Assembly Bill A2473

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

                                  2473

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            January 19, 2011
                               ___________

Introduced  by  M.  of  A.  CANESTRARI  -- read once and referred to the
  Committee on Health

AN ACT to amend the public health law, in  relation  to  establishing  a
  demonstration  program  to study transition authorization panels as an
  approach to secure decisions regarding  the  transition  of  incapable
  patients  who do not have legally authorized decisionmakers from inpa-
  tient care to post-acute care; and providing for the  repeal  of  such
  provisions upon expiration thereof

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

  Section 1. The legislature finds and declares that in  many  instances
there  are  hospital patients who are medically ready to transition to a
different level of care,  such  as  nursing  home  care,  home  care  or
assisted living, but they lack capacity to authorize the transition, and
also  lack a family member or other person who can authorize the transi-
tion on their behalf. As a result, such patients can be subject to inor-
dinate delays in accomplishing a needed transition, and  can  remain  as
hospital  inpatients  for  long  periods.  That  delay is harmful to the
interests of those patients, as well as to other persons  who  may  need
the  scarce  inpatient  resources,  to  hospitals,  to payors and to the
public in general.
  The legislature further finds that while  article  81  of  the  mental
hygiene  law provides a procedure for the court-appointment of guardians
who could be empowered to authorize transition for such  patients,  such
procedure  was designed for longer-term assistance with an incapacitated
person's personal and property affairs, and includes features that often
go beyond what is needed for transition-related decisions  alone.  As  a
result,  the  guardianship  proceeding can require far more time, effort
and expense than is warranted for this limited, non-contested decision.
  Accordingly, the legislature finds that it would be valuable to  study
an  alternative  approach to secure decisions relating to the transition

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06141-01-1
              

A. 2473                             2

of isolated incapable patients from inpatient care to  post-acute  care.
Specifically,  the  transition authorization panel demonstration program
shows promise as means to protect the rights and interests of  incapable
patients in the transition decision, while allowing such decisions to be
made within a reasonable timeframe.
  S  2.  The public health law is amended by adding a new section 2803-t
to read as follows:
  S 2803-T. TRANSITION AUTHORIZATION PANEL DEMONSTRATION  PROGRAM.    1.
THERE  IS  HEREBY  ESTABLISHED  A  TRANSITION AUTHORIZATION PANEL DEMON-
STRATION PROGRAM,  CONDUCTED  AT  SIX  PROGRAM  SITES,  TO  EVALUATE  AN
APPROACH  TO  SECURE  DECISIONS  RELATING  TO THE TRANSITION OF ISOLATED
PATIENTS FROM INPATIENT CARE TO POST-ACUTE CARE.
  2. AS USED IN THIS SECTION:
  (A) "ELIGIBLE PATIENT" MEANS AN INPATIENT AT A PARTICIPATING  HOSPITAL
WHO, ACCORDING TO THE PATIENT'S ATTENDING PHYSICIAN:
  (I) IS READY TO BE DISCHARGED AS AN INPATIENT, BUT NEEDS TO BE TRANSI-
TIONED TO POST-ACUTE CARE;
  (II)  LACKS  CAPACITY  TO CONSENT TO THE DISCHARGE AND TO ADMISSION TO
POST-ACUTE CARE;
  (III) DOES NOT HAVE A GUARDIAN, HEALTH CARE AGENT OR POWER  OF  ATTOR-
NEY,  OR  A FAMILY MEMBER, FRIEND OR OTHER REPRESENTATIVE WHO IS REASON-
ABLY AVAILABLE AND WILLING TO MAKE A TRANSITION DECISION ON HIS  OR  HER
BEHALF,  WHOSE  CONSENT  WOULD BE ACCEPTED BY A PROPOSED POST-ACUTE CARE
PROVIDER, AND WHO IS LEGALLY AUTHORIZED TO  MAKE  ALL  REQUIRED  TRANSI-
TION-RELATED FINANCIAL ARRANGEMENTS;
  (IV)  HAS  A  DISCHARGE PLAN THAT IDENTIFIES AN APPROPRIATE POST-ACUTE
CARE PROVIDER THAT IS OR MAY BE WILLING TO ADMIT THE PATIENT IF A  TRAN-
SITION  AUTHORIZATION  PANEL  WERE  TO  AUTHORIZE THE TRANSITION AND, IF
NECESSARY, MAKE TRANSITION-RELATED FINANCIAL ARRANGEMENTS; AND
  (V) HAS NOT EXPRESSED AN OBJECTION TO ANY OF THE FOREGOING FINDINGS OR
TO BEING TRANSITIONED TO THE PROPOSED POST-ACUTE FACILITY OR SERVICE OR,
IF APPLICABLE, THE PROPOSED TRANSITION-RELATED FINANCIAL ARRANGEMENTS;
  (B) "PARTICIPATING HOSPITAL" MEANS ANY  OF  THE  FOLLOWING  HOSPITALS,
UPON  THE  CHIEF EXECUTIVE OFFICER OF THE HOSPITAL NOTIFYING THE COMMIS-
SIONER IN WRITING THAT THE HOSPITAL ELECTS TO BE A PARTICIPATING  HOSPI-
TAL,  AND UNTIL THE CHIEF EXECUTIVE OFFICER OF THE HOSPITAL NOTIFIES THE
COMMISSIONER IN WRITING THAT  THE  HOSPITAL  ELECTS  TO  CEASE  BEING  A
PARTICIPATING HOSPITAL:
  (I) CROUSE HOSPITAL, SYRACUSE, NY.
  (II) GLENS FALLS HOSPITAL, GLENS FALLS, NY.
  (III) MEMORIAL HOSPITAL, ALBANY, NY.
  (IV) SAMARITAN HOSPITAL, TROY, NY.
  (V) UNIVERSITY OF ROCHESTER MEDICAL CENTER, ROCHESTER, NY.
  (VI) WYCKOFF HEIGHTS MEDICAL CENTER, BROOKLYN, NY.
  (C) "POST-ACUTE CARE" MEANS CARE PROVIDED BY A RESIDENTIAL HEALTH CARE
FACILITY,  TRANSITIONAL  CARE  UNIT, HOME CARE SERVICES, ASSISTED LIVING
PROGRAM, ADULT CARE FACILITY, HOSPICE, AND AN INPATIENT TREATMENT FACIL-
ITY OR RESIDENTIAL FACILITY LICENSED OR OPERATED BY THE OFFICE OF  ALCO-
HOLISM  AND SUBSTANCE ABUSE SERVICES, THE OFFICE OF MENTAL HEALTH OR THE
OFFICE FOR PEOPLE  WITH  DEVELOPMENTAL  DISABILITIES,  OR  AN  INPATIENT
TREATMENT  FACILITY OR RESIDENTIAL FACILITY LICENSED BY A HEALTH, MENTAL
HYGIENE OR SOCIAL SERVICES AGENCY OF ANOTHER STATE.
  (D) "TRANSITION AUTHORIZATION" MEANS A DECISION, MADE BY A  TRANSITION
AUTHORIZATION  PANEL  PURSUANT TO THIS SECTION, TO AUTHORIZE THE TRANSI-
TION OF AN ELIGIBLE PATIENT FROM A PARTICIPATING HOSPITAL TO A  SPECIFIC

A. 2473                             3

POST-ACUTE CARE PROVIDER, AND "AUTHORIZE A TRANSITION" OR "AUTHORIZE THE
TRANSITION" MEANS TO MAKE SUCH DECISION.
  (E)  "TRANSITION  AUTHORIZATION PANEL AGENT" OR "AGENT" MEANS AN INDI-
VIDUAL AUTHORIZED BY THE TRANSITION AUTHORIZATION  PANEL  TO  CARRY  OUT
TRANSITION RELATED FINANCIAL ARRANGEMENTS.
  (F)  "TRANSITION  AUTHORIZATION PANEL" OR "PANEL" MEANS A THREE-PERSON
PANEL, CONVENED PURSUANT TO THIS SECTION, TO AUTHORIZE THE TRANSITION OF
AN ELIGIBLE PATIENT FROM A PARTICIPATING HOSPITAL TO A  POST-ACUTE  CARE
PROVIDER, AND TO MAKE TRANSITION-RELATED FINANCIAL ARRANGEMENTS.
  (G)  "TRANSITION  AUTHORIZATION  PANEL  POOL"  MEANS  THE FULL POOL OF
PERSONS QUALIFIED AND DESIGNATED TO SERVE  ON  TRANSITION  AUTHORIZATION
PANELS AT A PROGRAM SITE.
  (H) "TRANSITION-RELATED FINANCIAL ARRANGEMENTS" MEANS ACTS NECESSARY:
  (I) TO EXPEND THE ELIGIBLE PATIENT'S FUNDS FOR POST-ACUTE CARE FOR ONE
HUNDRED  TWENTY DAYS OR UNTIL THE COURT APPOINTMENT OF A GUARDIAN OF THE
PROPERTY PURSUANT TO ARTICLE  EIGHTY-ONE  OF  THE  MENTAL  HYGIENE  LAW,
WHICHEVER OCCURS FIRST.
  (II)  TO  APPLY  FOR  THE ELIGIBLE PATIENT'S ENROLLMENT IN MEDICAID OR
MEDICARE.
  (III) TO ACCESS FINANCIAL INFORMATION ABOUT THE ELIGIBLE PATIENT  FROM
FINANCIAL  INSTITUTIONS  TO  THE  EXTENT  NECESSARY FOR THE PURPOSES SET
FORTH IN SUBPARAGRAPHS (I) AND (II) OF THIS PARAGRAPH.
  (I) "FINANCIAL INSTITUTION" MEANS A FINANCIAL INSTITUTION  AS  DEFINED
IN SUBDIVISION TWO OF SECTION 5-1501 OF THE GENERAL OBLIGATIONS LAW.
  (J)  "ADMINISTRATOR"  MEANS  THE  ADMINISTRATOR OF THE PROGRAM FOR THE
PARTICIPATING  HOSPITAL  DESIGNATED  UNDER  SUBDIVISION  THREE  OF  THIS
SECTION.
  3. EACH PARTICIPATING HOSPITAL SHALL:
  (A) DESIGNATE A PERSON AS ADMINISTRATOR OF THE PROGRAM WITH RESPECT TO
THAT PROGRAM SITE;
  (B)  CARRY OUT, AND BEAR THE COSTS OF, THE ADMINISTRATIVE RESPONSIBIL-
ITIES OF THE PROGRAM AS SET FORTH IN THIS SECTION, WITH RESPECT TO  THAT
PROGRAM SITE; AND
  (C)  CREATE  AND MAINTAIN RECORDS OF (I) ALL REQUESTS, PANELS CONVENED
AND ACTIONS TAKEN PURSUANT TO THIS SECTION, AND (II) ALL  TRANSITION-RE-
LATED  FINANCIAL  ARRANGEMENTS  MADE  PURSUANT  TO  THIS SECTION.   SUCH
RECORDS SHALL BE MADE AVAILABLE TO THE DEPARTMENT UPON REQUEST.
  4. (A) A PARTICIPATING HOSPITAL MAY CREATE A TRANSITION  AUTHORIZATION
PANEL POOL AT A PROGRAM SITE, WHICH SHALL HAVE THREE CLASSES OF MEMBERS:
  (I)  ONE CLASS OF MEMBERS SHALL BE QUALIFIED PERSONS DESIGNATED BY THE
HOSPITAL;
  (II) ONE CLASS OF MEMBERS SHALL BE QUALIFIED PERSONS DESIGNATED BY THE
LOCAL SOCIAL SERVICES COMMISSIONER; AND
  (III) ONE CLASS OF MEMBERS SHALL BE QUALIFIED  PERSONS  DESIGNATED  BY
THE NEW YORK STATE OFFICE OF LONG TERM CARE OMBUDSMAN.
  (B)  FOR  THE  PURPOSES OF THIS SUBDIVISION, "QUALIFIED PERSONS" MEANS
ADULT PERSONS WITH RECOGNIZED EXPERTISE OR DEMONSTRATED INTEREST IN  THE
CARE AND TREATMENT OF HOSPITAL AND POST-ACUTE CARE PATIENTS, AND WHO CAN
BE  EXPECTED TO APPLY THE STANDARDS OF THIS SECTION IN GOOD FAITH AND IN
THE BEST INTERESTS OF THE ELIGIBLE PATIENT.
  (C) THE PARTICIPATING HOSPITAL AND THE LOCAL SOCIAL  SERVICES  COMMIS-
SIONER  SHALL  JOINTLY  APPOINT  ONE  MEMBER  AS CHAIR OF THE TRANSITION
AUTHORIZATION PANEL POOL.
  5. (A) THE REVIEW OF REQUESTS FOR  TRANSITION  AUTHORIZATION  AND  FOR
TRANSITION-RELATED  FINANCIAL ARRANGEMENTS SHALL BE UNDERTAKEN BY PANELS
OF THREE MEMBERS DRAWN FROM THE TRANSITION AUTHORIZATION PANEL POOL, ONE

A. 2473                             4

FROM EACH CLASS. THE PARTICIPATING HOSPITAL SHALL APPOINT ONE MEMBER  AS
PANEL CHAIR.
  (B)  NO  PERSON WHO IS A HEALTH CARE PROFESSIONAL ACTIVELY INVOLVED IN
THE TREATMENT OF THE PATIENT WHOSE CASE  IS  UNDER  CONSIDERATION  BY  A
PANEL  MAY  SERVE  ON  THE  PANEL WITH RESPECT TO SUCH PATIENT, ALTHOUGH
OTHER HOSPITAL PERSONNEL MAY SERVE ON THE PANEL IF OTHERWISE QUALIFIED.
  6. (A) THE ATTENDING PHYSICIAN OF AN ELIGIBLE PATIENT MAY REQUEST THAT
A PANEL BE CONVENED BY SUBMITTING A WRITTEN REQUEST TO  THE  ADMINISTRA-
TOR. THE REQUEST MUST:
  (I) INDICATE THAT IT IS A REQUEST FOR THE PANEL TO AUTHORIZE THE TRAN-
SITION  OF  THE  PATIENT  TO POST-ACUTE CARE AND, IF APPLICABLE, TO MAKE
TRANSITION-RELATED FINANCIAL ARRANGEMENTS;
  (II) SET FORTH THE REASONS FOR BELIEVING THAT THE PATIENT IS AN ELIGI-
BLE PATIENT; AND
  (III) SET FORTH THE PROPOSED POST-ACUTE CARE PROVIDER  (OR  PROVIDERS,
IF APPLICATIONS HAVE OR WILL BE MADE TO MORE THAN ONE);
  (B)  UPON RECEIPT OF THE REQUEST, THE ADMINISTRATOR MAY EITHER DECLINE
THE REQUEST AND NOTIFY THE ATTENDING PHYSICIAN OF THE REASON  WHICH  MAY
INCLUDE  BUT  NOT  BE  LIMITED  TO THE FACT THAT ALTHOUGH THE PATIENT IS
ELIGIBLE, A TRANSITION CAN BE ACCOMPLISHED WITHOUT THE NEED  TO  CONVENE
THE PANEL, OR ELSE TAKE THE FOLLOWING STEPS TO CONVENE THE PANEL:
  (I)  SET A TIME, DATE AND PLACE FOR THE TRANSITION AUTHORIZATION PANEL
TO REVIEW THE REQUEST. SUCH REVIEW MAY BE SCHEDULED  FOR  ANY  TIME  AND
DATE  AT  LEAST  THREE  DAYS  AFTER  THE  REQUEST  AND NOTICE IS SENT AS
PROVIDED IN THIS PARAGRAPH; HOWEVER, THE REVIEW SHALL BE HELD EARLIER OR
LATER THAN THE DATE SET FORTH IN THE NOTICE IF ALL PERSONS WHO ARE ENTI-
TLED TO NOTICE, AS SET FORTH IN THIS PARAGRAPH,  AGREE,  IN  WRITING  OR
VERBALLY  (AS  DOCUMENTED  BY THE ADMINISTRATOR), TO THE TIME, PLACE AND
DATE OF THE REVIEW.
  (II) SEND A COPY OF THE REQUEST AND NOTICE,  BY  HAND,  MAIL,  FAX  OR
E-MAIL, TO THE FOLLOWING PERSONS:
  (A) THREE MEMBERS OF THE TRANSITION AUTHORIZATION PANEL POOL, ONE FROM
EACH  CLASS,  SELECTED  BY  THE  POOL CHAIR, WHO ARE WILLING AND ABLE TO
SERVE AS A PANEL FOR THE PURPOSE OF THIS REVIEW;
  (B) THE PATIENT, IF THERE IS ANY INDICATION OF THE  PATIENT'S  ABILITY
TO COMPREHEND SUCH NOTICE;
  (C)  TO A FAMILY MEMBER OR FRIEND OF THE PATIENT WHO MAY BE REASONABLY
AVAILABLE AND WILLING TO MAKE  A  TRANSITION  DECISION  ON  HIS  OR  HER
BEHALF, IF THERE IS ANY SUCH PERSON;
  (D)  IF THE PATIENT WAS ADMITTED FROM A FACILITY OR RESIDENCE LICENSED
BY THE OFFICE OF MENTAL HEALTH OR THE OFFICE FOR  PEOPLE  WITH  DEVELOP-
MENTAL DISABILITIES, TO  THE FACILITY DIRECTOR AND TO THE MENTAL HYGIENE
LEGAL  SERVICES  OFFICE  UNDER ARTICLE FORTY-SEVEN OF THE MENTAL HYGIENE
LAW; AND
  (E) TO THE PATIENT'S ATTENDING PHYSICIAN.
  (III) PROVIDE NOTICE TO  THE  PATIENT  AND  TO  MENTAL  HYGIENE  LEGAL
SERVICES  WHICH SHALL INFORM THE PATIENT THAT HE OR SHE WILL BE AFFORDED
AN OPPORTUNITY TO ADDRESS THE  PANEL,  MAY  BE  PRESENT  FOR  ANY  OTHER
ADDRESSES  MADE  TO THE PANEL, AND MAY BE PRESENT FOR OTHER PARTS OF THE
PANEL REVIEW AS THE CHAIR MAY PERMIT, BUT THAT HE OR  SHE  WILL  NOT  BE
PERMITTED TO BE PRESENT DURING THE PANEL'S DELIBERATION.
  (IV) PROVIDE NOTICE TO PERSONS DESCRIBED IN CLAUSES (B) THROUGH (E) OF
SUBPARAGRAPH  (II)  OF THIS PARAGRAPH WHICH SHALL INFORM THE PERSON THAT
HE OR SHE WILL BE AFFORDED AN OPPORTUNITY TO ADDRESS THE PANEL, AND  MAY
BE  PRESENT  FOR  SUCH  OTHER PARTS OF THE PANEL REVIEW AS THE CHAIR MAY
PERMIT, THAT THE PATIENT AND MENTAL HYGIENE LEGAL SERVICES (WHEN REPRES-

A. 2473                             5

ENTING A PATIENT) MAY BE PRESENT WHEN ANY  OTHER  PERSON  ADDRESSES  THE
PANEL,  AND  THAT  NO  PERSON  DESCRIBED  IN  CLAUSES (B) THROUGH (E) OF
SUBPARAGRAPH (II) OF THIS PARAGRAPH SHALL BE  PERMITTED  TO  BE  PRESENT
DURING THE PANEL'S DELIBERATION.
  7. (A) PRIOR TO OR DURING THE REVIEW, THE PANEL CHAIR MAY REQUEST AND,
NOTWITHSTANDING  ANY  OTHER  LAW  TO  THE CONTRARY, SHALL BE ENTITLED TO
RECEIVE FROM ANY HEALTH CARE PROVIDER AND  DISCLOSE  TO  THE  PANEL  ANY
INFORMATION  WHICH  IS RELEVANT TO THE PANEL'S REVIEW. INFORMATION WHICH
IS CONFIDENTIAL, AS PROVIDED FOR BY LAW, SHALL BE KEPT  CONFIDENTIAL  BY
THE  PANEL AND ANY LIMITATIONS ON THE FURTHER RELEASE THEREOF IMPOSED BY
LAW UPON THE PARTY FURNISHING THE INFORMATION SHALL APPLY TO THE PANEL.
  (B) THE PANEL SHALL MEET IN PERSON OR BY VIDEO CONFERENCE  TO  CONDUCT
ITS REVIEW.
  (C)  THE  PANEL  CHAIR MAY REQUEST THE ATTENDANCE AT THE REVIEW OF ANY
PERSON WHO MIGHT ASSIST THE PANEL IN ITS REVIEW.
  (D) THE PATIENT AND MENTAL HYGIENE LEGAL SERVICES (WHEN REPRESENTING A
PATIENT) MAY BE PRESENT WHEN ANY OTHER PERSON ADDRESSES THE PANEL.
  (E) WHERE PRACTICABLE, THE PANEL MEMBERS  SHALL  PERSONALLY  INTERVIEW
AND OBSERVE THE PATIENT PRIOR TO MAKING THEIR DECISION.
  (F)  NO  PERSON  DESCRIBED  IN CLAUSES (B) THROUGH (E) OF SUBPARAGRAPH
(II) OF PARAGRAPH (B) OF  SUBDIVISION  SIX  OF  THIS  SECTION  SHALL  BE
PERMITTED TO BE PRESENT DURING THE PANEL DELIBERATION.
  (G) THE PANEL CHAIR MAY ADJOURN AND RECONVENE THE PANEL AS NECESSARY.
  (H)  THE ADMINISTRATOR SHALL ARRANGE FOR MINUTES TO BE TAKEN AND MAIN-
TAINED OF ANY PANEL MEETING, BUT NO RECORDING OR TRANSCRIPTION SHALL  BE
REQUIRED.
  (I) IN ITS REVIEW, THE PANEL SHALL CONSIDER WHETHER THE PROPOSED TRAN-
SITION  IS  TO  A  FACILITY OR PROGRAM THAT APPEARS ABLE (I) TO MEET THE
PATIENT'S NEEDS, AND (II) TO DO SO  IN  THE  LEAST  RESTRICTIVE  SETTING
REASONABLY AVAILABLE TO THE PATIENT.
  8.  (A) THE PANEL SHALL MAKE A DETERMINATION, BY MAJORITY VOTE, AS TO:
(I) WHETHER THE PATIENT IS AN ELIGIBLE PATIENT, (II) WHETHER TO  AUTHOR-
IZE THE PROPOSED TRANSITION (PROVIDED THAT, IF THE PATIENT HAS A GUARDI-
AN,  HEALTH CARE AGENT, SURROGATE OR OTHER REPRESENTATIVE WHO IS REASON-
ABLY AVAILABLE AND WILLING TO MAKE A TRANSITION DECISION ON HIS  OR  HER
BEHALF,  BUT  WHO  IS  NOT LEGALLY AUTHORIZED TO MAKE FINANCIAL ARRANGE-
MENTS, THEN SUCH PERSON AND  NOT  THE  PANEL  SHALL  DECIDE  WHETHER  TO
AUTHORIZE THE PROPOSED TRANSITION), AND (III) WHETHER TO AUTHORIZE TRAN-
SITION-RELATED  FINANCIAL ARRANGEMENTS.   THE DETERMINATION SHALL BE SET
FORTH IN WRITING AND SHALL BE SIGNED BY  THE  CHAIR  ON  BEHALF  OF  THE
PANEL.
  (B)  IF  THE  PANEL  DETERMINES  TO  AUTHORIZE THE PROPOSED TRANSITION
AND/OR  TRANSITION-RELATED  FINANCIAL  ARRANGEMENTS,  THE  AUTHORIZATION
SHALL  BE  SET  FORTH  IN AN ORDER, SIGNED BY THE CHAIR ON BEHALF OF THE
PANEL. THE ORDER SHALL DESCRIBE THE SCOPE OF SUCH AUTHORIZATION AND,  IF
IT  AUTHORIZES  TRANSITION-RELATED  FINANCIAL  ARRANGEMENTS, DESIGNATE A
TRANSITION AUTHORIZATION PANEL AGENT.
  (C) THE DETERMINATION, AND THE ORDER IF THERE IS ONE,  SHALL  BE  MADE
PART OF THE PATIENT'S MEDICAL RECORD.
  (D) NOTWITHSTANDING ANY LAW TO THE CONTRARY, THE ADMINISTRATOR AND THE
AGENT  SHALL  DISCLOSE  THE  ORDER  TO SUCH PERSONS AS NECESSARY FOR THE
PURPOSE OF CARRYING OUT ITS TERMS.
  (E) THE ORDER AUTHORIZING THE PROPOSED TRANSITION SHALL BE, AND MAY BE
RELIED UPON BY THE PARTICIPATING HOSPITAL, BY POST-ACUTE CARE PROVIDERS,
BY FINANCIAL INSTITUTIONS, AND BY OTHER THIRD-PARTIES AS LEGAL AUTHORITY

A. 2473                             6

FOR THEM TO PERFORM OR COOPERATE IN THE PERFORMANCE  OF  THE  AUTHORIZED
ACTS, INCLUDING LEGAL AUTHORITY:
  (I) FOR THE PARTICIPATING HOSPITAL TO DISCHARGE THE PATIENT;
  (II) FOR THE POST-ACUTE CARE PROVIDER TO ADMIT THE PATIENT;
  (III)  FOR  THE  TRANSITION  AUTHORIZATION PANEL AGENT TO MAKE TRANSI-
TION-RELATED FINANCIAL ARRANGEMENTS; AND
  (IV) FOR MEDICAID, FINANCIAL INSTITUTIONS AND OTHER PARTIES TO PROVIDE
FINANCIAL AND OTHER PERSONAL INFORMATION ABOUT THE  PATIENT  RELATED  TO
THE  TRANSITION  AND  TRANSITION-RELATED  FINANCIAL  ARRANGEMENTS TO THE
ADMINISTRATOR OR AGENT, AND TO OTHERWISE COOPERATE IN THE TRANSITION-RE-
LATED FINANCIAL ARRANGEMENTS.
  SUCH PARTIES SHALL BE IMMUNE FROM LIABILITY FOR ACTIONS TAKEN IN  GOOD
FAITH AND REASONABLE RELIANCE UPON SUCH ORDER.
  (F)  A TRANSITION AUTHORIZATION PANEL AGENT, IN THE PERFORMANCE OF HIS
OR HER DUTIES UNDER THIS SECTION, SHALL BE DEEMED THE PERSONAL REPRESEN-
TATIVE OF THE PATIENT FOR PURPOSES OF FEDERAL  REGULATIONS  RELATING  TO
THE PRIVACY OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (HIPAA).
  9. A PARTICIPATING HOSPITAL, THE LOCAL SOCIAL SERVICES DEPARTMENT, AND
ANY OTHER PERSON MAY, BUT SHALL NOT BE REQUIRED TO, ENTER INTO AN AGREE-
MENT  WITH  A POST-ACUTE CARE PROVIDER FOR SUCH HOSPITAL, DEPARTMENT, OR
OTHER PERSON TO PETITION FOR THE APPOINTMENT OF A GUARDIAN UNDER ARTICLE
EIGHTY-ONE OF THE MENTAL HYGIENE LAW FOR A PATIENT TRANSITIONED PURSUANT
TO THE ORDER OF A TRANSITION AUTHORIZATION PANEL, EITHER BEFORE OR AFTER
THE TRANSITION, AS A WAY TO PROVIDE FOR BROADER AND  LONGER  TERM  DECI-
SIONMAKING AUTHORITY WITH RESPECT TO THE TRANSITIONED PATIENT. THE CHIEF
EXECUTIVE  OFFICER  OF A PARTICIPATING HOSPITAL, OR HIS OR HER DESIGNEE,
THAT ENTERS INTO SUCH AGREEMENT PRIOR TO THE PATIENT'S  DISCHARGE  SHALL
BE  DEEMED  TO HAVE THE AUTHORITY TO COMMENCE A PETITION UNDER PARAGRAPH
SEVEN OF SUBDIVISION (A) OF SECTION 81.06 OF THE MENTAL HYGIENE LAW.
  10. NO PERSON SHALL BE SUBJECT TO CRIMINAL OR CIVIL LIABILITY OR SANC-
TION BY A GOVERNMENTAL AGENCY FOR ACTIONS TAKEN REASONABLY AND  IN  GOOD
FAITH  PURSUANT TO THIS ARTICLE (A) AS A MEMBER OR AGENT OF A TRANSITION
AUTHORIZATION PANEL, OR AS ADMINISTRATOR OF A  TRANSITION  AUTHORIZATION
PROGRAM; (B) DISCHARGING, TRANSFERRING OR ADMITTING A PATIENT FROM OR TO
A  FACILITY PURSUANT TO AN ORDER OF A TRANSITION AUTHORIZATION PANEL; OR
(C) DISCLOSING FINANCIAL  INFORMATION  ABOUT  A  PATIENT  OR  DISBURSING
PATIENT FUNDS PURSUANT TO AN ORDER OF A TRANSITION AUTHORIZATION PANEL.
  11.  (A) THE ADMINISTRATOR OF EACH PANEL SHALL SUBMIT AN ANNUAL REPORT
TO THE COMMISSIONER, DUE WITHIN THIRTY DAYS OF EACH ANNIVERSARY  OF  THE
EFFECTIVE DATE OF THIS SECTION.  THE REPORT SHALL SET FORTH:
  (I)  WITH  RESPECT  TO EACH REQUEST TO CONVENE BY A PANEL, THE TYPE OF
POST-ACUTE CARE REQUESTED;   THE LENGTH OF TIME FROM  THE  DATE  OF  THE
REQUEST  UNTIL (A) THE PANEL CONVENED, (B) THE PANEL ISSUED ITS DETERMI-
NATION, AND (C) THE PATIENT WAS DISCHARGED FROM THE PARTICIPATING HOSPI-
TAL (IF THE DETERMINATION APPROVED THE TRANSITION);  THE  CATEGORIES  OF
PERSONS  WHO ADDRESSED THE PANEL; THE NUMBER OF UNANIMOUS AND NON-UNANI-
MOUS PANEL VOTES; WHETHER THE ORDER CALLED FOR TRANSITION-RELATED FINAN-
CIAL ARRANGEMENTS AND IF SO WHETHER THOSE ARRANGEMENTS WERE SUCCESSFULLY
MADE; WHETHER THE PATIENT AND/OR FAMILY MEMBER OBJECTED TO  THE  PANEL'S
DECISION; AND ANY DATA OR OTHER INFORMATION AVAILABLE TO THE ADMINISTRA-
TOR  REGARDING THE IMPACT OF THE DEMONSTRATION ON THE HOSPITAL'S AVERAGE
INPATIENT LENGTH OF STAY.
  (II) AN EVALUATION BY THE PARTICIPATING  HOSPITAL,  THE  LOCAL  SOCIAL
SERVICES  DEPARTMENT,  AND  THE  NEW YORK STATE OFFICE OF LONG TERM CARE
OMBUDSMAN REGARDING WHETHER TRANSITION AUTHORIZATION  PANELS  ADEQUATELY
PROTECTED  THE INTERESTS AND RIGHTS OF PATIENTS INCLUDING THEIR INTEREST

A. 2473                             7

IN BEING TRANSITIONED TO THE LEAST RESTRICTIVE SETTING REASONABLY AVAIL-
ABLE, AND THE SUCCESS OF THE TRANSITION PLANS APPROVED BY THE PROGRAM IN
MEETING THE NEEDS OF PATIENTS AND THEIR RECOMMENDATIONS  FOR  AMENDMENTS
TO  THIS  SECTION,  AND RECOMMENDATIONS REGARDING THE MERIT OF EXTENDING
THIS DEMONSTRATION PROGRAM OR ADOPTING A PERMANENT AND STATEWIDE TRANSI-
TION AUTHORIZATION PROGRAM.
  (B) THE COMMISSIONER SHALL COMPILE THE REPORTS SUBMITTED TO HIM OR HER
AS REQUIRED BY THIS SUBDIVISION, AND PROMPTLY SUBMIT SUCH REPORTS TO THE
TEMPORARY PRESIDENT OF THE SENATE, THE  SPEAKER  OF  THE  ASSEMBLY,  THE
MINORITY  LEADER  OF THE SENATE AND THE MINORITY LEADER OF THE ASSEMBLY,
AND MAKE SUCH REPORTS AVAILABLE TO THE PUBLIC. THE COMMISSIONER MAY  ADD
HIS OR HER OWN RECOMMENDATIONS TO THAT COMPILATION.
  S  3.  This act shall take effect immediately, and shall expire and be
deemed repealed three years and ninety days after it shall have become a
law.