§ 2802-B — Health equity impact assessments

§ 2802-b. Health equity impact assessments. 1. Definitions. As used in\nthis section:\n (a) "Application" means an application under this article for the\nconstruction, establishment, change in the establishment, merger,\nacquisition, elimination or substantial reduction, expansion, or\naddition of a hospital service or health-related service of a hospital\nthat requires review or approval by the council or the commissioner,\nwhere the application is filed or submitted to the council, the\ncommissioner or the department after this section takes effect.\nProvided, however, that an application for the change in the\nestablishment, merger or acquisition of a hospital shall not be included\nin this definition if the application would not result in the\nelimination, or substantial reduction, expansion, addition or change in\nlocation of a hospital service or health related service of the\nhospital.\n (b) "Project" means the construction, establishment, change in the\nestablishment, merger, acquisition, elimination, or substantial\nreduction, expansion, or addition of a hospital service or\nhealth-related service of a hospital that is the subject of an\napplication.\n (c) "Health equity impact assessment" or "impact assessment" means an\nassessment of whether, and if so how, a project will improve access to\nhospital services and health care, health equity and reduction of health\ndisparities, with particular reference to members of medically\nunderserved groups, in the applicant's service area.\n (d) "Medically underserved group" means: low-income people; racial and\nethnic minorities; immigrants; women; lesbian, gay, bisexual,\ntransgender, or other-than-cisgender people; people with disabilities;\nolder adults; persons living with a prevalent infectious disease or\ncondition; persons living in rural areas; people who are eligible for or\nreceive public health benefits; people who do not have third-party\nhealth coverage or have inadequate third-party health coverage; and\nother people who are unable to obtain health care.\n 2. (a) (i) Every application shall include a health equity impact\nassessment of the project. The health equity impact assessment shall be\nfiled together with the application, and the application shall not be\ncomplete without the impact statement. The applicant shall promptly\namend or modify the impact statement as necessary.\n (ii) However, in the case of a diagnostic and treatment center whose\npatient population is over fifty percent combined patients enrolled in\nMedicaid or uninsured, a health equity impact assessment is not required\nunless the application includes a change in controlling person,\nprincipal stockholder, or principal member (as defined in section\ntwenty-eight hundred one-a of this article) of the applicant.\n (b) In considering whether and on what terms to approve an\napplication, the commissioner and the council, as the case may be, shall\nconsider the health equity impact statement.\n 3. Scope and contents of a health equity impact assessment. A health\nequity impact assessment shall include:\n (a) A demonstration of whether, and if so how, the proposed project\nwill improve access to hospital services and health care, health equity\nand reduction of health disparities, with particular reference to\nmembers of medically underserved groups, in the applicant's service\narea.\n (b) The extent to which medically underserved groups in the\napplicant's service area use the applicant's hospital or health-related\nservices or similar services at the time of the application and the\nextent to which they are expected to if the project is implemented.\n (c) The performance of the applicant in meeting its obligations, if\nany, under section twenty-eight hundred seven-k of this article and\nfederal regulations requiring providing uncompensated care, community\nservices, and access by minorities and people with disabilities to\nprograms receiving federal financial assistance, including the existence\nof any civil rights access complaints against the applicant, and how the\napplicant's meeting of these obligations will be affected by\nimplementation of the project.\n (d) How and to what extent the applicant will provide hospital and\nhealth-related services to the medically indigent, Medicare recipients,\nMedicaid recipients and members of medically underserved groups if the\nproject is implemented.\n (e) The amount of indigent care, both free and below cost, that will\nbe provided by the applicant if the project is approved.\n (f) Access by public or private transportation, including\napplicant-sponsored transportation services, to the applicant's hospital\nor health-related services if the project is implemented.\n (g) The means of assuring effective communication between the\napplicant's hospital and health-related service staff and people of\nlimited English-speaking ability and those with speech, hearing or\nvisual impairments handicaps if the project is implemented.\n (h) The extent to which implementation of the project will reduce\narchitectural barriers for people with mobility impairments.\n (i) A review of how the applicant will maintain or improve the quality\nof hospital and health-related services including a review of:\n (i) demographics of the applicant's service area;\n (ii) economic status of the population of the applicant's service\narea;\n (iii) physician and professional staffing issues related to the\nproject;\n (iv) availability of similar services at other institutions in or near\nthe applicant's service area; and\n (v) historical and projected market shares of hospital and health care\nservice providers in the applicant's service area.\n (j) The extent to which the availability and provision of reproductive\nhealth services and maternal health care in the applicant's service area\nwill be affected if the project is implemented. Applicants shall\ndemonstrate how the project will impact the delivery of statutorily\nprotected reproductive health care, pursuant to section twenty-five\nhundred ninety-nine-aa of this chapter, and maternity services.\n 4. The health equity impact assessment shall be prepared for the\napplicant by an independent entity and include the meaningful engagement\nof public health experts, organizations representing employees of the\napplicant, stakeholders, and community leaders and residents of the\napplicant's service area.\n 5. The department shall publicly post the application and the health\nequity impact assessment on its website within one week of the filing\nwith the department, including any filing with the council. The\napplicant shall publicly post the application and the health equity\nimpact assessment on its website within one week of acknowledgement by\nthe department.\n