S T A T E   O F   N E W   Y O R K
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                                   764

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 5, 2011
                               ___________

Introduced  by  M.  of  A. GANTT, HOYT -- Multi-Sponsored by -- M. of A.
  MORELLE, PEOPLES-STOKES -- read once and referred to the Committee  on
  Education

AN ACT to amend the education law and the public health law, in relation
  to the powers of the boards of education for the city school districts
  of  Rochester  and  Buffalo  to  arrange and provide integrated health
  services to the school community directly and/or through contractors

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

  Section 1.  Legislative intent. The legislature finds:
  1. Two trends, one sociological and one political, underpin a need for
the  fiscally  dependent school districts of the cities of Rochester and
Buffalo to obtain express authority to develop and operate programs  for
integrated  health  services  within  the  districts,  in a manner which
embraces the best and most economic available  technologies,  and  which
harnesses  the  health care resources of their respective communities in
the most effective possible manner.  It  is  found,  further,  that  the
public  interest is served by permitting those districts to provide such
services directly, and/or by  the  use  of  contractors,  including  the
boards  of  cooperative  educational  services, which shall be expressly
authorized to contract to provide some or all of such services; and that
the costs of assuming such services be ameliorated by authorizing subsi-
dy and/or reimbursement for such services on the same basis and  in  the
same  manner  as  a  county health department would be eligible for such
subsidy or reimbursement for similar school health services.
  2. During the first two decades of the twentieth  century,  exercising
police  powers,  city  health  departments  in  the  cities of New York,
Rochester and Buffalo as an element of municipal health  and  sanitation
efforts  began  providing  health services within city schools. Starting
with vaccinations and milk stations to  provide  pasteurized  milk,  the

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

                                                           LBD03205-01-1

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programs evolved into providing school physicians and nurses and medical
inspections.  When  "medical inspection" was codified under State law in
1913, in what is now section nine hundred one of the education law,  the
city  school districts in the cities of New York, Rochester and Buffalo,
in which the city health departments were  actively  engaged  in  school
health  services,  were excepted from the legislation. The term "medical
inspection" in that statute has been  replaced  with  the  term  "school
health  services," under chapter 477 of the laws of 2004. Over time, the
school health function for the city school districts  of  Rochester  and
Buffalo  devolved  from  city  health  departments  to the county health
departments in the counties of Monroe and Erie, by resolution and  char-
ter,  as  authorized by section one thousand seventeen-a of the optional
county government law. The county of Monroe and the county of Erie ther-
eupon provided and funded school health services for decades. The  coun-
ties have determined that even with available reimbursement, they are no
longer  able  to  provide  school  health  services  to  the city school
districts. The county of Monroe eliminated staffing and funding  in  its
2004  budget; and the county of Erie has eliminated staffing and funding
in its 2005 budget. In December 2004,  the  Appellate  Division,  Fourth
Department  of the New York State Supreme Court affirmed that the county
of Monroe had the authority  to  withdraw  from  providing  and  funding
school health services to the city school district of Rochester.
  3.  Within  the cities of Rochester and Buffalo, there exists a marked
concentration of poverty, of racial concentration or isolation,  and  of
limited English language capacity, which together increase the risk that
school age children do not have access to any regular or adequate health
services  outside  of  school; and that unless the school districts have
the authority to provide such services directly or through  contractors,
and  to  develop  an  integrated  health services network with available
community resources, the legislature finds  that  many  children  within
those  cities  are  likely  to  continue  to have insufficient access to
health care, with the inexorable result that their educational  develop-
ment will also be impaired, to the long term detriment of those children
and to the state itself. Census data and other studies in Rochester, for
example,  demonstrate that the city school district of Rochester has the
second highest per capita poverty rate among all school districts in the
state of New York; and ranks twelfth in  child  poverty  in  the  United
States.  In  the  2001-2002  school  year,  eleven  per cent of incoming
kindergarteners in  Rochester  had  health  problems  requiring  ongoing
medical supervision, while seven per cent of parents reported that their
child  starting  kindergarten  had no primacy care physician, and twenty
per cent had never seen a dentist. Fifteen per  cent  of  those  parents
reported  that their child had been hospitalized in a neonatal intensive
care unit at birth.
  4. Particularly since the  city  school  districts  of  Rochester  and
Buffalo  are fiscally dependent, the legislature finds that it is in the
public interest to provide  that  whenever  integrated  health  services
would  be  subject  to  reimbursement or subsidy if provided by a county
health department then when such services are provided by a city  school
district  (or  by  its  contractors)  which  had  received school health
services from the county of Monroe or the county of Erie  in  the  past,
that  such  city school district shall be deemed to be eligible for such
reimbursement or subsidy as if it were a county  health  department.  In
that  manner, the economic impact of termination of county school health
services will be limited to the local  costs,  and  the  districts  will
continue  to benefit from state reimbursement to the same degree as when

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school health services were provided by the county  health  departments.
It is the intent of the legislature that school district eligibility for
such  reimbursement  shall be retroactive to the first day of the school
fiscal year in which the county government which had previously provided
funding and staffing for school health services eliminated that aid from
its  budget.  In the case of the city school district of Rochester, such
eligibility shall be  retroactive  to  July  1,  2004.  The  legislature
further  finds  that  it  is  in  the public interest to permit the city
school districts in the cities of Rochester and Buffalo to contract  and
pay for some part or all of its integrated health services programs with
boards  of  cooperative  educational  services  serving  the counties of
Monroe and Erie, and for such boards of cooperative educational services
to provide such health services. This act shall be known  as  the  Inte-
grated Health Services for Fiscally Dependent School Districts Act.
  S  2.  Section  901  of  the  education law is amended by adding a new
subdivision 3 to read as follows:
  3. IN THE SCHOOL DISTRICTS EXCEPTED FROM THIS  ARTICLE,  WHERE  SCHOOL
HEALTH  SERVICES  ARE  NOT BEING FUNDED OR STAFFED BY THE HEALTH DEPART-
MENTS OF THE CITY OR COUNTY IN WHICH SUCH DISTRICT IS LOCATED; OR IF, IN
THE DISCRETION OF THE BOARD OF EDUCATION, ADDITIONAL  INTEGRATED  HEALTH
SERVICES  ARE  WARRANTED,  THEN  THE  BOARD  OF EDUCATION OF SUCH SCHOOL
DISTRICT SHALL BE AUTHORIZED, BUT NOT REQUIRED TO PROVIDE,  DIRECTLY  OR
BY  ONE  OR  MORE  CONTRACTS SUCH SCHOOL HEALTH SERVICES AS THE BOARD OF
EDUCATION DETERMINES ARE USEFUL OR NECESSARY TO  MEET  THE  CURRENT  AND
EVOLVING   HEALTH   NEEDS   OF   THEIR   SCHOOL  POPULATIONS,  INCLUDING
SCHOOL-BASED AND INTEGRATED SCHOOL-LINKED HEALTH SERVICES WHICH  MAY  BE
LINKED TO COMMUNITY-BASED HEALTH CARE SYSTEMS, AND SERVICES WHICH EMPLOY
TELEMEDICINE  OR  OTHER  EMERGING TECHNOLOGIES. WHERE AN EXCEPTED SCHOOL
DISTRICT PROVIDES SCHOOL HEALTH  SERVICES  WHICH  WOULD  BE  SUBJECT  TO
REIMBURSEMENT OR SUBSIDY IF PROVIDED BY A COUNTY HEALTH DEPARTMENT, THEN
NOTWITHSTANDING  ANY  PROVISION  OF ANY OTHER STATE LAW, THE CITY SCHOOL
DISTRICT SHALL BE ELIGIBLE FOR SUCH SUBSIDY OR REIMBURSEMENT AS WOULD  A
COUNTY  HEALTH  DEPARTMENT.  THIS  ELIGIBILITY  SHALL  APPLY NOT ONLY TO
SERVICES PROVIDED BY SUCH CITY SCHOOL DISTRICT  DIRECTLY,  BUT  ALSO  TO
SERVICES  PROVIDED INDIRECTLY, THROUGH CONTRACTS WITH A BOARD OF COOPER-
ATIVE EDUCATIONAL SERVICES, OR THROUGH ANY OTHER QUALIFIED  PROVIDER  OF
HEALTH  CARE  SERVICES.  SUCH  ELIGIBILITY  SHALL  BE DEEMED TO APPLY TO
DIRECT OR CONTRACT SERVICES PERFORMED BY OR FOR THE CITY SCHOOL DISTRICT
ON OR AFTER THE FIRST DAY OF THE FIRST FISCAL YEAR IN WHICH  THE  COUNTY
IN WHICH SUCH CITY SCHOOL DISTRICT IS LOCATED DID NOT PROVIDE FUNDING OR
STAFFING FOR SCHOOL HEALTH SERVICES.
  S  3.  Section  2554 of the education law is amended by adding two new
subdivisions 28  and 29 to read as follows:
  28. TO PROVIDE, IN DISTRICTS EXCEPTED FROM THE PROVISIONS OF  SUBDIVI-
SION  ONE OF SECTION NINE HUNDRED ONE OF THIS CHAPTER, SUCH SCHOOL-BASED
OR SCHOOL-LINKED INTEGRATED SCHOOL  HEALTH  SERVICES  AS  THE  BOARD  OF
EDUCATION  MAY, IN ITS DISCRETION DEEM WARRANTED, EITHER DIRECTLY, OR BY
ONE OR MORE CONTRACTS WITH A BOARD OF COOPERATIVE  EDUCATIONAL  SERVICES
AND/OR  WITH  HEALTH  CARE  PROVIDERS SERVING THE COMMUNITY IN WHICH THE
DISTRICT IS SITUATED. BOARDS OF EDUCATION ARE AUTHORIZED AND  ENCOURAGED
TO  DEVELOP  MODELS  FOR HEALTH CARE DELIVERY WHICH ARE TAILORED TO MEET
THE SPECIFIC NEEDS OF THEIR POPULATIONS IN A MANNER WHICH IS AS  ECONOM-
ICAL  AS  POSSIBLE,  BUT  WHICH  EMBODIES EMERGING TECHNOLOGIES AND ALSO
UTILIZES NEW AND ADVANCED MODELS FOR HEALTH SERVICES, AS WELL AS  TRADI-
TIONAL SCHOOL HEALTH MODELS, AND TO ADD, AMEND, SUPPLEMENT, OR ELIMINATE
SPECIFIC  HEALTH  CARE SERVICES BASED UPON EFFECTIVENESS, COST, EVOLVING

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NEEDS, OR THE AVAILABILITY OF NEW APPROACHES TO SCHOOL HEALTH  SERVICES.
SERVICES  MAY  BE  SCHOOL-BASED  OR  MAY BE LINKED IN COLLABORATION WITH
LOCAL HOSPITALS, CLINICS, AND HEALTH CARE PROFESSIONALS AND AGENCIES AND
MAY  ALSO  HAVE  CHARACTERISTICS  OF BOTH SCHOOL-BASED AND SCHOOL-LINKED
MODELS, SUCH AS  TELEMEDICINE  COMPONENTS  AND  USE  OF  MOBILE  MEDICAL
SERVICE UNITS.
  29.  TO SEEK AND APPLY FOR AND RECEIVE, IN DISTRICTS EXCEPTED FROM THE
PROVISIONS OF SUBDIVISION ONE OF SECTION NINE HUNDRED ONE OF THIS  CHAP-
TER,  STATE  AID  FUNDING  WHICH  IS  OR MAY BECOME AVAILABLE TO MUNICI-
PALITIES UNDER ARTICLE SIX OF THE PUBLIC HEALTH LAW FOR THE SCHOOL-BASED
OR SCHOOL-LINKED INTEGRATED SCHOOL  HEALTH  SERVICES  PROVIDED  BY  SUCH
DISTRICTS,  AS  DETAILED UNDER SUBDIVISION TWENTY-EIGHT OF THIS SECTION.
ANY APPLICATION FOR SUCH STATE AID FUNDING  UNDER  ARTICLE  SIX  OF  THE
PUBLIC  HEALTH LAW WOULD BE SUBMITTED IN ACCORDANCE WITH SUCH PROCEDURES
AS MAY BE PROMULGATED BY THE COMMISSIONER.
  S 4. Section 2566 of the education law is  amended  by  adding  a  new
subdivision 10 to read as follows:
  10.  TO  HAVE  SUPERVISION  AND  DIRECTION OF INTEGRATED SCHOOL HEALTH
SERVICES AUTHORIZED BY THE BOARD OF EDUCATION UNDER SUBDIVISION  TWENTY-
EIGHT OF SECTION TWENTY-FIVE HUNDRED FIFTY-FOUR OF THIS CHAPTER.
  S  5. Subdivision 4 of section 1950 of the education law is amended by
adding a new paragraph oo to read as follows:
  OO. TO ENTER INTO CONTRACTS WITH CITY SCHOOL DISTRICTS PROVIDING INTE-
GRATED SCHOOL HEALTH SERVICES UNDER SUBDIVISION THREE  OF  SECTION  NINE
HUNDRED ONE OF THIS CHAPTER, AND WHICH ARE LOCATED WITHIN OR ADJACENT TO
THE  SUPERVISORY DISTRICT OF A BOARD OF COOPERATIVE EDUCATIONAL SERVICES
AND/OR THE TERRITORY  SERVED  BY  A  BOARD  OF  COOPERATIVE  EDUCATIONAL
SERVICES,  TO  PROVIDE ALL OR PART OF THE SERVICES REQUESTED BY THE CITY
SCHOOL DISTRICT UPON MUTUALLY AGREEABLE TERMS.   BOARDS  OF  COOPERATIVE
EDUCATIONAL  SERVICES  ARE  HEREBY  AUTHORIZED  AND  EMPOWERED TO DO AND
PERFORM ANY AND ALL ACTS NECESSARY  OR  DESIRABLE  IN  RELATION  TO  THE
PERFORMANCE OF ANY SUCH CONTRACTS.
  S  6. Section 600 of the public health law, as added by chapter 901 of
the laws of 1986, is amended to read as follows:
  S 600. State aid; general requirements. 1. In order to be eligible for
state aid under this title, a municipality shall be required to  do  the
following in accordance with the provisions of this article:
  [1.] A. submit an application to the department for state aid;
  [2.] B.  submit a municipal public health services plan to the depart-
ment for approval;
  [3.] C. implement and adhere to the municipal public  health  services
plan, as approved;
  [4.] D. submit a detailed report to the department of all expenditures
on  services  funded  by this title for the immediately preceding fiscal
year of such municipality;
  [5.] E. employ a person to supervise the provision  of  public  health
services  in  accordance with the provisions of section six hundred four
of this chapter; and
  [6.] F. appropriate or otherwise make funds  available  to  finance  a
prescribed share of the cost of public health services.
  2. A SCHOOL DISTRICT WHICH IS EXCEPTED FROM THE PROVISIONS OF SUBDIVI-
SION  ONE OF SECTION NINE HUNDRED ONE OF THE EDUCATION LAW SHALL ALSO BE
ELIGIBLE FOR STATE AID FUNDING WHICH IS OR MAY BECOME AVAILABLE TO MUNI-
CIPALITIES UNDER THIS  TITLE  FOR  THE  SAME  OR  SIMILAR  SERVICES,  AS
PROVIDED  FOR  BY  THE  PROVISIONS OF SUBDIVISION TWENTY-NINE OF SECTION
TWENTY-FIVE HUNDRED FIFTY-FOUR OF THE EDUCATION LAW. THE  PROVISIONS  OF

A. 764                              5

THIS  ARTICLE  REGULATING THE DEVELOPMENT, APPROVAL, IMPLEMENTATION, AND
FEE ASSESSMENT OF MUNICIPAL PUBLIC  HEALTH  PLANS  SHALL  NOT  APPLY  TO
SCHOOL  DISTRICTS,  WHICH  SHALL  SUBMIT APPLICATIONS IN ACCORDANCE WITH
SUCH PROCEDURES AS MAY BE PROMULGATED BY THE COMMISSIONER OF EDUCATION.
  S  7.  This  act  shall take effect immediately and shall apply to all
contracts entered into on or after such effective date; provided, howev-
er, that for purposes  of  a  subsidy  or  reimbursement  authorized  by
section  two  of  this act, a school district in which county funding or
staffing was not made available for  the  2004-2005  school  year,  such
school  district  shall  be  entitled  to  receive such reimbursement or
subsidy for any health service rendered by the  school  district  on  or
after  (i)  July  1,  2004,  or  (ii)  the first day of the first school
district fiscal year in which the county did  not  fund  or  staff  such
school district, whichever is earlier.