Bill Text: NY A01208 | 2019-2020 | General Assembly | Introduced


Bill Title: Authorizes collaborative programs for community paramedicine services as part of the hospital-home care-physician collaboration program.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2020-01-08 - referred to health [A01208 Detail]

Download: New_York-2019-A01208-Introduced.html


                STATE OF NEW YORK
        ________________________________________________________________________
                                          1208
                               2019-2020 Regular Sessions
                   IN ASSEMBLY
                                    January 14, 2019
                                       ___________
        Introduced by M. of A. GOTTFRIED, RAIA, LUPARDO, D'URSO, WOERNER, STECK,
          TAGUE  --  Multi-Sponsored  by  -- M. of A. PALMESANO -- read once and
          referred to the Committee on Health
        AN ACT to amend the public health law, in relation to authorizing colla-
          borative programs for community paramedicine services
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  Section  2805-x  of  the  public  health law, as added by
     2  section 48 of part B of chapter 57 of the laws of 2015,  is  amended  to
     3  read as follows:
     4    §  2805-x.  Hospital-home care-physician collaboration program. 1. The
     5  purpose of this section shall be to facilitate innovation  in  hospital,
     6  home  care agency and physician collaboration in meeting the community's
     7  health care needs. It shall provide a  framework  to  support  voluntary
     8  initiatives  in collaboration to improve patient care access and manage-
     9  ment, patient health outcomes, cost-effectiveness in the use  of  health
    10  care services and community population health. Such collaborative hospi-
    11  tal-home  care-physician  initiatives  may  also include payors, skilled
    12  nursing facilities, emergency medical services and other  interdiscipli-
    13  nary  providers,  practitioners  and  service  entities  as part of such
    14  hospital-home care-physician collaborative provided,  however,  that  in
    15  the  case  of  collaborative community paramedicine as set forth in this
    16  section and article thirty of  this  chapter,  the  collaborative  shall
    17  minimally comprise hospital, home care, physician, and emergency medical
    18  services partners.
    19    2. For purposes of this section:
    20    (a)  "Hospital"  shall  include  a general hospital as defined in this
    21  article or other inpatient facility for rehabilitation or specialty care
    22  within the definition of hospital in this article.
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD03394-01-9

        A. 1208                             2
     1    (b) "Home care agency" shall mean a certified home health agency, long
     2  term home health care program or licensed home care services  agency  as
     3  defined in article thirty-six of this chapter.
     4    (c)  "Payor"  shall  mean  a  health plan approved pursuant to article
     5  forty-four of this chapter, or article thirty-two or forty-three of  the
     6  insurance law.
     7    (d)  "Practitioner"  shall  mean  any  of the health, mental health or
     8  health related professions licensed  pursuant  to  title  eight  of  the
     9  education law.
    10    (e)  "Emergency  medical services" (EMS) shall mean the services of an
    11  ambulance service or an advanced life  support  first  response  service
    12  certified  under  article  thirty  of  this chapter staffed by emergency
    13  medical technicians or advanced emergency medical technicians to provide
    14  basic or advanced life support and, for the purposes  of  the  community
    15  paramedicine  collaboration  model set forth in subdivision four of this
    16  section, also to provide  such  services  pursuant  to  such  models  in
    17  circumstances  other  than the initial emergency medical care and trans-
    18  portation of sick and injured persons.
    19    3. The commissioner is authorized to provide financing including,  but
    20  not  limited  to,  grants  or positive adjustments in medical assistance
    21  rates or premium payments, to the extent of funds  available  and  allo-
    22  cated  or  appropriated  therefor, including funds provided to the state
    23  through federal waivers, funds made available  through  state  appropri-
    24  ations  and/or  funding  through section twenty-eight hundred seven-v of
    25  this article, as well as waivers of regulations under title ten  of  the
    26  New  York  codes, rules and regulations, to support the voluntary initi-
    27  atives and objectives of this section.  Nothing in this section shall be
    28  construed to limit, or to imply the need for state approval of, collabo-
    29  rative initiatives  enumerated  in  this  section  which  are  otherwise
    30  permissible  under law or regulation, provided however that the approval
    31  of the commissioner shall be required for either state funding or  regu-
    32  latory waivers as provided for under this section.
    33    4.  Hospital-home  care-physician collaborative initiatives under this
    34  section may include, but shall not be limited to:
    35    (a) Hospital-home care-physician  integration  initiatives,  including
    36  but not limited to:
    37    (i)  transitions  in  care  initiatives to help effectively transition
    38  patients to post-acute care  at  home,  coordinate  follow-up  care  and
    39  address issues critical to care plan success and readmission avoidance;
    40    (ii)  clinical  pathways  for  specified conditions, guiding patients'
    41  progress and outcome goals, as well as effective health services use;
    42    (iii) application of telehealth/telemedicine  services  in  monitoring
    43  and  managing  patient  conditions,  and promoting self-care/management,
    44  improved outcomes and effective services use;
    45    (iv) facilitation of  physician  house  calls  to  homebound  patients
    46  and/or  to  patients  for whom such home visits are determined necessary
    47  and effective for patient care management;
    48    (v) additional models for prevention of  avoidable  hospital  readmis-
    49  sions and emergency room visits;
    50    (vi) health home development;
    51    (vii)  development  and  demonstration  of new models of integrated or
    52  collaborative care and care management not otherwise achievable  through
    53  existing models; [and]
    54    (viii)  bundled payment demonstrations for hospital-to-post-acute-care
    55  for specified conditions or categories  of  conditions,  in  particular,
    56  conditions  predisposed  to  high  prevalence  of readmission, including

        A. 1208                             3
     1  those currently subject to federal/state penalty, and  other  discharges
     2  with extensive post-acute needs; and
     3    (ix) models of community paramedicine, under which hospitals, emergen-
     4  cy  medical services who utilize employed or volunteer emergency medical
     5  technicians or advanced emergency medical  technicians,  physicians  and
     6  home  care  agencies,  in joint partnership, may develop and implement a
     7  plan for the collaborative provision of services in community  settings.
     8  In  addition to emergency services provided under article thirty of this
     9  chapter, models of  community  paramedicine  may  include  collaborative
    10  services to at-risk individuals living in the community to prevent emer-
    11  gencies,  avoidable  emergency room need, avoidable transport and poten-
    12  tially avoidable hospital admissions and readmissions; community  param-
    13  edicine  services  to  individuals with behavioral health conditions, or
    14  developmental or intellectual disabilities, shall  further  include  the
    15  collaboration  of  appropriate  providers  of behavioral health services
    16  licensed or certified under the mental hygiene law;
    17    (b) Recruitment, training and retention of hospital/home  care  direct
    18  care  staff  and  physicians,  in geographic or clinical areas of demon-
    19  strated need. Such initiatives may include, but are not limited to,  the
    20  following activities:
    21    (i)  outreach and public education about the need and value of service
    22  in health occupations;
    23    (ii) training/continuing education  and  regulatory  facilitation  for
    24  cross-training  to  maximize  flexibility  in  the utilization of staff,
    25  including:
    26    (A) training of hospital nurses in home care;
    27    (B) dual certified nurse aide/home health aide certification; [and]
    28    (C) dual personal care aide/HHA certification; and
    29    (D) orientation and/or collaborative training of EMS,  hospital,  home
    30  care, physician and, as necessary, other participating provider staff in
    31  community paramedicine;
    32    (iii) salary/benefit enhancement;
    33    (iv) career ladder development; and
    34    (v) other incentives to practice in shortage areas; and
    35    (c)  Hospital  - home care - physician collaboratives for the care and
    36  management of special needs, high-risk and high-cost patients, including
    37  but not limited to best practices, and training and education of  direct
    38  care practitioners and service employees.
    39    5.  Hospitals  and  home care agencies which are provided financing or
    40  waivers pursuant to this section shall report to the commissioner on the
    41  patient, service and cost experiences pursuant to this section,  includ-
    42  ing the extent to which the project goals are achieved. The commissioner
    43  shall  compile  and  make  such  reports  available  on the department's
    44  website.
    45    § 2. The public health law is amended by adding a new  section  3001-a
    46  to read as follows:
    47    §  3001-a. Community paramedicine services. Notwithstanding any incon-
    48  sistent provision of this article, an emergency  medical  technician  or
    49  advanced emergency medical technician in course of his or her work as an
    50  employee  or  volunteer  of  an  ambulance  service  or an advanced life
    51  support first response service certified under this article  to  provide
    52  emergency  medical  services may also participate in models of community
    53  paramedicine pursuant to section twenty-eight  hundred  five-x  of  this
    54  chapter.
    55    § 3. This act shall take effect immediately.
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