S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7018
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               April 3, 2019
                                ___________
 
 Introduced  by  M. of A. PEOPLES-STOKES -- read once and referred to the
   Committee on Health
 
 AN ACT to amend the public health law,  in  relation  to  directing  the
   commissioner of health to establish demonstration projects authorizing
   equity  investment in the operation of residential health care facili-
   ties

   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) THE COMMISSIONER SHALL ON OR BEFORE DECEMBER THIRTY-FIRST, TWO
 THOUSAND NINETEEN, ESTABLISH UP TO TWO DEMONSTRATION PROJECTS TO  DEVEL-
 OP,  EVALUATE AND IMPLEMENT AN INNOVATIVE APPROACH TO ENCOURAGING EQUITY
 INVESTORS TO PROVIDE NEEDED FINANCIAL RESOURCES FOR AND HOLD  AN  EQUITY
 INTEREST AS OPERATORS OF RESIDENTIAL HEALTH CARE FACILITIES. ONE PROJECT
 SHALL  BE  IN  THE UPSTATE REGION OF THE STATE.  THE OTHER DEMONSTRATION
 PROJECT SHALL BE IN A DOWNSTATE REGION IN THE STATE. IN ANTICIPATION  OF
 THE  FINANCIAL  IMPACT  ON  RESIDENTIAL  HEALTH CARE FACILITIES FROM THE
 STATE'S EXPANSION OF MANDATORY MANAGED CARE TO LONG TERM CARE  SERVICES,
 THE  DEMONSTRATIONS  SHALL BE DESIGNED TO PROMOTE THE DEVELOPMENT OF NEW
 SOURCES OF CAPITAL FOR THE OPERATION OF RESIDENTIAL HEALTH CARE  FACILI-
 TIES, AND TO MEASURE THE ABILITY OF SUCH INVESTMENT TO POSITIVELY IMPACT
 FACILITIES IN TERMS OF CAPITAL IMPROVEMENTS, INVESTMENT IN NEW TECHNOLO-
 GY,  AND  IMPROVEMENT  TO  THE  QUALITY  OF CARE AND QUALITY OF LIFE FOR
 FACILITY RESIDENTS MEASURED BY BROADLY ACCEPTED INDUSTRY METRICS INCLUD-
 ING, BUT NOT LIMITED TO, THOSE RELATED TO REDUCTION IN RATES OF REHOSPI-
 TALIZATON, MDS QUALITY INDICATORS, END OF LIFE CARE, MEDICAL ORDERS  FOR
 LIFE-SUSTAINING  TREATMENT  AND NURSING FACILITY "CULTURE CHANGE" INITI-
 ATIVES. THE FACILITIES  PARTICIPATING  IN  THE  DEMONSTRATIONS  AND  THE
 COMMISSIONER  SHALL  MUTUALLY DEVELOP THE APPROPRIATE METRICS TO MEASURE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD10797-01-9
              

 A. 7018                             2
 
 SUCH IMPACT WHICH SHALL SERVE AS THE BASIS FOR THE REPORT TO THE  GOVER-
 NOR AND THE LEGISLATURE REQUIRED BY PARAGRAPH (H) OF THIS SUBDIVISION.
   (B)  FOR PURPOSES OF SUCH DEMONSTRATIONS, THE COMMISSIONER MAY APPROVE
 DEMONSTRATION PROJECTS EACH INVOLVING THE  PURCHASE  OF  UP  TO  FIFTEEN
 EXISTING  RESIDENTIAL  HEALTH  CARE  FACILITIES  WHICH HAVE HISTORIES OF
 PROVIDING HIGH QUALITY CARE TO RESIDENTS.
   (C) THE EQUITY INVESTOR SHALL PARTICIPATE IN EACH FACILITY THROUGH THE
 CREATION OF LIMITED LIABILITY COMPANIES ESTABLISHED TO OPERATE THE RESI-
 DENTIAL HEALTH CARE FACILITIES.
   (D) THE RESIDENTIAL HEALTH CARE FACILITIES MAY BE OPERATED BY  LIMITED
 LIABILITY  COMPANIES  FORMED  PURSUANT  TO THE LIMITED LIABILITY COMPANY
 LAW, WHOSE MEMBERS ARE NOT NATURAL PERSONS  SO  LONG  AS  AT  LEAST  ONE
 MEMBER OF SUCH LIMITED LIABILITY COMPANIES IS A NATURAL PERSON OF SUFFI-
 CIENT  EXPERIENCE  AND  EXPERTISE IN DELIVERING HIGH QUALITY NURSING AND
 HEALTH RELATED CARE TO WHOM THE EQUITY INVESTOR HAS  DELEGATED,  TO  THE
 SATISFACTION OF THE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL, RESPONSI-
 BILITY FOR THE DAY TO DAY MANAGEMENT AND OPERATION OF THE FACILITY.
   (E) THE PROVISIONS OF PARAGRAPH (B) OF SUBDIVISION THREE AND PARAGRAPH
 (C)  OF  SUBDIVISION  FOUR OF THIS SECTION SHALL NOT APPLY TO THE EQUITY
 INVESTOR OR ITS OWNERS; PROVIDED, HOWEVER, THAT THE  PUBLIC  HEALTH  AND
 HEALTH  PLANNING  COUNCIL MAY REQUIRE COMMERCIALLY REASONABLE DISCLOSURE
 OF THE IDENTITY OF LIMITED LIABILITY COMPANY MEMBERS, PROVIDED THAT  THE
 NUMBER OF INVESTORS IS NOT GREATER THAN THIRTY-FIVE.
   (F)  THE  PROVISIONS  OF PARAGRAPHS (E) AND (F) OF SUBDIVISION FOUR OF
 THIS SECTION SHALL NOT APPLY TO RESIDENTIAL HEALTH CARE FACILITIES OPER-
 ATED PURSUANT TO THIS SUBDIVISION. NOTHING IN THIS SECTION SHALL PROHIB-
 IT A LIMITED LIABILITY COMPANY FROM BEING THE SOLE MEMBER OF THE LIMITED
 LIABILITY COMPANIES REFERRED TO IN PARAGRAPH (C) AND (D) OF THIS  SUBDI-
 VISION  PROVIDED  THAT  THE FORMER LIMITED LIABILITY COMPANY OR AT LEAST
 ONE OF ITS MEMBERS CONFORMS TO THE REQUIREMENTS OF SUCH PARAGRAPHS.
   (G) RESIDENTIAL HEALTH CARE FACILITIES PARTICIPATING  IN  THIS  DEMON-
 STRATION  PROGRAM  SHALL  BE  SUBJECT  TO ALL OPERATING STANDARDS AS SET
 FORTH IN THIS ARTICLE AND THE REGULATIONS PROMULGATED  PURSUANT  THERETO
 AND  SHALL  BE  SUBJECT TO ANY PROVISIONS OF THIS CHAPTER FOR FAILURE TO
 COMPLY WITH SUCH STANDARDS.  ADDITIONALLY,  FACILITIES  IN  THIS  DEMON-
 STRATION PROGRAM SHALL COMPLY WITH ALL DEPARTMENT REGULATIONS PERTAINING
 TO ADMISSIONS OF MEDICAID PATIENTS.
   (H)  NO LATER THAN TWO YEARS AFTER THE FIRST FACILITY COMMENCES OPERA-
 TION PURSUANT TO THIS  DEMONSTRATION  PROGRAM,  THE  COMMISSIONER  SHALL
 PROVIDE  THE  GOVERNOR,  THE  TEMPORARY  PRESIDENT OF THE SENATE AND THE
 SPEAKER OF THE ASSEMBLY WITH A WRITTEN EVALUATION OF  THE  DEMONSTRATION
 PROGRAMS.    SUCH  EVALUATION SHALL ADDRESS THE OVERALL EFFECTIVENESS OF
 THE PROGRAM IN PROVIDING ACCESS TO  CAPITAL  INVESTMENT  BY  RESIDENTIAL
 HEALTH CARE FACILITIES AND EVALUATE THE IMPACT PRIVATE EQUITY INVESTMENT
 HAS  ON  THE QUALITY OF CARE AS EVIDENCED BY STAFF RETENTION AND QUALITY
 INDICATORS, AND ACCESS TO CARE FOR VARIOUS RESIDENT POPULATIONS.
   (I) RESIDENTIAL HEALTH CARE FACILITIES PARTICIPATING  IN  THIS  DEMON-
 STRATION  PROGRAM SHALL SUBMIT SUCH QUALITY REPORTS AS SHALL BE REQUIRED
 AND DIRECTED BY THE COMMISSIONER, INCLUDING INFORMATION ON PATIENT  CARE
 QUALITY  INDICATORS, STAFFING LEVELS AND PATTERNS AND ACCESS TO CARE FOR
 VARIOUS PATIENT POPULATIONS.
   § 2. This act shall take effect on the sixtieth  day  after  it  shall
 have  become  a  law; provided, however, that effective immediately, the
 addition, amendment and/or repeal of any rule  or  regulation  necessary
 for  the implementation of this act on its effective date are authorized
 and directed to be made and completed on or before such effective date.