFORE DECEMBER FIRST, TWO THOU-
SAND ELEVEN.
  S 2. The state finance law is amended by adding a new section 99-t  to
read as follows:
  S  99-T.  NEW  YORK STATE HOME CARE QUALITY OF CARE INNOVATIONS INITI-
ATIVE 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 HOME CARE QUALITY OF CARE  INNO-
VATIONS INITIATIVE FUND".
  2.  SUCH FUND SHALL CONSIST OF ALL MONEYS APPROPRIATED FOR THE PURPOSE
OF SUCH FUND AND ANY GRANT, GIFT OR BEQUEST MADE FOR  PURPOSES  OF  HOME
CARE  QUALITY OF CARE INNOVATIONS PURSUANT TO SECTION THIRTY-SIX HUNDRED
SIXTEEN-B OF THE PUBLIC HEALTH LAW.
  3. MONIES OF THE FUND SHALL BE MADE AVAILABLE TO THE  COMMISSIONER  OF
HEALTH  FOR  THE PURPOSE OF PROVIDING GRANTS AND FOR THE EXPENSES OF THE
DEPARTMENT PURSUANT TO THE NEW YORK STATE  HOME  CARE  QUALITY  OF  CARE
INNOVATIONS  INITIATIVE AS ADDED BY SECTION THIRTY-SIX HUNDRED SIXTEEN-B
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 3. This act shall take effect immediately.

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Senate Bill S7193

Sponsored By

Archive: Last Bill Status - In Senate Committee Health Committee

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2009-S7193 (ACTIVE) - Details

2009-S7193 (ACTIVE) - Summary

2009-S7193 (ACTIVE) - Sponsor Memo

2009-S7193 (ACTIVE) - Bill Text download pdf

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Sponsored By

Thomas K. Duane

Archive: Last Bill Status - In Senate Committee Health Committee

Actions

2009-S7193 (ACTIVE) - Details

2009-S7193 (ACTIVE) - Summary

2009-S7193 (ACTIVE) - Sponsor Memo

2009-S7193 (ACTIVE) - Bill Text download pdf

Comments