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.
Ayes (37): DeFrancisco, Bonacic, Farley, Flanagan, Golden, Griffo, Grisanti, Hannon, Lanza, Larkin, LaValle, Little, Marcellino, Nozzolio, O'Mara, Ranzenhofer, Robach, Savino, Seward, Young, Valesky, Martins, Krueger, Diaz, Dilan, Rivera, Gianaris, Breslin, Montgomery, Parker, Peralta, Perkins, Stavisky, Squadron, Kennedy, Espaillat, Hassell-Thompson
Ayes (57): Addabbo, Avella, Ball, Bonacic, Boyle, Breslin, Carlucci, DeFrancisco, Diaz, Dilan, Farley, Felder, Flanagan, Gallivan, Gianaris, Gipson, Griffo, Grisanti, Hannon, Hoylman, Kennedy, Klein, Krueger, Lanza, Larkin, Latimer, LaValle, Libous, Little, Marcellino, Marchione, Martins, Maziarz, Montgomery, Nozzolio, O'Brien, O'Mara, Parker, Peralta, Perkins, Ranzenhofer, Ritchie, Rivera, Robach, Sampson, Sanders, Savino, Serrano, Seward, Skelos, Squadron, Stavisky, Stewart-Cousins, Tkaczyk, Valesky, Young, Zeldin
Excused (4): Espaillat, Golden, Hassell-Thomps, Smith
TITLE OF BILL: An act to amend the public health law, in relation to establishing a hospital-home care-physician collaboration program
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.
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.
This bill will promote efficiency and coordination in service delivery, with better outcomes, reduced costs, and ultimately sustainability and access of care.
The bill would take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 5258 2013-2014 Regular Sessions IN SENATE 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 THES. 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.