S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                 11072--A
 
                           I N  A S S E M B L Y
 
                              October 7, 2020
                                ___________
 
 Introduced  by  COMMITTEE ON RULES -- (at request of M. of A. Gottfried,
   Reyes) -- read once and referred to the Committee on Health -- commit-
   tee discharged, bill amended, ordered reprinted as amended and  recom-
   mitted to said committee
 
 AN  ACT  to  amend  the  public health law, in relation to health equity
   assessments in the establishment or construction of a hospital

   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
 2802-b to read as follows:
   § 2802-B. HEALTH EQUITY IMPACT ASSESSMENTS. 1. DEFINITIONS. AS USED IN
 THIS SECTION:
   (A) "APPLICATION" MEANS AN APPLICATION  UNDER  THIS  ARTICLE  FOR  THE
 CONSTRUCTION, ESTABLISHMENT, CHANGE IN THE ESTABLISHMENT, MERGER, ACQUI-
 SITION,  CLOSURE,  OR SUBSTANTIAL REDUCTION, EXPANSION, OR ADDITION OF A
 HOSPITAL SERVICE OR HEALTH-RELATED SERVICE OF A HOSPITAL  THAT  REQUIRES
 REVIEW  OR APPROVAL BY THE COUNCIL OR THE COMMISSIONER, WHERE THE APPLI-
 CATION IS FILED OR SUBMITTED TO THE COUNCIL,  THE  COMMISSIONER  OR  THE
 DEPARTMENT AFTER THIS SECTION TAKES EFFECT.
   (B)  "PROJECT"  MEANS  THE  CONSTRUCTION, ESTABLISHMENT, CHANGE IN THE
 ESTABLISHMENT, MERGER, ACQUISITION, CLOSURE, OR SUBSTANTIAL REDUCTION OF
 A HOSPITAL SERVICE OR HEALTH-RELATED SERVICE OF A HOSPITAL THAT  IS  THE
 SUBJECT OF AN APPLICATION.
   (C)  "HEALTH EQUITY IMPACT ASSESSMENT" OR "IMPACT ASSESSMENT" MEANS AN
 ASSESSMENT OF WHETHER, AND IF SO HOW, A PROJECT WILL IMPROVE  ACCESS  TO
 HOSPITAL SERVICES AND HEALTH CARE, HEALTH EQUITY AND REDUCTION OF HEALTH
 DISPARITIES,  WITH  PARTICULAR  REFERENCE TO MEMBERS OF MEDICALLY UNDER-
 SERVED GROUPS, IN THE APPLICANT'S SERVICE AREA.
   (D) "MEDICALLY UNDERSERVED GROUP" MEANS: LOW-INCOME PEOPLE; RACIAL AND
 ETHNIC MINORITIES; IMMIGRANTS; WOMEN; LESBIAN, GAY, BISEXUAL,  TRANSGEN-
 DER,  OR  OTHER-THAN-CISGENDER  PEOPLE;  PEOPLE WITH DISABILITIES; OLDER
 ADULTS; PERSONS LIVING WITH A PREVALENT INFECTIOUS DISEASE OR CONDITION;
 PERSONS LIVING IN RURAL AREAS; PEOPLE WHO ARE ELIGIBLE  FOR  OR  RECEIVE
 PUBLIC HEALTH BENEFITS; PEOPLE WHO DO NOT HAVE THIRD-PARTY HEALTH COVER-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD17431-02-0

 A. 11072--A                         2
 
 AGE OR HAVE INADEQUATE THIRD-PARTY HEALTH COVERAGE; AND OTHER PEOPLE WHO
 ARE UNABLE TO OBTAIN HEALTH CARE.
   2.  (A) EVERY APPLICATION SHALL INCLUDE A HEALTH EQUITY IMPACT ASSESS-
 MENT OF THE PROJECT. THE IMPACT ASSESSMENT SHALL BE FILED TOGETHER  WITH
 THE  APPLICATION,  AND THE APPLICATION SHALL NOT BE COMPLETE WITHOUT THE
 IMPACT STATEMENT. THE APPLICANT  SHALL  PROMPTLY  AMEND  OR  MODIFY  THE
 IMPACT STATEMENT AS NECESSARY.
   (B)  IN  CONSIDERING  WHETHER AND ON WHAT TERMS TO APPROVE AN APPLICA-
 TION, THE COMMISSIONER AND THE  COUNCIL,  AS  THE  CASE  MAY  BE,  SHALL
 CONSIDER THE HEALTH EQUITY IMPACT STATEMENT.
   3.  SCOPE  AND CONTENTS OF A HEALTH EQUITY IMPACT ASSESSMENT. A HEALTH
 EQUITY IMPACT ASSESSMENT SHALL INCLUDE:
   (A) A DEMONSTRATION OF WHETHER, AND IF SO HOW,  THE  PROPOSED  PROJECT
 WILL  IMPROVE ACCESS TO HOSPITAL SERVICES AND HEALTH CARE, HEALTH EQUITY
 AND REDUCTION  OF  HEALTH  DISPARITIES,  WITH  PARTICULAR  REFERENCE  TO
 MEMBERS  OF  MEDICALLY  UNDERSERVED  GROUPS,  IN THE APPLICANT'S SERVICE
 AREA.
   (B) THE EXTENT TO WHICH MEDICALLY UNDERSERVED  GROUPS  IN  THE  APPLI-
 CANT'S  SERVICE  AREA  USE  THE  APPLICANT'S  HOSPITAL OR HEALTH-RELATED
 SERVICES OR SIMILAR SERVICES AT THE TIME  OF  THE  APPLICATION  AND  THE
 EXTENT TO WHICH THEY ARE EXPECTED TO IF THE PROJECT IS IMPLEMENTED.
   (C)  THE  PERFORMANCE  OF THE APPLICANT IN MEETING ITS OBLIGATIONS, IF
 ANY, UNDER SECTION TWENTY-EIGHT HUNDRED  SEVEN-K  OF  THIS  ARTICLE  AND
 FEDERAL  REGULATIONS  REQUIRING  PROVIDING UNCOMPENSATED CARE, COMMUNITY
 SERVICES, AND ACCESS BY  MINORITIES  AND  PEOPLE  WITH  DISABILITIES  TO
 PROGRAMS RECEIVING FEDERAL FINANCIAL ASSISTANCE, INCLUDING THE EXISTENCE
 OF ANY CIVIL RIGHTS ACCESS COMPLAINTS AGAINST THE APPLICANT, AND HOW THE
 APPLICANT'S MEETING OF THESE OBLIGATIONS WILL BE AFFECTED BY IMPLEMENTA-
 TION OF THE PROJECT.
   (D)  HOW  AND  TO  WHAT EXTENT THE APPLICANT WILL PROVIDE HOSPITAL AND
 HEALTH-RELATED SERVICES TO THE MEDICALLY INDIGENT, MEDICARE  RECIPIENTS,
 MEDICAID  RECIPIENTS  AND MEMBERS OF MEDICALLY UNDERSERVED GROUPS IF THE
 PROJECT IS IMPLEMENTED.
   (E) THE AMOUNT OF INDIGENT CARE, BOTH FREE AND BELOW COST,  THAT  WILL
 BE PROVIDED BY THE APPLICANT IF THE PROJECT IS APPROVED.
   (F)  ACCESS  BY PUBLIC OR PRIVATE TRANSPORTATION, INCLUDING APPLICANT-
 SPONSORED  TRANSPORTATION  SERVICES,  TO  THE  APPLICANT'S  HOSPITAL  OR
 HEALTH-RELATED SERVICES IF THE PROJECT IS IMPLEMENTED.
   (G)  THE  MEANS OF ASSURING EFFECTIVE COMMUNICATION BETWEEN THE APPLI-
 CANT'S HOSPITAL AND HEALTH-RELATED SERVICE STAFF AND PEOPLE  OF  LIMITED
 ENGLISH-SPEAKING  ABILITY  AND  THOSE  WITH  SPEECH,  HEARING  OR VISUAL
 IMPAIRMENTS HANDICAPS IF THE PROJECT IS IMPLEMENTED.
   (H) THE EXTENT TO WHICH IMPLEMENTATION  OF  THE  PROJECT  WILL  REDUCE
 ARCHITECTURAL BARRIERS FOR PEOPLE WITH MOBILITY IMPAIRMENTS.
   (I) A REVIEW OF HOW THE APPLICANT WILL MAINTAIN OR IMPROVE THE QUALITY
 OF HOSPITAL AND HEALTH-RELATED SERVICES INCLUDING A REVIEW OF:
   (I) DEMOGRAPHICS OF THE APPLICANT'S SERVICE AREA;
   (II)  ECONOMIC  STATUS  OF  THE  POPULATION OF THE APPLICANT'S SERVICE
 AREA;
   (III) PHYSICIAN  AND  PROFESSIONAL  STAFFING  ISSUES  RELATED  TO  THE
 PROJECT;
   (IV) AVAILABILITY OF SIMILAR SERVICES AT OTHER INSTITUTIONS IN OR NEAR
 THE APPLICANT'S SERVICE AREA; AND
   (V) HISTORICAL AND PROJECTED MARKET SHARES OF HOSPITAL AND HEALTH CARE
 SERVICE PROVIDERS IN THE APPLICANT'S SERVICE AREA.

 A. 11072--A                         3
 
   4.  THE  HEALTH  EQUITY  IMPACT  ASSESSMENT  SHALL BE PREPARED FOR THE
 APPLICANT BY AN INDEPENDENT ENTITY AND INCLUDE THE MEANINGFUL ENGAGEMENT
 OF PUBLIC HEALTH EXPERTS, ORGANIZATIONS REPRESENTING  EMPLOYEES  OF  THE
 APPLICANT,  STAKEHOLDERS,  AND  COMMUNITY  LEADERS  AND RESIDENTS OF THE
 APPLICANT'S SERVICE AREA.
   5.  THE  DEPARTMENT SHALL PUBLICLY POST THE APPLICATION AND THE HEALTH
 EQUITY IMPACT ASSESSMENT ON THE DEPARTMENT'S WEBSITE WITHIN ONE WEEK  OF
 THE FILING WITH THE DEPARTMENT, INCLUDING ANY FILING WITH THE COUNCIL.
   § 2. This act shall take effect on the one hundred eightieth day after
 it becomes a law.  Effective immediately, the commissioner of health and
 the public health and health planning council shall make regulations and
 take  other  actions  reasonably necessary to implement this act on that
 date.