S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3438
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 29, 2019
                                ___________
 
 Introduced  by M. of A. GANTT -- 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
 programs evolved into providing school physicians and nurses and medical
 inspections. When "medical inspection" was codified under State  law  in
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD00746-01-9

 A. 3438                             2
 
 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
 school health services were provided by the county  health  departments.
 It is the intent of the legislature that school district eligibility for

 A. 3438                             3
 
 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.
   §  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 TELE-
 MEDICINE 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.
   § 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
 NEEDS,  OR THE AVAILABILITY OF NEW APPROACHES TO SCHOOL HEALTH SERVICES.
 SERVICES MAY BE SCHOOL-BASED OR MAY  BE  LINKED  IN  COLLABORATION  WITH

 A. 3438                             4
 
 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.
   § 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 ARTICLE.
   §  5. Subdivision 4 of section 1950 of the education law is amended by
 adding a new paragraph pp to read as follows:
   PP. 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.
   § 6. Section 600 of the public health law, as amended by section 14 of
 part E of chapter 56 of the laws of 2013, is amended to read as follows:
   § 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 which is
 approved by the commissioner in accordance with section six hundred  one
 of this title;
   [2.] B. provide core public health services, as defined in section six
 hundred  two  of this title, in accordance with an application for state
 aid submitted by the municipality and approved by the commissioner;
   [3.] C. submit  a  community  health  assessment  in  accordance  with
 section six hundred two-a of this title;
   [4.]  D.  establish,  collect and report fees and revenue for services
 provided by the municipality, in accordance with section six hundred six
 of this title; and
   [5.] E. 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
 THIS  ARTICLE  REGULATING THE DEVELOPMENT, APPROVAL, IMPLEMENTATION, AND
 FEE ASSESSMENT OF MUNICIPAL PUBLIC  HEALTH  PLANS  SHALL  NOT  APPLY  TO

 A. 3438                             5
 
 SCHOOL  DISTRICTS,  WHICH  SHALL  SUBMIT APPLICATIONS IN ACCORDANCE WITH
 SUCH PROCEDURES AS MAY BE PROMULGATED BY THE COMMISSIONER OF EDUCATION.
   §  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  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.