Senate Bill S434

                                 BILL NUMBER:  S434

 TITLE OF BILL :
An act to amend the public health law, in relation to the early rate
restructuring work group and early intervention demonstration projects


 PURPOSE :
This legislation would direct the Commissioner of Health, in
consultation with the Commissioner of the Office of Mental Retardation
and Developmental Disabilities, to establish an early intervention
rate restructuring work group to review and make recommendations for a
redesign of the reimbursement system for early intervention services,
to report to the legislature and prepare for implementation of a
redesigned reimbursement system. The bill also directs the
Commissioners to develop and disseminate an RPF to establish early
intervention demonstration projects so that children with multiple
services needs can receive services in a comprehensive, coordinated,
collaborative, family-centered approach and explore alternative
services delivery and reimbursement models.

 SUMMARY OF PROVISIONS :
Sections one of the bill creates two new sections 2555 and 2555-a of
the public health creating the early intervention rate restructuring
work group, directing the commissioners to collect data on early
intervention providers and to report to the legislature on the work
              

group's findings and recommendations no later than March 31, 2010. It
also adds a new section 2555-a to the public health law creating the
early intervention demonstration projects at least two of which shall
begin no later than January 1, 2010.

Section two of the bill provides for an immediate effective date.

 JUSTIFICATION :
The Individuals with Disabilities Education Act (IDEA), Part C, the
Federal law authorizing Early Intervention (EI) services, requires
comprehensive, coordinated, and collaborative services across State
agencies as well as individual providers, in order to most effectively
meet the needs of infants and toddlers with disabilities and their
families. Despite attempts to comply with both the mandate and the
spirit and intent of the law, the design of New York State's Early
Intervention Program (EIP) has instead encouraged the proliferation of
individual, private providers, delivering separate and discrete
services with little or no effective coordination. In addition, while
overall costs for these services are quite high, the fee-for-service
reimbursement to providers is often inadequate to cover their
expenses, particularly for comprehensive agencies serving children
with significant disabilities and multiple service needs.

The current reimbursement system for EI services was developed and
implemented in 1994. From the initial establishment of the rates,
there were concerns regarding the adequacy of several of the factors
used to calculate the rates. Since the initial rates, there have been
very few adjustments to reflect the continually increasing costs. The
lack of increases in the EI rates have caused these rates to fall
dramatically behind those of comparable services and has jeopardized
the viability of these critical services to infants and toddlers with
disabilities and their families. The current rates are wholly
inadequate for some providers, such as comprehensive agency providers,
which incur additional expenses to provide training and supervision of
their staff, additional team meeting and coordination time, as well as
additional reporting and paperwork requirements. The fee-for-service
nature of the reimbursement system has also caused significant
problems for providers serving children with more significant
disabilities and frequent absences due to illness or medical

complications. The problems with reimbursement have caused a number of
providers to stop delivering Early Intervention services.

In order to truly comply with the mandate and intent of IDEA, this
bill requires that an Early Intervention Rate Restructuring Work Group
be established to redesign the Early Intervention program
reimbursement and that Early Intervention Demonstration Projects be
established so that children with multiple service needs can receive
services in a comprehensive, coordinated, collaborative,
family-centered approach which explore alternative service delivery
and reimbursement models for effectiveness and efficiency.

 LEGISLATIVE HISTORY :
Same as S.8050 of 2008 reported to Rules Committee

 FISCAL IMPLICATIONS :
None, as the demonstrations established in the bill can be funded with
existing Early Intervention funding.

 EFFECTIVE DATE :
Immediately.