N.Y. Public Health Law § 2952: Rural health network development grant program

§ 2952. Rural health network development grant program. To the extent

of funds available therefor, the sum of seven million dollars shall

annually be available for periods prior to January first, two thousand

three, and up to six million five hundred thirty thousand dollars

annually for the period January first, two thousand three through

December thirty-first, two thousand four, up to seven million sixty-two

thousand dollars for the period January first, two thousand five through

December thirty-first, two thousand six annually, up to seven million

sixty-two thousand dollars annually for the period January first, two

thousand seven through December thirty-first, two thousand ten, up to

one million seven hundred sixty-six thousand dollars for the period

January first, two thousand eleven through March thirty-first, two

thousand eleven, and within amounts appropriated for each state fiscal

year on and after April first, two thousand eleven, shall be available

to the commissioner from funds made available pursuant to section

twenty-eight hundred seven-l of this chapter for grants pursuant to this

section. 1. The commissioner shall establish a rural health network

development grant program for the purpose of assisting community based

health care providers, consumers and organizations in rural areas to

promote more effective health care delivery through the coordination,

development, planning, implementation and operation of rural health

networks pursuant to this title. Such grants shall support activities

and organizational costs including, but not limited to, the recruitment

of qualified health care professionals, the performance of feasibility

studies, the development of affiliation agreements among rural health

providers, the development of managed care capacities, the expansion and

integration of public and preventive health services into community

based primary care systems, the integration and expansion of prehospital

emergency medical services and related consulting and legal fees.

2. To be eligible to receive grant funding pursuant to this section,

the applicant shall submit a network plan to the commissioner for

approval; the network plan shall identify network participants and

indicate how the members or participants of the rural health network

intend to respond to the health care needs of the rural area, improve

access to and the quality of care for residents of the community,

promote the coordination of resources among providers and reduce

duplication of services while achieving cost and other operational

efficiencies.

3. a. The commissioner shall make grants to rural health networks, or

rural health care providers planning to develop a rural health network.

The network plan submitted by a rural health network or rural health

care providers planning to form a network for grant funds pursuant to

this section shall be consistent with guidelines issued by the

commissioner, in consultation with the New York state rural health

council and the legislative commission on the development of rural

resources. Such guidelines shall include, but need not be limited to,

the duration of rural health network grants, appropriate funding levels

and criteria for providing an appropriate geographic distribution of

grantees; provided, however, that the amount of any such grant shall be

based on the scope and nature of the proposed activities described in

such plan and that the quality of any such plan complies with the

conditions for approval pursuant to paragraph b of subdivision three of

this section.

b. The commissioner may require revisions or amendments to the initial

network plan prior to approval for funding, or periodic updates from an

applicant to reflect the current status of a network's development or

operation and to assure that the plan is implemented in accordance with

its approved terms. In approving grants the commissioner shall consider

the following:

(i) The specific objectives and description of the proposed network,

including considerations of the existing health care services currently

being delivered within the rural area, and the unmet health care needs

of the community;

(ii) The degrees to which the plan demonstrates enhanced costs and

service delivery efficiencies and access to necessary and high quality

health care services by rural residents;

(iii) The degree to which stated objectives and the scope of the

network plan may reasonably be implemented and achieved using existing

and projected resources;

(iv) The degree to which information sharing, communication, and

cooperation between health care providers, human service entities and

consumers would be fostered;

(v) The contribution the network would make toward the identification

and development of innovative delivery systems;

(vi) The degree to which management and continuity of care would be

fostered and improved;

(vii) The degree to which participating providers are represented on

governing bodies of the network;

(viii) The degree to which consumers within the area served or to be

served by the network are made aware of and have an effective

opportunity to provide input in the creation and on-going development of

a network plan; and

(ix) The degree to which providers within the area served by the

network are made aware of and have an effective opportunity to

participate in or become a member of the network.

c. The commissioner shall act on such application within ninety days

after its receipt. In the event waivers of any regulations are requested

by an applicant, the commissioner shall have an additional thirty days

to act upon such application.

4. The commissioner or his or her duly authorized representative may

provide or contract to provide technical assistance in the creation and

implementation of rural health networks and to promote community

organization, collaboration and communication in rural network

development across the state. The funding for any such contract shall

not be made available from funds provided for purposes of this section

by section twenty-eight hundred seven-l of this chapter.

5. If the commissioner determines that a grant is being used for

purposes other than those which are in conformity with this title, the

commissioner may withdraw his or her approval of the project and require

repayment of all or part of such grant to the state. The commissioner

shall cause reports to be prepared and submitted for each project by the

grantees at such times and in such manner as are consistent with the

purposes of this title.

6. a. The commissioner or his or her duly authorized representative

may also, promote appropriate active state supervision necessary to

promote state action immunity under the federal antitrust laws, inspect

or request additional documentation to verify that a network plan is

implemented in accordance with its approved terms as they relate to

antitrust activity.

b. The commissioner shall review a network plan and all agreements

between participating providers of a network organized pursuant to the

not-for-profit corporation law at any time with respect to their effect

on competition, access, and quality of care, may seek the advice of the

attorney general and may require amendments to such agreements where he

or she determines that the benefits of anti-competitive activity are

outweighed by any disadvantages.

c. The commissioner may revoke, limit or annul approval to implement a

network plan, or portions thereof, after review and a hearing, for

failure to implement such plan in accordance with its terms as

appropriate for the promotion of state action immunity under the federal

antitrust laws.

d. The commissioner shall, at the request of any rural health network,

review network agreements with respect to their effect on competition,

access and quality of care, may seek the advice of the attorney general,

and may require amendments to such agreements where he or she determines

that the benefits of anticompetitive activity are outweighed by any

disadvantage.

7. For the purpose of promoting maximum effectiveness in the

utilization of state and local monies and innovative approaches, the

commissioner is authorized to waive, modify or suspend the respective

provisions of rules and regulations promulgated pursuant to this chapter

if the commissioner determines that such waiver, modification or

suspension is necessary for the successful implementation of this title

and provided that the commissioner determines that the health, safety

and general welfare of people receiving health care will not be impaired

as a result of such waiver, modification, or suspension. Such waiver,

modification or suspension may be granted for up to two years. In

addition, upon the request of a rural health network organized pursuant

to the not-for-profit corporation law and approved pursuant to

subdivision fourteen of section twenty-eight hundred one-a of this

chapter thereto, through its network plan or its amendments, the

commissioner is authorized to permit such rural health network to make

applications or fulfill regulatory requirements on behalf of members of

the network for purposes of, but not limited to, certificate of need,

quality assurance, reimbursement, and professional credentialing and

privileging.

8. The commissioner shall consult with federal, state, and local

officials with respect to securing their cooperation in coordinating

related programs and regulatory waivers and shall provide the

legislature with recommendations to facilitate such efforts.

9. Notwithstanding any inconsistent provision of law, the commissioner

may approve a rural health network, to receive directly reimbursement

for the planning and coordination of services including but not limited

to such experimental and other payment methods as global budget, pooling

arrangements, or capitation payments for whole or in-part inpatient

hospital services and ambulatory care services provided by the component

entities of the network. Reimbursement including payments made by

governmental agencies shall be subject to the approval of the state

director of the budget and to the availability of federal financial

participation pursuant to title XIX of the federal social security act

in expenditures made for eligible patients. The commissioner may impose

such terms and conditions as necessary and appropriate for receipt of

such funds.