senate Bill S5258

2013-2014 Legislative Session

Establishes the hospital-home care-physician collaboration program in the department of health

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Archive: Last Bill Status - Passed Senate


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jun 16, 2014 referred to health
delivered to assembly
passed senate
Jun 02, 2014 advanced to third reading
May 29, 2014 2nd report cal.
May 28, 2014 1st report cal.948
May 06, 2014 reported and committed to finance
Jan 08, 2014 referred to health
May 15, 2013 referred to health

Votes

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May 6, 2014 - Health committee Vote

S5258
17
0
committee
17
Aye
0
Nay
0
Aye with Reservations
0
Absent
0
Excused
0
Abstained
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Co-Sponsors

S5258 - Bill Details

See Assembly Version of this Bill:
A7899
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Add ยง2805-w, Pub Health L

S5258 - Bill Texts

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Establishes the hospital-home care-physician collaboration program in the department of health to facilitate innovation in hospital, home care agency and physician collaboration in meeting health care needs in communities.

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BILL NUMBER:S5258

TITLE OF BILL: An act to amend the public health law, in relation to
establishing a hospital-home care-physician collaboration program

PURPOSE:

To facilitate improvement, efficiency and strengthened infrastructure
in the health care system though collaborative hospital, home care and
physician initiatives. Provides support for these initiatives through
funding and regulatory flexibility. Also includes nursing homes,
multidisciplinary providers and practitioners, payors, and other
service entities as additional potential partners.

SUMMARY OF PROVISIONS:

Section one establishes a new section 2805-w of the public health law,
"Hospital-Home Care-Physician Collaboration Program."

Subdivision 1 states the purpose, to provide a framework to support
collaborative hospital-home care-physician initiatives for improving
patient care access and management, patient health outcomes,
cost-effectiveness in the use of health care services, and community
population health. Collaborating partners may also include skilled
nursing facilities, other interdisciplinary providers and
practitioners, payors and others.

Subdivision 2 defines key terms used in the section.

Subdivision 3 authorizes the Commissioner of Health to provide support
to facilitate these initiatives, including:

(a) Grants, rate adjustments, premium adjustments or other financing,
to the extent available to support the program. Includes as potential
funding sources state-secured waivers (e.g., the state is seeking
through waivers $10 billion in federal health care reinvestment
funding.

(b) Regulatory flexibility waivers for the program. Subdivision 4
specifies categories and subcategories of collaborative initiatives
under the program, including but not limited to:

(a) Integration initiatives, including: Transitions in care; Clinical
pathways; Application of telehealth/telemedicine services;
Facilitation of physician house calls; Prevention of avoidable
hospital readmissions and emergency room visits; Health Home
development; Development and demonstration of new models of integrated
or collaborative care and care management not otherwise achievable
through existing models; and Bundled payment demonstrations for
hospital-to-post-acute-care.

(b) Recruitment, training, retention and placement of essential direct
care personnel.

(c) Initiatives in the care and management of special needs, high-risk
and high-cost patients, through best practices, training and education


of direct care practitioners and personnel. Subdivision 5 provides
for reporting requirements.

Section 2 establishes an immediate effective date for the bill.

JUSTIFICATION:

Communities and the providers which serve them face increasing
challenges in adapting to the changing health care system and to
meeting citizens' health care needs. Both patient and system needs are
growing in complexity, diversity and demand.

Provider collaboration is a highly effective and vital vehicle to
coordinate and maximize both clinical efforts and local resources in
meeting patient/community needs. In addition, such collaboration leads
to better integration of health care services and is critical to
facilitating quality of care, advanced care management techniques and
health care cost-efficiency.

The major benefits of hospital, home care agency and physician
collaboration are being seen in the overall improved management and
delivery of services, in effective patient care transition programs,
telehealth/telemedicine services, specialty care management, physician
house call programs, preventive as well as post-acute and chronic care
initiatives, and other innovations. These collaborative initiatives
hold potential for further, far-reaching benefit to patients and to
the evolving system, particularly in resource-limited areas. These
initiatives are in sync with the state's major health care reform
policies, its 1115 waiver and waiver reinvestment proposals, the
federal Affordable Care Act, and industry-led trends.

The benefits of these initiatives compel state policy, program and
financial support. In supporting these initiatives, this legislation
will facilitate patient care management, outcomes, efficiency, health
care infrastructure and population health.

LEGISLATIVE HISTORY:

New bill.

FISCAL IMPLICATIONS:

This bill will promote efficiency and coordination in service
delivery, with better outcomes, reduced costs, and ultimately
sustainability and access of care.

EFFECTIVE DATE:

The bill would take effect immediately.

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

                                  5258

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                              May 15, 2013
                               ___________

Introduced  by  Sen.  HANNON -- 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  a
  hospital-home care-physician collaboration program

  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
2805-w to read as follows:
  S  2805-W. HOSPITAL-HOME CARE-PHYSICIAN COLLABORATION PROGRAM.  1. THE
PURPOSE OF THIS SECTION SHALL BE TO FACILITATE INNOVATION  IN  HOSPITAL,
HOME  CARE AGENCY AND PHYSICIAN COLLABORATION IN MEETING THE COMMUNITY'S
HEALTH CARE NEEDS. IT SHALL PROVIDE A  FRAMEWORK  TO  SUPPORT  VOLUNTARY
INITIATIVES  IN COLLABORATION TO IMPROVE PATIENT CARE ACCESS AND MANAGE-
MENT, PATIENT HEALTH OUTCOMES, COST-EFFECTIVENESS IN THE USE  OF  HEALTH
CARE SERVICES AND COMMUNITY POPULATION HEALTH. SUCH COLLABORATIVE INITI-
ATIVES  MAY  ALSO  INCLUDE  PAYORS, SKILLED NURSING FACILITIES AND OTHER
INTERDISCIPLINARY PROVIDERS, PRACTITIONERS AND SERVICE ENTITIES.
  2. FOR PURPOSES OF THIS SECTION:
  (A) "HOSPITAL" SHALL INCLUDE A GENERAL HOSPITAL  AS  DEFINED  IN  THIS
ARTICLE OR OTHER INPATIENT FACILITY FOR REHABILITATION OR SPECIALTY CARE
WITHIN THE DEFINITION OF HOSPITAL IN THIS ARTICLE.
  (B) "HOME CARE AGENCY" SHALL MEAN A CERTIFIED HOME HEALTH AGENCY, LONG
TERM  HOME  HEALTH CARE PROGRAM OR LICENSED HOME CARE SERVICES AGENCY AS
DEFINED IN ARTICLE THIRTY-SIX OF THIS CHAPTER.
  (C) "PAYOR" SHALL MEAN A HEALTH  PLAN  APPROVED  PURSUANT  TO  ARTICLE
FORTY-FOUR  OF THIS CHAPTER, OR ARTICLE THIRTY-TWO OR FORTY-THREE OF THE
INSURANCE LAW.
  (D) "PRACTITIONER" SHALL MEAN ANY OF  THE  HEALTH,  MENTAL  HEALTH  OR
HEALTH  RELATED  PROFESSIONS  LICENSED  PURSUANT  TO  TITLE EIGHT OF THE
EDUCATION LAW.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10954-01-3

S. 5258                             2

  3. THE COMMISSIONER IS AUTHORIZED TO PROVIDE FINANCING INCLUDING,  BUT
NOT  LIMITED  TO,  GRANTS  OR POSITIVE ADJUSTMENTS IN MEDICAL ASSISTANCE
RATES OR PREMIUM PAYMENTS, TO THE EXTENT OF FUNDS  AVAILABLE  AND  ALLO-
CATED  OR  APPROPRIATED  THEREFOR, INCLUDING FUNDS PROVIDED TO THE STATE
THROUGH  FEDERAL  WAIVERS,  FUNDS MADE AVAILABLE THROUGH STATE APPROPRI-
ATIONS AND/OR FUNDING THROUGH SECTION TWENTY-EIGHT  HUNDRED  SEVEN-V  OF
THIS  ARTICLE,  AS WELL AS WAIVERS OF REGULATIONS UNDER TITLE TEN OF THE
NEW YORK CODES, RULES AND REGULATIONS, TO SUPPORT THE  VOLUNTARY  INITI-
ATIVES AND OBJECTIVES OF THIS SECTION.
  4.  HOSPITAL-HOME  CARE-PHYSICIAN COLLABORATIVE INITIATIVES UNDER THIS
SECTION MAY INCLUDE, BUT ARE NOT BE LIMITED TO:
  (A) HOSPITAL-HOME CARE-PHYSICIAN  INTEGRATION  INITIATIVES,  INCLUDING
BUT NOT LIMITED TO:
  (I)  TRANSITIONS  IN  CARE  INITIATIVES TO HELP EFFECTIVELY TRANSITION
PATIENTS TO POST-ACUTE CARE  AT  HOME,  COORDINATE  FOLLOW-UP  CARE  AND
ADDRESS ISSUES CRITICAL TO CARE PLAN SUCCESS AND READMISSION AVOIDANCE;
  (II)  CLINICAL  PATHWAYS  FOR  SPECIFIED CONDITIONS, GUIDING PATIENTS'
PROGRESS AND OUTCOME GOALS, AS WELL AS EFFECTIVE HEALTH SERVICES USE;
  (III) APPLICATION OF TELEHEALTH/TELEMEDICINE  SERVICES  IN  MONITORING
AND  MANAGING  PATIENT  CONDITIONS,  AND PROMOTING SELF-CARE/MANAGEMENT,
IMPROVED OUTCOMES AND EFFECTIVE SERVICES USE;
  (IV) FACILITATION OF  PHYSICIAN  HOUSE  CALLS  TO  HOMEBOUND  PATIENTS
AND/OR  TO  PATIENTS  FOR WHOM SUCH HOME VISITS ARE DETERMINED NECESSARY
AND EFFECTIVE FOR PATIENT CARE MANAGEMENT;
  (V) ADDITIONAL MODELS FOR PREVENTION OF  AVOIDABLE  HOSPITAL  READMIS-
SIONS AND EMERGENCY ROOM VISITS;
  (VI) HEALTH HOME DEVELOPMENT;
  (VII)  DEVELOPMENT  AND  DEMONSTRATION  OF NEW MODELS OF INTEGRATED OR
COLLABORATIVE CARE AND CARE MANAGEMENT NOT OTHERWISE ACHIEVABLE  THROUGH
EXISTING MODELS; AND
  (VIII)  BUNDLED PAYMENT DEMONSTRATIONS FOR HOSPITAL-TO-POST-ACUTE-CARE
FOR SPECIFIED CONDITIONS OR CATEGORIES  OF  CONDITIONS,  IN  PARTICULAR,
CONDITIONS  PREDISPOSED  TO  HIGH  PREVALENCE  OF READMISSION, INCLUDING
THOSE CURRENTLY SUBJECT TO FEDERAL/STATE PENALTY, AND  OTHER  DISCHARGES
WITH EXTENSIVE POST-ACUTE NEEDS;
  (B)  RECRUITMENT,  TRAINING AND RETENTION OF HOSPITAL/HOME CARE DIRECT
CARE STAFF AND PHYSICIANS, IN GEOGRAPHIC OR  CLINICAL  AREAS  OF  DEMON-
STRATED NEED.  SUCH INITIATIVES MAY INCLUDE, BUT ARE NOT LIMITED TO, THE
FOLLOWING ACTIVITIES:
  (I)  OUTREACH AND PUBLIC EDUCATION ABOUT THE NEED AND VALUE OF SERVICE
IN HEALTH OCCUPATIONS;
  (II) TRAINING/CONTINUING EDUCATION  AND  REGULATORY  FACILITATION  FOR
CROSS-TRAINING  TO  MAXIMIZE  FLEXIBILITY  IN  THE UTILIZATION OF STAFF,
INCLUDING:
  (A) TRAINING OF HOSPITAL NURSES IN HOME CARE;
  (B) DUAL CERTIFIED NURSE AIDE/HOME HEALTH AIDE CERTIFICATION; AND
  (C) DUAL PERSONAL CARE AIDE/HHA CERTIFICATION;
  (III) SALARY/BENEFIT ENHANCEMENT;
  (IV) CAREER LADDER DEVELOPMENT; AND
  (V) OTHER INCENTIVES TO PRACTICE IN SHORTAGE AREAS; AND
  (C)  HOSPITAL, HOME CARE, PHYSICIAN COLLABORATIVES FOR  THE  CARE  AND
MANAGEMENT OF SPECIAL NEEDS, HIGH-RISK AND HIGH-COST PATIENTS, INCLUDING
BUT  NOT LIMITED TO BEST PRACTICES, AND TRAINING AND EDUCATION OF DIRECT
CARE PRACTITIONERS AND SERVICE EMPLOYEES.
  5. HOSPITALS AND HOME CARE AGENCIES WHICH ARE  PROVIDED  FINANCING  OR
WAIVERS PURSUANT TO THIS SECTION SHALL REPORT TO THE COMMISSIONER ON THE

S. 5258                             3

PATIENT,  SERVICE AND COST EXPERIENCES PURSUANT TO THIS SECTION, INCLUD-
ING THE EXTENT TO WHICH THE PROJECT GOALS ARE ACHIEVED. THE COMMISSIONER
SHALL COMPILE AND  MAKE  SUCH  REPORTS  AVAILABLE  ON  THE  DEPARTMENT'S
WEBSITE.
  S 2. This act shall take effect immediately.

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