S4607

An Act concerning the Regional Hub Program and amending P.L.2019, c.517.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. Section 3 of P.L.2019, c.517 (C.30:4D-8.18) is amended to read as follows:

3. a. The Department of Human Services shall establish a Regional Health Hub Program, and shall designate Regional Health Hubs in appropriate areas of the State, as provided by [this act] P.L.2019, c.517 (C.30:4D-8.16 et seq.) and including at least one area located in Hudson county. The Regional Health Hub Program shall replace the Medicaid Accountable Care Organization Demonstration Project established pursuant to P.L.2011, c.114 (C.30:4D-8.1 et seq.), which is now subject to expiration by law.

b. The following certified accountable care organizations and accountable care look-alike organizations, which are operating in this State as of the effective date of this act, shall be grandfathered into the Regional Health Hub Program, and shall be automatically designated as Regional Health Hubs, for the purposes of [this act] P.L.2019, c.517 (C.30:4D-8.16 et seq.):

(1) the Healthy Greater Newark ACO;

(2) the Trenton Health Team;

(3) the Camden Coalition of Health Care Providers; and

(4) the Health Coalition of Passaic County.

c. The Department of Human Services, in consultation with the Department of Health, shall be authorized to designate additional non-profit organizations to operate as Regional Health Hubs under the Regional Health Hub Program, pursuant to section 4 of [this act] P.L.2019, c.517 (C.30:4D-8.19), as determined to be appropriate.

(cf: P.L.2019, c.517, s.3)

2. Section 6 of P.L.2019, c.517 (C.30:4D-8.21) is amended to read as follows:

6. a. Each designated Regional Health Hub shall engage in the following mandatory activities:

(1) establish, operate, and maintain a health information platform that allows for population-level views and analytics, and patient-level health interventions. Unless annually exempted by the commissioner, each Regional Health Hub's health information platform shall, to the extent practicable, be interoperable with all other Regional Health Hubs' platforms, and with any other Statewide health information platform designated by the commissioner;

(2) convene and obtain relevant input from community stakeholders within the Regional Health Hub's core region. At a minimum, convening activities shall include quarterly opportunities for the active engagement and interaction of relevant stakeholders, including, but not limited to, managed care organizations, local and State government entities, health care and social service providers, community-based organizations, and local consumers of health care;

(3) upon request, provide the department and other State agencies, including the Departments of Health, Children and Families, and Community Affairs, with information and feedback to assist the departments in program design, population analysis, strategic planning, and other appropriate functions; [and]

(4) engage in any other activity that the commissioner deems necessary to achieve the goals of [this act] P.L.2019, c.517 (C.30:4D-8.16 et seq.); and

(5) assume oversight and coordination responsibilities focused on transparency, accountability, regional evaluation, and healthcare access coordination related to hospitals receiving charity care funding within each region. Such responsibilities shall include, but not be limited to:

(a) evaluating regional healthcare needs and identifying gaps in access to care;

(b) analyzing charity care utilization trends such as demographic and zip code-level data;

(d) evaluating appointment wait times and other barriers to timely care;

(e) assessing relevant health outcome trends; and

(f) reporting any findings to the Department of Health.

Nothing in this paragraph shall be construed as authorizing a Regional Health Hub to serve as a fiscal intermediary, administrator, or distributor of charity care funding or as altering the funding mechanism for charity care payments pursuant to P.L.1992, c.160 (C.26:2H-18.51 et al.).

b. Each designated Regional Health Hub shall be authorized to engage in the following activities as necessary either to further the Regional Health Hub's goals or to comport with the provisions of the proposal submitted by the Regional Health Hub to the department pursuant to section 7 of [this act] P.L.2019, c.517 (C.30:4D-8.16 et seq.):

(1) plan and execute population-level and patient-level health interventions;

(2) establish, operate, and maintain, or partner with a third-party who will establish, operate, and maintain, a community resource inventory that is capable of referring and tracking the referral of community members to appropriate services;

(3) perform a health needs assessment on all or part of the population in the Regional Health Hub's core region;

(4) perform quality improvement activities based on population-level data and health needs assessment findings;

(5) develop screening protocols that provide for a comprehensive risk assessment to determine a patient's need for follow-up and wrap-around services related to the social determinants of health;

(6) facilitate the coordination, within the Regional Health Hub's core region, of health care and ancillary services related to the social determinants of health, including, but not limited to, food assistance services, legal services, and other social services, for high-need populations;

(7) provide care management services to the entire population, or to underserved sub-populations, in the Regional Health Hub's core region;

(8) submit reports to the commissioner describing the health needs in the Regional Health Hub's core region, identifying the Regional Health Hub's near and long-term health goals for the core region, and describing the activities that have been undertaken, and the progress that has been made, over the preceding year, by the Regional Health Hub and relevant stakeholders in the core region to improve the effectiveness or efficiency of the core region's health care system; and

(9) engage in any other appropriate activity that the commissioner or Regional Health Hub deems relevant to the attainment of the Regional Health Hub's goals.

c. Nothing in this section shall be deemed to limit the activities that a Regional Health Hub may conduct on behalf of other State departments or funders.

(cf: P.L.2019, c.517, s.6)

3. The Commissioner of Human Services shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), as may be necessary to implement the provisions of this act.

4. This act shall take effect immediately.

STATEMENT

This bill revises current law establishing the Regional Health Hub Program to require the Department of Human Services to designate at least one area located in Hudson county as a Regional Health Hub.

The bill expands the role of Regional Health Hubs to include oversight and coordination responsibilities focused on transparency, accountability, regional evaluation, and healthcare access coordination related to hospitals receiving charity care funding within each region.