Senate Bill S2817

                                 BILL NUMBER:  S2817

 TITLE OF BILL :
An act to amend the public health law, in relation to directing the
commissioner of health to establish a program to engage at-risk
pregnant women in early and continuous prenatal care to prevent
complications during childbirth

 PURPOSE :
Babies born prematurely, who are more likely to suffer from a variety
of health conditions, have a disproportionate impact on the overall
costs of health care, This bill creates a program designed for the
early identification of women who are at-risk to deliver preterm and
focuses attention on their medical care in order to minimize the
likelihood that they will give birth to premature babies.

 SUMMARY OF PROVISIONS :
The bill establishes a community-based outreach program which will
enable high risk pregnant women, through psycho-social care management
and obstetric evaluation, to engage in early and continuous prenatal
care for the prevention of complications during childbirth and the
reduction of neonatal intensive care admissions.

 EXISTING LAW :
None.

              

 JUSTIFICATION :
According to a July 2006 report published by the Institute of
Medicine, the rate of preterm births, which cost society $26 billion a
year, has increased 30% since 1981. Costs associated with such births
approximate $52,000 per infant born preterm and include those for
medical care, early intervention, special education services and
maternal delivery, as well as lost household and labor market
productivity. Similarly, the March of Dimes estimates, it maintains
conservatively, that lifetime medical costs for babies born
prematurely approach $500,000. It likewise asserts that premature
babies, who are more likely to suffer from cerebral palsy, chronic
lung disease, mental retardation and vision and hearing loss, "spend
nearly 17 days in the hospital over the 12 months following birth,
compared to 2 to 3 days for healthy, full term babies and    visit the
doctor's office 50% more often." Further, women who give birth to
premature babies miss over 50% more time from work during the six
months following delivery than do women who deliver full-term babies.

Acknowledging the impact of such statistics on the overall delivery of
health care to society, many physicians contend that a more effective
way to combat the problem of premature births is to emphasize medical
care for pregnant mothers, thereby shifting the focus of such care
from survival of a premature newborn to the prevention of
circumstances leading to preterm birth.  The Monroe Plan Healthy
Beginnings Program, implemented in Monroe County and upon which this
bill is based, provides enhanced care management to high-risk pregnant
women and has been successful in reducing the number of neonatal
intensive care unit admissions (NICU) over 50%.  Such progress has
been facilitated by the program's practice of coupling psycho-social
care management with observation from obstetricians and prenatal care
assistance providers.

The implementation of this initiative, which was identified by the
Center for Health Care Strategies, Inc. as one of five Medicaid "Best
Buys" for 2007, will potentially result in Medicaid NICU savings of
$27 million (13.5 million state share) in the first year and $80
million ($40 million state share) by the third year.

 LEGISLATIVE HISTORY :
New bill.
 FISCAL IMPLICATIONS :
To be determined.

 LOCAL FISCAL IMPLICATIONS :
None.

 EFFECTIVE DATE :
The bill takes effect immediately upon enactment.