Health equity impact assessments

§ 2802-b. Health equity impact assessments. 1. Definitions. As used in
this section:

(a) "Application" means an application under this article for the
construction, establishment, change in the establishment, merger,
acquisition, elimination or substantial reduction, expansion, or
addition of a hospital service or health-related service of a hospital
that requires review or approval by the council or the commissioner,
where the application is filed or submitted to the council, the
commissioner or the department after this section takes effect.
Provided, however, that an application for the change in the
establishment, merger or acquisition of a hospital shall not be included
in this definition if the application would not result in the
elimination, or substantial reduction, expansion, addition or change in
location of a hospital service or health related service of the
hospital.

(b) "Project" means the construction, establishment, change in the
establishment, merger, acquisition, elimination, or substantial
reduction, expansion, or addition of a hospital service or
health-related service of a hospital that is the subject of an
application.

(c) "Health equity impact assessment" or "impact assessment" means an
assessment of whether, and if so how, a project will improve access to
hospital services and health care, health equity and reduction of health
disparities, with particular reference to members of medically
underserved groups, in the applicant's service area.

(d) "Medically underserved group" means: low-income people; racial and
ethnic minorities; immigrants; women; lesbian, gay, bisexual,
transgender, or other-than-cisgender people; people with disabilities;
older adults; persons living with a prevalent infectious disease or
condition; persons living in rural areas; people who are eligible for or
receive public health benefits; people who do not have third-party
health coverage or have inadequate third-party health coverage; and
other people who are unable to obtain health care.

2. (a) (i) Every application shall include a health equity impact
assessment of the project. The health equity impact assessment shall be
filed together with the application, and the application shall not be
complete without the impact statement. The applicant shall promptly
amend or modify the impact statement as necessary.

(ii) However, in the case of a diagnostic and treatment center whose
patient population is over fifty percent combined patients enrolled in
Medicaid or uninsured, a health equity impact assessment is not required
unless the application includes a change in controlling person,
principal stockholder, or principal member (as defined in section
twenty-eight hundred one-a of this article) of the applicant.

(b) In considering whether and on what terms to approve an
application, the commissioner and the council, as the case may be, shall
consider the health equity impact statement.

3. Scope and contents of a health equity impact assessment. A health
equity impact assessment shall include:

(a) A demonstration of whether, and if so how, the proposed project
will improve access to hospital services and health care, health equity
and reduction of health disparities, with particular reference to
members of medically underserved groups, in the applicant's service
area.

(b) The extent to which medically underserved groups in the
applicant's service area use the applicant's hospital or health-related
services or similar services at the time of the application and the
extent to which they are expected to if the project is implemented.

(c) The performance of the applicant in meeting its obligations, if
any, under section twenty-eight hundred seven-k of this article and
federal regulations requiring providing uncompensated care, community
services, and access by minorities and people with disabilities to
programs receiving federal financial assistance, including the existence
of any civil rights access complaints against the applicant, and how the
applicant's meeting of these obligations will be affected by
implementation of the project.

(d) How and to what extent the applicant will provide hospital and
health-related services to the medically indigent, Medicare recipients,
Medicaid recipients and members of medically underserved groups if the
project is implemented.

(e) The amount of indigent care, both free and below cost, that will
be provided by the applicant if the project is approved.

(f) Access by public or private transportation, including
applicant-sponsored transportation services, to the applicant's hospital
or health-related services if the project is implemented.

(g) The means of assuring effective communication between the
applicant's hospital and health-related service staff and people of
limited English-speaking ability and those with speech, hearing or
visual impairments handicaps if the project is implemented.

(h) The extent to which implementation of the project will reduce
architectural barriers for people with mobility impairments.

(i) A review of how the applicant will maintain or improve the quality
of hospital and health-related services including a review of:

(i) demographics of the applicant's service area;

(ii) economic status of the population of the applicant's service
area;

(iii) physician and professional staffing issues related to the
project;

(iv) availability of similar services at other institutions in or near
the applicant's service area; and

(v) historical and projected market shares of hospital and health care
service providers in the applicant's service area.

(j) The extent to which the availability and provision of reproductive
health services and maternal health care in the applicant's service area
will be affected if the project is implemented. Applicants shall
demonstrate how the project will impact the delivery of statutorily
protected reproductive health care, pursuant to section twenty-five
hundred ninety-nine-aa of this chapter, and maternity services.

4. The health equity impact assessment shall be prepared for the
applicant by an independent entity and include the meaningful engagement
of public health experts, organizations representing employees of the
applicant, stakeholders, and community leaders and residents of the
applicant's service area.

5. The department shall publicly post the application and the health
equity impact assessment on its website within one week of the filing
with the department, including any filing with the council. The
applicant shall publicly post the application and the health equity
impact assessment on its website within one week of acknowledgement by
the department.