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

                                  1411

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            January 12, 2015
                               ___________

Introduced  by  M. of A. PAULIN, GOTTFRIED, BENEDETTO -- Multi-Sponsored
  by -- M. of A. HIKIND, HOOPER -- read once and referred to the Commit-
  tee on Health

AN ACT to amend the public health law, in relation to retail clinics and
  limited services clinics

  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
230-e to read as follows:
  S 230-E. RETAIL CLINICS. 1. AS USED IN THIS SECTION,  "RETAIL  CLINIC"
MEANS  A  FACILITY  OR PORTION OF A FACILITY, REGARDLESS OF OWNERSHIP OR
FORM OF ORGANIZATION, THAT PROVIDES HEALTH CARE  SERVICES  OR  TREATMENT
(OTHER  THAN  PHARMACY) PROVIDED BY A HEALTH CARE PRACTITIONER LICENSED,
CERTIFIED, REGISTERED OR AUTHORIZED TO PRACTICE UNDER TITLE EIGHT OF THE
EDUCATION LAW, ACTING WITHIN HIS OR HER LAWFUL SCOPE OF PRACTICE,  THAT:
(A)  IS WITHIN THE SPACE OF A RETAIL BUSINESS OPERATION, SUCH AS A PHAR-
MACY OR A STORE OPEN TO THE GENERAL PUBLIC;  (B)  IS  LABELED,  BRANDED,
ADVERTISED  OR  MARKETED  WITH  THE  NAME OR SYMBOL OF A RETAIL BUSINESS
ENTITY; OR (C) IS LABELED, BRANDED, ADVERTISED OR MARKETED WITH THE NAME
OR SYMBOL OF A BUSINESS  ENTITY,  OTHER  THAN  A  BUSINESS  ENTITY  THAT
PROVIDES  HEALTH  CARE  SERVICES  OR TREATMENT PROVIDED AT THE FACILITY.
HOWEVER, A FACILITY OR PORTION OF A FACILITY SHALL NOT BE DEEMED TO BE A
RETAIL CLINIC IF IT ORDINARILY IS USED ONLY FOR  PROVIDING  HEALTH  CARE
SERVICES TO EMPLOYEES OF THE RETAIL BUSINESS OPERATION.
  2. THE TREATMENTS AND SERVICES THAT MAY BE PROVIDED BY A RETAIL CLINIC
SHALL  BE LIMITED TO THE PROVISION OF TREATMENT AND SERVICES TO PATIENTS
FOR ACUTE EPISODIC ILLNESS OR CONDITION; EPISODIC  PREVENTIVE  TREATMENT
AND SERVICES SUCH AS IMMUNIZATIONS; OPHTHALMIC DISPENSING AND OPHTHALMO-
LOGIC  OR  OPTOMETRIC  SERVICES  PROVIDED  IN CONNECTION WITH OPHTHALMIC
DISPENSING; OR TREATMENT AND SERVICES FOR MINOR  TRAUMAS  THAT  ARE  NOT
REASONABLY  LIKELY  TO  BE  LIFE-THREATENING OR POTENTIALLY DISABLING IF

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04863-01-5
              

A. 1411                             2

AMBULATORY CARE WITHIN THE CAPACITY OF THE RETAIL  CLINIC  IS  PROVIDED;
BUT  SHALL  NOT  INCLUDE  MONITORING  OR  TREATMENT  AND  SERVICES  OVER
PROLONGED PERIODS.
  3.  A RETAIL CLINIC SHALL BE DEEMED TO BE A "HEALTH CARE PROVIDER" FOR
THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAPTER. A PRESCRIBER
PRACTICING IN A RETAIL CLINIC SHALL NOT BE DEEMED TO BE IN THE EMPLOY OF
A PHARMACY OR PRACTICING IN A HOSPITAL FOR PURPOSES OF  SUBDIVISION  TWO
OF SECTION SIXTY-EIGHT HUNDRED SEVEN OF THE EDUCATION LAW.
  4.  THE  COMMISSIONER SHALL MAKE REGULATIONS SETTING FORTH OPERATIONAL
AND PHYSICAL PLANT STANDARDS FOR  RETAIL  CLINICS,  INCLUDING,  BUT  NOT
LIMITED  TO: REQUIRING ACCREDITATION; DESIGNATING OR LIMITING THE TREAT-
MENTS AND SERVICES THAT MAY BE PROVIDED; PROHIBITING  THE  PROVISION  OF
SERVICES TO PATIENTS TWENTY-FOUR MONTHS OF AGE OR YOUNGER; THE PROVISION
OF  SPECIFIC  IMMUNIZATIONS  TO  PATIENTS YOUNGER THAN EIGHTEEN YEARS OF
AGE; AND REQUIREMENTS OR GUIDELINES FOR ADVERTISING AND SIGNAGE, DISCLO-
SURE OF OWNERSHIP INTERESTS, INFORMED CONSENT, RECORD KEEPING,  REFERRAL
FOR  TREATMENT  AND  CONTINUITY OF CARE, CASE REPORTING TO THE PATIENT'S
PRIMARY CARE OR  OTHER  HEALTH  CARE  PROVIDERS,  DESIGN,  CONSTRUCTION,
FIXTURES,  AND  EQUIPMENT.  SUCH  REGULATIONS  ALSO  SHALL  PROMOTE  AND
STRENGTHEN  PRIMARY  CARE  THROUGH:  (A)  THE  INTEGRATION  OF  SERVICES
PROVIDED  BY  RETAIL CLINICS WITH THE SERVICES PROVIDED BY THE PATIENT'S
OTHER HEALTH CARE PROVIDERS; AND (B) THE REFERRAL OF PATIENTS TO  APPRO-
PRIATE  HEALTH  CARE  PROVIDERS,  INCLUDING  APPROPRIATE TRANSMISSION OF
PATIENT HEALTH RECORDS.
  5. THIS SECTION DOES NOT AUTHORIZE ANY FORM OF OWNERSHIP OR  ORGANIZA-
TION  OF  A  RETAIL  CLINIC OR PRACTICE OF ANY PROFESSION THAT WOULD NOT
OTHERWISE BE LEGAL, AND DOES NOT EXPAND THE SCOPE  OF  PRACTICE  OF  ANY
HEALTH  CARE PRACTITIONER. WHERE ANY REGULATION UNDER THIS SECTION WOULD
AFFECT THE SCOPE OF PRACTICE OF A  HEALTH  CARE  PRACTITIONER  LICENSED,
REGISTERED,  CERTIFIED  OR AUTHORIZED UNDER TITLE EIGHT OF THE EDUCATION
LAW, THE REGULATION SHALL BE MADE WITH THE CONCURRENCE  OF  THE  COMMIS-
SIONER OF EDUCATION.
  S  2.  Section  2801-a of the public health law is amended by adding a
new subdivision 17 to read as follows:
  17. (A) DIAGNOSTIC OR TREATMENT CENTERS ESTABLISHED TO PROVIDE  HEALTH
CARE SERVICES WITHIN THE SPACE OF A RETAIL BUSINESS OPERATION, SUCH AS A
PHARMACY,  A STORE OPEN TO THE GENERAL PUBLIC OR WITHIN SPACE USED BY AN
EMPLOYER FOR PROVIDING HEALTH CARE SERVICES TO  ITS  EMPLOYEES,  MAY  BE
OWNED  AND/OR  OPERATED  BY  LEGAL ENTITIES FORMED UNDER THE LAWS OF NEW
YORK WHOSE STOCKHOLDERS OR  MEMBERS,  AS  APPLICABLE,  ARE  NOT  NATURAL
PERSONS AND WHOSE PRINCIPAL STOCKHOLDERS AND MEMBERS, AS APPLICABLE, AND
CONTROLLING  PERSONS  COMPLY  WITH  ALL  APPLICABLE REQUIREMENTS OF THIS
SECTION AND DEMONSTRATE, TO THE SATISFACTION OF THE  PUBLIC  HEALTH  AND
HEALTH PLANNING COUNCIL, SUFFICIENT EXPERIENCE AND EXPERTISE IN DELIVER-
ING  HIGH QUALITY HEALTH CARE SERVICES. IN ADDITION, A GENERAL HOSPITAL,
A DIAGNOSTIC AND TREATMENT CENTER, AND ANY ENTITY THAT  COULD  OTHERWISE
OWN  A DIAGNOSTIC AND TREATMENT CENTER, MAY OWN A LIMITED SERVICES CLIN-
IC. SUCH DIAGNOSTIC AND TREATMENT CENTERS SHALL BE REFERRED TO  IN  THIS
SECTION AS "LIMITED SERVICES CLINICS". FOR PURPOSES OF THIS SUBDIVISION,
THE  PUBLIC  HEALTH  AND  HEALTH  PLANNING COUNCIL SHALL ADOPT AND AMEND
RULES AND REGULATIONS, NOTWITHSTANDING  ANY  INCONSISTENT  PROVISION  OF
THIS SECTION, TO ADDRESS ANY MATTER IT DEEMS PERTINENT TO THE ESTABLISH-
MENT  OF  LIMITED  SERVICES  CLINICS; PROVIDED THAT SUCH RULES AND REGU-
LATIONS SHALL INCLUDE, BUT NOT BE LIMITED TO,  PROVISIONS  GOVERNING  OR
RELATING  TO:  (I) ANY DIRECT OR INDIRECT CHANGES OR TRANSFERS OF OWNER-
SHIP INTERESTS OR VOTING RIGHTS IN SUCH ENTITIES OR  THEIR  STOCKHOLDERS

A. 1411                             3

OR  MEMBERS,  AS  APPLICABLE,  AND  PROVIDE FOR PUBLIC HEALTH AND HEALTH
PLANNING COUNCIL APPROVAL OF ANY CHANGE IN CONTROLLING INTERESTS,  PRIN-
CIPAL  STOCKHOLDERS,  CONTROLLING  PERSONS,  PARENT COMPANY OR SPONSORS;
(II)  OVERSIGHT  OF  THE  OPERATOR  AND  ITS SHAREHOLDERS OR MEMBERS, AS
APPLICABLE, INCLUDING LOCAL GOVERNANCE OF THE LIMITED SERVICES  CLINICS;
AND  (III)  RELATING  TO THE CHARACTER AND COMPETENCE AND QUALIFICATIONS
OF, AND CHANGES RELATING TO, THE DIRECTORS AND OFFICERS OF THE  OPERATOR
AND  ITS  PRINCIPAL STOCKHOLDERS, CONTROLLING PERSONS, PARENT COMPANY OR
SPONSORS.
  (B) THE FOLLOWING PROVISIONS OF THIS SECTION SHALL NOT APPLY TO LIMIT-
ED SERVICES CLINICS OPERATED PURSUANT TO THIS SUBDIVISION: (I) PARAGRAPH
(A) OF SUBDIVISION THREE OF THIS SECTION; (II) PARAGRAPH (B) OF SUBDIVI-
SION THREE OF THIS SECTION, RELATING TO STOCKHOLDERS AND  MEMBERS  OTHER
THAN  PRINCIPAL  STOCKHOLDERS AND PRINCIPAL MEMBERS; (III) PARAGRAPH (C)
OF SUBDIVISION FOUR OF THIS SECTION,  RELATING  TO  THE  DISPOSITION  OF
STOCK  OR  VOTING  RIGHTS; AND (IV) PARAGRAPH (E) OF SUBDIVISION FOUR OF
THIS SECTION, RELATING TO THE OWNERSHIP OF STOCK OR MEMBERSHIP.
  (C) A LIMITED SERVICES CLINIC SHALL BE DEEMED TO  BE  A  "HEALTH  CARE
PROVIDER"  FOR  THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAP-
TER. A PRESCRIBER PRACTICING IN A LIMITED SERVICES CLINIC SHALL  NOT  BE
DEEMED TO BE IN THE EMPLOY OF A PHARMACY OR PRACTICING IN A HOSPITAL FOR
PURPOSES  OF SUBDIVISION TWO OF SECTION SIXTY-EIGHT HUNDRED SEVEN OF THE
EDUCATION LAW.
  (D) THE COMMISSIONER SHALL PROMULGATE REGULATIONS SETTING FORTH OPERA-
TIONAL AND PHYSICAL PLANT STANDARDS FOR LIMITED SERVICES CLINICS,  WHICH
MAY BE DIFFERENT FROM THE REGULATIONS OTHERWISE APPLICABLE TO DIAGNOSTIC
OR  TREATMENT CENTERS, INCLUDING, BUT NOT LIMITED TO: REQUIRING ACCREDI-
TATION; DESIGNATING OR LIMITING THE TREATMENTS AND SERVICES THAT MAY  BE
PROVIDED;  PROHIBITING THE PROVISION OF SERVICES TO PATIENTS TWENTY-FOUR
MONTHS OF AGE OR YOUNGER; THE PROVISION  OF  SPECIFIC  IMMUNIZATIONS  TO
PATIENTS  YOUNGER THAN EIGHTEEN YEARS OF AGE; AND REQUIREMENTS OR GUIDE-
LINES FOR ADVERTISING AND SIGNAGE, DISCLOSURE  OF  OWNERSHIP  INTERESTS,
INFORMED  CONSENT, RECORD KEEPING, REFERRAL FOR TREATMENT AND CONTINUITY
OF CARE, CASE REPORTING TO THE PATIENT'S PRIMARY CARE  OR  OTHER  HEALTH
CARE  PROVIDERS,  DESIGN,  CONSTRUCTION,  FIXTURES,  AND EQUIPMENT. SUCH
REGULATIONS ALSO SHALL PROMOTE AND STRENGTHEN PRIMARY CARE THROUGH:  (I)
THE  INTEGRATION  OF  SERVICES PROVIDED BY LIMITED SERVICES CLINICS WITH
THE SERVICES PROVIDED BY THE PATIENT'S OTHER HEALTH CARE PROVIDERS;  AND
(II)  THE  REFERRAL  OF  PATIENTS  TO APPROPRIATE HEALTH CARE PROVIDERS,
INCLUDING APPROPRIATE TRANSMISSION OF PATIENT HEALTH RECORDS.
  (E) WHERE A LIMITED SERVICES CLINIC IS A RETAIL CLINIC  UNDER  SECTION
TWO  HUNDRED  THIRTY-E  OF  THIS  CHAPTER,  IT  SHALL BE SUBJECT TO THAT
SECTION IN ADDITION TO THIS SUBDIVISION.
  S 3. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided  that  effective  immediately,  the
commissioner  of  health  shall  make regulations and take other actions
reasonably necessary to implement the provisions of  the  public  health
law enacted by this act when they take effect.

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

                                 1411--A

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            January 12, 2015
                               ___________

Introduced  by  M. of A. PAULIN, GOTTFRIED, BENEDETTO, LINARES -- Multi-
  Sponsored by -- M. of A. HIKIND, HOOPER -- read once and  referred  to
  the Committee on Health -- committee discharged, bill amended, ordered
  reprinted as amended and recommitted to said committee

AN ACT to amend the public health law, in relation to retail clinics and
  limited services clinics

  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
230-e to read as follows:
  S  230-E.  RETAIL CLINICS. 1. AS USED IN THIS SECTION, "RETAIL CLINIC"
MEANS A FACILITY OR PORTION OF A FACILITY, REGARDLESS  OF  OWNERSHIP  OR
FORM  OF  ORGANIZATION,  THAT PROVIDES HEALTH CARE SERVICES OR TREATMENT
(OTHER THAN PHARMACY) PROVIDED BY A HEALTH CARE  PRACTITIONER  LICENSED,
CERTIFIED, REGISTERED OR AUTHORIZED TO PRACTICE UNDER TITLE EIGHT OF THE
EDUCATION  LAW, ACTING WITHIN HIS OR HER LAWFUL SCOPE OF PRACTICE, THAT:
(A) IS WITHIN THE SPACE OF A RETAIL BUSINESS OPERATION, SUCH AS A  PHAR-
MACY  OR  A  STORE  OPEN TO THE GENERAL PUBLIC; (B) IS LABELED, BRANDED,
ADVERTISED OR MARKETED WITH THE NAME OR  SYMBOL  OF  A  RETAIL  BUSINESS
ENTITY; OR (C) IS LABELED, BRANDED, ADVERTISED OR MARKETED WITH THE NAME
OR  SYMBOL  OF  A  BUSINESS  ENTITY,  OTHER  THAN A BUSINESS ENTITY THAT
PROVIDES HEALTH CARE SERVICES OR TREATMENT  PROVIDED  AT  THE  FACILITY.
HOWEVER, A FACILITY OR PORTION OF A FACILITY SHALL NOT BE DEEMED TO BE A
RETAIL  CLINIC  IF  IT ORDINARILY IS USED ONLY FOR PROVIDING HEALTH CARE
SERVICES TO EMPLOYEES OF THE RETAIL BUSINESS OPERATION.
  2. THE TREATMENTS AND SERVICES THAT MAY BE PROVIDED BY A RETAIL CLINIC
SHALL BE LIMITED TO THE PROVISION OF TREATMENT AND SERVICES TO  PATIENTS
FOR  ACUTE  EPISODIC ILLNESS OR CONDITION; EPISODIC PREVENTIVE TREATMENT
AND SERVICES SUCH AS IMMUNIZATIONS; OPHTHALMIC DISPENSING AND OPHTHALMO-
LOGIC OR OPTOMETRIC SERVICES  PROVIDED  IN  CONNECTION  WITH  OPHTHALMIC
DISPENSING;  OR  TREATMENT  AND  SERVICES FOR MINOR TRAUMAS THAT ARE NOT

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04863-04-5
              

A. 1411--A                          2

REASONABLY LIKELY TO BE LIFE-THREATENING  OR  POTENTIALLY  DISABLING  IF
AMBULATORY  CARE  WITHIN  THE CAPACITY OF THE RETAIL CLINIC IS PROVIDED;
BUT  SHALL  NOT  INCLUDE  MONITORING  OR  TREATMENT  AND  SERVICES  OVER
PROLONGED PERIODS.
  3.  A RETAIL CLINIC SHALL BE DEEMED TO BE A "HEALTH CARE PROVIDER" FOR
THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAPTER. A PRESCRIBER
PRACTICING IN A RETAIL CLINIC SHALL NOT BE DEEMED TO BE IN THE EMPLOY OF
A PHARMACY OR PRACTICING IN A HOSPITAL FOR PURPOSES OF  SUBDIVISION  TWO
OF SECTION SIXTY-EIGHT HUNDRED SEVEN OF THE EDUCATION LAW.
  4.  (A)  THE  COMMISSIONER SHALL MAKE REGULATIONS SETTING FORTH OPERA-
TIONAL AND PHYSICAL PLANT STANDARDS FOR RETAIL CLINICS,  INCLUDING,  BUT
NOT LIMITED TO:
  (I) REQUIRING THAT RETAIL CLINICS ATTAIN AND MAINTAIN ACCREDITATION BY
AN  APPROPRIATE  ACCREDITING  ENTITY  APPROVED  BY  THE COMMISSIONER AND
REQUIRING TIMELY REPORTING TO THE DEPARTMENT IF A  RETAIL  CLINIC  LOSES
ITS ACCREDITATION;
  (II)  DESIGNATING  OR LIMITING THE TREATMENTS AND SERVICES THAT MAY BE
PROVIDED;
  (III) PROHIBITING THE PROVISION OF SERVICES  TO  PATIENTS  TWENTY-FOUR
MONTHS OF AGE OR YOUNGER;
  (IV)  REQUIRING  RETAIL  CLINICS TO ACCEPT WALK-INS AND OFFER EXTENDED
BUSINESS HOURS;
  (V) REQUIREMENTS OR GUIDELINES FOR ADVERTISING AND SIGNAGE, DISCLOSURE
OF OWNERSHIP INTERESTS, INFORMED CONSENT, RECORD KEEPING,  REFERRAL  FOR
TREATMENT AND CONTINUITY OF CARE, CASE REPORTING TO THE PATIENT'S PRIMA-
RY  CARE OR OTHER HEALTH CARE PROVIDERS, DESIGN, CONSTRUCTION, FIXTURES,
AND EQUIPMENT.    SIGNAGE  SHALL  ALSO  BE  REQUIRED  TO  INDICATE  THAT
PRESCRIPTIONS  AND  OVER-THE-COUNTER  SUPPLIES  MAY  BE  PURCHASED  BY A
PATIENT FROM ANY BUSINESS AND DO NOT NEED TO BE PURCHASED ON-SITE; AND
  (VI) NOT TREATING ANY PATIENT FOR THE SAME CONDITION OR  ILLNESS  MORE
THAN THREE TIMES IN A YEAR.
  (B)  SUCH  REGULATIONS  ALSO SHALL PROMOTE AND STRENGTHEN PRIMARY CARE
THROUGH:
  (I) INQUIRING OF EACH PATIENT WHETHER HE OR SHE  HAS  A  PRIMARY  CARE
PROVIDER;
  (II)  THE  INTEGRATION OF SERVICES PROVIDED BY RETAIL CLINICS WITH THE
SERVICES PROVIDED BY THE PATIENT'S OTHER HEALTH CARE PROVIDERS; AND
  (III) THE REFERRAL OF PATIENTS TO APPROPRIATE HEALTH  CARE  PROVIDERS,
INCLUDING APPROPRIATE TRANSMISSION OF PATIENT HEALTH RECORDS.
  (C) RETAIL CLINICS ALREADY IN OPERATION AT THE TIME THIS SECTION TAKES
EFFECT  MUST  COMPLY WITH ACCREDITATION REQUIREMENTS UNDER THIS SUBDIVI-
SION WITHIN ONE HUNDRED EIGHTY DAYS AFTER THIS SECTION TAKES EFFECT.
  5. THIS SECTION DOES NOT AUTHORIZE ANY FORM OF OWNERSHIP OR  ORGANIZA-
TION  OF  A  RETAIL  CLINIC OR PRACTICE OF ANY PROFESSION THAT WOULD NOT
OTHERWISE BE LEGAL, AND DOES NOT EXPAND THE SCOPE  OF  PRACTICE  OF  ANY
HEALTH  CARE PRACTITIONER. WHERE ANY REGULATION UNDER THIS SECTION WOULD
AFFECT THE SCOPE OF PRACTICE OF A  HEALTH  CARE  PRACTITIONER  LICENSED,
REGISTERED,  CERTIFIED  OR AUTHORIZED UNDER TITLE EIGHT OF THE EDUCATION
LAW, THE REGULATION SHALL BE MADE WITH THE CONCURRENCE  OF  THE  COMMIS-
SIONER OF EDUCATION.
  S  2.  Section  2801-a of the public health law is amended by adding a
new subdivision 17 to read as follows:
  17. (A) A DIAGNOSTIC OR TREATMENT CENTER THAT IS A RETAIL CLINIC UNDER
SECTION TWO HUNDRED THIRTY-E OF  THIS  CHAPTER,  OR  ESTABLISHED  WITHIN
SPACE  USED  BY  AN  EMPLOYER  FOR PROVIDING HEALTH CARE SERVICES TO ITS

A. 1411--A                          3

EMPLOYEES, MAY BE OWNED OR OPERATED BY A LEGAL ENTITY FORMED  UNDER  THE
LAWS OF NEW YORK:
  (I)  THAT  IS,  OR IS OWNED AND CONTROLLED BY, THE APPLICABLE BUSINESS
ENTITY UNDER PARAGRAPH (A), (B) OR (C) OF SUBDIVISION ONE OF SECTION TWO
HUNDRED THIRTY-E OF THIS CHAPTER OR THE EMPLOYER TO WHOSE  EMPLOYEES  IT
PROVIDES HEALTH CARE SERVICES;
  (II)  WHOSE  STOCKHOLDERS OR MEMBERS, AS APPLICABLE, MAY INCLUDE OTHER
THAN NATURAL PERSONS;
  (III) WHOSE PRINCIPAL STOCKHOLDERS AND  MEMBERS,  AS  APPLICABLE,  AND
CONTROLLING  PERSONS  COMPLY  WITH  ALL  APPLICABLE REQUIREMENTS OF THIS
SECTION; AND
  (IV) THAT DEMONSTRATES, TO THE SATISFACTION OF THE PUBLIC  HEALTH  AND
HEALTH PLANNING COUNCIL, SUFFICIENT EXPERIENCE AND EXPERTISE IN DELIVER-
ING  HIGH  QUALITY  HEALTH  CARE  SERVICES,  AND A COMMITMENT TO OPERATE
LIMITED SERVICES CLINICS IN MEDICALLY UNDERSERVED AREAS OF THE STATE.
  (B) A DIAGNOSTIC AND TREATMENT CENTER UNDER THIS SUBDIVISION SHALL  BE
REFERRED TO IN THIS SUBDIVISION AS A "LIMITED SERVICES CLINIC".
  (C)  FOR  PURPOSES  OF  THIS SUBDIVISION, THE PUBLIC HEALTH AND HEALTH
PLANNING COUNCIL SHALL ADOPT AND AMEND RULES AND  REGULATIONS,  NOTWITH-
STANDING  ANY  INCONSISTENT  PROVISION  OF  THIS SECTION, TO ADDRESS ANY
MATTER IT DEEMS PERTINENT TO THE ESTABLISHMENT OF LIMITED SERVICES CLIN-
ICS; PROVIDED THAT SUCH RULES AND REGULATIONS SHALL INCLUDE, BUT NOT  BE
LIMITED TO, PROVISIONS GOVERNING OR RELATING TO:
  (I) ANY DIRECT OR INDIRECT CHANGES OR TRANSFERS OF OWNERSHIP INTERESTS
OR  VOTING  RIGHTS IN SUCH ENTITIES OR THEIR STOCKHOLDERS OR MEMBERS, AS
APPLICABLE;
  (II) PROVIDE FOR PUBLIC HEALTH AND HEALTH PLANNING COUNCIL APPROVAL OF
ANY CHANGE IN CONTROLLING INTERESTS, PRINCIPAL STOCKHOLDERS, CONTROLLING
PERSONS, PARENT COMPANY OR SPONSORS;
  (III) OVERSIGHT OF THE OPERATOR AND ITS SHAREHOLDERS  OR  MEMBERS,  AS
APPLICABLE, INCLUDING LOCAL GOVERNANCE OF THE LIMITED SERVICES CLINICS;
  (IV)  RELATING  TO THE CHARACTER AND COMPETENCE AND QUALIFICATIONS OF,
AND CHANGES RELATING TO, THE DIRECTORS AND OFFICERS OF THE OPERATOR  AND
ITS PRINCIPAL STOCKHOLDERS, CONTROLLING PERSONS, PARENT COMPANY OR SPON-
SORS; AND
  (V)  IN  DETERMINING  WHETHER  TO  APPROVE ADDITIONAL LIMITED SERVICES
CLINIC LOCATIONS FOR THE OPERATOR, THE DEPARTMENT SHALL CONSIDER WHETHER
THE OPERATOR HAS FULFILLED ITS COMMITMENT TO  OPERATE  LIMITED  SERVICES
CLINICS IN MEDICALLY UNDERSERVED AREAS OF THE STATE.
  (D) THE FOLLOWING PROVISIONS OF THIS SECTION SHALL NOT APPLY TO LIMIT-
ED SERVICES CLINICS:
  (I) PARAGRAPH (A) OF SUBDIVISION THREE OF THIS SECTION;
  (II)  PARAGRAPH  (B) OF SUBDIVISION THREE OF THIS SECTION, RELATING TO
STOCKHOLDERS AND MEMBERS OTHER THAN PRINCIPAL STOCKHOLDERS AND PRINCIPAL
MEMBERS;
  (III) PARAGRAPH (C) OF SUBDIVISION FOUR OF THIS SECTION,  RELATING  TO
THE DISPOSITION OF STOCK OR VOTING RIGHTS; AND
  (IV)  PARAGRAPH  (E)  OF SUBDIVISION FOUR OF THIS SECTION, RELATING TO
THE OWNERSHIP OF STOCK OR MEMBERSHIP.
  (E) A LIMITED SERVICES CLINIC SHALL BE DEEMED TO  BE  A  "HEALTH  CARE
PROVIDER"  FOR  THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAP-
TER. A PRESCRIBER PRACTICING IN A LIMITED SERVICES CLINIC SHALL  NOT  BE
DEEMED TO BE IN THE EMPLOY OF A PHARMACY OR PRACTICING IN A HOSPITAL FOR
PURPOSES  OF SUBDIVISION TWO OF SECTION SIXTY-EIGHT HUNDRED SEVEN OF THE
EDUCATION LAW.

A. 1411--A                          4

  (F) THE COMMISSIONER SHALL PROMULGATE REGULATIONS SETTING FORTH OPERA-
TIONAL AND PHYSICAL PLANT STANDARDS FOR LIMITED SERVICES CLINICS,  WHICH
MAY BE DIFFERENT FROM THE REGULATIONS OTHERWISE APPLICABLE TO DIAGNOSTIC
OR TREATMENT CENTERS, INCLUDING, BUT NOT LIMITED TO:
  (I)  REQUIRING  THAT  LIMITED  SERVICES  CLINICS  ATTAIN  AND MAINTAIN
ACCREDITATION BY AN  APPROPRIATE  ACCREDITING  ENTITY  APPROVED  BY  THE
COMMISSIONER  AND  REQUIRING  TIMELY  REPORTING  TO  THE DEPARTMENT IF A
LIMITED SERVICES CLINIC LOSES ITS ACCREDITATION;
  (II) DESIGNATING OR LIMITING THE TREATMENTS AND SERVICES THAT  MAY  BE
PROVIDED;
  (III)  PROHIBITING  THE  PROVISION OF SERVICES TO PATIENTS TWENTY-FOUR
MONTHS OF AGE OR YOUNGER;
  (IV) REQUIRING LIMITED SERVICES CLINICS TO ACCEPT WALK-INS  AND  OFFER
EXTENDED BUSINESS HOURS;
  (V)  GUIDELINES  FOR  ADVERTISING AND SIGNAGE, DISCLOSURE OF OWNERSHIP
INTERESTS, INFORMED CONSENT, RECORD KEEPING, REFERRAL FOR TREATMENT  AND
CONTINUITY  OF  CARE,  CASE  REPORTING  TO THE PATIENT'S PRIMARY CARE OR
OTHER HEALTH CARE PROVIDERS, DESIGN, CONSTRUCTION, FIXTURES, AND  EQUIP-
MENT;  SIGNAGE SHALL ALSO BE REQUIRED TO INDICATE THAT PRESCRIPTIONS AND
OVER-THE-COUNTER SUPPLIES MAY BE PURCHASED BY A PATIENT FROM  ANY  BUSI-
NESS AND DO NOT NEED TO BE PURCHASED ON-SITE; AND
  (VI)  WHERE A LIMITED SERVICES CLINIC IS A RETAIL CLINIC, NOT TREATING
ANY PATIENT FOR THE SAME CONDITION OR ILLNESS MORE THAN THREE TIMES IN A
YEAR.
  (G) SUCH REGULATIONS ALSO SHALL PROMOTE AND  STRENGTHEN  PRIMARY  CARE
THROUGH:
  (I)  INQUIRING  OF  EACH  PATIENT WHETHER HE OR SHE HAS A PRIMARY CARE
PROVIDER;
  (II) THE INTEGRATION OF SERVICES PROVIDED BY LIMITED SERVICES  CLINICS
WITH THE SERVICES PROVIDED BY THE PATIENT'S OTHER HEALTH CARE PROVIDERS;
AND
  (III)  THE  REFERRAL OF PATIENTS TO APPROPRIATE HEALTH CARE PROVIDERS,
INCLUDING APPROPRIATE TRANSMISSION OF PATIENT HEALTH RECORDS.
  S 3. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided  that  effective  immediately,  the
commissioner  of  health  shall  make regulations and take other actions
reasonably necessary to implement the provisions of  the  public  health
law enacted by this act when they take effect.