senate Bill S4253A

Adds certain school based health services to list of services which need not be provided by a managed care program

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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

  • 15 / Mar / 2013
    • REFERRED TO HEALTH
  • 08 / Jan / 2014
    • REFERRED TO HEALTH
  • 30 / Jan / 2014
    • AMEND AND RECOMMIT TO HEALTH
  • 30 / Jan / 2014
    • PRINT NUMBER 4253A

Summary

Adds certain school based health services (i.e., services provided by certain clinics which provide primary health care services within an elementary or secondary public school setting) to the list of services which need not be provided by a managed care program but which shall be continued to be provided outside of managed care programs in accordance with applicable reimbursement methodologies.

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Bill Details

See Assembly Version of this Bill:
A5148A
Versions:
S4253
S4253A
Legislative Cycle:
2013-2014
Current Committee:
Senate Health
Law Section:
Social Services Law
Laws Affected:
Amd ยง364-j, Soc Serv L
Versions Introduced in Previous Legislative Cycles:
2011-2012: A1444, A1444
2009-2010: A1022, A1022
2007-2008: A3600, A3600

Sponsor Memo

BILL NUMBER:S4253A

TITLE OF BILL: An act to amend the social services law, in relation
to school-based health services under managed care programs

PURPOSE OR GENERAL IDEA OF BILL: To assure that Medicaid managed care
enrollees have continued access to school-based health services.

SUMMARY OF SPECIFIC PROVISIONS: Section 1 amends section 364-j(3)(e)
of the Social Services Law by adding a new subparagraph (x) adding
school-based health services to the list of services which need not be
provided by a managed care program.

Section 2 provides for an immediate effective date.

JUSTIFICATION: School-based health centers are recognized as a highly
effective vehicle for delivering crucially needed, timely health care
services to the most vulnerable underserved and uninsured school-age
children. The Department of Health has on several occasions delayed a
requirement that managed care programs contract with school-based
health centers. Managed care programs require each enrollee to choose
a primary care practitioner. But they generally will only contract
with physicians as primary care practitioners. Since school-based
health centers use mostly nurse practitioners, physician's assistants
and certified social workers with back up of physicians and
psychologists or psychiatrists, managed care programs are unlikely to
contract with school-based health centers as primary care providers
for eligible students who are enrolled in managed care. School-based
health centers have become an integral part of the fabric of the
communities where they are located. Often, they are the only
accessible primary care and mental health providers for the most
high-risk children and youth. While this bill would eliminate the
requirement that managed care providers offer school based health
services, it would allow for the establishment of procedures and
linkages which assure that the care of children enrolled in Medicaid
managed care programs is coordinated. This bill maintains a reasonable
balance between the development of managed care programs and the need
to assure continued access to school based health services.

PRIOR LEGISLATIVE HISTORY: Senate: New Bill. Assembly: 1999-00:A.8634
passed the Assembly; 2001-02: A.2531 passed the Assembly; 2003-04:
A.3503 passed the Assembly; 2005-06: A.3270 passed the Assembly; 2007:
A.3600 referred to Social Services; 2008: A.3600 passed Assembly;
2009-10: A.1022 passed the Assembly; 2011-12: A.1444 referred to
Social Services Committee.

FISCAL IMPLICATIONS: None. The Department of Health has been unable to
develop a model for the incorporation of school-based health services
into managed care programs.

EFFECTIVE DATE: Immediate.

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

                                 4253--A

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                             March 15, 2013
                               ___________

Introduced  by  Sens.  MONTGOMERY,  GIPSON, HASSELL-THOMPSON, KENNEDY --
  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 commit-
  tee

AN ACT to amend the social services law,  in  relation  to  school-based
  health services under managed care programs

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

  Section 1.  Subparagraphs (viii) and (ix) of paragraph (d) of subdivi-
sion 3 of section 364-j of  the  social  services  law,  as  amended  by
section  38  of part A of chapter 56 of the laws of 2013, are amended to
read as follows:
  (viii) HIV COBRA case management; [and]
  (ix) THE SERVICES PROVIDED ARE BY  A  CLINIC  LICENSED  UNDER  ARTICLE
TWENTY-EIGHT  OF  THE  PUBLIC  HEALTH  LAW,  OR  SPONSORED BY A FACILITY
LICENSED UNDER SUCH ARTICLE, WHICH PROVIDES PRIMARY CARE SERVICES WITHIN
AN ELEMENTARY OR SECONDARY PUBLIC SCHOOL SETTING; AND
  (X) other services as determined by the commissioner of health.
  S 2. This act shall take effect immediately  provided,  however,  that
the amendments to paragraph (d) of subdivision 3 of section 364-j of the
social services law made by section one of this act shall not affect the
repeal of such section and shall be deemed repealed therewith.



 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04069-03-4

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