S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                        1411--A
                              2015-2016 Regular Sessions
                                 I N  A S S E M B L Y
                                   January 12, 2015
                                      ___________
       Introduced  by  M. of A. PAULIN, GOTTFRIED, BENEDETTO, LINARES -- Multi-
         Sponsored by -- M. of A. HIKIND, HOOPER -- read once and  referred  to
         the Committee on Health -- committee discharged, bill amended, ordered
         reprinted as amended and recommitted to said committee
       AN ACT to amend the public health law, in relation to retail clinics and
         limited services clinics
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1. The public health law is amended by adding  a  new  section
    2  230-e to read as follows:
    3    S  230-E.  RETAIL CLINICS. 1. AS USED IN THIS SECTION, "RETAIL CLINIC"
    4  MEANS A FACILITY OR PORTION OF A FACILITY, REGARDLESS  OF  OWNERSHIP  OR
    5  FORM  OF  ORGANIZATION,  THAT PROVIDES HEALTH CARE SERVICES OR TREATMENT
    6  (OTHER THAN PHARMACY) PROVIDED BY A HEALTH CARE  PRACTITIONER  LICENSED,
    7  CERTIFIED, REGISTERED OR AUTHORIZED TO PRACTICE UNDER TITLE EIGHT OF THE
    8  EDUCATION  LAW, ACTING WITHIN HIS OR HER LAWFUL SCOPE OF PRACTICE, THAT:
    9  (A) IS WITHIN THE SPACE OF A RETAIL BUSINESS OPERATION, SUCH AS A  PHAR-
   10  MACY  OR  A  STORE  OPEN TO THE GENERAL PUBLIC; (B) IS LABELED, BRANDED,
   11  ADVERTISED OR MARKETED WITH THE NAME OR  SYMBOL  OF  A  RETAIL  BUSINESS
   12  ENTITY; OR (C) IS LABELED, BRANDED, ADVERTISED OR MARKETED WITH THE NAME
   13  OR  SYMBOL  OF  A  BUSINESS  ENTITY,  OTHER  THAN A BUSINESS ENTITY THAT
   14  PROVIDES HEALTH CARE SERVICES OR TREATMENT  PROVIDED  AT  THE  FACILITY.
   15  HOWEVER, A FACILITY OR PORTION OF A FACILITY SHALL NOT BE DEEMED TO BE A
   16  RETAIL  CLINIC  IF  IT ORDINARILY IS USED ONLY FOR PROVIDING HEALTH CARE
   17  SERVICES TO EMPLOYEES OF THE RETAIL BUSINESS OPERATION.
   18    2. THE TREATMENTS AND SERVICES THAT MAY BE PROVIDED BY A RETAIL CLINIC
   19  SHALL BE LIMITED TO THE PROVISION OF TREATMENT AND SERVICES TO  PATIENTS
   20  FOR  ACUTE  EPISODIC ILLNESS OR CONDITION; EPISODIC PREVENTIVE TREATMENT
   21  AND SERVICES SUCH AS IMMUNIZATIONS; OPHTHALMIC DISPENSING AND OPHTHALMO-
   22  LOGIC OR OPTOMETRIC SERVICES  PROVIDED  IN  CONNECTION  WITH  OPHTHALMIC
   23  DISPENSING;  OR  TREATMENT  AND  SERVICES FOR MINOR TRAUMAS THAT ARE NOT
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD04863-04-5
       A. 1411--A                          2
    1  REASONABLY LIKELY TO BE LIFE-THREATENING  OR  POTENTIALLY  DISABLING  IF
    2  AMBULATORY  CARE  WITHIN  THE CAPACITY OF THE RETAIL CLINIC IS PROVIDED;
    3  BUT  SHALL  NOT  INCLUDE  MONITORING  OR  TREATMENT  AND  SERVICES  OVER
    4  PROLONGED PERIODS.
    5    3.  A RETAIL CLINIC SHALL BE DEEMED TO BE A "HEALTH CARE PROVIDER" FOR
    6  THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAPTER. A PRESCRIBER
    7  PRACTICING IN A RETAIL CLINIC SHALL NOT BE DEEMED TO BE IN THE EMPLOY OF
    8  A PHARMACY OR PRACTICING IN A HOSPITAL FOR PURPOSES OF  SUBDIVISION  TWO
    9  OF SECTION SIXTY-EIGHT HUNDRED SEVEN OF THE EDUCATION LAW.
   10    4.  (A)  THE  COMMISSIONER SHALL MAKE REGULATIONS SETTING FORTH OPERA-
   11  TIONAL AND PHYSICAL PLANT STANDARDS FOR RETAIL CLINICS,  INCLUDING,  BUT
   12  NOT LIMITED TO:
   13    (I) REQUIRING THAT RETAIL CLINICS ATTAIN AND MAINTAIN ACCREDITATION BY
   14  AN  APPROPRIATE  ACCREDITING  ENTITY  APPROVED  BY  THE COMMISSIONER AND
   15  REQUIRING TIMELY REPORTING TO THE DEPARTMENT IF A  RETAIL  CLINIC  LOSES
   16  ITS ACCREDITATION;
   17    (II)  DESIGNATING  OR LIMITING THE TREATMENTS AND SERVICES THAT MAY BE
   18  PROVIDED;
   19    (III) PROHIBITING THE PROVISION OF SERVICES  TO  PATIENTS  TWENTY-FOUR
   20  MONTHS OF AGE OR YOUNGER;
   21    (IV)  REQUIRING  RETAIL  CLINICS TO ACCEPT WALK-INS AND OFFER EXTENDED
   22  BUSINESS HOURS;
   23    (V) REQUIREMENTS OR GUIDELINES FOR ADVERTISING AND SIGNAGE, DISCLOSURE
   24  OF OWNERSHIP INTERESTS, INFORMED CONSENT, RECORD KEEPING,  REFERRAL  FOR
   25  TREATMENT AND CONTINUITY OF CARE, CASE REPORTING TO THE PATIENT'S PRIMA-
   26  RY  CARE OR OTHER HEALTH CARE PROVIDERS, DESIGN, CONSTRUCTION, FIXTURES,
   27  AND EQUIPMENT.    SIGNAGE  SHALL  ALSO  BE  REQUIRED  TO  INDICATE  THAT
   28  PRESCRIPTIONS  AND  OVER-THE-COUNTER  SUPPLIES  MAY  BE  PURCHASED  BY A
   29  PATIENT FROM ANY BUSINESS AND DO NOT NEED TO BE PURCHASED ON-SITE; AND
   30    (VI) NOT TREATING ANY PATIENT FOR THE SAME CONDITION OR  ILLNESS  MORE
   31  THAN THREE TIMES IN A YEAR.
   32    (B)  SUCH  REGULATIONS  ALSO SHALL PROMOTE AND STRENGTHEN PRIMARY CARE
   33  THROUGH:
   34    (I) INQUIRING OF EACH PATIENT WHETHER HE OR SHE  HAS  A  PRIMARY  CARE
   35  PROVIDER;
   36    (II)  THE  INTEGRATION OF SERVICES PROVIDED BY RETAIL CLINICS WITH THE
   37  SERVICES PROVIDED BY THE PATIENT'S OTHER HEALTH CARE PROVIDERS; AND
   38    (III) THE REFERRAL OF PATIENTS TO APPROPRIATE HEALTH  CARE  PROVIDERS,
   39  INCLUDING APPROPRIATE TRANSMISSION OF PATIENT HEALTH RECORDS.
   40    (C) RETAIL CLINICS ALREADY IN OPERATION AT THE TIME THIS SECTION TAKES
   41  EFFECT  MUST  COMPLY WITH ACCREDITATION REQUIREMENTS UNDER THIS SUBDIVI-
   42  SION WITHIN ONE HUNDRED EIGHTY DAYS AFTER THIS SECTION TAKES EFFECT.
   43    5. THIS SECTION DOES NOT AUTHORIZE ANY FORM OF OWNERSHIP OR  ORGANIZA-
   44  TION  OF  A  RETAIL  CLINIC OR PRACTICE OF ANY PROFESSION THAT WOULD NOT
   45  OTHERWISE BE LEGAL, AND DOES NOT EXPAND THE SCOPE  OF  PRACTICE  OF  ANY
   46  HEALTH  CARE PRACTITIONER. WHERE ANY REGULATION UNDER THIS SECTION WOULD
   47  AFFECT THE SCOPE OF PRACTICE OF A  HEALTH  CARE  PRACTITIONER  LICENSED,
   48  REGISTERED,  CERTIFIED  OR AUTHORIZED UNDER TITLE EIGHT OF THE EDUCATION
   49  LAW, THE REGULATION SHALL BE MADE WITH THE CONCURRENCE  OF  THE  COMMIS-
   50  SIONER OF EDUCATION.
   51    S  2.  Section  2801-a of the public health law is amended by adding a
   52  new subdivision 17 to read as follows:
   53    17. (A) A DIAGNOSTIC OR TREATMENT CENTER THAT IS A RETAIL CLINIC UNDER
   54  SECTION TWO HUNDRED THIRTY-E OF  THIS  CHAPTER,  OR  ESTABLISHED  WITHIN
   55  SPACE  USED  BY  AN  EMPLOYER  FOR PROVIDING HEALTH CARE SERVICES TO ITS
       A. 1411--A                          3
    1  EMPLOYEES, MAY BE OWNED OR OPERATED BY A LEGAL ENTITY FORMED  UNDER  THE
    2  LAWS OF NEW YORK:
    3    (I)  THAT  IS,  OR IS OWNED AND CONTROLLED BY, THE APPLICABLE BUSINESS
    4  ENTITY UNDER PARAGRAPH (A), (B) OR (C) OF SUBDIVISION ONE OF SECTION TWO
    5  HUNDRED THIRTY-E OF THIS CHAPTER OR THE EMPLOYER TO WHOSE  EMPLOYEES  IT
    6  PROVIDES HEALTH CARE SERVICES;
    7    (II)  WHOSE  STOCKHOLDERS OR MEMBERS, AS APPLICABLE, MAY INCLUDE OTHER
    8  THAN NATURAL PERSONS;
    9    (III) WHOSE PRINCIPAL STOCKHOLDERS AND  MEMBERS,  AS  APPLICABLE,  AND
   10  CONTROLLING  PERSONS  COMPLY  WITH  ALL  APPLICABLE REQUIREMENTS OF THIS
   11  SECTION; AND
   12    (IV) THAT DEMONSTRATES, TO THE SATISFACTION OF THE PUBLIC  HEALTH  AND
   13  HEALTH PLANNING COUNCIL, SUFFICIENT EXPERIENCE AND EXPERTISE IN DELIVER-
   14  ING  HIGH  QUALITY  HEALTH  CARE  SERVICES,  AND A COMMITMENT TO OPERATE
   15  LIMITED SERVICES CLINICS IN MEDICALLY UNDERSERVED AREAS OF THE STATE.
   16    (B) A DIAGNOSTIC AND TREATMENT CENTER UNDER THIS SUBDIVISION SHALL  BE
   17  REFERRED TO IN THIS SUBDIVISION AS A "LIMITED SERVICES CLINIC".
   18    (C)  FOR  PURPOSES  OF  THIS SUBDIVISION, THE PUBLIC HEALTH AND HEALTH
   19  PLANNING COUNCIL SHALL ADOPT AND AMEND RULES AND  REGULATIONS,  NOTWITH-
   20  STANDING  ANY  INCONSISTENT  PROVISION  OF  THIS SECTION, TO ADDRESS ANY
   21  MATTER IT DEEMS PERTINENT TO THE ESTABLISHMENT OF LIMITED SERVICES CLIN-
   22  ICS; PROVIDED THAT SUCH RULES AND REGULATIONS SHALL INCLUDE, BUT NOT  BE
   23  LIMITED TO, PROVISIONS GOVERNING OR RELATING TO:
   24    (I) ANY DIRECT OR INDIRECT CHANGES OR TRANSFERS OF OWNERSHIP INTERESTS
   25  OR  VOTING  RIGHTS IN SUCH ENTITIES OR THEIR STOCKHOLDERS OR MEMBERS, AS
   26  APPLICABLE;
   27    (II) PROVIDE FOR PUBLIC HEALTH AND HEALTH PLANNING COUNCIL APPROVAL OF
   28  ANY CHANGE IN CONTROLLING INTERESTS, PRINCIPAL STOCKHOLDERS, CONTROLLING
   29  PERSONS, PARENT COMPANY OR SPONSORS;
   30    (III) OVERSIGHT OF THE OPERATOR AND ITS SHAREHOLDERS  OR  MEMBERS,  AS
   31  APPLICABLE, INCLUDING LOCAL GOVERNANCE OF THE LIMITED SERVICES CLINICS;
   32    (IV)  RELATING  TO THE CHARACTER AND COMPETENCE AND QUALIFICATIONS OF,
   33  AND CHANGES RELATING TO, THE DIRECTORS AND OFFICERS OF THE OPERATOR  AND
   34  ITS PRINCIPAL STOCKHOLDERS, CONTROLLING PERSONS, PARENT COMPANY OR SPON-
   35  SORS; AND
   36    (V)  IN  DETERMINING  WHETHER  TO  APPROVE ADDITIONAL LIMITED SERVICES
   37  CLINIC LOCATIONS FOR THE OPERATOR, THE DEPARTMENT SHALL CONSIDER WHETHER
   38  THE OPERATOR HAS FULFILLED ITS COMMITMENT TO  OPERATE  LIMITED  SERVICES
   39  CLINICS IN MEDICALLY UNDERSERVED AREAS OF THE STATE.
   40    (D) THE FOLLOWING PROVISIONS OF THIS SECTION SHALL NOT APPLY TO LIMIT-
   41  ED SERVICES CLINICS:
   42    (I) PARAGRAPH (A) OF SUBDIVISION THREE OF THIS SECTION;
   43    (II)  PARAGRAPH  (B) OF SUBDIVISION THREE OF THIS SECTION, RELATING TO
   44  STOCKHOLDERS AND MEMBERS OTHER THAN PRINCIPAL STOCKHOLDERS AND PRINCIPAL
   45  MEMBERS;
   46    (III) PARAGRAPH (C) OF SUBDIVISION FOUR OF THIS SECTION,  RELATING  TO
   47  THE DISPOSITION OF STOCK OR VOTING RIGHTS; AND
   48    (IV)  PARAGRAPH  (E)  OF SUBDIVISION FOUR OF THIS SECTION, RELATING TO
   49  THE OWNERSHIP OF STOCK OR MEMBERSHIP.
   50    (E) A LIMITED SERVICES CLINIC SHALL BE DEEMED TO  BE  A  "HEALTH  CARE
   51  PROVIDER"  FOR  THE PURPOSES OF TITLE TWO-D OF ARTICLE TWO OF THIS CHAP-
   52  TER. A PRESCRIBER PRACTICING IN A LIMITED SERVICES CLINIC SHALL  NOT  BE
   53  DEEMED TO BE IN THE EMPLOY OF A PHARMACY OR PRACTICING IN A HOSPITAL FOR
   54  PURPOSES  OF SUBDIVISION TWO OF SECTION SIXTY-EIGHT HUNDRED SEVEN OF THE
   55  EDUCATION LAW.
       A. 1411--A                          4
    1    (F) THE COMMISSIONER SHALL PROMULGATE REGULATIONS SETTING FORTH OPERA-
    2  TIONAL AND PHYSICAL PLANT STANDARDS FOR LIMITED SERVICES CLINICS,  WHICH
    3  MAY BE DIFFERENT FROM THE REGULATIONS OTHERWISE APPLICABLE TO DIAGNOSTIC
    4  OR TREATMENT CENTERS, INCLUDING, BUT NOT LIMITED TO:
    5    (I)  REQUIRING  THAT  LIMITED  SERVICES  CLINICS  ATTAIN  AND MAINTAIN
    6  ACCREDITATION BY AN  APPROPRIATE  ACCREDITING  ENTITY  APPROVED  BY  THE
    7  COMMISSIONER  AND  REQUIRING  TIMELY  REPORTING  TO  THE DEPARTMENT IF A
    8  LIMITED SERVICES CLINIC LOSES ITS ACCREDITATION;
    9    (II) DESIGNATING OR LIMITING THE TREATMENTS AND SERVICES THAT  MAY  BE
   10  PROVIDED;
   11    (III)  PROHIBITING  THE  PROVISION OF SERVICES TO PATIENTS TWENTY-FOUR
   12  MONTHS OF AGE OR YOUNGER;
   13    (IV) REQUIRING LIMITED SERVICES CLINICS TO ACCEPT WALK-INS  AND  OFFER
   14  EXTENDED BUSINESS HOURS;
   15    (V)  GUIDELINES  FOR  ADVERTISING AND SIGNAGE, DISCLOSURE OF OWNERSHIP
   16  INTERESTS, INFORMED CONSENT, RECORD KEEPING, REFERRAL FOR TREATMENT  AND
   17  CONTINUITY  OF  CARE,  CASE  REPORTING  TO THE PATIENT'S PRIMARY CARE OR
   18  OTHER HEALTH CARE PROVIDERS, DESIGN, CONSTRUCTION, FIXTURES, AND  EQUIP-
   19  MENT;  SIGNAGE SHALL ALSO BE REQUIRED TO INDICATE THAT PRESCRIPTIONS AND
   20  OVER-THE-COUNTER SUPPLIES MAY BE PURCHASED BY A PATIENT FROM  ANY  BUSI-
   21  NESS AND DO NOT NEED TO BE PURCHASED ON-SITE; AND
   22    (VI)  WHERE A LIMITED SERVICES CLINIC IS A RETAIL CLINIC, NOT TREATING
   23  ANY PATIENT FOR THE SAME CONDITION OR ILLNESS MORE THAN THREE TIMES IN A
   24  YEAR.
   25    (G) SUCH REGULATIONS ALSO SHALL PROMOTE AND  STRENGTHEN  PRIMARY  CARE
   26  THROUGH:
   27    (I)  INQUIRING  OF  EACH  PATIENT WHETHER HE OR SHE HAS A PRIMARY CARE
   28  PROVIDER;
   29    (II) THE INTEGRATION OF SERVICES PROVIDED BY LIMITED SERVICES  CLINICS
   30  WITH THE SERVICES PROVIDED BY THE PATIENT'S OTHER HEALTH CARE PROVIDERS;
   31  AND
   32    (III)  THE  REFERRAL OF PATIENTS TO APPROPRIATE HEALTH CARE PROVIDERS,
   33  INCLUDING APPROPRIATE TRANSMISSION OF PATIENT HEALTH RECORDS.
   34    S 3. This act shall take effect on the one hundred eightieth day after
   35  it shall have become a law; provided  that  effective  immediately,  the
   36  commissioner  of  health  shall  make regulations and take other actions
   37  reasonably necessary to implement the provisions of  the  public  health
   38  law enacted by this act when they take effect.