2023 New York Laws › PBH - Public Health › Article 28 - Hospitals › 2802-B - Health Equity Impact Assessments.

§ 2802-b. Health equity impact assessments. 1. Definitions. As used in
this section:
(a)  "Application"  means  an  application  under this article for the
construction,  establishment,  change  in  the  establishment,   merger,
acquisition,   elimination   or  substantial  reduction,  expansion,  or
addition of a hospital service or health-related service of  a  hospital
that  requires  review  or  approval by the council or the commissioner,
where the  application  is  filed  or  submitted  to  the  council,  the
commissioner   or  the  department  after  this  section  takes  effect.
Provided,  however,  that  an  application  for  the   change   in   the
establishment, merger or acquisition of a hospital shall not be included
in   this  definition  if  the  application  would  not  result  in  the
elimination, or substantial reduction, expansion, addition or change  in
location  of  a  hospital  service  or  health  related  service  of the
hospital.
(b) "Project" means the construction,  establishment,  change  in  the
establishment,   merger,   acquisition,   elimination,   or  substantial
reduction,  expansion,  or   addition   of   a   hospital   service   or
health-related  service  of  a  hospital  that  is  the  subject  of  an
application.
(c) "Health equity impact assessment" or "impact assessment" means  an
assessment  of  whether, and if so how, a project will improve access to
hospital services and health care, health equity and reduction of health
disparities,  with  particular  reference  to   members   of   medically
underserved groups, in the applicant's service area.
(d) "Medically underserved group" means: low-income people; racial and
ethnic   minorities;   immigrants;   women;   lesbian,   gay,  bisexual,
transgender, or other-than-cisgender people; people  with  disabilities;
older  adults;  persons  living  with  a prevalent infectious disease or
condition; persons living in rural areas; people who are eligible for or
receive public health benefits;  people  who  do  not  have  third-party
health  coverage  or  have  inadequate  third-party health coverage; and
other people who are unable to obtain health care.
2. (a) (i) Every application shall  include  a  health  equity  impact
assessment  of the project. The health equity impact assessment shall be
filed together with the application, and the application  shall  not  be
complete  without  the  impact  statement.  The applicant shall promptly
amend or modify the impact statement as necessary.
(ii) However, in the case of a diagnostic and treatment  center  whose
patient  population  is over fifty percent combined patients enrolled in
Medicaid or uninsured, a health equity impact assessment is not required
unless  the  application  includes  a  change  in  controlling   person,
principal  stockholder,  or  principal  member  (as  defined  in section
twenty-eight hundred one-a of this article) of the applicant.
(b)  In  considering  whether  and  on  what  terms  to   approve   an
application, the commissioner and the council, as the case may be, shall
consider the health equity impact statement.
3.  Scope  and contents of a health equity impact assessment. A health
equity impact assessment shall include:
(a) A demonstration of whether, and if so how,  the  proposed  project
will  improve access to hospital services and health care, health equity
and reduction  of  health  disparities,  with  particular  reference  to
members  of  medically  underserved  groups,  in the applicant's service
area.
(b)  The  extent  to  which  medically  underserved  groups   in   the
applicant's  service area use the applicant's hospital or health-related
services or similar services at the time  of  the  application  and  the
extent to which they are expected to if the project is implemented.
(c)  The  performance  of the applicant in meeting its obligations, if
any, under section twenty-eight hundred  seven-k  of  this  article  and
federal  regulations  requiring  providing uncompensated care, community
services, and access by  minorities  and  people  with  disabilities  to
programs receiving federal financial assistance, including the existence
of any civil rights access complaints against the applicant, and how the
applicant's   meeting   of   these   obligations  will  be  affected  by
implementation of the project.
(d) How and to what extent the applicant  will  provide  hospital  and
health-related  services to the medically indigent, Medicare recipients,
Medicaid recipients and members of medically underserved groups  if  the
project is implemented.
(e)  The  amount of indigent care, both free and below cost, that will
be provided by the applicant if the project is approved.
(f)  Access   by   public   or   private   transportation,   including
applicant-sponsored transportation services, to the applicant's hospital
or health-related services if the project is implemented.
(g)   The  means  of  assuring  effective  communication  between  the
applicant's hospital and health-related  service  staff  and  people  of
limited  English-speaking  ability  and  those  with  speech, hearing or
visual impairments handicaps if the project is implemented.
(h) The extent to which implementation  of  the  project  will  reduce
architectural barriers for people with mobility impairments.
(i) A review of how the applicant will maintain or improve the quality
of hospital and health-related services including a review of:
(i) demographics of the applicant's service area;
(ii)  economic  status  of  the  population of the applicant's service
area;
(iii) physician  and  professional  staffing  issues  related  to  the
project;
(iv) availability of similar services at other institutions in or near
the applicant's service area; and
(v) historical and projected market shares of hospital and health care
service providers in the applicant's service area.
(j) The extent to which the availability and provision of reproductive
health services and maternal health care in the applicant's service area
will  be  affected  if  the  project  is  implemented.  Applicants shall
demonstrate how the project will  impact  the  delivery  of  statutorily
protected  reproductive  health  care,  pursuant  to section twenty-five
hundred ninety-nine-aa of this chapter, and maternity services.
4. The health equity impact  assessment  shall  be  prepared  for  the
applicant by an independent entity and include the meaningful engagement
of  public  health  experts, organizations representing employees of the
applicant, stakeholders, and community  leaders  and  residents  of  the
applicant's service area.
5.  The  department shall publicly post the application and the health
equity impact assessment on its website within one week  of  the  filing
with  the  department,  including  any  filing  with  the  council.  The
applicant shall publicly post the  application  and  the  health  equity
impact  assessment  on its website within one week of acknowledgement by
the department.