2023 New York Laws › PBH - Public Health › Article 28 - Hospitals › 2805-X - Hospital-Home Care-Physician Collaboration Program.

§  2805-x.  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
management, patient health outcomes, cost-effectiveness in  the  use  of
health care services and community population health. Such collaborative
initiatives  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.
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
allocated  or  appropriated  therefor,  including  funds provided to the
state through  federal  waivers,  funds  made  available  through  state
appropriations  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 initiatives and objectives of this section.
4. Hospital-home care-physician collaborative initiatives  under  this
section may include, but shall 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
readmissions 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
demonstrated 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.
(d) Collaborative programs  to  address  disparities  in  health  care
access  or treatment, and/or conditions of higher prevalence, in certain
populations, where such collaborative programs could provide and  manage
services  in a more effective, person-centered and cost-efficient manner
for reduction or elimination of such disparities.
(i) Such programs may target one  or  more  disparate  conditions,  or
areas  of under-service, evidenced in defined populations, including but
not be limited to:
(A) cardiovascular disease;
(B) hypertension;
(C) diabetes;
(D) chronic kidney disease;
(E) obesity;
(F) asthma;
(G) sickle cell disease;
(H) sepsis;
(I) lupus;
(J) breast, lung, prostate and colorectal cancers;
(K) geographic shortage  of  primary  care,  prenatal/obstetric  care,
specialty   medical   care,   home   health   care,  or  culturally  and
linguistically compatible care;
(L) alcohol, tobacco, or substance abuse;
(M) post-traumatic stress disorder and other conditions more prevalent
among veterans of the United States military services;
(N) attracting members  of  minority  populations  to  the  field  and
practice of medicine; and
(O) such other areas approved by the commissioner.
(ii)  Collaborative  hospital-home  care-physician,  and as applicable
additional partner, models may include under such disparities programs:
(A) service planning and design;
(B) recruitment of specialty personnel and/or  specialty  training  of
professionals or other direct care personnel (including physicians, home
care and hospital staffs), patients and informal caregivers;
(C) continuing medical education and clinical training for physicians,
follow-up evaluations, and supporting educational materials;
(D)  use  of  evidenced-based  approaches  and/or  best  practices  to
treatment;
(E) reimbursement of uncovered services;
(F) bundled  or  other  integrated  payment  methods  to  support  the
necessary, coordinated and cost-effective services;
(G)   regulatory   waivers   to  facilitate  flexibility  in  provider
collaboration and person-centered care;
(H) patient/family peer support and education;
(I) data collection, research and evaluation of efficacy; and/or
(J) other components or innovations satisfactory to the commissioner.
(iii) Nothing contained in this paragraph shall prevent  a  physician,
physicians  group,  home  care  agency,  or  hospital  from individually
applying for said grant.
(iv)  The  commissioner  shall  consult  with  physicians,  home  care
agencies, hospitals, consumers, statewide associations representative of
such  participants,  and  other  experts  in health care disparities, in
developing an application process for grant funding or rate  adjustment,
and   for   request   of   state   regulatory   waivers,  to  facilitate
implementation of disparities programs under this paragraph.
5. Hospitals and home care agencies which are  provided  financing  or
waivers pursuant to this section shall report to the commissioner on the
patient,   service  and  cost  experiences  pursuant  to  this  section,
including the extent to  which  the  project  goals  are  achieved.  The
commissioner  shall  compile  and  make  such  reports  available on the
department's website.