§ 2904-B — Health systems agencies

§ 2904-b. Health systems agencies. 1. For the purposes of this\nsection, "health systems agency" shall mean a corporation organized\npursuant to the not-for-profit corporation law which is approved by the\ngovernor pursuant to subdivision (c) of section twenty-nine hundred four\nof this article, incorporated within the state, which is not a\nsubsidiary of, or otherwise controlled by, any other private or public\ncorporation or other legal entity, and which only engages in health\nplanning and development activities and functions.\n 2. The powers of a health systems agency shall include those necessary\nto perform the duties and functions provided for in this section.\n 3. An employee who participates in the management of a health benefit\nplan may serve as a member of the board of directors of a health systems\nagency representing employers or unions. No member may participate or\nvote in agency proceedings involving an individual provider, purchaser,\nor patient, or a specific activity or transaction, if the member has a\nfinancial interest in the outcome of the board's proceedings other than\nas an individual consumer of health care services.\n 4. Each such health systems agency shall consist of a fixed number of\nmembers as determined by the health systems agency upon recommendation\nof the regional nominating committee established pursuant to section\ntwenty-nine hundred four-c of this article to be necessary to\nappropriately represent the diverse needs and concerns of the region.\nThe regional nominating committee shall approve a board of directors of\nsuch health systems agency in accordance with section two thousand nine\nhundred four-c of this article that is broadly representative of the\nregion served by the agency and that meets the following requirements:\n (a) A majority of the members, but not more than sixty percent of the\nmembers, shall be residents of the health service region served by the\nagency who are consumers of health care and major purchasers of health\ncare, including labor organizations and business corporations, in the\nregion. A consumer shall mean a person who is not a provider of health\ncare as defined in accordance with paragraph (c) of this subdivision.\n (b) The remainder of the members shall be residents of or have their\nprincipal place of business in the health service region served by the\nagency who are providers of health care and who, to the extent\npracticable, are representative of the variety of disciplines and\ninterests of the health care system including (i) physicians, dentists,\nnurse practitioners, nurses, optometrists, podiatrists, physician's\nassistants, and other health professionals; (ii) health facilities\nincluding hospitals; (iii) health care insurers; (iv) health maintenance\norganizations; (v) health professional schools; (vi) the allied health\nprofessions; and (vii) other providers of health care. Not less than\none-half of the providers of health care of the governing body of a\nhealth systems agency shall be direct providers of health care and of\nsuch direct providers of health care, at least one shall be a person\nengaged in the administration of a health facility.\n (c) A "provider of health care" means an individual (i) who is a\ndirect provider of health care or who is a representative of different\ndisciplines, professions or sectors of health care providers and whose\nprimary current activity is the provision of health care to individuals\nor the administration (including trustees or members of boards of\ndirectors) of health facilities in which such care is provided; or (ii)\nwho holds a fiduciary position with, or has a fiduciary interest in, any\nentity which has as its primary purpose the delivery of health care, the\nconduct of research into or instruction for health professionals in the\nprovision of health care, or the production of or supply of drugs or\nother articles for individuals or entities for use in the provision of\nor in research into or instruction in the provisions of health care; or\n(iii) who is a professional in the provision of health care, or the\nproduction of or supply of drugs or other articles for individuals or\nentities for use in the provision of or in research into or instruction\nin the provision of health care; or (iv) who is a professional employee\nof a health professions school; or (v) who is a spouse of an individual\ndescribed in subparagraph (i), (ii), (iii) or (iv) of this paragraph.\n (d) Any individual may nominate another individual for consideration\nby the health systems agency for appointment to the board of directors\nof the respective agency. Such nominee shall reside or have their\nprincipal place of business within the respective health service region.\nIn considering an individual for appointment to such agency, the agency\nshall, to the extent practicable, submit to the regional nominating\ncommittee prospective members which are representative of local\ngovernment, local health care providers, payors, consumers of health\ncare, members of labor organizations and business corporations.\n 5. (a) Members of the agency appointed on or after January first,\nnineteen hundred ninety-four shall have fixed terms of five years. No\npersons appointed on or after January first, nineteen hundred\nninety-four shall be a member of an agency for more than ten years in\nany period of fifteen consecutive years including periods prior to\nJanuary first, nineteen hundred ninety-four. A person appointed to fill\na membership vacancy on an agency shall be representative of that\nmembership category. The commissioner, in consultation with the health\nsystems agencies, shall devise an equitable method of converting to\nthese membership term requirements so that all such agencies shall be in\ncompliance by December thirty-first, nineteen hundred ninety-six.\n (b) A board member shall hold over and continue to discharge the\nduties of his position after the expiration of the term for which such\nboard member shall have been appointed until a successor shall be chosen\nand qualified; but after the expiration of such term, the position shall\nbe deemed vacant for the purpose of choosing a successor. An\nappointment for a term shortened by reason of a predecessor holding over\nshall be for the residue of the term only.\n 6. A health systems agency may establish standing committees,\nsubcommittees, and advisory committees as deemed necessary. To the\nextent practicable, all standing committees, subcommittees, and advisory\ngroups appointed by the health systems agency shall be appointed in such\nmanner as to provide broad representation in such a manner that a\nmajority of the members shall be consumers of health care.\n 7. Each health systems agency shall:\n (a) recommend to the appropriate authority approval or disapproval of\napplications for the establishment or construction of a hospital, the\ncertification of home health agencies, and the authorization to provide\na long-term home health care program; provided, however, that any such\nstudies or activities conducted by the agency preparatory to such\napproval or disapproval shall not include any such study or activity\nregarding financial feasibility, character or competence, or\narchitectural and technical analysis;\n (b) assist appropriate state agencies in the development of standards\nand guidelines to determine public need for hospital and other health\nservices;\n (c) serve as a community resource to actively promote increased public\nknowledge and responsibility regarding the availability and appropriate\nutilization of health care services;\n (d) develop regional health plans and carry out facility and health\nservices planning;\n (e) identify in consultation with local providers, employers, payors,\nand consumers priorities for improving health care delivery in the\nregion;\n (f) promote cooperative ventures, networking, and other voluntary\ncooperative efforts to improve quality, efficiency, affordability, and\naccess to health care services in the region, including the provision of\ntechnical assistance to rural networks;\n (g) perform special studies to identify health care needs and service\nrequirements in the region;\n (h) review and comment on community service plans;\n (i) conduct community education for consumers, providers, payors and\nfor the general public in the region;\n (j) collect and maintain regional and other health care data to be\nmade available to the public, researchers, providers and others for\nhealth care education and development in the region;\n (k) assist in the development and implementation of regional and local\nhealth delivery system initiatives including global budgets, rural\nnetworks and health networks;\n (l) make recommendations for improving health care status and identify\ngaps and needed health care services in the region;\n (m) undertake other activities to promote the delivery of health care\nservices in the region with the goal of improving affordability,\nquality, efficiency, and access to health care services;\n (n) when requested by the commissioner or otherwise required by law or\nregulation, provide recommendations to the commissioner regarding the\nawarding of grants for health services in the region;\n (o) coordinate its activities with other appropriate general or\nspecial purpose regional health and human services planning or\nadministrative agencies including area agencies on aging, local and\nregional alcohol abuse, drug abuse and mental health planning agencies,\nsocial services agencies, county public health departments, and local\nhealth officers. The health systems agency shall, as appropriate, obtain\ndata from other agencies for use in planning and development activities,\nenter into agreements with other such agencies, and to the extent\npracticable, provide technical assistance to such other agencies;\n (p) submit a semi-annual report to the senate and assembly health\ncommittees detailing the activities of each agency during that reporting\nperiod;\n (q) annually submit a copy of its operating budget to the chairman of\nthe senate finance committee and the chairman of the assembly ways and\nmeans committee and the director of the division of the budget. Such\noperating budget shall contain information detailing contributions\nreceived and the types and sources of contributions eligible for\nmatching grants;\n (r) not permit local contributions from organizations or individuals,\nincluding but not limited to, a health care provider subject to the\nprovisions of article twenty-eight, thirty-six or forty-four of this\nchapter, who are subject to review by the health systems agencies\nprovided, however, that this prohibition shall not apply to local\ngovernments or to associations representing health care providers as\ndescribed herein;\n (s) through its board of directors adopt rules governing the agency's\nability to sell resources and engage in fee for service activities or\nother contractual arrangements. No health systems agency shall engage\nin any fee for service activity with a provider or potential provider of\nhealth care services except local government without prior approval of\nthe state hospital review and planning council. Such approval shall be\nissued or denied in a timely manner;\n (t) perform any other duties and functions of the health systems\nagency required by law; and\n (u) meet as often as necessary to carry out their functions pursuant\nto this section.\n 8. Each health systems agency may hire an executive director. The\nexecutive director may hire employees and consultants as authorized by\nthe agency and may prescribe their duties.\n 9. The commissioner upon request of the health systems agencies may\nprovide technical assistance to the agency for the duties and activities\nprescribed herein.\n 10. The governor shall withdraw approval given to health systems\nagencies for failure to comply with such requirements or failure\nthereafter to comply with such requirements.\n 11. The commissioner may promulgate such rules and regulations\nincluding performance criteria as necessary to carry out the purposes of\nthis article.\n 12. The commissioner shall promulgate rules and regulations regarding\nconflicts of interest and records of the health systems agencies.\n