Senate Bill S5273

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

                                 5273--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             April 27, 2009
                               ___________

Introduced  by  Sen.  MONTGOMERY  -- 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, the insurance law and the social
  services law, in relation to the  provision  of  child  abuse  medical
  services at child advocacy centers and reimbursement therefor

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

  Section 1.  Short title. This act shall be known and may be  cited  as
the "child abuse medical services act".
  S  2.    Legislative intent. The legislature hereby finds and declares
that a child or adolescent who has been sexually abused needs  immediate
medical attention and treatment. It is critical, therefore, that a child
or  adolescent victimized by sexual assault, misconduct, or exploitation
has direct access to a medical provider  who  is  specially  trained  to
evaluate,  diagnose,  and  treat  children and adolescents who have been
sexually abused. Furthermore,  medical  services  must  be  specifically
tailored  to  the  health,  mental health, and social needs of an abused
child or adolescent. Child advocacy centers, accredited by the  National
Children's Alliance and recognized by the New York state office of chil-
dren  and  family services, provide such specialized medical services to
abused and maltreated children and adolescents. Child  advocacy  centers
provide  trained  and experienced medical providers who are members of a
multi-disciplinary team located in a facility dedicated to children  and
adolescents  who  have  been  abused  or  maltreated  where children and
adolescents can find timely, complete, sensitive medical help,  therapy,
and  support. To ensure abused children and adolescents direct access to
child abuse medical providers at child advocacy centers and  the  avail-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02552-02-0

              

S. 5273--A                          2

ability  of such services, the legislature hereby enacts the child abuse
medical services act.
  S  3.  The public health law is amended by adding a new section 4406-f
to read as follows:
  S 4406-F. ACCESS TO CHILD ABUSE MEDICAL PROVIDERS  AT  CHILD  ADVOCACY
CENTERS.  1. FOR THE PURPOSES OF THIS SECTION, THE FOLLOWING TERMS SHALL
HAVE THE FOLLOWING MEANINGS:
  A. "CHILD ABUSE MEDICAL PROVIDER" MEANS  A  PHYSICIAN  LICENSED  UNDER
ARTICLE  ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, NURSE PRACTITIONER
CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW,  OR
PHYSICIAN  ASSISTANT  OR SPECIALIST ASSISTANT LICENSED UNDER ARTICLE ONE
HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW TO PRACTICE IN  THE  STATE  OF
NEW  YORK  WHO  HAS  COMPLETED  A CHILD ABUSE MEDICAL PROVIDER EDUCATION
PROGRAM AND PROVIDES MEDICAL ASSESSMENT AND SERVICES  TO  CHILDREN,  WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED, AT A CHILD ADVOCACY CENTER.
  B. "CHILD ABUSE MEDICAL PROVIDER EDUCATION PROGRAM" MEANS A PROGRAM OF
EDUCATION  DEVELOPED  AND  IMPLEMENTED OR APPROVED BY THE DEPARTMENT, IN
CONSULTATION WITH THE OFFICE OF CHILDREN AND  FAMILY  SERVICES,  SPECIF-
ICALLY  TO  TRAIN  PHYSICIANS,  NURSE  PRACTITIONERS,  AND PHYSICIAN AND
SPECIALIST ASSISTANTS LICENSED TO PRACTICE PURSUANT TO  TITLE  EIGHT  OF
THE  EDUCATION  LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT OF ABUSED
AND MALTREATED CHILDREN.
  C. "CHILD ADVOCACY CENTER" MEANS A LOCAL OR REGIONAL MULTIDISCIPLINARY
TEAM FULLY ACCREDITED BY THE NATIONAL CHILDREN'S ALLIANCE  AND  APPROVED
BY  THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR THE PURPOSE OF INVES-
TIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  D. "CHILD SEXUAL ABUSE" MEANS ANY OF THE OFFENSES DESCRIBED IN ARTICLE
ONE HUNDRED THIRTY, TWO HUNDRED THIRTY, OR TWO  HUNDRED  SIXTY-THREE  OF
THE  PENAL  LAW WHEN COMMITTED AGAINST A PERSON LESS THAN EIGHTEEN YEARS
OF AGE.
  E. "MEDICAL ASSESSMENT" MEANS THE EVALUATION, DIAGNOSIS, AND TREATMENT
OF A CHILD BY A CHILD ABUSE MEDICAL PROVIDER, WHICH INCLUDES BUT IS  NOT
LIMITED  TO  A THOROUGH MEDICAL HISTORY AND COMPLETE PHYSICAL AND MENTAL
HEALTH EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD HAS BEEN SEXUALLY
ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY APPROPRIATE FOLLOW-UP
FOR THE CHILD PURSUANT TO A  PROTOCOL  APPROVED  BY  THE  DEPARTMENT  IN
CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES.
  2.  NO  CHILD  WHO  HAS BEEN OR MAY HAVE BEEN SEXUALLY ABUSED SHALL BE
DENIED DIRECT ACCESS TO A CHILD ABUSE MEDICAL PROVIDER AT A CHILD  ADVO-
CACY  CENTER.  A  HEALTH MAINTENANCE ORGANIZATION SHALL NOT DENY A CHILD
DIRECT ACCESS TO A CHILD ABUSE MEDICAL  PROVIDER  AT  A  CHILD  ADVOCACY
CENTER FOR A MEDICAL ASSESSMENT OR LIMIT SUCH ACCESS WHEN:
  A.  A  CHILD  DISCLOSES SEXUAL ABUSE TO A PARENT, OTHER PERSON LEGALLY
RESPONSIBLE FOR THE CARE OF THE CHILD AS DEFINED  BY  THE  FAMILY  COURT
ACT,  OR A PERSON OR OFFICIAL REQUIRED TO REPORT SEXUAL ABUSE OF A CHILD
PURSUANT TO SECTION FOUR HUNDRED THIRTEEN OF THE SOCIAL SERVICES LAW;
  B. A PARENT, OTHER PERSON LEGALLY RESPONSIBLE FOR CARE OF THE CHILD AS
DEFINED BY THE FAMILY COURT ACT, OR A PERSON OR  OFFICIAL  ACTING  IN  A
PROFESSIONAL  CAPACITY REQUIRED TO REPORT SEXUAL ABUSE OF A CHILD PURSU-
ANT TO SECTION FOUR HUNDRED THIRTEEN OF  THE  SOCIAL  SERVICES  LAW  HAS
REASONABLE  CAUSE  TO  SUSPECT  THAT THE CHILD HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED;
  C. A CHILD PROTECTIVE AGENCY,  AS  DEFINED  IN  SECTION  ONE  THOUSAND
TWELVE  OF  THE FAMILY COURT ACT, HAS REASONABLE CAUSE TO BELIEVE THAT A
CHILD IN ITS CUSTODY HAS BEEN OR MAY HAVE BEEN SEXUALLY ABUSED; OR
  D. A COURT ORDER DIRECTS A MEDICAL ASSESSMENT OF A CHILD.

S. 5273--A                          3

  3. IT SHALL BE THE DUTY OF THE ADMINISTRATIVE OFFICER OR OTHER  PERSON
IN CHARGE OF EACH HEALTH MAINTENANCE ORGANIZATION TO:
  A.  ADVISE  EACH  ENROLLEE,  IN  WRITING,  OF  THE  PROVISIONS OF THIS
SECTION, AND
  B.  ESTABLISH, AND DISCLOSE TO  ALL  ENROLLEES,  PARTICIPATING  HEALTH
CARE  PROVIDERS,  THE COMMISSIONER, AND THE SUPERINTENDENT OF INSURANCE,
METHODS OF ENSURING THAT A CHILD COVERED UNDER THE PLAN WHO HAS  OR  MAY
HAVE  BEEN  SEXUALLY  ABUSED  HAS  DIRECT  ACCESS TO CHILD ABUSE MEDICAL
PROVIDERS AT CHILD ADVOCACY CENTERS.
  4. THE AMOUNT OF REIMBURSEMENT WHICH  SHALL  BE  PAID  FOR  A  MEDICAL
ASSESSMENT OF A CHILD BY A CHILD ABUSE MEDICAL PROVIDER AT A CHILD ADVO-
CACY  CENTER  SHALL  EQUAL  THE AMOUNT THAT WOULD BE PAID TO A QUALIFIED
PROVIDER WITHIN THE PLAN. THERE SHALL  BE  NO  ADDITIONAL  COST  TO  THE
INSURED  BEYOND  WHAT  THE  INSURED  WOULD  OTHERWISE  PAY  FOR SERVICES
RECEIVED WITHIN THE NETWORK.
  S 4. Subdivision 1 of section 4408 of the public health law is amended
by adding a new paragraph (p-2) to read as follows:
  (P-2) NOTICE THAT A CHILD ENROLLEE WHO HAS BEEN OR MAY HAVE BEEN SEXU-
ALLY ABUSED SHALL HAVE DIRECT ACCESS TO A CHILD ABUSE  MEDICAL  PROVIDER
AT A CHILD ADVOCACY CENTER;
  S 5. Subsection (i) of section 3216 of the insurance law is amended by
adding a new paragraph 27 to read as follows:
  (27)  (A) EVERY POLICY WHICH PROVIDES COVERAGE FOR HOSPITAL, SURGICAL,
OR MEDICAL CARE SHALL PROVIDE THE FOLLOWING COVERAGE  FOR  CHILD  SEXUAL
ABUSE PURSUANT TO THIS PARAGRAPH.
  (B) FOR THE PURPOSES OF THIS PARAGRAPH, THE FOLLOWING TERMS SHALL HAVE
THE FOLLOWING MEANINGS:
  (I)  "CHILD  ABUSE  MEDICAL PROVIDER" MEANS A PHYSICIAN LICENSED UNDER
ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, NURSE  PRACTITIONER
CERTIFIED  UNDER SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW, OR
PHYSICIAN ASSISTANT OR SPECIALIST ASSISTANT LICENSED UNDER  ARTICLE  ONE
HUNDRED  THIRTY-ONE-B  OF  THE EDUCATION LAW TO PRACTICE IN THE STATE OF
NEW YORK WHO HAS COMPLETED A  CHILD  ABUSE  MEDICAL  PROVIDER  EDUCATION
PROGRAM  AND  PROVIDES  MEDICAL ASSESSMENT AND SERVICES TO CHILDREN, WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED, AT A CHILD ADVOCACY CENTER.
  (II) "CHILD ABUSE MEDICAL PROVIDER EDUCATION PROGRAM" MEANS A  PROGRAM
OF  EDUCATION DEVELOPED AND IMPLEMENTED OR APPROVED BY THE DEPARTMENT OF
HEALTH, IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES,
SPECIFICALLY TO TRAIN PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN AND
SPECIALIST ASSISTANTS LICENSED TO PRACTICE PURSUANT TO  TITLE  EIGHT  OF
THE  EDUCATION  LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT OF ABUSED
AND MALTREATED CHILDREN.
  (III) "CHILD ADVOCACY CENTER" MEANS A LOCAL OR REGIONAL MULTIDISCIPLI-
NARY TEAM FULLY ACCREDITED  BY  THE  NATIONAL  CHILDREN'S  ALLIANCE  AND
APPROVED  BY  THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR THE PURPOSE
OF INVESTIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  (IV) "CHILD SEXUAL ABUSE" MEANS ANY OF THE OFFENSES DESCRIBED IN ARTI-
CLE ONE HUNDRED THIRTY, TWO HUNDRED THIRTY, OR TWO  HUNDRED  SIXTY-THREE
OF  THE  PENAL  LAW  WHEN  COMMITTED AGAINST A PERSON LESS THAN EIGHTEEN
YEARS OF AGE.
  (V) "MEDICAL ASSESSMENT" MEANS THE EVALUATION, DIAGNOSIS,  AND  TREAT-
MENT OF A CHILD BY A CHILD ABUSE MEDICAL PROVIDER, WHICH INCLUDES BUT IS
NOT  LIMITED  TO  A  THOROUGH  MEDICAL HISTORY AND COMPLETE PHYSICAL AND
MENTAL HEALTH EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD  HAS  BEEN
SEXUALLY  ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY APPROPRIATE
FOLLOW-UP FOR THE CHILD PURSUANT TO A PROTOCOL APPROVED BY  THE  DEPART-

S. 5273--A                          4

MENT  OF  HEALTH  IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY
SERVICES.
  (C)  NO  POLICY  SHALL  DENY  TO A CHILD WHO HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED DIRECT ACCESS TO A CHILD ABUSE  MEDICAL  PROVIDER  AT  A
CHILD  ADVOCACY  CENTER  FOR  A  MEDICAL ASSESSMENT OR LIMIT SUCH ACCESS
WHEN:
  (I) A CHILD DISCLOSES SEXUAL ABUSE TO A PARENT, OTHER  PERSON  LEGALLY
RESPONSIBLE  FOR  THE  CARE  OF THE CHILD AS DEFINED BY THE FAMILY COURT
ACT, OR A PERSON OR OFFICIAL REQUIRED TO REPORT SEXUAL ABUSE OF A  CHILD
PURSUANT TO SECTION FOUR HUNDRED THIRTEEN OF THE SOCIAL SERVICES LAW;
  (II)  A PARENT, OTHER PERSON LEGALLY RESPONSIBLE FOR CARE OF THE CHILD
AS DEFINED IN THE FAMILY COURT ACT, OR A PERSON OR OFFICIAL ACTING IN  A
PROFESSIONAL  CAPACITY REQUIRED TO REPORT SEXUAL ABUSE OF A CHILD PURSU-
ANT TO SECTION FOUR HUNDRED THIRTEEN OF  THE  SOCIAL  SERVICES  LAW  HAS
REASONABLE  CAUSE  TO  SUSPECT  THAT THE CHILD HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED;
  (III) A CHILD PROTECTIVE AGENCY, AS DEFINED IN  SECTION  ONE  THOUSAND
TWELVE  OF  THE FAMILY COURT ACT, HAS REASONABLE CAUSE TO BELIEVE THAT A
CHILD IN ITS CUSTODY HAS BEEN OR MAY HAVE BEEN SEXUALLY ABUSED; OR
  (IV) A COURT ORDER DIRECTS A MEDICAL ASSESSMENT OF A CHILD.
  S 6. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 16 to read as follows:
  (16) (A) EVERY INSURER DELIVERING A GROUP OR BLANKET POLICY OR ISSUING
A GROUP OR BLANKET POLICY FOR DELIVERY  IN  THIS  STATE  WHICH  PROVIDES
COVERAGE  FOR  HOSPITAL,  SURGICAL,  OR  MEDICAL  CARE SHALL PROVIDE THE
FOLLOWING COVERAGE FOR CHILD SEXUAL ABUSE PURSUANT TO THIS PARAGRAPH.
  (B) FOR THE PURPOSES OF THIS PARAGRAPH, THE FOLLOWING TERMS SHALL HAVE
THE FOLLOWING MEANINGS:
  (I) "CHILD ABUSE MEDICAL PROVIDER" MEANS A  PHYSICIAN  LICENSED  UNDER
ARTICLE  ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, NURSE PRACTITIONER
CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW,  OR
PHYSICIAN  ASSISTANT  OR SPECIALIST ASSISTANT LICENSED UNDER ARTICLE ONE
HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW TO PRACTICE IN  THE  STATE  OF
NEW  YORK  WHO  HAS  COMPLETED  A CHILD ABUSE MEDICAL PROVIDER EDUCATION
PROGRAM AND PROVIDES MEDICAL ASSESSMENT AND SERVICES  TO  CHILDREN,  WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED, AT A CHILD ADVOCACY CENTER.
  (II)  "CHILD ABUSE MEDICAL PROVIDER EDUCATION PROGRAM" MEANS A PROGRAM
OF EDUCATION DEVELOPED AND IMPLEMENTED OR APPROVED BY THE DEPARTMENT  OF
HEALTH, IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES,
SPECIFICALLY TO TRAIN PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN AND
SPECIALIST  ASSISTANTS  LICENSED  TO PRACTICE PURSUANT TO TITLE EIGHT OF
THE EDUCATION LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT  OF  ABUSED
AND MALTREATED CHILDREN.
  (III) "CHILD ADVOCACY CENTER" MEANS A LOCAL OR REGIONAL MULTIDISCIPLI-
NARY  TEAM  FULLY  ACCREDITED  BY  THE  NATIONAL CHILDREN'S ALLIANCE AND
APPROVED BY THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR  THE  PURPOSE
OF INVESTIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  (IV) "CHILD SEXUAL ABUSE" MEANS ANY OF THE OFFENSES DESCRIBED IN ARTI-
CLE  ONE  HUNDRED THIRTY, TWO HUNDRED THIRTY, OR TWO HUNDRED SIXTY-THREE
OF THE PENAL LAW WHEN COMMITTED AGAINST  A  PERSON  LESS  THAN  EIGHTEEN
YEARS OF AGE.
  (V)  "MEDICAL  ASSESSMENT" MEANS THE EVALUATION, DIAGNOSIS, AND TREAT-
MENT OF A CHILD BY A CHILD ABUSE MEDICAL PROVIDER, WHICH INCLUDES BUT IS
NOT LIMITED TO A THOROUGH MEDICAL  HISTORY  AND  COMPLETE  PHYSICAL  AND
MENTAL  HEALTH  EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD HAS BEEN
SEXUALLY ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY  APPROPRIATE

S. 5273--A                          5

FOLLOW-UP  FOR  THE CHILD PURSUANT TO A PROTOCOL APPROVED BY THE DEPART-
MENT OF HEALTH IN CONSULTATION WITH THE OFFICE OF  CHILDREN  AND  FAMILY
SERVICES.
  (C)  NO  POLICY  SHALL  DENY  TO A CHILD WHO HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED DIRECT ACCESS TO A CHILD ABUSE  MEDICAL  PROVIDER  AT  A
CHILD  ADVOCACY  CENTER  FOR  A  MEDICAL ASSESSMENT OR LIMIT SUCH ACCESS
WHEN:
  (I) A CHILD DISCLOSES SEXUAL ABUSE TO A PARENT, OTHER  PERSON  LEGALLY
RESPONSIBLE  FOR  THE  CARE  OF THE CHILD AS DEFINED BY THE FAMILY COURT
ACT, OR A PERSON OR OFFICIAL REQUIRED TO REPORT SEXUAL ABUSE OF A  CHILD
PURSUANT TO SECTION FOUR HUNDRED THIRTEEN OF THE SOCIAL SERVICES LAW;
  (II)  A PARENT, OTHER PERSON LEGALLY RESPONSIBLE FOR CARE OF THE CHILD
AS DEFINED IN THE FAMILY COURT ACT, OR A PERSON OR OFFICIAL ACTING IN  A
PROFESSIONAL  CAPACITY REQUIRED TO REPORT SEXUAL ABUSE OF A CHILD PURSU-
ANT TO SECTION FOUR HUNDRED THIRTEEN OF  THE  SOCIAL  SERVICES  LAW  HAS
REASONABLE  CAUSE  TO  SUSPECT  THAT THE CHILD HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED;
  (III) A CHILD PROTECTIVE AGENCY, AS DEFINED IN  SECTION  ONE  THOUSAND
TWELVE  OF  THE FAMILY COURT ACT, HAS REASONABLE CAUSE TO BELIEVE THAT A
CHILD IN ITS CUSTODY HAS BEEN OR MAY HAVE BEEN SEXUALLY ABUSED; OR
  (IV) A COURT ORDER DIRECTS A MEDICAL ASSESSMENT OF A CHILD.
  S 7. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (gg) to read as follows:
  (GG)  (1)  A MEDICAL EXPENSE INDEMNITY CORPORATION, A HOSPITAL SERVICE
CORPORATION OR A HEALTH SERVICE CORPORATION WHICH PROVIDES COVERAGE  FOR
HOSPITAL, SURGICAL, OR MEDICAL CARE SHALL PROVIDE THE FOLLOWING COVERAGE
FOR CHILD SEXUAL ABUSE.
  (2) FOR THE PURPOSES OF THIS SUBSECTION THE FOLLOWING TERMS SHALL HAVE
THE FOLLOWING MEANINGS:
  (A)  "CHILD  ABUSE  MEDICAL PROVIDER" MEANS A PHYSICIAN LICENSED UNDER
ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, NURSE  PRACTITIONER
CERTIFIED  UNDER SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW, OR
PHYSICIAN ASSISTANT OR SPECIALIST ASSISTANT LICENSED UNDER  ARTICLE  ONE
HUNDRED  THIRTY-ONE-B  OF  THE EDUCATION LAW TO PRACTICE IN THE STATE OF
NEW YORK WHO HAS COMPLETED A  CHILD  ABUSE  MEDICAL  PROVIDER  EDUCATION
PROGRAM  AND  PROVIDES  MEDICAL ASSESSMENT AND SERVICES TO CHILDREN, WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED, AT A CHILD ADVOCACY CENTER.
  (B) "CHILD ABUSE MEDICAL PROVIDER EDUCATION PROGRAM" MEANS  A  PROGRAM
OF  EDUCATION DEVELOPED AND IMPLEMENTED OR APPROVED BY THE DEPARTMENT OF
HEALTH, IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES,
SPECIFICALLY TO TRAIN PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN AND
SPECIALIST ASSISTANTS LICENSED TO PRACTICE PURSUANT TO  TITLE  EIGHT  OF
THE  EDUCATION  LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT OF ABUSED
AND MALTREATED CHILDREN.
  (C) "CHILD ADVOCACY CENTER" MEANS A LOCAL OR  REGIONAL  MULTIDISCIPLI-
NARY  TEAM  FULLY  ACCREDITED  BY  THE  NATIONAL CHILDREN'S ALLIANCE AND
APPROVED BY THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR  THE  PURPOSE
OF INVESTIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  (D)  "CHILD SEXUAL ABUSE" MEANS ANY OF THE OFFENSES DESCRIBED IN ARTI-
CLE ONE HUNDRED THIRTY, TWO HUNDRED THIRTY, OR TWO  HUNDRED  SIXTY-THREE
OF  THE  PENAL  LAW  WHEN  COMMITTED AGAINST A PERSON LESS THAN EIGHTEEN
YEARS OF AGE.
  (E) "MEDICAL ASSESSMENT" MEANS THE EVALUATION, DIAGNOSIS,  AND  TREAT-
MENT OF A CHILD BY A CHILD ABUSE MEDICAL PROVIDER, WHICH INCLUDES BUT IS
NOT  LIMITED  TO  A  THOROUGH  MEDICAL HISTORY AND COMPLETE PHYSICAL AND
MENTAL HEALTH EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD  HAS  BEEN

S. 5273--A                          6

SEXUALLY  ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY APPROPRIATE
FOLLOW-UP FOR THE CHILD PURSUANT TO A PROTOCOL APPROVED BY  THE  DEPART-
MENT  OF  HEALTH  IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY
SERVICES.
  (3)  NO  POLICY  SHALL  DENY  TO A CHILD WHO HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED DIRECT ACCESS TO A CHILD ABUSE  MEDICAL  PROVIDER  AT  A
CHILD  ADVOCACY  CENTER  FOR  A  MEDICAL ASSESSMENT OR LIMIT SUCH ACCESS
WHEN:
  (I) A CHILD DISCLOSES SEXUAL ABUSE TO A PARENT, OTHER  PERSON  LEGALLY
RESPONSIBLE  FOR  THE  CARE  OF THE CHILD AS DEFINED BY THE FAMILY COURT
ACT, OR A PERSON OR OFFICIAL REQUIRED TO REPORT SEXUAL ABUSE OF A  CHILD
PURSUANT TO SECTION FOUR HUNDRED THIRTEEN OF THE SOCIAL SERVICES LAW;
  (II)  A PARENT, OTHER PERSON LEGALLY RESPONSIBLE FOR CARE OF THE CHILD
AS DEFINED IN THE FAMILY COURT ACT, OR A PERSON OR OFFICIAL ACTING IN  A
PROFESSIONAL  CAPACITY REQUIRED TO REPORT SEXUAL ABUSE OF A CHILD PURSU-
ANT TO SECTION FOUR HUNDRED THIRTEEN OF  THE  SOCIAL  SERVICES  LAW  HAS
REASONABLE  CAUSE  TO  SUSPECT  THAT THE CHILD HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED;
  (III) A CHILD PROTECTIVE AGENCY, AS DEFINED IN  SECTION  ONE  THOUSAND
TWELVE  OF  THE FAMILY COURT ACT, HAS REASONABLE CAUSE TO BELIEVE THAT A
CHILD IN ITS CUSTODY HAS BEEN OR MAY HAVE BEEN SEXUALLY ABUSED; OR
  (IV) A COURT ORDER DIRECTS A MEDICAL ASSESSMENT OF A CHILD.
  S 8. Paragraphs 16 and 17 of subsection (a) of section 3217-a  of  the
insurance  law, as added by chapter 705 of the laws of 1996, are amended
and a new paragraph 18 is added to read as follows:
  (16) notice of all appropriate mailing addresses and telephone numbers
to be utilized by insureds seeking information or authorization; [and]
  (17) where applicable, a listing by specialty, which may be in a sepa-
rate document that is updated annually, of the name, address, and  tele-
phone  number  of all participating providers, including facilities, and
in addition, in the case of physicians, board certification[.]; AND
  (18)  WHERE  APPLICABLE,  NOTICE  OF  THE  PROVISIONS   OF   PARAGRAPH
TWENTY-SEVEN  OF  SUBSECTION  (I)  OF SECTION THREE THOUSAND TWO HUNDRED
SIXTEEN AND PARAGRAPH SIXTEEN OF SUBSECTION (K) OF SECTION  THREE  THOU-
SAND  TWO  HUNDRED TWENTY-ONE OF THIS ARTICLE AND OF METHODS OF ENSURING
THAT A CHILD COVERED UNDER THE POLICY WHO HAS  BEEN  OR  MAY  HAVE  BEEN
SEXUALLY  ABUSED  HAS  DIRECT ACCESS TO CHILD ABUSE MEDICAL PROVIDERS AT
CHILD ADVOCACY CENTERS.
  S 9. Paragraphs 17 and 18 of subsection (a) of  section  4324  of  the
insurance  law, as added by chapter 705 of the laws of 1996, are amended
and a new paragraph 19 is added to read as follows:
  (17) where applicable, a listing by specialty, which may be in a sepa-
rate document that is updated annually, of the name, address, and  tele-
phone  number  of all participating providers, including facilities, and
in addition, in the case of physicians, board certification; [and]
  (18) a description of the mechanisms by which subscribers may  partic-
ipate in the development of the policies of the corporation[.]; AND
  (19)  WHERE APPLICABLE, NOTICE OF THE PROVISIONS OF SUBSECTION (GG) OF
SECTION FOUR THOUSAND THREE HUNDRED THREE OF THIS ARTICLE AND OF METHODS
OF ENSURING THAT A CHILD COVERED UNDER THE POLICY WHO HAS  BEEN  OR  MAY
HAVE  BEEN  SEXUALLY  ABUSED  HAS  DIRECT  ACCESS TO CHILD ABUSE MEDICAL
PROVIDERS AT CHILD ADVOCACY CENTERS.
  S 10. Subdivision 1 of section 364-j of the  social  services  law  is
amended  by adding five new paragraphs (z), (aa), (bb), (cc) and (dd) to
read as follows:

S. 5273--A                          7

  (Z) "CHILD ABUSE MEDICAL PROVIDER". A PHYSICIAN LICENSED UNDER ARTICLE
ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, NURSE  PRACTITIONER  CERTI-
FIED  UNDER  SECTION  SIXTY-NINE  HUNDRED  TEN  OF THE EDUCATION LAW, OR
PHYSICIAN ASSISTANT OR SPECIALIST ASSISTANT LICENSED UNDER  ARTICLE  ONE
HUNDRED  THIRTY-ONE-B  OF  THE EDUCATION LAW TO PRACTICE IN THE STATE OF
NEW YORK WHO HAS COMPLETED A  CHILD  ABUSE  MEDICAL  PROVIDER  EDUCATION
PROGRAM  AND  PROVIDES  MEDICAL ASSESSMENT AND SERVICES TO CHILDREN, WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED, AT A CHILD ADVOCACY CENTER.
  (AA) "CHILD ABUSE MEDICAL PROVIDER EDUCATION PROGRAM".  A  PROGRAM  OF
EDUCATION  DEVELOPED  AND  IMPLEMENTED  OR APPROVED BY THE DEPARTMENT OF
HEALTH, IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES,
SPECIFICALLY TO TRAIN PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN AND
SPECIALIST ASSISTANTS LICENSED TO PRACTICE PURSUANT TO  TITLE  EIGHT  OF
THE  EDUCATION  LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT OF ABUSED
AND MALTREATED CHILDREN.
  (BB) "CHILD ADVOCACY CENTER". A LOCAL  OR  REGIONAL  MULTIDISCIPLINARY
TEAM  FULLY  ACCREDITED BY THE NATIONAL CHILDREN'S ALLIANCE AND APPROVED
BY THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR THE PURPOSE OF  INVES-
TIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  (CC)  "CHILD  SEXUAL  ABUSE". ANY OF THE OFFENSES DESCRIBED IN ARTICLE
ONE HUNDRED THIRTY, TWO HUNDRED THIRTY OR TWO HUNDRED SIXTY-THREE OF THE
PENAL LAW WHEN COMMITTED AGAINST A PERSON LESS THAN  EIGHTEEN  YEARS  OF
AGE.
  (DD) "MEDICAL ASSESSMENT". THE EVALUATION, DIAGNOSIS, AND TREATMENT OF
A  CHILD  BY  A  CHILD ABUSE MEDICAL PROVIDER, WHICH INCLUDES BUT IS NOT
LIMITED TO A THOROUGH MEDICAL HISTORY AND COMPLETE PHYSICAL  AND  MENTAL
HEALTH EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD HAS BEEN SEXUALLY
ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY APPROPRIATE FOLLOW-UP
FOR  THE  CHILD  PURSUANT  TO  A  PROTOCOL APPROVED BY THE DEPARTMENT OF
HEALTH IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES.
  S 11. Subparagraphs (ix) and (x) of paragraph (e) of subdivision 3  of
section  364-j  of the social services law, as amended by chapter 648 of
the laws of 1999, are amended and a new paragraph (xi) is added to  read
as follows:
  (ix) HIV COBRA case management; [and]
  (x) other services as determined by the commissioner of health[.]; AND
  (XI) MEDICAL ASSESSMENT OF A CHILD WHO HAS BEEN OR MAY HAVE BEEN SEXU-
ALLY  ABUSED, WHICH ASSESSMENT SHALL INSTEAD BE REFERRED IMMEDIATELY AND
DIRECTLY TO A CHILD ABUSE MEDICAL PROVIDER AT A CHILD ADVOCACY CENTER.
  S 12. Subparagraphs (ii) and (iii) of paragraph (a) of  subdivision  4
of section 364-j of the social services law, as amended by section 14 of
part C of chapter 58 of the laws of 2004, are amended and a new subpara-
graph (iv) is added to read as follows:
  (ii)  provided, however, if a major public hospital, as defined in the
public health law, is designated by the  commissioner  of  health  as  a
managed  care provider in a social services district the commissioner of
health shall designate at least one other managed care provider which is
not a major public hospital or  facility  operated  by  a  major  public
hospital; [and]
  (iii)  under  a  managed  care program, not all managed care providers
must be required to provide the same set of medical assistance services.
The managed  care  program  shall  establish  procedures  through  which
participants  will  be assured access to all medical assistance services
to which they are otherwise entitled, other  than  through  the  managed
care provider, where:

S. 5273--A                          8

  (A)  the  service  is  not reasonably available directly or indirectly
from the managed care provider,
  (B) it is necessary because of emergency or geographic unavailability,
or
  (C) the services provided are family planning services; or
  (D)  the services are dental services and are provided by a diagnostic
and treatment center licensed under article twenty-eight of  the  public
health  law which is affiliated with an academic dental center and which
has been granted an operating certificate pursuant  to  article  twenty-
eight  of  the  public  health law to provide such dental services.  Any
diagnostic and treatment center providing dental  services  pursuant  to
this  clause shall prior to June first of each year report to the gover-
nor, temporary president of the senate and speaker of  the  assembly  on
the  following:  the  total  number of visits made by medical assistance
recipients during the immediately preceding calendar year; the number of
visits made by medical  assistance  recipients  during  the  immediately
preceding  calendar year by recipients who were enrolled in managed care
programs; the number of visits made  by  medical  assistance  recipients
during  the  immediately  preceding calendar year by recipients who were
enrolled in managed care programs that  provide  dental  benefits  as  a
covered  service;  and the number of visits made by the uninsured during
the immediately preceding calendar year; or
  (E) other services as defined by the commissioner of health[.]; AND
  (IV) MEDICAL ASSESSMENT OF A CHILD WHO HAS BEEN OR MAY HAVE BEEN SEXU-
ALLY ABUSED SHALL BE REFERRED IMMEDIATELY AND DIRECTLY TO A CHILD  ABUSE
MEDICAL PROVIDER AT A CHILD ADVOCACY CENTER.
  S 13. The social services law is amended by adding a new section 368-g
to read as follows:
  S  368-G.  REIMBURSEMENT FOR CHILD SEXUAL ABUSE MEDICAL ASSESSMENT. 1.
FOR THE PURPOSES OF THIS SECTION, THE FOLLOWING  TERMS  SHALL  HAVE  THE
FOLLOWING MEANINGS:
  (A)  "CHILD  ABUSE  MEDICAL PROVIDER" MEANS A PHYSICIAN LICENSED UNDER
ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, NURSE  PRACTITIONER
CERTIFIED  UNDER SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW, OR
PHYSICIAN ASSISTANT OR SPECIALIST ASSISTANT LICENSED UNDER  ARTICLE  ONE
HUNDRED  THIRTY-ONE-B  OF  THE EDUCATION LAW TO PRACTICE IN THE STATE OF
NEW YORK WHO HAS COMPLETED A  CHILD  ABUSE  MEDICAL  PROVIDER  EDUCATION
PROGRAM  AND  PROVIDES  MEDICAL  ASSESSMENT AND SERVICES TO CHILDREN WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED AT A CHILD ADVOCACY CENTER.
  (B) "CHILD ABUSE MEDICAL PROVIDER EDUCATION PROGRAM" MEANS  A  PROGRAM
OF  EDUCATION DEVELOPED AND IMPLEMENTED OR APPROVED BY THE DEPARTMENT OF
HEALTH, IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES,
SPECIFICALLY TO TRAIN PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN AND
SPECIALIST ASSISTANTS LICENSED TO PRACTICE PURSUANT TO  TITLE  EIGHT  OF
THE  EDUCATION  LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT OF ABUSED
AND MALTREATED CHILDREN.
  (C) "CHILD ADVOCACY CENTER" MEANS A LOCAL OR  REGIONAL  MULTIDISCIPLI-
NARY  TEAM  FULLY  ACCREDITED  BY  THE  NATIONAL CHILDREN'S ALLIANCE AND
APPROVED BY THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR  THE  PURPOSE
OF INVESTIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  (D)  "CHILD SEXUAL ABUSE" MEANS ANY OF THE OFFENSES DESCRIBED IN ARTI-
CLE ONE HUNDRED THIRTY, TWO HUNDRED THIRTY, AND TWO HUNDRED  SIXTY-THREE
OF  THE  PENAL  LAW  WHEN  COMMITTED AGAINST A PERSON LESS THAN EIGHTEEN
YEARS OF AGE.
  (E) "MEDICAL ASSESSMENT" MEANS THE EVALUATION, DIAGNOSIS,  AND  TREAT-
MENT OF A CHILD BY A CHILD ABUSE MEDICAL PROVIDER, WHICH INCLUDES BUT IS

S. 5273--A                          9

NOT  LIMITED  TO  A  THOROUGH  MEDICAL HISTORY AND COMPLETE PHYSICAL AND
MENTAL HEALTH EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD  HAS  BEEN
SEXUALLY  ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY APPROPRIATE
FOLLOW-UP  FOR  THE CHILD PURSUANT TO A PROTOCOL APPROVED BY THE DEPART-
MENT OF HEALTH IN CONSULTATION WITH THE OFFICE OF  CHILDREN  AND  FAMILY
SERVICES.
  2.  A  SOCIAL  SERVICES DISTRICT SHALL REIMBURSE A CHILD ABUSE MEDICAL
PROVIDER AT A CHILD CARE CENTER ELIGIBLE FOR FUNDING AS A  COMPREHENSIVE
HEALTH SERVICES PROGRAM AT THE MAXIMUM REIMBURSEMENT THAT THE DEPARTMENT
OF HEALTH MAY PAY FOR PROVIDING OR ARRANGING FOR MEDICAL ASSESSMENT OF A
CHILD  WHO  HAS BEEN OR MAY HAVE BEEN SEXUALLY ABUSED IN ACCORDANCE WITH
THE FEDERAL SOCIAL SECURITY ACT AND REGULATIONS PROMULGATED THEREUNDER.
  3. CHILD ADVOCACY CENTERS THAT ARE NOT ELIGIBLE FOR FUNDING AS COMPRE-
HENSIVE HEALTH SERVICES PROGRAMS  SHALL  BE  RESPONSIBLE  FOR  PROVIDING
MEDICAL  ASSESSMENTS  AND SERVICES TO CHILDREN WHO HAVE BEEN OR MAY HAVE
BEEN SEXUALLY ABUSED PURSUANT TO A PROTOCOL APPROVED BY  THE  DEPARTMENT
OF  HEALTH  IN  CONSULTATION  WITH  THE  OFFICE  OF  CHILDREN AND FAMILY
SERVICES, WHICH SHALL INCLUDE BUT NOT BE LIMITED TO:
  (A) MEDICAL EVALUATION, DIAGNOSIS, AND TREATMENT OF  THE  CHILD  BY  A
CHILD  ABUSE  MEDICAL  PROVIDER,  WHICH INCLUDES BUT IS NOT LIMITED TO A
THOROUGH MEDICAL HISTORY AND COMPLETE PHYSICAL EXAMINATION TO  DETERMINE
WHETHER OR NOT A CHILD HAS BEEN SEXUALLY ABUSED;
  (B) DIAGNOSIS AND TREATMENT OF THE CHILD;
  (C) IDENTIFICATION OF APPROPRIATE FOLLOW-UP FOR THE CHILD; AND
  (D)  COORDINATION  OF  THE MEDICAL ASSESSMENT WITH A MULTIDISCIPLINARY
INVESTIGATION AND FOLLOW-UP OF SUCH CHILD.
  4. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, THE PER  UNIT  RATE  OF
PAYMENT FOR MEDICAL ASSESSMENT AND SERVICES FURNISHED BY THE CHILD ADVO-
CACY  CENTERS TO CHILDREN WHO HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED
AND WHO ARE ELIGIBLE FOR PAYMENTS MADE BY  STATE  GOVERNMENTAL  AGENCIES
SHALL  BE INCREASED TO AN AMOUNT EQUAL TO ONE HUNDRED TWENTY DOLLARS PER
UNIT.
  S 14. This act shall take effect on  the  one  hundred  twentieth  day
after  it  shall  have  become  a  law; provided that the departments of
health, insurance and family assistance are authorized to promulgate any
and all rules and regulations and take any other measures  necessary  to
implement  this  act  on  its effective date on or before such date; and
provided further that the amendments to  subdivisions  1,  3  and  4  of
section  364-j  of  the social services law made by sections ten, eleven
and twelve of this act shall not affect the repeal of such  section  and
shall be deemed repealed therewith.