Current through Register Vol. 46, No. 39, September 25, 2024
(a)
In accordance with Public Health Law § 2802-b, applications under Article
28, meeting the criteria set forth in this section, shall include a health
equity impact assessment. The purpose of the health equity impact assessment is
to demonstrate how a proposed project affects the accessibility and delivery of
health care services to enhance health equity and contribute to mitigating
health disparities in the facility's service area, specifically for medically
underserved groups.
(b)
Definitions. For the purposes of this section the following terms shall have
the following meaning:
(1)Independent
entity means individual or organization with demonstrated expertise
and experience in the study of health equity, anti-racism, and community and
stakeholder engagement, and with preferred expertise and experience in the
study of health care access or delivery of health care services, able to
produce an objective written assessment using a standard format of whether,
and, if so, how, the facility's proposed project will impact access to and
delivery of health care services, particularly for members of medically
underserved groups.
(2)
Conflict of Interest means having a financial interest in the
approval of an application or assisting in drafting any part of the application
on behalf of the facility, other than the health equity assessment.
(3)
Stakeholders shall
include individuals or organizations currently or anticipated to be served by
the facility, employees of the facility including facility boards or
committees, public health experts including local health departments, residents
of the facility's service area and organizations representing those residents,
patients or residents of the facility, community-based organizations, and
community leaders.
(4)
Meaningful engagement shall mean providing advance notice to
stakeholders and an opportunity for stakeholders to provide feedback concerning
the facility's proposed project, including phone calls, community forums,
surveys, and written statements. Meaningful engagement must be reasonable and
culturally competent based on the type of stakeholder being engaged (for
example, people with disabilities should be offered a range of audiovisual
modalities to complete an electronic online survey).
(c) In accordance with Public Health Law
2802-b, applications for the construction, establishment, change in
establishment, merger, acquisition, elimination or substantial reduction,
expansion or addition of a hospital service or health-related service of a
hospital that require review or approval by the public health and health
planning council or the commissioner, shall include a health equity impact
assessment; provided, however, that a health equity impact assessment shall not
be required for the following:
(1) projects
that do not require prior approval but instead only require a written notice to
be submitted to the Department prior to commencement of a project pursuant to
Part 710 of this Title;
(2) minor
construction and equipment projects subject only to limited review pursuant to
Part 710 of this Title, unless such project would result in the elimination,
reduction, expansion or addition of beds or services;
(3) establishment (new or change in
ownership) of an operator, including mergers and acquisitions, unless such
establishment would result:
(i) the
elimination of a hospital service or health-related service;
(ii) a 10 percent or greater reduction in the
number of certified beds, certified services, or operating hours or
(iii) a change of location of a hospital
service or health-related service; and
(4) applications made by a diagnostic and
treatment center whose patient population is over fifty percent combined
patients or residents enrolled in Medicaid or uninsured, unless the application
includes a change in controlling person, principal stockholder, or principal
member of the facility.
(d) A health equity impact assessment shall
be performed by an independent entity without a conflict of interest, using a
standard format provided by the Department, and shall include:
(1) meaningful engagement of stakeholders
commensurate to the size, scope and complexity of the facility's proposed
project and conducted throughout the process of developing the health equity
impact assessment, to incorporate and reflect community voices;
(2) a description of the mechanisms used to
conduct meaningful engagement;
(3) a
documented summary of statements received from stakeholders through meaningful
engagement as submitted to, or prepared by, the facility or independent entity.
The Department reserves the right to request and review individual statements
as submitted, or prepared by the facility or independent entity, while
reviewing the health equity impact assessment.
(4) documentation of the contractual
agreement between the independent entity and the facility;
(5) a signed attestation from the independent
entity that there is no conflict of interest; and
(6) a description of the independent entity's
qualifications.
(e) When
submitting an application to the Department requiring a health equity impact
assessment, the application must include:
(1)
a full version of the application and a version with proposed redactions, if
any, to be shared publicly; and
(2)
a signed written acknowledgment that the health equity impact assessment was
reviewed by the facility, including a narrative explaining how the facility has
or will mitigate potential negative impacts to medically underserved groups
identified in the health equity impact assessment. The narrative must also be
made available to the public and posted conspicuously on the facility's website
until a decision on the application is rendered by the public health and health
planning council or the commissioner.
