Senator Montgomery urges Governor Cuomo to sign 56012/A7866 which would create a permanent Medicaid carve-out for School Based Health Centers (SBHC5) in New York State. Our state is home to 252 SBHCs, the largest number in the country and serves more than 200,000 students annually. Across the nation, providers and legislators look to us as an example of how to provide comprehensive medical care to children.
Since 1985, School-Based Health Centers have been ‘carved-out of the Medicaid Managed Care (MMC) program, enabling them to receive reimbursement directly from the New York State Department of Health. If this carve-out is allowed to end, MMC health plans will become the middlemen. Forcing SBHC5 to negotiate directly with insurance companies would create numerous complications for reimbursement. It is estimated to cost SBHC5 another $16.2 million on top of the budget cuts they suffered earlier this year.
SBHC5 were cut by 20% in this year’s budget. At the same time, the methodology to determine how these funds are distributed was changed. This has had a devastating impact on clinics across the state. Many SBHC sponsors have experienced cuts ranging anywhere from 25% to 70% and has resulted in real consequences. SUNY Downstate immediately announced the closure of four centers this year because of the funding cut. Fortunately, the closures were postponed. The SBHC that serves the Francis Scott Key Campus operated by the Bedford Stuyvesant Family Health Center, will close at the end of the year, leaving hundreds of children without services.
The children served by SBHCs are:
- primarily of color (44% served are Hispanic or Latino & 31% are Black or African American)
- often from low-income households
- many are undocumented
- many are uninsured
For read Senator Montgomery's letter, download the attachment.
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