Do companies that are based out of State or internationally but procure health care personnel for New York health care entities need to register?

Yes. NYS Public Health Law (PHL) § 2999-ii defines Temporary Health Care Services Agencies (or agencies) as a person, firm, corporation, partnership, association, or other entity in the business of providing or procuring temporary employment of health care personnel for health care entities. This includes: a nurses' registry licensed under Article Eleven of the General Business Law; and entities that utilize apps or other technology-based solutions to provide or procure temporary employment of health care personnel in health care entities.

All agencies in the business of providing or procuring temporary employment of health care personnel for health care entities in New York State are considered temporary health care services agencies and therefore required to register with the Department of Health.

Do locum tenens companies, in the business of providing or procuring the temporary services of physicians, physician assistants or nurse practitioners to fill gaps in a health care provider's coverage, need to register?

Yes. NYS Public Health Law (PHL) § 2999-ii defines Temporary Health Care Services Agencies (or agencies) as a person, firm, corporation, partnership, association, or other entity in the business of providing or procuring temporary employment of health care personnel for health care entities. This includes: a nurses' registry licensed under Article Eleven of the General Business Law; and entities that utilize apps or other technology-based solutions to provide or procure temporary employment of health care personnel in health care entities. All agencies in the business of providing or procuring temporary employment of health care personnel for health care entities in New York State are considered temporary health care services agencies and therefore required to register with the Department of Health.

Are healthcare professionals who are independent contractors included in requirements?

Individuals who only provide their own services on a temporary basis to health care entities, including health care practitioners that offer temporary coverage to other health care practitioners, are not included in the definition of Temporary Health Care Services Agency.

A health system client has a professional limited liability company that is part of the health system network. The PLLC employs only network staff to work only for hospitals within the network. For example, an RN employed by one hospital in the network could be employed by the PLLC to work at another hospital in the network. The nurses are employed as per diems. Our client's arrangement is basically the network hiring nurses for itself. Must the PLLC register under the new Public Health Law Article 29-K?

Yes. The PLLC in this instance would be considered an agency in the business of providing or procuring temporary employment of health care personnel for health care entities in New York State and is therefore considered a temporary health care services gency and required to register with the Department of Health.

Do staffing & recruiting firms or agencies that operate in other industries (i.e. technology, professional services staffing) need to register?

NYS Public Health Law (PHL) § 2999-ii defines Temporary Health Care Services Agencies (or agencies) as a person, firm, corporation, partnership, association, or other entity in the business of providing or procuring temporary employment of health care personnel for health care entities.

All agencies in the business of providing or procuring temporary employment of health care personnel for health care entities in New York State are considered temporary health care services gencies and therefore required to register with the Department of Health.

Does "health care personnel" include health care titles not listed in the statute (i.e. Advanced Practice Nurses, Nurse Practitioners, Physicians' Assistants, Physicians)?

"Health care personnel" means nurses, certified nurse aides and licensed or unlicensed direct care workers provided by the temporary health care services agency to provide temporary services in a health care entity. "Direct care worker" is defined as any individual who is responsible for patient/resident handling or patient/resident assessment as a regular or incidental part of their services, including any licensed or unlicensed health care worker. If the personnel the agency procures for health care entities in New York State fits this definition, the agency must register with the Department of Health.

Do staffing and recruiting firms or agencies that place foreign-educated health care professionals at healthcare facilities within New York for placements longer than 12 months meet the definition of a "temporary" health care services agency and need to register with the Department? What constitutes "temporary" for purposes of the statute?

NYS Public Health Law (PHL) § 2999-ii defines Temporary Health Care Services Agencies (or agencies) as a person, firm, corporation, partnership, association, or other entity in the business of providing or procuring temporary employment of health care personnel for health care entities, regardless of length of placement.

Do companies that only provide or procure temporary health care personnel to management service organizations, management groups or other organizations responsible for staffing health care entities, need to register with the Department?

Yes. Pursuant to PHL § 2999-ii(3) a health care entity is defined broadly to mean "an agency, corporation, facility, or individual providing medical or health care services." As such, if an agency provides or procures health care personnel on a temporary basis for the purpose of providing medical or health care services within a health care entity, the agency would need to register with the Department.

Do apps or other technology-based solutions that connect health care personnel with health care entities for the purpose of temporary coverage within the health care entity, need to register with the Department?

Yes. PHL § 2999-ii(8) defines temporary health care services agencies (or agencies) to include entities that utilize apps or other technology-based solutions to provide or procure temporary employment of health care personnel in health care entities. This does not require that the temporary health care services agency be the one that employs the health care personnel. To the extent an app or technology-based solution is in the business of providing or procuring temporary health care personnel for health care entities, it would need to register with the Department as a temporary health care services agency.

Do entities that utilize apps or technology-based solutions to connect health care personnel with health care entities to fill individual shifts, need to register with the Department as a temporary health care services agency? What if the entity does not directly employ the temporary health care personnel but instead pays them as an independent contractor or the facility pays the health care personnel directly?

Pursuant to PHL 2999-ii(8) "temporary health care services agency" or "agency" means an entity in the business of providing or procuring temporary employment of health care personnel for health care entities and includes entities that utilize apps or other technology-based solutions. For purposes of meeting the definition of an agency under Article 29-k, the Department interprets "temporary employment" very broadly. As such, if an agency contracts with a health care entity for the provision or procurement of health care personnel for health care entities, that entity, app or technology platform needs to register with the Department, regardless of whether it employs temporary health care personnel in a traditional sense (i.e. W-2 employee) or contracts with health care personnel (i.e. 1099).

When did this requirement go into effect?

The requirement for temporary health care services agencies and health care technology platforms to register with the Department, as set forth in Article 29-K of the PHL, went into effect on August 1, 2023.

What is the deadline for submission of the required files?

The deadline for submission of the registration application has been extended to November 15, 2023. Any person operating a temporary health care services agency in New York State must submit the registration application, along with Appendices 1-5, and registration fee of $1,000 by November 15, 2023.

The submission of the first Quarterly Reporting file, including Appendices 6-9, will be due by November 30, 2023. The final 2023 reporting file with Appendices 6-9 should include November and December 2023 data, which will be due January 31, 2024.

However, starting in 2024, quarterly reporting shall be as follows:

• Quarter 1: January - March = report due April 30
• Quarter 2: April - June = report due July 31
• Quarter 3: July - September = report due October 31
• Quarter 4: October - December = report due January 31

Are agencies required to have approved registrations or have submitted registration packages by 9/30/2023?

An applicant must submit the registration file, along with Appendices 1-5, and renewal fee by November 15, 2023.

Are agencies who have not submitted registrations by 9/30/2023 able to continue operating and keep healthcare workers at NY facilities on assignment for a period of time?

Article 29-K of the PHL went into effect on August 1, 2023. A grace period for submitting registration materials has been extended to November 15, 2023, at which time the Department will begin enforcing the registration requirement. Agencies that fail to register with the Department may be subject to penalties and fines of up to $2,000 for every day they fail to register.

How do agencies submit documents, contracts, and invoices?

The Department is collecting data using the secure file transfer tool, SendVault. To submit a registration file including five appendices (due November 15, 2023) or quarterly reporting file including four appendices (due November 30, 2023) please follow the steps below.

• Step 1: Download and prepare your Registration and Quarterly Reporting materials.
• Step 2: When you are ready to submit, use the following SendVault link and follow the instructions provided: SendVault
• Step 3: Submitting data via SendVault requires a Department-provided password. If you need the password, please email TempAgencyRegistration@health.ny.gov to request it.
• Step 4: If you are submitting for the first time, SendVault will require the installation of IBM Aspera Connect on your web browser (e.g., Google Chrome).
• Step 5: File submissions should follow the naming convention: agency name - contents being uploaded (e.g., "XYZ Temporary Staffing Agency - August 1, 2023 - October 31, 2023") and all files should be submitted as one package.

How does an agency pay the fees associated with the registration process? What is acceptable?

The annual registration fee must be submitted in the form of a check. Agencies should submit the check with the "Check Information Form" (PDF). Parent companies should specify each subsidiary agency for which they are registering when submitting the annual fee for more than one agency.

Checks must be made out to: New York State Department of Health

Checks must be sent to:
New York State Department of Health
Empire State Plaza
Corning Tower, Room 1695
Albany, NY 12237

Can DOH provide a W-9 so that an agency can cut a check for the annual registration?

Yes. The Department can provide this document upon request. Send your request to TempAgencyRegistration@health.ny.gov. The form will be provided in PDF format.

Does the agency address need to be an address in New York State?

The address of the agency does not need to be a New York State address.

If the agency's owner(s) do not own any health care entities, is it required to fill out Table 1b?

If a controlling person or family member of a controlling person does not own any health care entities, complete Table 1b by writing "N/A".

How is "family member" defined in Table 1b?

A "family member" is: (i) a spouse or domestic partner, (ii) a child, stepchild, parent or sibling of an employee or his/her spouse or domestic partner or (iii) any other relative currently living with an employee or whose assets the employee controls.

What is an example of "documentation that the agency is of good moral character"?

Applicants should complete the "Moral Character Affirmation" (PDF).

Are conversion fees charged to the health care entity (not the health care personnel) prohibited?

Pursuant to PHL § 2999-jj(3)(d), temporary health care services agencies are prohibited from requiring the payment of liquidated damages, employment fees, or other compensation should health care personnel be permanently hired by a health care entity. This prohibition applies to "any contract with any health care personnel or health care entity or otherwise." As such, "conversion fees" and other similar fees may not be a part of any temporary health care services contracts the agency may have with health care personnel or health care entities.

Can a temporary health care services agency require a health care entity, by contract, to reimburse recruitment and placement costs in the event an employee is hired on a permanent basis by the health care entity?

No. Pursuant to PHL § 2999-jj(3)(d), temporary health care services agencies are prohibited from requiring the payment of liquidated damages, employment fees, or other compensation should health care personnel be permanently hired by a health care entity. This prohibition applies to "any contract with any health care personnel or health care entity or otherwise.” This would include typical recruitment and placement costs, such as, but not limited to, advertising, identifying candidates, recruiting candidates, credentials checks, backgrounds checks, drug testing, and medical clearances.

Are there specific examples or suggested documentation on what the minimum licensing, training, and continuing education are?

Temporary health care services agencies must maintain documentation that all health care personnel are properly licensed and in good standing. Documentation may include, but is not limited to, a copy of personnel's state licensure, education transcripts, certificates of good standing, verification of registration status, copies of a verification search from the State Education Department's website, and/or proof that personnel have completed continuing education requirements.

Does the agency need to submit an Appendix with documentation showing that personnel are properly licensed and in good standing ?

Documentation that personnel meet minimum licensing, training, and continuing education standards must be maintained by temporary health care services agencies as a condition of registration. Pursuant to PHL § 2999-jj(3)(e), these records must be maintained for six years and be made available to the Department upon request. For purposes of the application, applicants will only need to submit the agency's policies on license verification, training, and continuing education.

What makes an administrator "qualified" to operate the agency?

The applicant should be able to demonstrate that the administrator has training, experience or education in a field that qualifies them to oversee the operation of a temporary health care services agency. This may include, but is not limited to, training, experience or education in health care, management, business administration, or human resources.

Are administrators required for agencies' satellite offices outside of NY state?

The law requires that each separate temporary health care services agency location have its own administrator. If an agency has a satellite office located outside of New York State, it will need a separate administrator to register with the Department.

Does an agency need to submit contracts with a different temporary health care services agency?

Pursuant to PHL § 2999-kk, temporary health care services agencies must submit to the Department copies of all contracts between the agency and health care entities to which it assigns or refers health care personnel, and copies of all invoices to health care entities. Contracts with other temporary health care services agencies do not need to be submitted to the Department.

How should agencies submit previously executed contracts with healthcare entities?

Temporary health care services agencies should work expeditiously to update all previously executed contracts with health care entities to bring them into compliance with Article 29-K of the PHL and must document in Tab 4 of the registration form a compliance plan for doing so. Note that executed contracts must be sent to the Department within five business days of their effective date.

Are the requirements for existing contracts, or only for newly established contracts?

Agencies must agree to the requirements for contracts as outlined in Tab 4 of the registration form for all active and existing contracts. If an agency is not currently meeting a requirement, the agency must describe a compliance plan to meet the condition in the tab, utilizing column C in Tab 4.

Does this apply to contracts with healthcare entities outside NY state?

The requirements of Article 29-K of the PHL only apply to contracts with health care entities located within New York State.

Has New York set maximum rates that can be charged by a temporary health care services agency?

No.

Should temporary health care services agencies submit amendments to the initial contracts?

Pursuant to PHL § 2999-kk(3) copies of all contracts between the agency and a health care entity to which it assigns or refers health care personnel must be submitted to the Department. Therefore, any amendments or addendums to an initial agreement (master services agreement, etc.) would need to be submitted to the Department. Note that pursuant to PHL § 2999-kk(3), contracts sent to the Department are not subject to disclosure under Article 6 of the Public Officers Law (Freedom of Information Law).

Is there a specific format for how contracts should be transmitted to the DOH?

There is no specific format for how contracts should be transmitted to the Department, but they must be complete and not redacted. Note that pursuant to PHL § 2999-kk(3), contracts sent to the Department are not subject to disclosure under Article 6 of the Public Officers Law (Freedom of Information Law).

Could an agency submit a report with all active clients and pertinent contract details, rather than entire contracts?

No. Pursuant to PHL § 2999-kk(3), copies of all contracts between the agency and a health care entity to which it assigns or refers health care personnel must be submitted to the Department, in addition to copies of all invoices to health care entities. Contracts must be transmitted to the Department without redactions in order to be considered to be in compliance with the statute. Note that pursuant to PHL § 2999-kk(3), contracts sent to the Department are not subject to disclosure under Article 6 of the Public Officers Law (Freedom of Information Law).

Should agencies include only current employees or both past and current employees?

Pursuant to PHL § 2999-mm, on a quarterly basis, agencies must provide a list of the states and zip codes of the primary residences of health care personnel. This list should include information for all health care personnel that worked at the entity during the quarter.

Should agencies include clerical staff information or just healthcare workers in the quarterly reports?

Health care personnel is defined in PHL § 2999-ii(4) as "nurses, certified nurse aides, and licensed or unlicensed direct care staff provided by the temporary health care services agency to provide temporary services in a health care entity." Information on clerical staff should not be included in quarterly reports.

Are there examples of the administrative charges to be disclosed?

Pursuant to PHL § 2999-mm, temporary health care services agencies must report a full disclosure of charges and compensation. This includes a full description of administrative charges. Administrative charges could encompass a wide range of things, including but not limited to fees charged by an agency for record-keeping; administration of the contract; overhead expenses for things such as rent, utilities, equipment, supplies, insurance policies; or salaries and benefits of administrative staff at the agency.

Do agencies need to submit each invoice sent to New York based clients, even if the invoices are sent weekly?

Copies of all invoices to health care entities must be submitted as an Appendix 8.

Will agencies receive proof of registration submission?

A Department representative will send an email to the agency contact when registration materials have been collected and approved.

How long will it take for registration to be reviewed and approved?

A timeline for approval of registration materials has not yet been determined. While its registration information is under review, an agency can continue to operate in New York State.

Where should additional questions be sent?

Questions should be sent to our team at TempAgencyRegistration@health.ny.gov. Additional questions and answers will be added to this FAQ page as they are received.

Is there any contact number where we can call for guidance?

The Department will be establishing a call line for agencies shortly; this will be added to our website and notice will be sent via our listserv.

How do I sign up for the listserv?

Individuals can send this request to via email to TempAgencyRegistration@health.ny.gov.

What information will be sent via listserv?

Updates related to materials and guidance including but not limited to Q&A responses will be sent via the listserv.

Is information submitted by temporary health care services agencies subject to disclosure under FOIL?

All documents maintained by the Department are subject to FOIL disclosure unless they fit into one or more FOIL exemptions. Upon receipt of a FOIL request, the Department performs a diligent search for responsive documents, which are then reviewed for responsiveness, FOIL exemptions, and legal privileges. Contracts with healthcare entities, which are routinely submitted to the Department by temporary health care services agencies pursuant to Public Health Law Article 29, are specifically protected from disclosure by PHL § 2999-kk(3), and therefore exempt from FOIL disclosure by Public Officers Law § 87(2)(a). Other information, including invoices and quarterly report information, may be subject to FOIL disclosure.

When is the THSA renewal due each year?

Article 29-K of the PHL went into effect on August 1, 2023. A grace period for submitting registration materials was extended to November 15, 2023. Due to the timing of the statute, registration materials are due and renewed, annually, by August 1st. Therefore, all staffing agency registrations will expire on July 31st, and need to be renewed prior to that date.