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

                                  5458

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                              May 14, 2015
                               ___________

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  diagnostic  or
  treatment centers within retail businesses

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. 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 OR A STORE OPEN TO THE GENERAL PUBLIC, OR WITHIN SPACE USED  BY
AN  EMPLOYER FOR PROVIDING HEALTH CARE SERVICES TO ITS EMPLOYEES, MAY BE
OPERATED BY LEGAL ENTITIES FORMED UNDER THE LAWS OF  THE  STATE  OF  NEW
YORK:  (I) WHOSE STOCKHOLDERS OR MEMBERS, AS APPLICABLE, ARE NOT NATURAL
PERSONS; (II) WHOSE PRINCIPAL STOCKHOLDERS AND MEMBERS,  AS  APPLICABLE,
AND  CONTROLLING PERSONS COMPLY WITH ALL APPLICABLE REQUIREMENTS OF THIS
SECTION; AND (III) THAT DEMONSTRATE, TO THE SATISFACTION OF  THE  PUBLIC
HEALTH  AND HEALTH PLANNING COUNCIL, SUFFICIENT EXPERIENCE AND EXPERTISE
IN DELIVERING HIGH QUALITY HEALTH CARE  SERVICES.  SUCH  DIAGNOSTIC  AND
TREATMENT  CENTERS  SHALL  BE  REFERRED  TO  IN THIS SECTION AS "LIMITED
SERVICES CLINICS".
  (B) FOR PURPOSES OF PARAGRAPH (A)  OF  THIS  SUBDIVISION,  THE  PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL SHALL ADOPT AND AMEND RULES AND REGU-
LATIONS,  NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION, TO
ADDRESS ANY MATTER IT DEEMS PERTINENT TO THE  ESTABLISHMENT  OF  LIMITED
SERVICES  CLINICS.  SUCH RULES AND REGULATIONS SHALL INCLUDE, BUT NOT BE
LIMITED TO, PROVISIONS GOVERNING OR RELATING TO: (I) ANY DIRECT OR INDI-
RECT CHANGES OR TRANSFERS OF OWNERSHIP INTERESTS  OR  VOTING  RIGHTS  IN
SUCH  ENTITIES  OR  THEIR  STOCKHOLDERS  OR MEMBERS, AS APPLICABLE; (II)
PUBLIC HEALTH AND HEALTH PLANNING COUNCIL  APPROVAL  OF  ANY  CHANGE  IN
CONTROLLING  INTERESTS,  PRINCIPAL  STOCKHOLDERS,  CONTROLLING  PERSONS,

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11104-01-5
              

S. 5458                             2

PARENT COMPANY OR SPONSORS; (III) OVERSIGHT  OF  THE  OPERATOR  AND  ITS
SHAREHOLDERS  OR  MEMBERS,  AS APPLICABLE, INCLUDING LOCAL GOVERNANCE OF
THE LIMITED SERVICES CLINICS; AND (IV) 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.
  (C) 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, RELAT-
ING 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.
  (D)  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 SERVICE 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.
  (E) 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  AND  REQUIRING  TIMELY  REPORTING  TO THE DEPARTMENT IF A
LIMITED SERVICE CLINIC LOSES ITS ACCREDITATION;
  (II) DESIGNATING OR LIMITING THE TREATMENTS AND SERVICES THAT  MAY  BE
PROVIDED, INCLUDING:
  (1)  PROHIBITING  THE  PROVISION  OF  SERVICES TO PATIENTS TWENTY-FOUR
MONTHS OF AGE OR YOUNGER;
  (2) THE PROVISION OF SPECIFIC IMMUNIZATIONS TO PATIENTS  YOUNGER  THAN
EIGHTEEN YEARS OF AGE;
  (III)  REQUIRING  LIMITED SERVICE CLINICS TO ACCEPT WALK-INS AND OFFER
EXTENDED BUSINESS HOURS;
  (IV) SETTING FORTH 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;
  (V)  REQUIRING  THE OPERATOR TO DIRECTLY EMPLOY A MEDICAL DIRECTOR WHO
IS LICENSED AND CURRENTLY REGISTERED TO PRACTICE MEDICINE IN  THE  STATE
OF NEW YORK; AND
  (VI)  REQUIRING  LIMITED  SERVICE  CLINICS  TO UTILIZE AND MAINTAIN AN
ELECTRONIC HEALTH RECORD SYSTEM THAT  CONNECTS  TO  THE  LOCAL  REGIONAL
HEALTH  INFORMATION  ORGANIZATION  TO  FACILITATE THE EXCHANGE OF HEALTH
INFORMATION.
  (F) 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.

S. 5458                             3

  (G) A LIMITED SERVICES CLINIC SHALL PROVIDE TREATMENT WITHOUT DISCRIM-
INATION AS TO RACE, COLOR, RELIGION, SEX, NATIONAL  ORIGIN,  DISABILITY,
SEXUAL ORIENTATION OR SOURCE OF PAYMENT.
  (H)  NOTWITHSTANDING  THIS SUBDIVISION AND ANY OTHER LAW OR REGULATION
TO THE CONTRARY AND SUBJECT TO THE PROVISIONS  OF  SECTION  TWENTY-EIGHT
HUNDRED TWO OF THIS ARTICLE, A DIAGNOSTIC AND TREATMENT CENTER, COMMUNI-
TY  HEALTH  CENTER  OR  FEDERALLY  QUALIFIED HEALTH CENTER MAY OPERATE A
LIMITED SERVICES CLINIC WHICH MEETS THE REGULATION PROMULGATED  PURSUANT
TO  PARAGRAPH (D) OF THIS SUBDIVISION REGARDING OPERATIONAL AND PHYSICAL
PLANT STANDARDS FOR LIMITED SERVICES CLINICS.
  S 2. This act shall take effect immediately.

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

                                 5458--B

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                              May 14, 2015
                               ___________

Introduced  by  Sens.  HANNON, LARKIN -- read twice and ordered printed,
  and when printed to  be  committed  to  the  Committee  on  Health  --
  reported  favorably from said committee and committed to the Committee
  on Finance -- committee discharged, bill amended, ordered reprinted as
  amended and recommitted  to  said  committee  --  recommitted  to  the
  Committee  on  Health  in  accordance  with  Senate  Rule 6, sec. 8 --
  reported favorably from said committee and committed to the  Committee
  on Finance -- committee discharged, bill amended, ordered reprinted as
  amended and recommitted to said committee

AN  ACT  to  amend the public health law, in relation to authorizing the
  establishment of limited service clinics

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  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  OR A STORE OPEN TO THE GENERAL PUBLIC, OR WITHIN SPACE USED BY
AN EMPLOYER FOR PROVIDING HEALTH CARE SERVICES TO ITS EMPLOYEES, MAY  BE
OPERATED  BY  LEGAL  ENTITIES  FORMED UNDER THE LAWS OF THE STATE OF NEW
YORK: (I) WHOSE STOCKHOLDERS OR MEMBERS, AS APPLICABLE, ARE NOT  NATURAL
PERSONS;  (II)  WHOSE PRINCIPAL STOCKHOLDERS AND MEMBERS, AS APPLICABLE,
AND CONTROLLING PERSONS COMPLY WITH ALL APPLICABLE REQUIREMENTS OF  THIS
SECTION;  AND  (III) THAT DEMONSTRATE, TO THE SATISFACTION OF THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL, SUFFICIENT EXPERIENCE AND  EXPERTISE
IN DELIVERING HIGH QUALITY HEALTH CARE SERVICES, AND FURTHER DEMONSTRATE
A  COMMITMENT  TO  OPERATE  LIMITED SERVICES CLINICS IN MEDICALLY UNDER-
SERVED AREAS OF THE STATE. SUCH DIAGNOSTIC AND TREATMENT  CENTERS  SHALL
BE REFERRED TO IN THIS SECTION AS "LIMITED SERVICES CLINICS".
  (B)  FOR  PURPOSES  OF  PARAGRAPH  (A) OF THIS SUBDIVISION, THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL SHALL ADOPT AND AMEND RULES AND REGU-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11104-04-6
              

S. 5458--B                          2

LATIONS, NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION,  TO
ADDRESS  ANY  MATTER  IT DEEMS PERTINENT TO THE ESTABLISHMENT OF LIMITED
SERVICES CLINICS. SUCH RULES AND REGULATIONS SHALL INCLUDE, BUT  NOT  BE
LIMITED TO, PROVISIONS GOVERNING OR RELATING TO: (I) ANY DIRECT OR INDI-
RECT  CHANGES  OR  TRANSFERS  OF OWNERSHIP INTERESTS OR VOTING RIGHTS IN
SUCH ENTITIES OR THEIR STOCKHOLDERS  OR  MEMBERS,  AS  APPLICABLE;  (II)
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; AND (IV) 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.
  (C) 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, RELAT-
ING  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.
  (D) 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 SERVICE 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.
  (E) 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 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, INCLUDING:
  (1) THE PROVISION OF TREATMENT AND  SERVICES  TO  PATIENTS  FOR  MINOR
ACUTE EPISODIC ILLNESSES OR CONDITIONS;
  (2)  EPISODIC  PREVENTIVE AND WELLNESS TREATMENTS AND SERVICES SUCH AS
IMMUNIZATIONS; AND
  (3) (A) TREATMENT AND SERVICES FOR MINOR TRAUMAS THAT ARE NOT  REASON-
ABLY LIKELY TO BE LIFE THREATENING OR POTENTIALLY DISABLING IF AMBULATO-
RY CARE WITHIN THE CAPACITY OF THE LIMITED SERVICES CLINIC IS PROVIDED;
  (B)  PROHIBITING  THE  PROVISION  OF  SERVICES TO PATIENTS TWENTY-FOUR
MONTHS OF AGE OR YOUNGER;
  (C) THE PROVISION OF SPECIFIC IMMUNIZATIONS TO PATIENTS  YOUNGER  THAN
EIGHTEEN YEARS OF AGE;
  (III)  REQUIRING LIMITED SERVICES CLINICS TO ACCEPT WALK-INS AND OFFER
EXTENDED BUSINESS HOURS;
  (IV) SETTING FORTH GUIDELINES FOR ADVERTISING AND SIGNAGE, WHICH SHALL
INCLUDE  SIGNAGE  INDICATING  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;
  (V)  SETTING  FORTH  GUIDELINES FOR DISCLOSURE OF OWNERSHIP INTERESTS,
INFORMED CONSENT, RECORD KEEPING, REFERRAL FOR TREATMENT AND  CONTINUITY

S. 5458--B                          3

OF  CARE,  CASE  REPORTING TO THE PATIENT'S PRIMARY CARE OR OTHER HEALTH
CARE PROVIDERS, DESIGN, CONSTRUCTION, FIXTURES, AND EQUIPMENT; AND
  (VI)  REQUIRING THE OPERATOR TO DIRECTLY EMPLOY A MEDICAL DIRECTOR WHO
IS LICENSED AND CURRENTLY REGISTERED TO PRACTICE MEDICINE IN  THE  STATE
OF NEW YORK.
  (F) SUCH REGULATIONS ALSO SHALL PROMOTE AND STRENGTHEN PRIMARY CARE BY
REQUIRING LIMITED SERVICES CLINICS TO:
  (I)  INQUIRE  OF  EACH  PATIENT  WHETHER  HE OR SHE HAS A PRIMARY CARE
PROVIDER;
  (II) MAINTAIN AND REGULARLY  UPDATE  A  LIST  OF  LOCAL  PRIMARY  CARE
PROVIDERS AND PROVIDE SUCH LIST TO EACH PATIENT WHO INDICATES THAT HE OR
SHE DOES NOT HAVE A PRIMARY CARE PROVIDER;
  (III)  REFER  PATIENTS TO THEIR PRIMARY CARE PROVIDERS OR OTHER HEALTH
CARE PROVIDERS AS APPROPRIATE;
  (IV) TRANSMIT, BY  ELECTRONIC  MEANS  WHENEVER  POSSIBLE,  RECORDS  OF
SERVICES TO PATIENTS' PRIMARY CARE PROVIDERS;
  (V) EXECUTE PARTICIPATION AGREEMENTS WITH HEALTH INFORMATION ORGANIZA-
TIONS,  ALSO  KNOWN  AS  QUALIFIED  ENTITIES,  PURSUANT TO WHICH LIMITED
SERVICES CLINICS AGREE TO PARTICIPATE IN THE STATEWIDE  HEALTH  INFORMA-
TION NETWORK FOR NEW YORK (SHIN-NY); AND
  (VI)  DECLINE  TO  TREAT ANY PATIENT FOR THE SAME CONDITION OR ILLNESS
MORE THAN THREE TIMES IN A YEAR.
  (G) A LIMITED SERVICES CLINIC SHALL PROVIDE TREATMENT WITHOUT DISCRIM-
INATION AS TO SOURCE OF PAYMENT.
  (H) NOTWITHSTANDING THIS SUBDIVISION AND OTHER LAW  OR  REGULATION  TO
THE  CONTRARY  AND  SUBJECT  TO  THE  PROVISIONS OF SECTION TWENTY-EIGHT
HUNDRED TWO OF THIS ARTICLE, A GENERAL HOSPITAL, A DIAGNOSTIC AND TREAT-
MENT CENTER, COMMUNITY  HEALTH  CENTER  OR  FEDERALLY  QUALIFIED  HEALTH
CENTER  MAY OPERATE A LIMITED SERVICES CLINIC WHICH MEETS THE REGULATION
PROMULGATED PURSUANT TO PARAGRAPH  (E)  OF  THIS  SUBDIVISION  REGARDING
OPERATIONAL PHYSICAL PLANT STANDARDS.
  (I)  IN  DETERMINING  WHETHER  TO  APPROVE ADDITIONAL LIMITED SERVICES
CLINIC LOCATIONS, THE DEPARTMENT SHALL CONSIDER WHETHER THE OPERATOR HAS
FULFILLED  ITS  COMMITMENT  TO  OPERATE  LIMITED  SERVICES  CLINICS   IN
MEDICALLY UNDERSERVED AREAS OF THE STATE.
  S 2. This act shall take effect immediately.

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

                                 5458--C

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                              May 14, 2015
                               ___________

Introduced  by  Sens.  HANNON, LARKIN -- read twice and ordered printed,
  and when printed to  be  committed  to  the  Committee  on  Health  --
  reported  favorably from said committee and committed to the Committee
  on Finance -- committee discharged, bill amended, ordered reprinted as
  amended and recommitted  to  said  committee  --  recommitted  to  the
  Committee  on  Health  in  accordance  with  Senate  Rule 6, sec. 8 --
  reported favorably from said committee and committed to the  Committee
  on Finance -- committee discharged, bill amended, ordered reprinted as
  amended  and  recommitted  to  said committee -- committee discharged,
  bill amended, ordered reprinted as amended  and  recommitted  to  said
  committee

AN  ACT  to  amend the public health law, in relation to authorizing the
  establishment of limited service clinics

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  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  OR A STORE OPEN TO THE GENERAL PUBLIC, OR WITHIN SPACE USED BY
AN EMPLOYER FOR PROVIDING HEALTH CARE SERVICES TO ITS EMPLOYEES, MAY  BE
OPERATED  BY  LEGAL  ENTITIES  FORMED UNDER THE LAWS OF THE STATE OF NEW
YORK: (I) WHOSE STOCKHOLDERS OR MEMBERS, AS APPLICABLE, ARE NOT  NATURAL
PERSONS;  (II)  WHOSE PRINCIPAL STOCKHOLDERS AND MEMBERS, AS APPLICABLE,
AND CONTROLLING PERSONS COMPLY WITH ALL APPLICABLE REQUIREMENTS OF  THIS
SECTION;  AND  (III) THAT DEMONSTRATE, TO THE SATISFACTION OF THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL, SUFFICIENT EXPERIENCE AND  EXPERTISE
IN DELIVERING HIGH QUALITY HEALTH CARE SERVICES, AND FURTHER DEMONSTRATE
A  COMMITMENT  TO  OPERATE  LIMITED SERVICES CLINICS IN MEDICALLY UNDER-
SERVED AREAS OF THE STATE. SUCH DIAGNOSTIC AND TREATMENT  CENTERS  SHALL
BE REFERRED TO IN THIS SECTION AS "LIMITED SERVICES CLINICS".

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD11104-05-6
              

S. 5458--C                          2

  (B)  FOR  PURPOSES  OF  PARAGRAPH  (A) OF THIS SUBDIVISION, THE PUBLIC
HEALTH AND HEALTH PLANNING COUNCIL SHALL ADOPT AND AMEND RULES AND REGU-
LATIONS, NOTWITHSTANDING ANY INCONSISTENT PROVISION OF THIS SECTION,  TO
ADDRESS  ANY  MATTER  IT DEEMS PERTINENT TO THE ESTABLISHMENT OF LIMITED
SERVICES  CLINICS.  SUCH RULES AND REGULATIONS SHALL INCLUDE, BUT NOT BE
LIMITED TO, PROVISIONS GOVERNING OR RELATING TO: (I) ANY DIRECT OR INDI-
RECT CHANGES OR TRANSFERS OF OWNERSHIP INTERESTS  OR  VOTING  RIGHTS  IN
SUCH  ENTITIES  OR  THEIR  STOCKHOLDERS  OR MEMBERS, AS APPLICABLE; (II)
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; AND (IV) 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.
  (C) 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, RELAT-
ING 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.
  (D)  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 SERVICE 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.
  (E) 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  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, INCLUDING:
  (A)  LIMITING  THE  SCOPE  OF SERVICES TO THE FOLLOWING, PROVIDED THAT
SUCH SERVICES SHALL NOT INCLUDE MONITORING  OR  TREATMENT  AND  SERVICES
OVER PROLONGED PERIODS:
  (1)  THE  PROVISION  OF  TREATMENT  AND SERVICES TO PATIENTS FOR MINOR
ACUTE EPISODIC ILLNESSES OR CONDITIONS;
  (2) EPISODIC PREVENTIVE AND WELLNESS TREATMENTS AND SERVICES  SUCH  AS
IMMUNIZATIONS; AND
  (3)  TREATMENT  AND SERVICES FOR MINOR TRAUMAS THAT ARE NOT REASONABLY
LIKELY TO BE LIFE THREATENING OR  POTENTIALLY  DISABLING  IF  AMBULATORY
CARE WITHIN THE CAPACITY OF THE LIMITED SERVICES CLINIC IS PROVIDED;
  (B)  PROHIBITING  THE  PROVISION  OF  SERVICES TO PATIENTS TWENTY-FOUR
MONTHS OF AGE OR YOUNGER;
  (C) THE PROVISION OF SPECIFIC IMMUNIZATIONS TO PATIENTS  YOUNGER  THAN
EIGHTEEN YEARS OF AGE;
  (III)  REQUIRING LIMITED SERVICES CLINICS TO ACCEPT WALK-INS AND OFFER
EXTENDED BUSINESS HOURS;

S. 5458--C                          3

  (IV) SETTING FORTH GUIDELINES FOR ADVERTISING AND SIGNAGE, WHICH SHALL
INCLUDE  SIGNAGE  INDICATING  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;
  (V)  SETTING  FORTH  GUIDELINES FOR 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; AND
  (VI) REQUIRING THE OPERATOR TO DIRECTLY EMPLOY A MEDICAL DIRECTOR  WHO
IS  LICENSED  AND CURRENTLY REGISTERED TO PRACTICE MEDICINE IN THE STATE
OF NEW YORK.
  (F) SUCH REGULATIONS ALSO SHALL PROMOTE AND STRENGTHEN PRIMARY CARE BY
REQUIRING LIMITED SERVICES CLINICS TO:
  (I) INQUIRE OF EACH PATIENT WHETHER HE  OR  SHE  HAS  A  PRIMARY  CARE
PROVIDER;
  (II)  MAINTAIN  AND  REGULARLY  UPDATE  A  LIST  OF LOCAL PRIMARY CARE
PROVIDERS AND PROVIDE SUCH LIST TO EACH PATIENT WHO INDICATES THAT HE OR
SHE DOES NOT HAVE A PRIMARY CARE PROVIDER;
  (III) REFER PATIENTS TO THEIR PRIMARY CARE PROVIDERS OR  OTHER  HEALTH
CARE PROVIDERS AS APPROPRIATE;
  (IV)  TRANSMIT,  BY  ELECTRONIC  MEANS  WHENEVER  POSSIBLE, RECORDS OF
SERVICES TO PATIENTS' PRIMARY CARE PROVIDERS;
  (V) EXECUTE PARTICIPATION AGREEMENTS WITH HEALTH INFORMATION ORGANIZA-
TIONS, ALSO KNOWN AS  QUALIFIED  ENTITIES,  PURSUANT  TO  WHICH  LIMITED
SERVICES  CLINICS  AGREE TO PARTICIPATE IN THE STATEWIDE HEALTH INFORMA-
TION NETWORK FOR NEW YORK (SHIN-NY); AND
  (VI) DECLINE TO TREAT ANY PATIENT FOR THE SAME  CONDITION  OR  ILLNESS
MORE THAN THREE TIMES IN A YEAR.
  (G) A LIMITED SERVICES CLINIC SHALL PROVIDE TREATMENT WITHOUT DISCRIM-
INATION AS TO SOURCE OF PAYMENT.
  (H)  NOTWITHSTANDING  THIS  SUBDIVISION AND OTHER LAW OR REGULATION TO
THE CONTRARY AND SUBJECT  TO  THE  PROVISIONS  OF  SECTION  TWENTY-EIGHT
HUNDRED TWO OF THIS ARTICLE, A GENERAL HOSPITAL, A DIAGNOSTIC AND TREAT-
MENT  CENTER,  COMMUNITY  HEALTH  CENTER  OR  FEDERALLY QUALIFIED HEALTH
CENTER MAY OPERATE A LIMITED SERVICES CLINIC WHICH MEETS THE  REGULATION
PROMULGATED  PURSUANT  TO  PARAGRAPH  (E)  OF THIS SUBDIVISION REGARDING
OPERATIONAL PHYSICAL PLANT STANDARDS.
  (I) IN DETERMINING WHETHER  TO  APPROVE  ADDITIONAL  LIMITED  SERVICES
CLINIC LOCATIONS, THE DEPARTMENT SHALL CONSIDER WHETHER THE OPERATOR HAS
FULFILLED   ITS  COMMITMENT  TO  OPERATE  LIMITED  SERVICES  CLINICS  IN
MEDICALLY UNDERSERVED AREAS OF THE STATE.
  S 2. This act shall take effect immediately.