Relates to direct access to school-based health centers under child health plus

15 Co-sponsors

• Eric Adams
• Neil D. Breslin
• Thomas K. Duane
• Pedro Espada Jr.
• Ruth Hassell-Thompson
• Shirley L. Huntley
• George Onorato
• Suzi Oppenheimer
• Kevin S. Parker
• Bill Perkins
• John L. Sampson
• Diane J. Savino
• Daniel L. Squadron
• Antoine M. Thompson
• David J. Valesky

Title of bill

An act to amend the public health law, in relation to school-based health centers

Purpose or general idea of bill

To enhance the provision and availability of primary and preventive care, dental and mental health services provided to eligible children under the Child Health Plus (CHP) program by School-Based Health Centers (SBHC).

Summary of specific provisions

Section one amends the Public Health Law (PHL) by adding two new subdivisions 13 and 14 to section 2510 of the (PHL).

Subdivision 13 defines the term "School-Based Health Center."

Subdivision 14 defines the term "Sponsoring organization."

Section two amends paragraph (i) of subdivision 9 of section 2511 of the PHL to authorize the State Commissioner of Health to contract with SBHCs within amounts appropriated for the provision of education and outreach to facilitate the enrollment of children in Medicaid and CHP.

Section three amends subdivision 9 of section 2511 of the PHL to include SBHCs as community based organizations eligible for funding for the purposes of public education, outreach, and recruitment of children eligible for CHP.

Section four amends the PHL by adding a new subdivision 21 to section 2511 to authorize direct access to primary and preventive health care services, dental services or mental health services in a SBHC by a CHP enrolled child when the sponsoring organization (a hospital or community health center) is part of the provider network of the CHP managed care plan in which the child is enrolled.

In addition, new subdivision 21 provides that the managed care plan must provide levels and methods of payment to SBHCs consistent with those provided for similar services in similar settings by similar providers in the managed care plan's network. Also under this subdivision, school-based health center are required to communicate with the child's primary care practitioner regarding the child's treatment plan as well as the health care services provided by the SBHC.

Justification

School-Based Health Centers are on the front lines promoting children's health in communities where there is limited access to health and mental health services. Repeated studies have shown that SBHCs improve the health and mental health of children and save the State money. They have been shown to prevent hospitalizations, reduce emergency room use, improve school performance and attendance and avoid lost work days for parents.

Also, studies comparing SBHCs and managed care plans have found that when adolescents who are enrolled in managed care can still use SBHCs, the adolescents have fewer emergency or urgent visits and more comprehensive health visits than those who are in managed care but do not have access to a SBHC.

This bill would break down barriers to SBHC participation in CHP managed care plans. In addition, it would expand the availability of services covered under the CHP program to assure that children have access to necessary physical and mental health services. The bill ensures continuity of care by requiring that the SBHC discuss any services or treatments with the primary care practitioner.

Prior legislative history

2001-02: A similar bill, A.8565, Passed Assembly 2003-04: A similar bill, A.3443, Passed Assembly 2005-06: A similar bill, A.2207, Passed Assembly 2007-08: A similar bill, S.3597, Passed Assembly

Fiscal implications

Any additional costs would be more than offset by improving the health and mental health of at-risk children and preventing hospital stays and emergency visits.

Effective date

90 days after enactment.