senate Bill S3200A

Amended

Relates to financial assistance from the office of victim services for post-exposure prophylaxis treatment for victims of sexual assault

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 11 / Feb / 2011
    • REFERRED TO HEALTH
  • 12 / Apr / 2011
    • REPORTED AND COMMITTED TO FINANCE
  • 02 / Jun / 2011
    • 1ST REPORT CAL.956
  • 06 / Jun / 2011
    • 2ND REPORT CAL.
  • 07 / Jun / 2011
    • ADVANCED TO THIRD READING
  • 14 / Jun / 2011
    • PASSED SENATE
  • 14 / Jun / 2011
    • DELIVERED TO ASSEMBLY
  • 14 / Jun / 2011
    • REFERRED TO WAYS AND MEANS
  • 04 / Jan / 2012
    • DIED IN ASSEMBLY
  • 04 / Jan / 2012
    • RETURNED TO SENATE
  • 04 / Jan / 2012
    • REFERRED TO HEALTH
  • 23 / Jan / 2012
    • AMEND (T) AND RECOMMIT TO HEALTH
  • 23 / Jan / 2012
    • PRINT NUMBER 3200A
  • 31 / Jan / 2012
    • REPORTED AND COMMITTED TO FINANCE
  • 18 / Apr / 2012
    • 1ST REPORT CAL.524
  • 19 / Apr / 2012
    • 2ND REPORT CAL.
  • 25 / Apr / 2012
    • AMENDED 3200B
  • 25 / Apr / 2012
    • ADVANCED TO THIRD READING
  • 15 / May / 2012
    • SUBSTITUTED BY A669C

Summary

Requires financial assistance from the office of victim services for HIV post-exposure prophylaxis treatment for victims of sexual assault.

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Bill Details

Versions:
S3200
S3200A
S3200B
Legislative Cycle:
2011-2012
Law Section:
Public Health Law
Laws Affected:
Amd §2805-i, Pub Health L; amd §§631 & 631-a, Exec L
Versions Introduced in Previous Legislative Cycles:
2009-2010: A2355A
2007-2008: A9915A

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Sponsor Memo

BILL NUMBER:S3200A

TITLE OF BILL:
An act
to amend the public health law and the executive law, in relation to
financial assistance from the office of victim services
for post-exposure
prophylaxis treatment for victims of sexual assault

PURPOSE:
To amend the public health law to enable survivors of sexual assault
who have undergone a forensic rape exam to receive the full Course of
HIV post exposure prophylaxis (PEP) treatment regardless of ability
to pay.

SUMMARY OF PROVISIONS:
This legislation provides for a simplification of payment procedures
for survivors of sexual assault who are found by medical examiners
conducting the Forensic Rape Exam (FRE) to be at risk for HIV/AIDS,
and therefore, in need of PEP as follows: at the time of exam,
survivors deemed at risk will be given a 9-day starter pack of the
PEP. The emergency department where the exam is conducted will bill
and be reimbursed by the OVS as they are currently. The OVS will be
billed for the remaining 21 days of treatment by the appropriate
clinic or in rural areas, as defined by statute, the county health
department.

JUSTIFICATION:
It is imperative to provide treatment to all survivors designated by
Forensic Rape Examiners as at risk for HIV/AIDS. The costs of
treating this HIV/AIDS fall upon the state nearly 90 percent of all
cases, resulting in a dollar amount, per case, that exceeds
preventive treatment by hundreds of thousands of dollars. Removing
the obstacles that stand between sexual assault survivors and PEP
treatment will decrease those individuals' chances of becoming
infected with HIV/AIDS. The recommended time to begin treatment is
within 36 hours of exposure.

Currently, some survivors who have been deemed at risk for HIV/AIDS do
not complete PEP treatment for a number of reasons including:
inability to cover the cost of medication while awaiting
reimbursement from the OVS; inability to fill out requisite
paperwork within three days as a result of paralyzing trauma caused
by the assault; inadequate time between current 3-day starter pack
and appointment with follow-up provider.

By streamlining the process and increasing outreach to assault
survivors who have undergone a forensic exam, this law would make PEP
treatment more accessible. This facilitation of long-term, preventive
care could save the state millions of dollars in treatment costs by
stemming potential HIV/AIDS cases.

LEGISLATIVE HISTORY:
2011: S.3200 Passed Senate, Died in Assembly
2009-2010: S.2680 (Morahan)
2008: S.7306 Passed Senate, Delivered to Governor, Veto
Memo #96, Tabled

FISCAL IMPLICATIONS:
Under the current system, the ova covers costs of PEP treatment in
most cases. The funding comes from restitution funds and federal
grant dollars.
This funding does not come from the state budget. However it is the
state that ends up paying for over 85 percent of the treatment to
those who become HIV positive, as that is the percentage that
qualifies for medical care that is state subsidized. The total cost
for PEP under the FRE provision for the most recent available year
was $180,000. The FRE universe is less than 4,000 persons per year. A
very small percentage of those survivors begin treatment.
There is no reason to anticipate a huge jump in those opting for the
PEP treatment.

EFFECTIVE DATE:
This act shall take effect on the one hundred eightieth day after it
shall become law.

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

                                 3200--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            February 11, 2011
                               ___________

Introduced  by  Sens. HANNON, JOHNSON, KRUEGER, MONTGOMERY, OPPENHEIMER,
  PARKER, SAVINO, SERRANO -- read twice and ordered  printed,  and  when
  printed  to  be committed to the Committee on Health -- recommitted to
  the Committee on Health in accordance with Senate Rule 6,  sec.  8  --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee

AN ACT to amend the public health law and the executive law, in relation
  to financial assistance from the office of victim services  for  post-
  exposure prophylaxis treatment for victims of sexual assault

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

  Section 1. Paragraph (c) of subdivision 1 of  section  2805-i  of  the
public health law, as amended by section 39 of part A-1 of chapter 56 of
the laws of 2010, is amended to read as follows:
  (c) offering and making available appropriate HIV post-exposure treat-
ment therapies in cases where it has been determined, in accordance with
guidelines  issued  by  the commissioner, that a significant exposure to
HIV has occurred, and informing the victim that payment  assistance  for
such  therapies [may be] IS available from the office of victim services
pursuant to the provisions of article twenty-two of the  executive  law;
PROVIDED, HOWEVER, THAT A FORENSIC RAPE EXAMINATION SHALL INCLUDE A NINE
DAY  STARTER  PACK  TO BE PROVIDED BY THE HOSPITAL EMERGENCY ROOM AT THE
TIME OF THE FORENSIC RAPE EXAMINATION. THE HOSPITAL EMERGENCY ROOM SHALL
DETERMINE WHICH CLINIC WITHIN THE HOSPITAL OR IF MORE CONVENIENT FOR THE
VICTIM, ANOTHER HOSPITAL  OR  CLINIC,  WHERE  FOLLOW-UP  CARE  SHALL  BE
PROVIDED.  IN  RURAL  COUNTIES PURSUANT TO SUBDIVISION TWELVE OF SECTION
TWO HUNDRED THIRTY-EIGHT OF THIS CHAPTER, WHERE HOSPITALS  DO  NOT  HAVE
THE  APPROPRIATE  FACILITY  TO  ACCOMMODATE FOLLOW-UP CARE, THE HOSPITAL
EMERGENCY ROOM DEPARTMENT SHALL REFER THE VICTIM TO THE  COUNTY  DEPART-
MENT  OF HEALTH, WHICH, IN TURN SHALL PROVIDE REFERRAL SERVICES FOR SUCH

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03995-03-2

S. 3200--A                          2

FOLLOW-UP CARE.  THE HOSPITALS, CLINICS, AND RURAL COUNTY HEALTH DEPART-
MENTS AS REFERENCED ABOVE ARE THE BILLING ENTITIES.
  S 2. Subdivision 13 of section 631 of the executive law, as amended by
section 22 of part A-1 of chapter 56 of the laws of 2010, is amended and
a new subdivision 13-a is added to read as follows:
  13. Notwithstanding any other provision of law, rule, or regulation to
the  contrary,  when  any New York state accredited hospital, accredited
sexual assault  examiner  program,  or  licensed  health  care  provider
furnishes  services  to  any  sexual assault survivor, including but not
limited to a health care forensic examination in accordance with the sex
offense evidence collection protocol and standards  established  by  the
department of health, such hospital, sexual assault examiner program, or
licensed  healthcare  provider shall provide such services to the person
without charge and shall  bill  the  office  directly.  The  office,  in
consultation  with  the  department of health, shall define the specific
services to be covered by the sexual assault forensic exam reimbursement
fee, which must include at a minimum forensic examiner services,  hospi-
tal  or  healthcare  facility  services related to the exam, and related
laboratory  tests  and  pharmaceuticals.  [Follow-up  HIV  post-exposure
prophylaxis  costs  shall  continue to be reimbursed according to estab-
lished office procedure. The office, in consultation with the department
of health, shall also generate the necessary regulations and  forms  for
the direct reimbursement procedure.] The rate for reimbursement shall be
the  amount  of itemized charges not exceeding eight hundred dollars, to
be reviewed and adjusted annually by the office in consultation with the
department of health. The hospital, sexual assault examiner program,  or
licensed  health  care  provider must accept this fee as payment in full
for these specified services. No additional billing of the survivor  for
said  services is permissible. A sexual assault survivor may voluntarily
assign any private insurance benefits to which she or he is entitled for
the healthcare forensic examination,  in  which  case  the  hospital  or
healthcare  provider  may  not  charge  the  office.  A hospital, sexual
assault examiner program or licensed health care provider shall, at  the
time  of  the  initial  visit,  request assignment of any private health
insurance benefits to which the sexual assault survivor is entitled on a
form prescribed by the office; provided, however,  such  sexual  assault
survivor  shall  be  advised  orally  and  in writing that he or she may
decline to provide such information regarding private  health  insurance
benefits  if  he  or she believes that the provision of such information
would substantially interfere with his or her personal privacy or safety
and in such event, the sexual assault forensic exam fee shall be paid by
the office. [Such sexual assault survivor shall  also  be  advised  that
providing  such  information may provide additional resources to pay for
services to other sexual assault victims.] If  he  or  she  declines  to
provide such health insurance information, he or she shall indicate such
decision  on  the form provided by the hospital, sexual assault examiner
program or licensed health care provider, which form shall be prescribed
by the office.
  13-A. NOTWITHSTANDING ANY OTHER PROVISIONS OF LAW, RULE, OR REGULATION
TO THE CONTRARY, WHEN ANY BILLING ENTITY PROVIDES PROPHYLACTIC TREATMENT
FOR SIGNIFICANT POSSIBLE EXPOSURE TO HIV TO A VICTIM OF  SEXUAL  ASSAULT
AS PRESCRIBED BY A LICENSED HEALTHCARE PROVIDER, SUCH TREATMENT SHALL BE
PROVIDED  TO  THE  PERSON WITHOUT CHARGE AND THE PHARMACY SHALL BILL THE
OFFICE DIRECTLY. THE OFFICE, IN  CONSULTATION  WITH  THE  DEPARTMENT  OF
HEALTH,  SHALL  GENERATE  THE  NECESSARY  REGULATIONS  AND FORMS FOR THE
DIRECT REIMBURSEMENT PROCEDURE. THE  RATE  FOR  REIMBURSEMENT  SHALL  BE

S. 3200--A                          3

ESTABLISHED AND REVIEWED AND ADJUSTED AT LEAST ANNUALLY BY THE OFFICE IN
CONSULTATION  WITH  THE  DEPARTMENT  OF  HEALTH. THE BILLING ENTITY MUST
ACCEPT THIS FEE AS PAYMENT  IN  FULL  FOR  THE  SPECIFIED  POST-EXPOSURE
PROPHYLACTIC  TREATMENT THERAPIES. NO ADDITIONAL BILLING OF THE SURVIVOR
FOR SAID MEDICATIONS IS  PERMISSIBLE.  A  SEXUAL  ASSAULT  SURVIVOR  MAY
VOLUNTARILY  ASSIGN ANY PRIVATE INSURANCE BENEFITS TO WHICH SHE OR HE IS
ENTITLED FOR THE PROPHYLACTIC MEDICATIONS, IN  WHICH  CASE  THE  BILLING
ENTITY  MAY  NOT CHARGE THE OFFICE.  A BILLING ENTITY SHALL, AT THE TIME
OF THE INITIAL VISIT, REQUEST ASSIGNMENT OF ANY PRIVATE HEALTH INSURANCE
BENEFITS TO WHICH THE SEXUAL ASSAULT SURVIVOR  IS  ENTITLED  ON  A  FORM
PRESCRIBED  BY THE OFFICE; PROVIDED, HOWEVER, SUCH SEXUAL ASSAULT SURVI-
VOR SHALL BE ADVISED ORALLY AND IN WRITING THAT HE OR SHE MAY DECLINE TO
PROVIDE SUCH INFORMATION REGARDING PRIVATE HEALTH INSURANCE BENEFITS  IF
HE OR SHE BELIEVES THAT THE PROVISION OF SUCH INFORMATION WOULD SUBSTAN-
TIALLY INTERFERE WITH HIS OR HER PERSONAL PRIVACY OR SAFETY AND, IN SUCH
EVENT,  THE  PROPHYLACTIC TREATMENT FEE SHALL BE PAID BY THE OFFICE.  IF
HE OR SHE DECLINES TO PROVIDE SUCH HEALTH INSURANCE INFORMATION,  HE  OR
SHE  SHALL  INDICATE  SUCH  DECISION ON THE FORM PROVIDED BY THE BILLING
ENTITY, WHICH FORM SHALL BE PRESCRIBED BY THE  OFFICE.    THE  NINE  DAY
STARTER  PACK PROVIDED TO THE VICTIM PURSUANT TO PARAGRAPH (C) OF SUBDI-
VISION ONE OF SECTION TWENTY-EIGHT HUNDRED FIVE-I OF THE  PUBLIC  HEALTH
LAW SHALL BE CONSIDERED PART OF THE FORENSIC RAPE EXAMINATION AND BILLED
ACCORDINGLY.  FOR THE REMAINING TWENTY-ONE DAYS OF TREATMENT, THE APPRO-
PRIATE CLINIC OR IN A RURAL AREA, THE COUNTY DEPARTMENT OF HEALTH, SHALL
BILL THE OFFICE OF VICTIM SERVICES AND BE REIMBURSED BY SUCH OFFICE.  IF
THE VICTIM IS NOT SEEKING REIMBURSEMENT FROM THE OFFICE, SUCH VICTIM CAN
CHOOSE FOLLOW-UP CARE BY ATTENDING THE APPROPRIATE CLINIC OR  SEEKING  A
PROVIDER OF HIS OR HER CHOICE.
  S  3. Paragraph (b) of subdivision 2 of section 631-a of the executive
law, as amended by section 27 of part A-1 of chapter 56 of the  laws  of
2010, is amended to read as follows:
  (b)  These  regulations shall also provide for services including, but
not limited to:
  (i) assistance to claimants seeking crime victims  compensation  bene-
fits;
  (ii) referrals, crisis intervention and other counseling services;
  (iii) services to elderly victims and to child victims and their fami-
lies;
  (iv) transportation and household assistance; and
  (v)  outreach  to  the  community  and  education  and training of law
enforcement and other criminal justice officials to the needs  of  crime
victims;
  (VI)  PROPHYLACTIC  TREATMENT  THERAPIES  IN  CASES  WHERE IT HAS BEEN
DETERMINED THAT A SIGNIFICANT EXPOSURE TO HIV HAS OCCURRED; AND
  (VII) IDENTIFYING HEALTH CARE  PROVIDERS  ACROSS  THE  STATE  WHO  CAN
PROVIDE  FOLLOW-UP CARE FOR VICTIMS INCLUDING BUT NOT LIMITED TO HOW AND
WHERE TO ACCESS HIV POST-EXPOSURE PROPHYLAXIS.
  S 4. This act shall take effect on the one hundred eightieth day after
it shall have become a law.

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