Documents for the September 13, 2013 Committee on Health Planning of the Public Health and Health Planning Council Special Meeting
The Public Health and Health Planning Council's Health Planning Committee is analyzing the increase in the number and types of ambulatory services providers that have developed and considering a set of recommendations to normalize public oversight of these practices and licensed facilities. On the agenda for the September meetings are retail clinics, urgent care, upgraded diagnostic and treatment centers (D&TCs) and freestanding emergency departments (freestanding EDs). Department of Health staff has prepared a series of reports to assist the Committee member's deliberations.
It should be noted that potential statutory/regulatory options related to retail clinics have already undergone a considerable amount of development and discussion. An internal DOH Executive Workgroup was formed in the fall of 2012 and issued a set of recommendations for further consideration. Retail clinic policies were also considered by the NYS Legislature earlier this year, but no legislation was passed. Consequently, no statutory or regulatory changes have been made related to retail clinics. However, many of the draft recommendations developed for retail clinics are central to the oversight of other ambulatory services providers that the Committee is discussing.
- Agenda (PDF)
- Description of attachments:
- Chart that summarizes and contrasts key elements of the ambulatory services spectrum. (PDF)
- Potential core recommendations that apply to retail clinics, urgent care, upgraded D&TCs and freestanding EDs. (PDF)
- Documents specific to each ambulatory services provider:
- Background paper that describes the provider service model and related issues.
- Policy paper that includes a range of statutory/regulatory options specific to each provider model, as well as the pros/cons, and other state/federal models.
- Set of potential recommendations specific to each ambulatory services model. The set of recommendations are a focused subset of the options detailed in "b" above and were chosen to help facilitate the Committee's discussion. All options available for consideration are offered to the Committee in the policy paper (described in "b" above) and the Committee can add, remove, alter or otherwise change any of the potential recommendations presented in this document.
- Retail Clinics
- Urgent Care
- Upgraded D&TCs
- Freestanding EDs
- Questions for Discussion:
- Should retail clinics and urgent care providers be required to accept a certain percentage of Medicaid patients? How would this be monitored?
- It is recommended that ambulatory services providers (retail clinics,urgent care, upgraded D&TCs and freestanding EDs) provide a list of primary care providers accepting new patients in their geographic area to patients who indicate they do not have a primary care provider. Is providing a list enough or should a referral be made?
- What policies and procedures should be considered to identify and limit the number of repeat encounters individual patients have with an ambulatory services provider (retail clinics, upgraded D&TCs and freestanding EDs) ?
- Should the definition of urgent care be more narrowly defined? What services or operational characteristics should define urgent care?
- Should physicians or other health care practitioners working in urgent care be required to have emergency medicine training and education requirements?
- CMS approves of and reimburses both 24/7 freestanding EDs and part-time ED models - should NYS approve part-time EDs?
- Should it be a requirement that freestanding EDs be affiliated with a hospital?