N.Y. Public Health Law § 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.