N.Y. Public Health Law § 2904-b: Health systems agencies

§ 2904-b. Health systems agencies. 1. For the purposes of this

section, "health systems agency" shall mean a corporation organized

pursuant to the not-for-profit corporation law which is approved by the

governor pursuant to subdivision (c) of section twenty-nine hundred four

of this article, incorporated within the state, which is not a

subsidiary of, or otherwise controlled by, any other private or public

corporation or other legal entity, and which only engages in health

planning and development activities and functions.

2. The powers of a health systems agency shall include those necessary

to perform the duties and functions provided for in this section.

3. An employee who participates in the management of a health benefit

plan may serve as a member of the board of directors of a health systems

agency representing employers or unions. No member may participate or

vote in agency proceedings involving an individual provider, purchaser,

or patient, or a specific activity or transaction, if the member has a

financial interest in the outcome of the board's proceedings other than

as an individual consumer of health care services.

4. Each such health systems agency shall consist of a fixed number of

members as determined by the health systems agency upon recommendation

of the regional nominating committee established pursuant to section

twenty-nine hundred four-c of this article to be necessary to

appropriately represent the diverse needs and concerns of the region.

The regional nominating committee shall approve a board of directors of

such health systems agency in accordance with section two thousand nine

hundred four-c of this article that is broadly representative of the

region served by the agency and that meets the following requirements:

(a) A majority of the members, but not more than sixty percent of the

members, shall be residents of the health service region served by the

agency who are consumers of health care and major purchasers of health

care, including labor organizations and business corporations, in the

region. A consumer shall mean a person who is not a provider of health

care as defined in accordance with paragraph (c) of this subdivision.

(b) The remainder of the members shall be residents of or have their

principal place of business in the health service region served by the

agency who are providers of health care and who, to the extent

practicable, are representative of the variety of disciplines and

interests of the health care system including (i) physicians, dentists,

nurse practitioners, nurses, optometrists, podiatrists, physician's

assistants, and other health professionals; (ii) health facilities

including hospitals; (iii) health care insurers; (iv) health maintenance

organizations; (v) health professional schools; (vi) the allied health

professions; and (vii) other providers of health care. Not less than

one-half of the providers of health care of the governing body of a

health systems agency shall be direct providers of health care and of

such direct providers of health care, at least one shall be a person

engaged in the administration of a health facility.

(c) A "provider of health care" means an individual (i) who is a

direct provider of health care or who is a representative of different

disciplines, professions or sectors of health care providers and whose

primary current activity is the provision of health care to individuals

or the administration (including trustees or members of boards of

directors) of health facilities in which such care is provided; or (ii)

who holds a fiduciary position with, or has a fiduciary interest in, any

entity which has as its primary purpose the delivery of health care, the

conduct of research into or instruction for health professionals in the

provision of health care, or the production of or supply of drugs or

other articles for individuals or entities for use in the provision of

or in research into or instruction in the provisions of health care; or

(iii) who is a professional in the provision of health care, or the

production of or supply of drugs or other articles for individuals or

entities for use in the provision of or in research into or instruction

in the provision of health care; or (iv) who is a professional employee

of a health professions school; or (v) who is a spouse of an individual

described in subparagraph (i), (ii), (iii) or (iv) of this paragraph.

(d) Any individual may nominate another individual for consideration

by the health systems agency for appointment to the board of directors

of the respective agency. Such nominee shall reside or have their

principal place of business within the respective health service region.

In considering an individual for appointment to such agency, the agency

shall, to the extent practicable, submit to the regional nominating

committee prospective members which are representative of local

government, local health care providers, payors, consumers of health

care, members of labor organizations and business corporations.

5. (a) Members of the agency appointed on or after January first,

nineteen hundred ninety-four shall have fixed terms of five years. No

persons appointed on or after January first, nineteen hundred

ninety-four shall be a member of an agency for more than ten years in

any period of fifteen consecutive years including periods prior to

January first, nineteen hundred ninety-four. A person appointed to fill

a membership vacancy on an agency shall be representative of that

membership category. The commissioner, in consultation with the health

systems agencies, shall devise an equitable method of converting to

these membership term requirements so that all such agencies shall be in

compliance by December thirty-first, nineteen hundred ninety-six.

(b) A board member shall hold over and continue to discharge the

duties of his position after the expiration of the term for which such

board member shall have been appointed until a successor shall be chosen

and qualified; but after the expiration of such term, the position shall

be deemed vacant for the purpose of choosing a successor. An

appointment for a term shortened by reason of a predecessor holding over

shall be for the residue of the term only.

6. A health systems agency may establish standing committees,

subcommittees, and advisory committees as deemed necessary. To the

extent practicable, all standing committees, subcommittees, and advisory

groups appointed by the health systems agency shall be appointed in such

manner as to provide broad representation in such a manner that a

majority of the members shall be consumers of health care.

7. Each health systems agency shall:

(a) recommend to the appropriate authority approval or disapproval of

applications for the establishment or construction of a hospital, the

certification of home health agencies, and the authorization to provide

a long-term home health care program; provided, however, that any such

studies or activities conducted by the agency preparatory to such

approval or disapproval shall not include any such study or activity

regarding financial feasibility, character or competence, or

architectural and technical analysis;

(b) assist appropriate state agencies in the development of standards

and guidelines to determine public need for hospital and other health

services;

(c) serve as a community resource to actively promote increased public

knowledge and responsibility regarding the availability and appropriate

utilization of health care services;

(d) develop regional health plans and carry out facility and health

services planning;

(e) identify in consultation with local providers, employers, payors,

and consumers priorities for improving health care delivery in the

region;

(f) promote cooperative ventures, networking, and other voluntary

cooperative efforts to improve quality, efficiency, affordability, and

access to health care services in the region, including the provision of

technical assistance to rural networks;

(g) perform special studies to identify health care needs and service

requirements in the region;

(h) review and comment on community service plans;

(i) conduct community education for consumers, providers, payors and

for the general public in the region;

(j) collect and maintain regional and other health care data to be

made available to the public, researchers, providers and others for

health care education and development in the region;

(k) assist in the development and implementation of regional and local

health delivery system initiatives including global budgets, rural

networks and health networks;

(l) make recommendations for improving health care status and identify

gaps and needed health care services in the region;

(m) undertake other activities to promote the delivery of health care

services in the region with the goal of improving affordability,

quality, efficiency, and access to health care services;

(n) when requested by the commissioner or otherwise required by law or

regulation, provide recommendations to the commissioner regarding the

awarding of grants for health services in the region;

(o) coordinate its activities with other appropriate general or

special purpose regional health and human services planning or

administrative agencies including area agencies on aging, local and

regional alcohol abuse, drug abuse and mental health planning agencies,

social services agencies, county public health departments, and local

health officers. The health systems agency shall, as appropriate, obtain

data from other agencies for use in planning and development activities,

enter into agreements with other such agencies, and to the extent

practicable, provide technical assistance to such other agencies;

(p) submit a semi-annual report to the senate and assembly health

committees detailing the activities of each agency during that reporting

period;

(q) annually submit a copy of its operating budget to the chairman of

the senate finance committee and the chairman of the assembly ways and

means committee and the director of the division of the budget. Such

operating budget shall contain information detailing contributions

received and the types and sources of contributions eligible for

matching grants;

(r) not permit local contributions from organizations or individuals,

including but not limited to, a health care provider subject to the

provisions of article twenty-eight, thirty-six or forty-four of this

chapter, who are subject to review by the health systems agencies

provided, however, that this prohibition shall not apply to local

governments or to associations representing health care providers as

described herein;

(s) through its board of directors adopt rules governing the agency's

ability to sell resources and engage in fee for service activities or

other contractual arrangements. No health systems agency shall engage

in any fee for service activity with a provider or potential provider of

health care services except local government without prior approval of

the state hospital review and planning council. Such approval shall be

issued or denied in a timely manner;

(t) perform any other duties and functions of the health systems

agency required by law; and

(u) meet as often as necessary to carry out their functions pursuant

to this section.

8. Each health systems agency may hire an executive director. The

executive director may hire employees and consultants as authorized by

the agency and may prescribe their duties.

9. The commissioner upon request of the health systems agencies may

provide technical assistance to the agency for the duties and activities

prescribed herein.

10. The governor shall withdraw approval given to health systems

agencies for failure to comply with such requirements or failure

thereafter to comply with such requirements.

11. The commissioner may promulgate such rules and regulations

including performance criteria as necessary to carry out the purposes of

this article.

12. The commissioner shall promulgate rules and regulations regarding

conflicts of interest and records of the health systems agencies.