§ 2904-b. Health systems agencies. 1. For the purposes of this
section, "health systems agency" shall mean a corporation organized
pursuant to the not-for-profit corporation law which is approved by the
governor pursuant to subdivision (c) of section twenty-nine hundred four
of this article, incorporated within the state, which is not a
subsidiary of, or otherwise controlled by, any other private or public
corporation or other legal entity, and which only engages in health
planning and development activities and functions.

2. The powers of a health systems agency shall include those necessary
to perform the duties and functions provided for in this section.

3. An employee who participates in the management of a health benefit
plan may serve as a member of the board of directors of a health systems
agency representing employers or unions. No member may participate or
vote in agency proceedings involving an individual provider, purchaser,
or patient, or a specific activity or transaction, if the member has a
financial interest in the outcome of the board's proceedings other than
as an individual consumer of health care services.

4. Each such health systems agency shall consist of a fixed number of
members as determined by the health systems agency upon recommendation
of the regional nominating committee established pursuant to section
twenty-nine hundred four-c of this article to be necessary to
appropriately represent the diverse needs and concerns of the region.
The regional nominating committee shall approve a board of directors of
such health systems agency in accordance with section two thousand nine
hundred four-c of this article that is broadly representative of the
region served by the agency and that meets the following requirements:

(a) A majority of the members, but not more than sixty percent of the
members, shall be residents of the health service region served by the
agency who are consumers of health care and major purchasers of health
care, including labor organizations and business corporations, in the
region. A consumer shall mean a person who is not a provider of health
care as defined in accordance with paragraph (c) of this subdivision.

(b) The remainder of the members shall be residents of or have their
principal place of business in the health service region served by the
agency who are providers of health care and who, to the extent
practicable, are representative of the variety of disciplines and
interests of the health care system including (i) physicians, dentists,
nurse practitioners, nurses, optometrists, podiatrists, physician's
assistants, and other health professionals; (ii) health facilities
including hospitals; (iii) health care insurers; (iv) health maintenance
organizations; (v) health professional schools; (vi) the allied health
professions; and (vii) other providers of health care. Not less than
one-half of the providers of health care of the governing body of a
health systems agency shall be direct providers of health care and of
such direct providers of health care, at least one shall be a person
engaged in the administration of a health facility.

(c) A "provider of health care" means an individual (i) who is a
direct provider of health care or who is a representative of different
disciplines, professions or sectors of health care providers and whose
primary current activity is the provision of health care to individuals
or the administration (including trustees or members of boards of
directors) of health facilities in which such care is provided; or (ii)
who holds a fiduciary position with, or has a fiduciary interest in, any
entity which has as its primary purpose the delivery of health care, the
conduct of research into or instruction for health professionals in the
provision of health care, or the production of or supply of drugs or
other articles for individuals or entities for use in the provision of
or in research into or instruction in the provisions of health care; or
(iii) who is a professional in the provision of health care, or the
production of or supply of drugs or other articles for individuals or
entities for use in the provision of or in research into or instruction
in the provision of health care; or (iv) who is a professional employee
of a health professions school; or (v) who is a spouse of an individual
described in subparagraph (i), (ii), (iii) or (iv) of this paragraph.

(d) Any individual may nominate another individual for consideration
by the health systems agency for appointment to the board of directors
of the respective agency. Such nominee shall reside or have their
principal place of business within the respective health service region.
In considering an individual for appointment to such agency, the agency
shall, to the extent practicable, submit to the regional nominating
committee prospective members which are representative of local
government, local health care providers, payors, consumers of health
care, members of labor organizations and business corporations.

5. (a) Members of the agency appointed on or after January first,
nineteen hundred ninety-four shall have fixed terms of five years. No
persons appointed on or after January first, nineteen hundred
ninety-four shall be a member of an agency for more than ten years in
any period of fifteen consecutive years including periods prior to
January first, nineteen hundred ninety-four. A person appointed to fill
a membership vacancy on an agency shall be representative of that
membership category. The commissioner, in consultation with the health
systems agencies, shall devise an equitable method of converting to
these membership term requirements so that all such agencies shall be in
compliance by December thirty-first, nineteen hundred ninety-six.

(b) A board member shall hold over and continue to discharge the
duties of his position after the expiration of the term for which such
board member shall have been appointed until a successor shall be chosen
and qualified; but after the expiration of such term, the position shall
be deemed vacant for the purpose of choosing a successor. An
appointment for a term shortened by reason of a predecessor holding over
shall be for the residue of the term only.

6. A health systems agency may establish standing committees,
subcommittees, and advisory committees as deemed necessary. To the
extent practicable, all standing committees, subcommittees, and advisory
groups appointed by the health systems agency shall be appointed in such
manner as to provide broad representation in such a manner that a
majority of the members shall be consumers of health care.

7. Each health systems agency shall:

(a) recommend to the appropriate authority approval or disapproval of
applications for the establishment or construction of a hospital, the
certification of home health agencies, and the authorization to provide
a long-term home health care program; provided, however, that any such
studies or activities conducted by the agency preparatory to such
approval or disapproval shall not include any such study or activity
regarding financial feasibility, character or competence, or
architectural and technical analysis;

(b) assist appropriate state agencies in the development of standards
and guidelines to determine public need for hospital and other health
services;

(c) serve as a community resource to actively promote increased public
knowledge and responsibility regarding the availability and appropriate
utilization of health care services;

(d) develop regional health plans and carry out facility and health
services planning;

(e) identify in consultation with local providers, employers, payors,
and consumers priorities for improving health care delivery in the
region;

(f) promote cooperative ventures, networking, and other voluntary
cooperative efforts to improve quality, efficiency, affordability, and
access to health care services in the region, including the provision of
technical assistance to rural networks;

(g) perform special studies to identify health care needs and service
requirements in the region;

(h) review and comment on community service plans;

(i) conduct community education for consumers, providers, payors and
for the general public in the region;

(j) collect and maintain regional and other health care data to be
made available to the public, researchers, providers and others for
health care education and development in the region;

(k) assist in the development and implementation of regional and local
health delivery system initiatives including global budgets, rural
networks and health networks;

(l) make recommendations for improving health care status and identify
gaps and needed health care services in the region;

(m) undertake other activities to promote the delivery of health care
services in the region with the goal of improving affordability,
quality, efficiency, and access to health care services;

(n) when requested by the commissioner or otherwise required by law or
regulation, provide recommendations to the commissioner regarding the
awarding of grants for health services in the region;

(o) coordinate its activities with other appropriate general or
special purpose regional health and human services planning or
administrative agencies including area agencies on aging, local and
regional alcohol abuse, drug abuse and mental health planning agencies,
social services agencies, county public health departments, and local
health officers. The health systems agency shall, as appropriate, obtain
data from other agencies for use in planning and development activities,
enter into agreements with other such agencies, and to the extent
practicable, provide technical assistance to such other agencies;

(p) submit a semi-annual report to the senate and assembly health
committees detailing the activities of each agency during that reporting
period;

(q) annually submit a copy of its operating budget to the chairman of
the senate finance committee and the chairman of the assembly ways and
means committee and the director of the division of the budget. Such
operating budget shall contain information detailing contributions
received and the types and sources of contributions eligible for
matching grants;

(r) not permit local contributions from organizations or individuals,
including but not limited to, a health care provider subject to the
provisions of article twenty-eight, thirty-six or forty-four of this
chapter, who are subject to review by the health systems agencies
provided, however, that this prohibition shall not apply to local
governments or to associations representing health care providers as
described herein;

(s) through its board of directors adopt rules governing the agency's
ability to sell resources and engage in fee for service activities or
other contractual arrangements. No health systems agency shall engage
in any fee for service activity with a provider or potential provider of
health care services except local government without prior approval of
the state hospital review and planning council. Such approval shall be
issued or denied in a timely manner;

(t) perform any other duties and functions of the health systems
agency required by law; and

(u) meet as often as necessary to carry out their functions pursuant
to this section.

8. Each health systems agency may hire an executive director. The
executive director may hire employees and consultants as authorized by
the agency and may prescribe their duties.

9. The commissioner upon request of the health systems agencies may
provide technical assistance to the agency for the duties and activities
prescribed herein.

10. The governor shall withdraw approval given to health systems
agencies for failure to comply with such requirements or failure
thereafter to comply with such requirements.

11. The commissioner may promulgate such rules and regulations
including performance criteria as necessary to carry out the purposes of
this article.

12. The commissioner shall promulgate rules and regulations regarding
conflicts of interest and records of the health systems agencies.