Senate Bill S2680B

2009-2010 Legislative Session

Relates to financial assistance from the crime victims board for post-exposure prophylaxis treatment for victims of sexual assault

download bill text pdf

Archive: Last Bill Status - In Senate Committee Health 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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Actions

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 28, 2010	print number 2680b
May 28, 2010	amend and recommit to health
May 19, 2010	print number 2680a
May 19, 2010	amend and recommit to health
Jan 06, 2010	referred to health
Feb 26, 2009	referred to health

Bill Amendments

Original

B (Active)

co-Sponsors

2009-S2680 - Details

See Assembly Version of this Bill:: A2355
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §2805-i, Pub Health L; amd §§631 & 631-a, Exec L
Versions Introduced in 2011-2012 Legislative Session:: A669

2009-S2680 - Summary

Requires financial assistance from the crime victims board for post-exposure prophylaxis treatment for victims of sexual assault.

2009-S2680 - Sponsor Memo

                                 BILL NUMBER:  S2680

 TITLE OF BILL :

An act to amend the public health law and the executive law, in
relation to financial assistance from the crime victims board for
post-exposure prophylaxis treatment for victims of sexual assault


 PURPOSE :

To amend the public health law so that victims of sexual assault would
have no financial obstacles in the way of receiving the full course of
HIV PEP (post exposure prophylaxis).

 SUMMARY OF PROVISIONS :

This legislation simplified payment procedures for victims of sexual
assault who are found by medical examiners to be at risk for HIV/AIDS
and in need of PEP. Under current procedures, victims, in most cases,
are reimbursed by the Crime Victims Board (CVB) for treatment costs.
However some victims, either those who are uninsured or those who are
insured but may be covered by their assailant's insurance. In some
cases young adults covered by their parents might want to maintain
confidentiality. These victims can be intimidated by paperwork and
out-of-pocket expenses, thereby risking their lives by forgoing

treatment. This legislation would allow all victims of sexual assault
deemed at risk of HIV/AIDS regardless of coverage to be provided with
streamlined payment system that would be submitted to the CVB.

 JUSTIFICATION :

By allowing victims of sexual assault to receive PEP treatment without
having to payout of pocket, this legislation would result in an
increase of victims opting for and completing treatment. This will
improve prognosis for victims of sexual assault, and thereby would
help stem the spread of HIV/AIDS. Many victims of sexual assault forgo
preventative treatment following an assault because of costs, fear,
and inconvenience. Failure to receive treatment not only jeopardizes
victim's health but when HIV/AIDS results from an assault, it
increases the spread of the virus thus exacerbating the epidemic. By
streamlining the process and increasing outreach to assault victims
who have submitted to 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 :

2008  S.7306  Passed Senate, Delivered to Governor, Veto Memo
96, Tabled

 FISCAL IMPLICATIONS :

Under the current system, the CVB covers costs of PEP treatment in
most cases. Treatment runs about $2,500 per person. Because of
increased accessibility there would be an increase in persons opting
for treatment; estimates are somewhere in the 100s per year. These
costs would be greatly offset by the long-term savings preventing more
cases of HIV/AIDS in the victim and to the victim's partners.

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

2009-S2680 - Bill Text download pdf

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

                                  2680

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                            February 26, 2009
                               ___________

Introduced  by  Sen. MORAHAN -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law and the executive law, in relation
  to financial assistance from the crime victims board 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 added by chapter 571  of  the  laws  of  2007,  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 crime victims board pursu-
ant to the provisions of article twenty-two of the executive law.
  S  2.  Subdivision 13 of section 631 of the executive law, as added by
chapter 264 of the laws of 2003, 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 board directly. The board, in  consul-
tation 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, hospital  or

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03647-01-9

S. 2680                             2

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  established  board
procedure.]  The  board,  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 eight
hundred dollars, to be reviewed and adjusted annually by  the  board  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  board.  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 survi-
vor  is  entitled  on a form prescribed by the board; 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 board. [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, sexu-
al assault examiner program or licensed health care provider, which form
shall be prescribed by the board.
  13-A. NOTWITHSTANDING ANY OTHER PROVISIONS OF LAW, RULE, OR REGULATION
TO THE CONTRARY, WHEN ANY PHARMACIST LICENSED BY NEW YORK STATE PROVIDES
PROPHYLACTIC TREATMENT FOR SIGNIFICANT POSSIBLE EXPOSURE  TO  HIV  TO  A
VICTIM  OF SEXUAL ASSAULT AS PRESCRIBED BY A LICENSED HEALTHCARE PROVID-
ER, SUCH TREATMENT SHALL BE PROVIDED TO THE PERSON  WITHOUT  CHARGE  AND
THE  PHARMACY  SHALL BILL THE BOARD DIRECTLY. THE BOARD, 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 ESTABLISHED AND REVIEWED AND  ADJUSTED  AT  LEAST
ANNUALLY BY THE BOARD IN CONSULTATION WITH THE DEPARTMENT OF HEALTH. THE
PHARMACY  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  PHARMACY MAY NOT CHARGE THE BOARD. A PHARMACY 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 BOARD; 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 SUBSTAN-
TIALLY INTERFERE WITH HIS OR HER PERSONAL PRIVACY OR SAFETY AND, IN SUCH
EVENT, THE PROPHYLACTIC TREATMENT FEE SHALL BE PAID BY THE BOARD. IF  HE
OR  SHE DECLINES TO PROVIDE SUCH HEALTH INSURANCE INFORMATION, HE OR SHE

S. 2680                             3

SHALL INDICATE SUCH DECISION ON THE FORM PROVIDED BY THE PHARMACY, WHICH
FORM SHALL BE PRESCRIBED BY THE BOARD.
  S  3. Paragraph (b) of subdivision 2 of section 631-a of the executive
law, as amended by chapter 263 of the laws of 1986, 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; AND
  (VI)  PROPHYLACTIC  TREATMENT  THERAPIES  IN  CASES  WHERE IT HAS BEEN
DETERMINED THAT A SIGNIFICANT EXPOSURE TO HIV HAS OCCURRED.
  S 4. This act shall take effect on the one hundred eightieth day after
it shall have become a law.

co-Sponsors

2009-S2680A - Details

See Assembly Version of this Bill:: A2355
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §2805-i, Pub Health L; amd §§631 & 631-a, Exec L
Versions Introduced in 2011-2012 Legislative Session:: A669

2009-S2680A - Summary

Requires financial assistance from the crime victims board for post-exposure prophylaxis treatment for victims of sexual assault.

2009-S2680A - Sponsor Memo

                                 BILL NUMBER:  S2680A

 TITLE OF BILL :
An act to amend the public health law and the executive law, in
relation to financial assistance from the crime victims board 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 9day starter pack of the PEP. The
emergency department where the exam is conducted will bill and be
reimbursed by the Crime Victims Board as they are currently. The CVB
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
CVB; 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, to name the most often cited.

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 :

2008 S.7306/Passed Senate, Delivered to Governor,
Veto Memo
96, Tabled

 FISCAL IMPLICATIONS :

Under the current system, the CVB 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.

2009-S2680A - Bill Text download pdf

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

                                 2680--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                            February 26, 2009
                               ___________

Introduced  by Sens. MORAHAN, HASSELL-THOMPSON -- 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 crime victims board 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  added  by  chapter 571 of the laws of 2007, 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 crime victims board pursu-
ant 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
FOLLOW-UP CARE.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03647-03-0

S. 2680--A                          2

  S 2. Subdivision 13 of section 631 of the executive law, as amended by
section 1 of part E of chapter 56 of the laws of 2009, 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 board directly. The board, in  consul-
tation 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, hospital  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  established  board
procedure.]  The  board,  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 board 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 board. 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 board; 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 substan-
tially interfere with his or her personal privacy or safety and in  such
event,  the sexual assault forensic exam fee shall be paid by the board.
[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
board.
  13-A. NOTWITHSTANDING ANY OTHER PROVISIONS OF LAW, RULE, OR REGULATION
TO THE CONTRARY, WHEN ANY PHARMACIST LICENSED BY NEW YORK STATE PROVIDES
PROPHYLACTIC TREATMENT FOR SIGNIFICANT POSSIBLE EXPOSURE  TO  HIV  TO  A
VICTIM  OF SEXUAL ASSAULT AS PRESCRIBED BY A LICENSED HEALTHCARE PROVID-
ER, SUCH TREATMENT SHALL BE PROVIDED TO THE PERSON  WITHOUT  CHARGE  AND
THE  PHARMACY  SHALL BILL THE BOARD DIRECTLY. THE BOARD, 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 ESTABLISHED AND REVIEWED AND  ADJUSTED  AT  LEAST
ANNUALLY BY THE BOARD IN CONSULTATION WITH THE DEPARTMENT OF HEALTH. THE

S. 2680--A                          3

PHARMACY  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  PHARMACY MAY NOT CHARGE THE BOARD. A PHARMACY 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 BOARD; 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 SUBSTAN-
TIALLY INTERFERE WITH HIS OR HER PERSONAL PRIVACY OR SAFETY AND, IN SUCH
EVENT, THE PROPHYLACTIC TREATMENT FEE SHALL BE PAID BY THE BOARD. IF  HE
OR  SHE DECLINES TO PROVIDE SUCH HEALTH INSURANCE INFORMATION, HE OR SHE
SHALL INDICATE SUCH DECISION ON THE FORM PROVIDED BY THE PHARMACY, WHICH
FORM SHALL BE PRESCRIBED BY THE  BOARD.    THE  NINE  DAY  STARTER  PACK
PROVIDED  TO  THE VICTIM PURSUANT TO PARAGRAPH (C) OF SUBDIVISION 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 APPROPRIATE CLINIC
OR IN A RURAL AREA, THE COUNTY DEPARTMENT  OF  HEALTH,  SHALL  BILL  THE
CRIME  VICTIMS  BOARD  AND BE REIMBURSED BY SUCH BOARD. IF THE VICTIM IS
NOT SEEKING  REIMBURSEMENT  FROM  THE  BOARD,  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 chapter 263 of the laws of 1986, 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.

co-Sponsors

2009-S2680B (ACTIVE) - Details

See Assembly Version of this Bill:: A2355
Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §2805-i, Pub Health L; amd §§631 & 631-a, Exec L
Versions Introduced in 2011-2012 Legislative Session:: A669

2009-S2680B (ACTIVE) - Summary

Requires financial assistance from the crime victims board for post-exposure prophylaxis treatment for victims of sexual assault.

2009-S2680B (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S2680B

TITLE OF BILL:
An act
to amend the public health law and the executive law, in relation to
financial assistance from the crime victims board 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 Crime Victims Board as they are
currently. The CVB 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 CVB; 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, to name the most often cited.

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:

2008:  S.7306/ Passed Senate, Delivered to Governor,
Veto Memo
96, Tabled


FISCAL IMPLICATIONS:

Under the current system, the CVB 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.

2009-S2680B (ACTIVE) - Bill Text download pdf

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

                                 2680--B

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                            February 26, 2009
                               ___________

Introduced  by Sens. MORAHAN, HASSELL-THOMPSON -- 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 -- 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 crime victims board 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 added by chapter 571  of  the  laws  of  2007,  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 crime victims board pursu-
ant  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.
                                                           LBD03647-08-0

S. 2680--B                          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  1 of part E of chapter 56 of the laws of 2009, 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 board directly. The board, in consul-
tation 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, hospital 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 established board
procedure.] The board, 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 board 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 board. 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 board; 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 substan-
tially  interfere with his or her personal privacy or safety and in such
event, the sexual assault forensic exam fee shall be paid by the  board.
[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
board.
  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
BOARD  DIRECTLY.  THE  BOARD,  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. 2680--B                          3

ESTABLISHED AND REVIEWED AND ADJUSTED AT LEAST ANNUALLY BY THE BOARD  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 BOARD. 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 BOARD; 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 SUBSTAN-
TIALLY INTERFERE WITH HIS OR HER PERSONAL PRIVACY OR SAFETY AND, IN SUCH
EVENT, THE PROPHYLACTIC TREATMENT FEE SHALL BE PAID BY THE BOARD. 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 BOARD.  THE NINE DAY STARTER  PACK
PROVIDED  TO  THE VICTIM PURSUANT TO PARAGRAPH (C) OF SUBDIVISION 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 APPROPRIATE CLINIC
OR IN A RURAL AREA, THE COUNTY DEPARTMENT  OF  HEALTH,  SHALL  BILL  THE
CRIME  VICTIMS  BOARD  AND BE REIMBURSED BY SUCH BOARD. IF THE VICTIM IS
NOT SEEKING  REIMBURSEMENT  FROM  THE  BOARD,  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 chapter 263 of the laws of 1986, 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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Sponsored By

Thomas P. Morahan

Archive: Last Bill Status - In Senate Committee Health Committee

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Ruth Hassell-Thompson

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