³ 2825-i. Healthcare safety net transformation program. 1. (a) A
statewide healthcare safety net transformation program shall be
established within the department for the purpose of supporting the
transformation of safety net hospitals to improve access, equity,
quality, and outcomes while increasing the financial sustainability of
safety net hospitals. Such program may provide or utilize new or
existing capital funding, or operating subsidies, or both. Any
application for this program must be jointly submitted by a safety net
hospital and at least one partner organization.

(b) All applications shall demonstrate how the requested funding and
regulatory flexibilities are necessary to achieve the program goals of
improving the safety net hospital's financial outlook and improving
health outcomes for the communities it serves. The commissioner shall
develop an application for this program that includes but is not limited
to the following information:

(i) key organizational information, including the organizational
structure of the safety net hospital and partner organization (including
any parent or subsidiary, and the interrelationship between all such
organizations) and the name, business address, and biography of each
director and officer of the safety net hospital, the partner, and other
organizations within either the safety net hospital's or the partner's
organizational structure;

(ii) the type of collaborative model proposed, including but not
limited to a merger, acquisition, management services contract, or
clinical integration;

(iii) a detailed description of the proposed transformation plan that
includes, at a minimum, a five-year strategic and operational plan
outlining the roles and responsibilities of the safety net hospital and
partner organization;

(iv) a timeline of key metrics and goals;

(v) any regulatory flexibilities required to implement such plan,
including the justification for why such flexibilities are necessary for
the transformation plan to achieve an improved financial outlook for the
safety net hospital and improved health outcomes for the communities it
serves;

(vi) the amount of funding requested for the first five years and
projected needs thereafter, including the rationale for why such funding
is necessary for the transformation plan to achieve an improved
financial outlook for the safety net hospital and improved health
outcomes for the communities it serves; and

(vii) detailed plans for any operational surplus after reaching
financial sustainability.

2. The commissioner shall enter an agreement with the president of the
dormitory authority of the state of New York pursuant to section sixteen
hundred eighty-r of the public authorities law, as required, which shall
apply to this agreement, subject to the approval of the director of the
division of the budget, for the purposes of the distribution and
administration of available funds pursuant to such agreement and made
available pursuant to this section and subject to appropriation. Such
funds may be awarded and distributed by the department to safety net
hospitals, or a partner organization, in the form of grants. To qualify
as a safety net hospital for purposes of this section, a hospital shall:

(a) be either a public hospital, a rural emergency hospital, critical
access hospital or sole community hospital;

(b) have at least thirty percent of its inpatient discharges made up
of medical assistance program eligible individuals, uninsured
individuals or medical assistance program dually eligible individuals
and at least thirty-five percent of its outpatient visits made up of
medical assistance program eligible individuals, uninsured individuals
or medical assistance program dually-eligible individuals;

(c) serve at least thirty percent of the residents of a county or a
multi-county area who are medical assistance program eligible
individuals, uninsured individuals or medical assistance program
dually-eligible individuals; or

(d) in the discretion of the commissioner, serve a significant
population of medical assistance program eligible individuals, uninsured
individuals or medical assistance program dually-eligible individuals.

3. Partner organizations may include, but are not limited to, health
systems, hospitals, health plans, residential health care facilities,
physician groups, community-based organization, or other healthcare
entities who can serve as partners in the transformation of the safety
net hospital.

4. Notwithstanding section one hundred sixty-three of the state
finance law, sections one hundred forty-two and one hundred forty-three
of the economic development law or any inconsistent provisions of law to
the contrary, awards may be provided without a competitive bid or
request for proposal process to safety net hospitals or partner
organizations for purposes of increasing access, equity, quality,
outcomes, and long-term financial sustainability of such safety net
hospitals.

5. Notwithstanding any provision of law to the contrary, the
commissioner may waive regulatory requirements to allow applicants to
more effectively or efficiently implement projects awarded through the
healthcare safety net transformation program, provided, however, that
regulations pertaining to minimum standards for hospitals for patient
safety, patient autonomy, patient privacy, patient rights, quality of
care, safe staffing, adverse event reporting, due process, scope of
practice, professional licensure, environmental protections, infection
control, provider reimbursement methodologies, character and competence,
or occupational standards and employee rights shall not be waived, nor
shall any regulations be waived if such waiver would risk patient
safety. Such waiver shall not exceed the life of the project or such
shorter time periods as the commissioner may determine. Any regulatory
relief granted pursuant to this subdivision shall be specifically
described and requested within each project application and be reviewed
by the commissioner.

6. Continued support under the program shall be contingent upon the
implementation of the approved plan and key milestones.

7. The release of any funding will be contingent upon compliance with
the transformation plan and a determination that acceptable progress has
been made with such plan. If key milestones and goals are not met,
additional financial resources may be withheld and redirected, upon the
recommendation of the commissioner and approval by the director of
budget.

8. The commissioner shall provide a report on an annual basis to the
speaker of the assembly, the temporary president of the senate, the
chair of the assembly ways and means committee, the chair of the senate
finance committee, and the director of the division of budget, on any
transformation plan approved under this section, including information
on partnership agreements, and any amendments thereto. The report shall
also include for each award, the name of the hospital and partner, the
corporate structure of any partner organization, a description of the
project and its purpose, the amount of the award and the disbursement
date, the regulations waived for each project and the justification for
such waiver, and the status of achievement of performance metrics and
milestones. Such report shall be provided until such time as the
department determines that the projects that receive funding pursuant to
this section are substantially complete.