NY State Senate Bill 2011-S1116

Senate Bill S1116

2011-2012 Legislative Session

Commissions a study regarding the quality of health care services received by foster children in New York state

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Archive: Last Bill Status - In Senate Committee Children And Families Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 04, 2012	referred to children and families
Jan 05, 2011	referred to children and families

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2011-S1116 (ACTIVE) - Details

See Assembly Version of this Bill:: A2500
Current Committee:: Senate Children And Families
Law Section:: Social Services
Versions Introduced in Other Legislative Sessions:: 2009-2010: S5924, A5497
2013-2014: A1977
2015-2016: A3252
2017-2018: A4831
2019-2020: A4980

2011-S1116 (ACTIVE) - Summary

Commissions a study regarding the quality of health care services received by foster children in New York state; provides for a report to be submitted by the commissioner of the office of children and family services detailing the findings of such study.

2011-S1116 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S1116

TITLE OF BILL:
An act
to commission a study regarding the quality of health care services
received by foster children in New York state

PURPOSE OR GENERAL IDEA OF BILL:
Commission a study to gather information from State agencies, foster
care agencies, local districts and advocates to better understand how
the Per-Diem, Fee-for Service and Managed Care financing constructs
affect the health outcomes of children in foster care.

SUMMARY OF SPECIFIC PROVISIONS:
Section one would require the office of children and family services
to contract with an external organization to conduct an evaluation of
the implementation and effectiveness of New York state's health care
delivery system for children in the custody or guardianship of the
state.

Section two would authorize the organization selected to conduct the
evaluation, access to nonidentifiable information from the office of
children and family services, department of health and local social
services district and voluntary agencies for the purpose of the
study. Allow for the collection of supplemental information as needed
for the purpose of the study.

Section three would require the office of children and family service
by June 30, 2010 to submit a report to the Governor, temporary
president of the senate, speaker of the assembly, chairperson of the
senate committee on social services and children and families and
chairperson of the
assembly committee on children and families, and the chairperson of
the senate and assembly committees on health.

JUSTIFICATION:
Studies have shown that in the United States, children entering foster
care have significantly higher rates of chronic and acute medical
problems, developmental delays, and psychological and behavioral
disorders than children within the general population, including
children from low income families. In New York State all children in
foster care who are citizens or permanent residents of the United
States, are eligible for healthcare services including mental health
treatment and behavioral therapies, under Medicaid. New York State
has a three tiered system for providing health care services to
foster children under Medicaid: a per-diem, fee-for-services and
managed care system. Approximately 75 percent of voluntary agencies
use the per-diem system for children place
under their care. Within the per-diem system a set amount of money is
provided to the voluntary foster care agency to cover the cost of a
foster child's medical care, based upon the number of days that
foster child is placed with the agency. The per-diem rate also allows
agencies .to offer health and mental health services on site or use
the rate to hire other medical professionals to work part-time on the
agency's premises. The remaining 25 percent of foster care agencies
opt to use the traditional fee-for services in lieu of the Medicaid
per-diem. The fee for-services Medicaid system allows beneficiaries to


go to any doctor who accepts their Medicaid card. The doctor then
bills Medicaid directly for the service provided. Some agencies
choose to use both the per-diem and fee-for-services to access health
care services which are either not allowed or cannot be afforded
under the agency's per-diem rate. An alternative to the
per-diem/fee-for-service option for Medicaid services is Medicaid
managed Care which is not available to all foster children. Managed
care provides a consistent network of medical providers that treat
both health and mental health care issues. Only foster children that
are in the direct care of the local social
services districts are able to enroll into Medicaid Managed Care,
however, not those placed in volunteer agencies. With the state
placing more children in the care of volunteer agencies, there are a
large number of children in care that are ineligible for Medicaid
Managed Care under current state law, and instead, receive healthcare
services through the per-diem system.

Evidence suggests that when foster care agencies use both the Medicaid
per-diem and fee-for-service billing mechanisms children in care
receive inconsistent health and mental health care services. Whether
this is due to an inadequately low per-diem rate or merely a gradual
evolution of the foster care medical financing construct, this
scattered usage of medical providers and billing arrangements means
that it is unknown whether foster children are receiving all
necessary medical services required by law and regulation. Exploring
whether the Medicaid per-diem/Fee-for-Service system for foster
children are effective in meeting the healthcare needs of New York
State's foster children is an essential first step in identifying a
solution. Although it has been proven that adequate health care for
foster children is vital in ensuring that they become healthy and
productive adults. Currently, many of the children's medical needs
are going untreated and unaccounted for. Gathering more information
from State agencies, foster care agencies, local districts and
advocates to better understand how the Per-Diem, Fee-For-Service and
Managed Care financing constructs affect the health outcomes of these
children in need, will allow policy makers to
make better decisions that will improve the health of children in
foster care.

PRIOR LEGISLATIVE HISTORY:
2009-10:  S.5924/A.5497

FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
Undetermined.

EFFECTIVE DATE:
This act shall take effect immediately.

2011-S1116 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  1116

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             January 5, 2011
                               ___________

Introduced  by  Sens.  PARKER, ADAMS, KRUEGER, PERKINS -- read twice and
  ordered printed, and when printed to be committed to the Committee  on
  Children and Families

AN  ACT  to  commission  a  study  regarding  the quality of health care
  services received by foster children in New York state

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  1.  The commissioner of the office of children and family
services shall contract with an external research organization to evalu-
ate the implementation and effectiveness of New York state's health care
delivery system for children in the care, custody or guardianship of the
office  of  children  and  family  services  or  local  social  services
districts  pursuant  to  articles 3, 7 and 10 of the family court act or
section 358-a, 384-a or 384-b of the social services law.    The  evalu-
ation shall include recommendations for improving the access to, and the
quality  of,  health  and behavioral health services for children in the
care, custody or guardianship of  the  office  of  children  and  family
services  or the local social services district. Such commissioner shall
select such research organization pursuant to a  request  for  proposals
process.  Preference shall be given to an organization based on adequacy
of  the  proposed  research  design,  research staff qualifications, and
availability of non-state dollars to  support  the  project,  and  other
criteria as determined by the commissioner of the office of children and
family services. The evaluation shall include, but not be limited to, an
examination of:
  (a)  the  quality of health and behavioral health services provided to
children in the care, custody or guardianship of the office of  children
and  family  services  or the local social services district, including,
but not limited to, whether children are receiving effective  or  neces-
sary  treatment  in  a  timely  fashion and in accordance with the regu-
lations of the office of children and family services;

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01333-01-1

S. 1116                             2

  (b) the average length of time from  referrals  for  children  in  the
care,  custody  or  guardianship  of  the  office of children and family
services or the local social services district, to receive treatment  to
the date of initial treatment;
  (c)  whether  sufficient  information  is  provided  to educate foster
parents on the health care delivery system for foster children,  includ-
ing identification of providers and appropriate billing arrangements;
  (d) the existence and adequacy of current oversight practice regarding
health  care  services for children in the care, custody or guardianship
of the office of children  and  family  services  or  the  local  social
services  district,  including monitoring or record keeping practices of
voluntary agencies, social services districts, family courts, the office
of children and family services and the department of health;
  (e) whether foster children who receive health care coverage under the
medicaid per-diem system receive adequate health and  behavioral  health
services;
  (f) whether foster children who receive health care coverage under the
medicaid  fee-for  service system receive adequate health and behavioral
health services;
  (g) to what extent the medicaid per-diem is used in  conjunction  with
direct  billing under fee-for service and whether this practice provides
foster children with adequate health and behavioral health services;
  (h) whether foster children who receive health care  services  through
enrollment  in  a medicaid managed care plan receive adequate health and
behavioral health services;
  (i) whether any difficulties exist in accessing prescription drugs for
foster children;
  (j) whether foster children or foster parents  are  being  billed  for
health care services provided to foster children which should be covered
under medicaid;
  (k) the number of voluntary agencies throughout the state that provide
health  care  services  to  foster children in their care through health
care professionals employed by their agency;
  (l) the quality of health care provided by health  care  professionals
hired  by  voluntary  agencies  and the benefits and drawbacks of having
health care services provided by voluntary agencies;
  (m) whether children leaving foster  care  or  placement  in  juvenile
justice  facilities, who would be otherwise eligible for medicaid cover-
age upon leaving placement, experience difficulty in  accessing  transi-
tional medicaid coverage or medicaid coverage in the community; and
  (n) what barriers exist for children in the care, custody or guardian-
ship  of  the office of children and family services or the local social
services district, to access health care services in the community.
  2. Notwithstanding any other law to the contrary, the selected  organ-
ization  shall  have access to necessary non-identifiable data collected
by the office of children and family services, the department of health,
local social  services  districts  and  voluntary  agencies,  and  shall
collect supplemental data as needed to conduct a thorough and comprehen-
sive  evaluation. Data collected shall not reveal the name, social secu-
rity number or any other information which may be used to  identify  the
child or the family of the child.
  3.  The  commissioner  of  the  office of children and family services
shall submit a report detailing the findings of such study to the gover-
nor, the temporary president of the senate, the speaker of the assembly,
and the chairperson of the senate committee on social services, children
and families, the chairperson of the assembly committee on children  and

S. 1116                             3

families  and  the chairpersons of the senate and assembly committees on
health on or before June 30, 2012.
  S 2. This act shall take effect immediately.

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Senate Bill S1116

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Sponsored By

Kevin S. Parker