Relates to vision care provided by managed care providers through school based health centers

BILL NUMBER:S5117A

Title of bill

An act to amend the social services law, in relation to vision care in school based health centers

Purpose of the bill

To enhance the availability of vision care services in a school-based health center setting.

Summary of specific provisions

Section 1 amends section 364-j(4)(a)(iii) of the Social Services Law by adding a new clause (E-1) adding certain vision care services at a school-based health center to the list of services which need not be provided by a managed care program. Such services, subject to approval by the Commissioner of Health (limited to up to five pilot programs), would be in partnership with a charitable foundation that agrees to provide free of charge eye glass frames and lenses at the center pursuant to a memorandum of agreement approved by the Commissioner The Commissioner is further authorized to approve payment rates for vision services at rates comparable to when such services are provided at a federally qualified health center (FQHC) or an entity licensed under Article 28 of the Public Health Law eligible for an ambulatory patient group (APG) rate.

Section 2 sets forth the effective date,

Justification

The FY2013-14 adopted budget included support for an innovative program designed to transform schools into community hubs. Community schools will integrate social, health and other services, as well as after-school programming to support students and their families. Each community "hub" could potentially include a wide array of programs and services, including health, vision care and dental clinics, youth development activities, tutoring, counseling programs, health education programs and social services, to name a few. Because every school community is different, each "hub" design would be unique. This bill deals exclusively with vision care services.

Successful precedent exists for a vision care program in a community school setting. The acclaimed Oyler School vision program in Cincinnati has proven sustainable and expandable. Implementation of this model in New York is crucial.. Eighty percent of what children learn is visual. Yet one in four students in North America has an undetected vision problem. For too many children, poor vision results in poor academic performance, low self-esteem and unrealized potential. Bridging this vision care gap is critical to our children's success.

Prior legislative history

New bill.

Fiscal implications

In the first year there would be no cost to the State or political subdivisions. All services and lenses and frames will be funded by a private foundation with the approval of the Commissioner of Health and subject to regulation and termination at the discretion of DOH. In subsequent years Medicaid would fund the vision care services provided by doctors, optometrists, and opticians under current NYS scope of practice law and rules and the lenses and frames would continue to be paid for by the foundation. Therefore, there would be some increased Medicaid cost of greater utilization of child vision care services but the State would continue to save on Medicaid expenditures it now make for lenses and frames.

Effective date

Immediately, application to withholding of payment in effect on or commencing after the effective date.