S T A T E O F N E W Y O R K ________________________________________________________________________ 4063 2015-2016 Regular Sessions I N S E N A T E February 26, 2015 ___________ Introduced by Sen. SAMPSON -- read twice and ordered printed, and when printed to be committed to the Committee on Finance AN ACT to amend the state finance law, the public health law and the labor law, in relation to enacting the "New York state community health care investment fund act" THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: 1 Section 1. Short title. This act shall be known and may be cited as 2 the "New York state community health care investment fund act". 3 S 2. Legislative intent. The legislature hereby declares that the 4 provision of health care in New York state must be affordable, accessi- 5 ble, and address the multi-faceted needs of its diverse population, from 6 pre-conception planning through the end of life. The legislature also 7 finds that many constituencies play an important role in the state's 8 health care infrastructure: consumers, health care professionals, 9 communities of faith, state and local governments, businesses, insurance 10 companies, community based organizations, home care agencies, school 11 based health clinics, nursing homes, and hospitals. 12 Health care in New York state also faces many challenges. New York 13 state is home to world class medical institutions and research centers. 14 According to the United Health Foundation 2006 America Health Rankings, 15 New York state has the 4th highest per capita spending on public health 16 in the nation, a low rate of motor vehicle deaths and a low rate of 17 cancer deaths. The health care challenges in New York state include a 18 high incidence of infectious disease, limited access to adequate prena- 19 tal care, and a low high school graduation rate. Twenty percent of the 20 state's children under 18 years of age live in poverty. Furthermore, the 21 state's overall rank among the rest of the country decreased between 22 2005 and 2006, from 26th place to 29th place. Despite a high per capita 23 spending on health ($316 per person) almost three million of its resi- 24 dents do not have health insurance. Not surprisingly, health disparities EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD09106-01-5 S. 4063 2 1 persist in low-income cities and neighborhoods and where racial and 2 ethnic minorities comprise a majority of the population. According to a 3 report released in 2004 by the New York city departments of health and 4 mental health, "more than 4,000 deaths would be prevented if the all- 5 cause mortality rate in the poorest neighborhoods were lowered to the 6 rate in the wealthiest neighborhoods." 7 Against this backdrop of high public health spending, significant 8 health care disparities experienced by ethnic and racial minorities and 9 approximately three million uninsured people in New York state, HMO 10 profits in New York state have soared in recent years while costs for 11 members have risen and reimbursement for health care providers has fall- 12 en. Premium increases statewide have increased about 20 percent, and 13 revenues have risen from $14.5 billion in 2001 to $17.4 billion in 2005. 14 In fact, premium rate increases outpaced medical payments from 2001 to 15 2005 by over $1 billion as New York's HMOs' profits climbed 93 percent, 16 from $672 million to $1.3 billion. HMOs' administrative and claims 17 adjustment costs went up by 24 percent from 2001 to 2005, and average 18 revenue per member increased an average of 8.6 percent annually. During 19 the same period, enrollments declined 14 percent, provider reimburse- 20 ments trended downward from 85.3 percent of every dollar to 81.7 21 percent, and out of pocket costs for members increased by 7.7 percent. 22 The legislature additionally finds that HMOs that conduct business in 23 New York state have a responsibility toward improving the health status 24 of the residents of this state and should assist in providing revenue to 25 support critical community health and economic development needs. 26 Definitions. For the purposes of this act, the following terms shall 27 have the following meanings: 28 1. New York state stimulus health care investment fund and New York 29 state health care entrepreneurial stimulus fund refer to the funds 30 established pursuant to section three of this act. 31 2. New York state community health care investment fund council refers 32 to the council established pursuant to section five of this act. 33 3. New York state community health care investment fund grant program 34 refers to the grant program established pursuant to section six of this 35 act. 36 4. New York state entrepreneurial stimulus investment grant program 37 refers to the program established pursuant to section seven of this act. 38 S 3. The state finance law is amended by adding two new sections 99-w 39 and 99-x to read as follows: 40 S 99-W. NEW YORK STATE COMMUNITY HEALTH CARE INVESTMENT FUND. 1. 41 THERE IS HEREBY ESTABLISHED IN THE JOINT CUSTODY OF THE COMPTROLLER AND 42 THE COMMISSIONER OF HEALTH A FUND TO BE KNOWN AS THE NEW YORK STATE 43 COMMUNITY HEALTH CARE INVESTMENT FUND. 44 2. SUCH FUND SHALL CONSIST OF ALL MONEYS APPROPRIATED FOR THE PURPOSE 45 OF SUCH FUND, ALL OTHER MONEYS CREDITED OR TRANSFERRED TO SUCH FUND 46 PURSUANT TO LAW, ALL MONEYS REQUIRED BY THE PROVISIONS OF THIS SECTION 47 OR ANY OTHER LAW TO BE PAID INTO OR CREDITED TO SUCH FUND, AND ALL 48 MONEYS RECEIVED BY THE FUND OR DONATED TO IT. 49 3. MONEYS OF SUCH FUND SHALL BE AVAILABLE FOR APPROPRIATION AND ALLO- 50 CATION TO THE DEPARTMENT OF HEALTH FOR PURPOSES OF DISTRIBUTING SUCH 51 MONEYS TO QUALIFIED ENTITIES OF THE NEW YORK STATE COMMUNITY HEALTH CARE 52 INVESTMENT FUND GRANT PROGRAM. FUNDS COLLECTED PURSUANT TO SECTION TWEN- 53 TY-FIVE OF THE PUBLIC HEALTH LAW SHALL BE USED FOR ONE OR MORE OF THE 54 FOLLOWING: 55 (A) PROJECTS THAT ADDRESS THE SIX CLINICAL INDICATORS AS ESTABLISHED 56 BY THE FEDERAL CENTER FOR DISEASE CONTROL'S GOAL TO ELIMINATE HEALTH S. 4063 3 1 DISPARITIES: INFANT MORTALITY; CANCER SCREENING AND MANAGEMENT; CARDIO- 2 VASCULAR DISEASE; DIABETES; HIV INFECTION/AIDS; AND IMMUNIZATIONS. 3 (B) PROJECTS THAT IMPROVE THE CULTURAL COMPETENCE OF THE HEALTH CARE 4 WORKFORCE. 5 (C) PROJECTS THAT COLLECT DATA REGARDING (I) ETHNIC AND MINORITY 6 REPRESENTATION IN THE NEW YORK STATE HEALTH CARE WORKFORCE AND (II) 7 ETHNIC AND RACIAL MINORITIES SERVED IN HOSPITALS AND NURSING HOMES. 8 (D) PROJECTS THAT CONDUCT SURVEYS ON RACIAL AND ETHNIC HEALTH DISPARI- 9 TIES. 10 (E) SCHOLARSHIPS TO RECRUIT AND TRAIN RACIAL AND ETHNIC MINORITIES IN 11 THE HEALTH CARE PROFESSIONS. 12 (F) PROJECTS THAT ADDRESS UNMET HEALTH CARE NEEDS IN RURAL AREAS. 13 4. MONEYS SHALL BE PAID OUT ON THE AUDIT AND WARRANT OF THE COMP- 14 TROLLER ON VOUCHERS CERTIFIED OR APPROVED BY THE COMMISSIONER OF HEALTH. 15 S 99-X. NEW YORK STATE HEALTH CARE ENTREPRENEURIAL STIMULUS FUND. 1. 16 THERE IS HEREBY ESTABLISHED IN THE JOINT CUSTODY OF THE COMPTROLLER AND 17 THE COMMISSIONER OF LABOR A FUND TO BE KNOWN AS THE NEW YORK STATE 18 HEALTH CARE ENTREPRENEURIAL STIMULUS FUND. 19 2. SUCH FUND SHALL CONSIST OF ALL MONEYS APPROPRIATED FOR THE PURPOSE 20 OF SUCH FUND, ALL OTHER MONEYS CREDITED OR TRANSFERRED TO SUCH FUND 21 PURSUANT TO LAW, ALL MONEYS REQUIRED BY THE PROVISIONS OF THIS SECTION 22 OR ANY OTHER LAW TO BE PAID INTO OR CREDITED TO SUCH FUND, AND ALL 23 MONEYS RECEIVED BY THE FUND OR DONATED TO IT. 24 3. MONEYS OF SUCH FUND SHALL BE AVAILABLE FOR APPROPRIATION AND ALLO- 25 CATION TO THE DEPARTMENT OF LABOR FOR PURPOSES OF DISTRIBUTING SUCH 26 MONEYS TO QUALIFIED PERSONS OR ENTITIES OF THE NEW YORK STATE ENTREPRE- 27 NEURIAL STIMULUS INVESTMENT GRANT PROGRAM. FUNDS COLLECTED PURSUANT TO 28 SECTION FORTY-FOUR OF THE LABOR LAW SHALL BE USED FOR ONE OR MORE OF THE 29 FOLLOWING: 30 GRANTS TO NEW INDIVIDUAL ENTREPRENEURS IN THE STATE AND TO PERSONS 31 QUALIFYING FOR UNEMPLOYMENT INSURANCE IN THE STATE, TO ASSIST WITH THEIR 32 FIRST-YEAR COSTS OF PURCHASING HEALTH INSURANCE, INCLUDING, BUT NOT 33 LIMITED TO, PARTICIPATION IN THE HEALTHY NEW YORK OR FAMILY HEALTH PLUS 34 PROGRAMS, ESTABLISHED PURSUANT TO SECTIONS FOUR THOUSAND THREE HUNDRED 35 TWENTY-SIX AND FOUR THOUSAND THREE HUNDRED TWENTY-SEVEN OF THE INSURANCE 36 LAW. 37 4. MONEYS SHALL BE PAID OUT ON THE AUDIT AND WARRANT OF THE COMP- 38 TROLLER ON VOUCHERS CERTIFIED OR APPROVED BY THE COMMISSIONER OF LABOR. 39 S 4. Any health maintenance organization, company or corporation, 40 certified under article 44 of the public health law or licensed pursuant 41 to the insurance law shall be subject to the following provisions: 42 1. On or before each April first, the superintendent of financial 43 services shall collect from the entities covered by this section all 44 moneys for deposit into the New York state community health care invest- 45 ment fund and the New York state health care entrepreneurial stimulus 46 fund. 47 2. The total amount paid by all entities covered by this section shall 48 equal: 49 a. in 2016 the sum of $35,000,000 for deposit into the New York state 50 community health care investment fund and the sum of $35,000,000 for 51 deposit into the New York state health care entrepreneurial stimulus 52 fund; 53 b. beginning in 2017, and each year thereafter, the total amount to be 54 collected for deposit into the New York state community health care 55 investment fund shall equal the total of the prior year deposits into 56 the New York state community health care investment fund multiplied by S. 4063 4 1 the sum of one plus any positive percent change in the total annual 2 profits of all companies and corporations covered by this section; 3 c. beginning in 2017, and each year thereafter, the total amount to be 4 collected for deposit into the New York state health care entrepreneuri- 5 al stimulus fund shall equal the total of the prior year deposits into 6 the New York state health care entrepreneurial stimulus fund multiplied 7 by the sum of one plus any positive percent change in the total annual 8 profits of all companies and corporations covered by this section. 9 3. The amount paid by each company or corporation covered by this 10 section shall equal their net income divided by the total net income of 11 all companies and corporations covered by this section, rounded to four 12 decimal places, multiplied by the total amount calculated pursuant to 13 paragraphs a, b and c of subdivision two of this section. 14 4. For any company or corporation with a net income of less than zero, 15 their amount shall be calculated based on their net income in the last 16 year that it was greater than zero. The superintendent of financial 17 services shall have the authority to grant waivers from this section 18 when deemed necessary to prevent an undue burden, provided that no 19 company or corporation may receive a full or partial waiver in any two 20 successive years. 21 5. Every not-for-profit health maintenance organization shall be 22 excluded from the provisions of this section. 23 S 5. The New York state community health care investment fund council. 24 1. There is hereby established the New York state community health care 25 investment fund council consisting of 13 members. The purpose of such 26 council is to oversee the New York state health care community invest- 27 ment funds, establish the RFP process, award grants and issue an annual 28 report. The members of such council shall consist of representatives 29 from the insurance industry, health care institutions and providers, and 30 consumer and advocacy groups. The members of the council shall be 31 appointed in the following manner: six state agency heads or their 32 representatives: one from the department of health; one from the office 33 for the aging; one from the office of mental health; one from the office 34 for people with developmental disabilities; one from the office of alco- 35 holism and substance abuse services; one from the office of children and 36 family services; and three members by the governor and one by the speak- 37 er of the assembly, one by the temporary president of the senate; one by 38 the minority leader of the assembly; and one by the minority leader of 39 the senate. 40 2. The New York state community health care investment fund council 41 shall issue an annual report to the governor and legislature. Such annu- 42 al report shall include, but not be limited to, the following: the 43 dollar amount of HMO investments; the amount of award money granted; the 44 names of the groups awarded grants; and a description of the projects 45 for which the grants were awarded. 46 3. No member shall receive any compensation for his or her services, 47 but shall be reimbursed for their actual and necessary expenses, includ- 48 ing travel expenses, incurred in the performance of their duties. 49 S 6. The public health law is amended by adding a new section 25 to 50 read as follows: 51 S 25. NEW YORK STATE COMMUNITY HEALTH CARE INVESTMENT FUND GRANT 52 PROGRAM. THE COMMISSIONER SHALL ESTABLISH THE NEW YORK STATE COMMUNITY 53 HEALTH CARE INVESTMENT FUND GRANT PROGRAM WHICH SHALL INCLUDE, BUT NOT 54 BE LIMITED TO THE FOLLOWING: 55 1. PROJECTS THAT ADDRESS THE SIX CLINICAL INDICATORS AS ESTABLISHED BY 56 THE FEDERAL CENTER FOR DISEASE CONTROL'S GOAL TO ELIMINATE HEALTH S. 4063 5 1 DISPARITIES: INFANT MORTALITY; CANCER SCREENING AND MANAGEMENT; CARDIO- 2 VASCULAR DISEASE; DIABETES; HIV INFECTION/AIDS; AND IMMUNIZATIONS; 3 2. PROJECTS THAT IMPROVE THE CULTURAL COMPETENCE OF THE HEALTH CARE 4 WORKFORCE; 5 3. PROJECTS THAT COLLECT DATA REGARDING ETHNIC AND MINORITY REPRESEN- 6 TATION IN THE NEW YORK STATE HEALTH CARE WORKFORCE AND ETHNIC AND RACIAL 7 MINORITIES SERVED IN HOSPITALS AND NURSING HOMES; 8 4. PROJECTS THAT CONDUCT SURVEYS ON RACIAL AND ETHNIC HEALTH DISPARI- 9 TIES; 10 5. SCHOLARSHIPS TO RECRUIT AND TRAIN RACIAL AND ETHNIC MINORITIES IN 11 THE HEALTH CARE PROFESSIONS; AND 12 6. PROJECTS THAT ADDRESS UNMET HEALTH CARE NEEDS IN RURAL AREAS. 13 S 7. The labor law is amended by adding a new section 44 to read as 14 follows: 15 S 44. NEW YORK STATE ENTREPRENEURIAL STIMULUS INVESTMENT GRANT 16 PROGRAM. 1. THE COMMISSIONER SHALL ESTABLISH WITHIN THE DEPARTMENT A 17 NEW YORK STATE ENTREPRENEURIAL STIMULUS INVESTMENT GRANT PROGRAM. THE 18 PURPOSE OF THE PROGRAM IS TO ENCOURAGE STATE RESIDENTS TO DIRECTLY 19 PARTICIPATE IN THE ECONOMY OF THE STATE BY ESTABLISHING NEW BUSINESS 20 ENTERPRISES. 21 2. THE COMMISSIONER SHALL ESTABLISH RULES AND REGULATIONS FOR IDENTI- 22 FYING QUALIFYING INDIVIDUALS, PROCEDURES FOR OUTREACH, CERTIFYING 23 PROGRAM PARTICIPATION, AND FOR THE APPLICATION AND AWARDING OF GRANTS 24 FROM THE NEW YORK STATE HEALTH CARE ENTREPRENEURIAL STIMULUS FUND. 25 S 8. This act shall take effect immediately.