2023 New York Laws › PBH - Public Health › Article 28 - Hospitals › 2815 - Health Facility Restructuring Program.

§ 2815. Health facility restructuring program. 1. Definitions. As used
in  this  section,  the  following  words  and  phrases  shall  have the
following meanings unless a different meaning is plainly required by the
context:
(a) "Agency" shall mean the New  York  state  housing  finance  agency
created by article three of the private housing finance law.
(b) "Authority" shall mean the dormitory authority of the state of New
York  created  by  title four of article eight of the public authorities
law which has succeeded to the  powers,  functions  and  duties  of  the
medical  care facilities finance agency pursuant to chapter eighty-three
of the laws of nineteen hundred ninety-five.
(c) "Participating  borrower"  shall  mean  a  not-for-profit  general
hospital, a not-for-profit diagnostic center, a not-for-profit treatment
center,  a  not-for-profit residential health care facility or any other
not-for-profit entity in possession of  a  valid  operating  certificate
issued  pursuant  to this article, each organized under the laws of this
state, which has been approved for participation in this program by  the
commissioner.
(d)  "Restructuring pool" shall mean the health facility restructuring
pool authorized to be established by  the  authority  pursuant  to  this
section.
2.  The  authority shall establish the restructuring pool. Funds shall
be transferred by the commissioner to the authority for deposit  in  the
restructuring   pool   as   authorized  pursuant  to  paragraph  (d)  of
subdivision one of section twenty-eight hundred  seven-l  and  paragraph
(b)  of  subdivision nineteen of section twenty-eight hundred seven-c of
this article or any other provision of law. Funds in  the  restructuring
pool  shall  be  held  by  the  authority  pursuant  to  this section as
custodian, administered by the authority pursuant to an  agreement  with
the  commissioner  and  invested by the authority in accordance with the
investment guidelines of the authority. All investment income  shall  be
credited  to,  and any repayments of loans as hereinafter provided shall
be deposited in, the restructuring pool, and spent  therefrom  only  for
the purposes set forth in this section.
3.  The commissioner, the authority and the agency shall enter into an
agreement, subject to the approval of the director of  the  budget,  for
the  purpose  of  administering the funds in the restructuring pool in a
manner that will benefit the public health by  encouraging  improvements
in  the  health  care  delivery  system  in  the  state.  A copy of such
agreement, and any amendment thereto, shall be provided to the chair  of
the  senate  finance  committee, the director of the division of budget,
and the chair of the assembly ways and means committee.  Such  agreement
shall include, but not be limited to, the following provisions:
(a)  for  the receipt, management and expenditure of funds held in the
restructuring pool by the authority;
(b) for the development  and  implementation  of  business  plans  for
participating  borrowers, addressing the development of service delivery
strategies, including strategies for the formation or  strengthening  of
networks,  affiliations  or  other  business  combinations,  designed to
provide long-term financial stability  within  and  among  participating
borrowers;
(c)  for  the  expenditure  or loan of funds by the authority from the
restructuring pool to reimburse  the  authority  or  the  agency,  where
appropriate,  for  the costs of engaging management, legal or accounting
consultants to identify, develop and implement improved  strategies  for
one or more participating borrowers for implementing the recommendations
of  such  consultants,  where  appropriate,  and for the payment of debt
service on bonds, notes or other obligations issued or incurred  by  the

authority  or  the  agency  to  fund  loans to one or more participating
borrowers;
(d)  for  assurances  that  participating  borrowers  will address the
recommendations of such consultants and furnish  the  commissioner,  the
authority,  and  where  applicable,  the  agency,  with  such additional
financial, management, legal and operational  information  as  each  may
deem  necessary  to monitor the performance of a participating borrower;
and
(e) for the agency to obtain funds from the restructuring pool  to  be
used for the purposes set forth in this section.
3-a. Any participating borrower may apply for restructuring pool funds
to  the  extent  such  funds  are derived from deposits made pursuant to
paragraph (d) of subdivision one of section twenty-eight hundred seven-l
of  this  article,  provided,   however,   that,   in   reviewing   such
applications,  the  commissioner  and  the  authority shall consider the
extent to which the applicant hospital has alternative available sources
of funds,  including,  but  not  limited  to,  funds  available  through
affiliation agreements with other hospitals or entities.
4.  To  the  extent  funds are available from a participating borrower
therefor, expenditures from the restructuring pool shall  be  repaid  to
the restructuring pool from repayments received by the authority, or the
agency  where  applicable, from a participating borrower pursuant to the
terms of any financing agreement, mortgage or loan  document  permitting
the  recovery  from the participating borrower of such expenditures. The
authority shall record and account for all such payments, which shall be
deposited in the restructuring pool.
5. Loans from the restructuring pool shall  be  made  pursuant  to  an
agreement  with the participating borrower specifying the terms thereof,
including repayment terms. The authority shall record  and  account  for
all such repayments, which shall be deposited in the restructuring pool.
The  authority  shall  notify the chair of the senate finance committee,
the director of the division of budget, the chair of the  assembly  ways
and  means  committee,  the chair of the senate committee on health, and
the chair of the assembly health  committee,  five  days  prior  to  the
making  of  a loan from the restructuring pool. The authority shall also
report quarterly to such chairpersons on the transactions in  the  pool,
including  but  not  limited  to  receipts  or  deposits  to  the  pool,
disbursements or loans made from the pool, investment  income,  and  the
balance on hand as of the end of the month for each such quarter.
5-a.  Notwithstanding  anything  in  this section to the contrary, the
authority is authorized and directed to transfer from the  restructuring
pool  to  the  department,  upon  written request of the director of the
budget and within thirty days thereof,  funds  repaid  by  participating
borrowers,  and  held  by  the  authority relating to restructuring pool
loans funded by amounts transferred to the  restructuring  pool  by  the
department  or  remaining  funds  in  the  restructuring  pool that were
transferred by the department, not to exceed  a  total  of  eighty-three
million  five  hundred  thousand  dollars,  excepting  therefrom amounts
necessary to pay expenses of the authority as provided in the  agreement
described  in  subdivision  three  of  this  section.  All participating
borrowers shall be obligated in their loan agreement to repay  no  later
than March thirty-first, two thousand twenty all funds borrowed from the
eighty-three  million  five  hundred thousand dollars transferred by the
department pursuant to this section, to fund  these  restructuring  pool
loans.  Further,  in  respect of these borrowed funds, all participating
borrowers shall be required under the terms of their loan  agreement  to
immediately  upon  receipt  of quality improvement incentive payments or
additional supplemental assistance initiate repayment of an amount equal

to the quality improvement incentive payments or additional supplemental
assistance not to exceed the amount of such  borrowed  funds,  unless  a
waiver  or  extension  of repayment has been approved by the director of
the budget.
6. The commissioner is authorized, with the assistance and cooperation
of  the  authority,  to  provide  a  program  of technical assistance to
participating borrowers.