Bill Text: NY S01805 | 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: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2020-01-08 - REFERRED TO HEALTH [S01805 Detail]
Download: New_York-2019-S01805-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 1805 2019-2020 Regular Sessions IN SENATE January 16, 2019 ___________ Introduced by Sen. RIVERA -- read twice and ordered printed, and when printed to be committed 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. 23 (b) "Home care agency" shall mean a certified home health agency, long 24 term home health care program or licensed home care services agency as 25 defined in article thirty-six of this chapter. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD03394-01-9S. 1805 2 1 (c) "Payor" shall mean a health plan approved pursuant to article 2 forty-four of this chapter, or article thirty-two or forty-three of the 3 insurance law. 4 (d) "Practitioner" shall mean any of the health, mental health or 5 health related professions licensed pursuant to title eight of the 6 education law. 7 (e) "Emergency medical services" (EMS) shall mean the services of an 8 ambulance service or an advanced life support first response service 9 certified under article thirty of this chapter staffed by emergency 10 medical technicians or advanced emergency medical technicians to provide 11 basic or advanced life support and, for the purposes of the community 12 paramedicine collaboration model set forth in subdivision four of this 13 section, also to provide such services pursuant to such models in 14 circumstances other than the initial emergency medical care and trans- 15 portation of sick and injured persons. 16 3. The commissioner is authorized to provide financing including, but 17 not limited to, grants or positive adjustments in medical assistance 18 rates or premium payments, to the extent of funds available and allo- 19 cated or appropriated therefor, including funds provided to the state 20 through federal waivers, funds made available through state appropri- 21 ations and/or funding through section twenty-eight hundred seven-v of 22 this article, as well as waivers of regulations under title ten of the 23 New York codes, rules and regulations, to support the voluntary initi- 24 atives and objectives of this section. Nothing in this section shall be 25 construed to limit, or to imply the need for state approval of, collabo- 26 rative initiatives enumerated in this section which are otherwise 27 permissible under law or regulation, provided however that the approval 28 of the commissioner shall be required for either state funding or regu- 29 latory waivers as provided for under this section. 30 4. Hospital-home care-physician collaborative initiatives under this 31 section may include, but shall not be limited to: 32 (a) Hospital-home care-physician integration initiatives, including 33 but not limited to: 34 (i) transitions in care initiatives to help effectively transition 35 patients to post-acute care at home, coordinate follow-up care and 36 address issues critical to care plan success and readmission avoidance; 37 (ii) clinical pathways for specified conditions, guiding patients' 38 progress and outcome goals, as well as effective health services use; 39 (iii) application of telehealth/telemedicine services in monitoring 40 and managing patient conditions, and promoting self-care/management, 41 improved outcomes and effective services use; 42 (iv) facilitation of physician house calls to homebound patients 43 and/or to patients for whom such home visits are determined necessary 44 and effective for patient care management; 45 (v) additional models for prevention of avoidable hospital readmis- 46 sions and emergency room visits; 47 (vi) health home development; 48 (vii) development and demonstration of new models of integrated or 49 collaborative care and care management not otherwise achievable through 50 existing models; [and] 51 (viii) bundled payment demonstrations for hospital-to-post-acute-care 52 for specified conditions or categories of conditions, in particular, 53 conditions predisposed to high prevalence of readmission, including 54 those currently subject to federal/state penalty, and other discharges 55 with extensive post-acute needs; andS. 1805 3 1 (ix) models of community paramedicine, under which hospitals, emergen- 2 cy medical services who utilize employed or volunteer emergency medical 3 technicians or advanced emergency medical technicians, physicians and 4 home care agencies, in joint partnership, may develop and implement a 5 plan for the collaborative provision of services in community settings. 6 In addition to emergency services provided under article thirty of this 7 chapter, models of community paramedicine may include collaborative 8 services to at-risk individuals living in the community to prevent emer- 9 gencies, avoidable emergency room need, avoidable transport and poten- 10 tially avoidable hospital admissions and readmissions; community param- 11 edicine services to individuals with behavioral health conditions, or 12 developmental or intellectual disabilities, shall further include the 13 collaboration of appropriate providers of behavioral health services 14 licensed or certified under the mental hygiene law; 15 (b) Recruitment, training and retention of hospital/home care direct 16 care staff and physicians, in geographic or clinical areas of demon- 17 strated need. Such initiatives may include, but are not limited to, the 18 following activities: 19 (i) outreach and public education about the need and value of service 20 in health occupations; 21 (ii) training/continuing education and regulatory facilitation for 22 cross-training to maximize flexibility in the utilization of staff, 23 including: 24 (A) training of hospital nurses in home care; 25 (B) dual certified nurse aide/home health aide certification; [and] 26 (C) dual personal care aide/HHA certification; and 27 (D) orientation and/or collaborative training of EMS, hospital, home 28 care, physician and, as necessary, other participating provider staff in 29 community paramedicine; 30 (iii) salary/benefit enhancement; 31 (iv) career ladder development; and 32 (v) other incentives to practice in shortage areas; and 33 (c) Hospital - home care - physician collaboratives for the care and 34 management of special needs, high-risk and high-cost patients, including 35 but not limited to best practices, and training and education of direct 36 care practitioners and service employees. 37 5. Hospitals and home care agencies which are provided financing or 38 waivers pursuant to this section shall report to the commissioner on the 39 patient, service and cost experiences pursuant to this section, includ- 40 ing the extent to which the project goals are achieved. The commissioner 41 shall compile and make such reports available on the department's 42 website. 43 § 2. The public health law is amended by adding a new section 3001-a 44 to read as follows: 45 § 3001-a. Community paramedicine services. Notwithstanding any incon- 46 sistent provision of this article, an emergency medical technician or 47 advanced emergency medical technician in course of his or her work as an 48 employee or volunteer of an ambulance service or an advanced life 49 support first response service certified under this article to provide 50 emergency medical services may also participate in models of community 51 paramedicine pursuant to section twenty-eight hundred five-x of this 52 chapter. 53 § 3. This act shall take effect immediately.
