What's happening
This bill defines school-based health centers and their sponsoring organizations, and establishes Medicaid reimbursement methods for their services.
Why it matters
Expands access to care for students. By clearly defining school-based health centers (SBHCs) and their sponsors, the bill paves the way for more schools to offer comprehensive health services—including behavioral, vision, dental, and chronic disease management—directly on campus, addressing barriers that keep children from getting needed care.
Ensures stable Medicaid funding for SBHCs. The legislation establishes specific Medicaid reimbursement methods for SBHCs, including protections for those sponsored by federally qualified health centers (FQHCs), which helps ensure these clinics are financially sustainable and able to continue serving vulnerable populations.
Promotes care coordination and quality improvement. The bill requires the development of a standardized agreement between SBHCs (or their sponsors) and managed care providers, encouraging integrated, high-quality care for children and adolescents and supporting participation in quality improvement initiatives.
Supports flexibility and choice for providers. SBHCs and their sponsoring organizations retain the ability to choose whether to receive Medicaid payments directly or through managed care providers, allowing adaptation to local needs and financial models that work best for their setting.
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Headline styles
Fund School Health Clinics
Plain English, a few words. Used as the page title.
Sponsors
History
- Vetoed memo.235
- Delivered to governor
- Returned to senate
- Passed assembly
- Ordered to third reading rules cal.450
- Substituted for A7866
- Referred to ways and means
- Delivered to assembly
- Passed senateVote 63–0
- Advanced to third reading
- 2nd report cal.
- 1st report cal.1157
Show 1 earlier action
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Fund School Health Clinics
Assembly Floor Calendar · Sponsor Richard Gottfried
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
6012
2017-2018 Regular Sessions
IN SENATE
May 10, 2017
Introduced by Sen. SEWARD -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the social services law, in relation to school-based health centers
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 1 of section 364-j of the social services law is amended by adding two new paragraphs (w) and (w-1) to read as follows:
(w) "School-based health center". A clinic licensed under article twenty-eight of the public health law or sponsored by a facility licensed under article twenty-eight of the public health law which provides primary and preventative care which may include but is not limited to health maintenance, well-child care, diagnosis and treatment of injury and acute illness, diagnosis and management of chronic disease, behavioral health services, vision care, dental care, and nutritional or other enhanced services to children and adolescents, any of which may be provided by referral, within an elementary, secondary or prekindergarten public school setting.
(w-1) "Sponsoring organization". A facility licensed under article twenty-eight of the public health law which acts as the sponsor for a school-based health center.
§ 2. Subparagraph (iii) of paragraph (a) of subdivision 4 of section 364-j of the social services law is amended by adding a new clause (E-2) to read as follows:
(E-2) the service is provided by school-based health centers: any such services provided other than by a managed care provider shall be paid in accordance with applicable reimbursement methodologies, which shall mean:
(1) for school-based health centers that are sponsored by a federally qualified health center, rates of reimbursement and requirements in
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11493-02-7
S. 6012 2
accordance with those mandated by 42 U.S.C. Secs. 1396a(bb), 1396b(m)(2)(A)(ix) and 1936a(a)(13)(C); and
(2) for school-based health centers that are sponsored by an entity licensed pursuant to article twenty-eight of the public health law that is not a federally qualified health center or is a federally qualified health center that chooses not to receive reimbursement pursuant to subclause one of this clause, rates of reimbursement at the fee for service rate for such services in effect on the effective date of this clause for the ambulatory patient group rate for the applicable service and in accordance with any future adjustments made to such rates by the department of health; provided that the commissioner of health shall develop a standard memorandum of understanding to be entered into by school-based health centers or their sponsoring organizations and managed care providers to provide for the delivery of coordinated health care and participation in quality improvement initiatives; and provided further that this clause shall not preclude a school-based health center or sponsoring organization from choosing to receive payments for services through managed care providers.
§ 3. This act shall take effect immediately, provided that the amendments to section 364-j of the social services law, made by sections one and two of this act, shall not affect the expiration and repeal of such section, and shall expire and be deemed repealed therewith.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the social services law, in relation to school-based health centers
Purpose
To permanently carve-out School-Based Health Centers (SBHC) from the State's Medicaid Managed Care (MMC) program.
Summary of provisions
Section 1 of the bill adds 2 new paragraphs (w) and (w-1) to Subdivision I of Section 364-j of the Social Services law to create definitions for a "School-Based Health Center" and a "Sponsoring organization" of a School-Based Health Center.
Section 2 provides that the Commissioner of Health shall not require the services provided by SBHCs to be provided through the State's Medicaid Managed program. In addition, the Commissioner of of Health is required to:
*reimburse SBHCs sponsored by Federally Qualified Health Centers (FQHCs) pursuant to federally mandated rate methodologies;
*reimburse SBHCs that are not sponsored by FQHCs or those who do not opt for the FQHC rate at APG rates: and
*develop a standard memorandum of understanding to be entered into by sponsoring organizations and managed care providers to provide for the delivery of coordinated health care and participation in quality improvement initiatives.
Section 3 provides for an immediate effective date.
Justification
SBHCs provide comprehensive physical, chronic, mental and dental health services to over 230,000 underserved youth in rural, urban and suburban areas of the State, regardless of insurance status or ability to pay. They are a proven model for increasing access to health and mental health services, reducing ethnic and racial disparities in the communities they serve, improving school attendance and performance, and saving the State money. According to the New York State Department of Health (NYS DOH), 31% of students served are black or African American and 44% are identified as Hispanic or Latino. Currently 13% are uninsured.
Since 1985, School-Based Health Centers have been "carved-out" of the Medicaid Managed Care program, enabling them to receive reimbursement directly from NYS DOH on a fee-for-service basis. NYS DOH is planning to end the carve-out as of July 1, 2018. Under the "carve-in", NYS DOH will disburse payments directly to MMC health plans and SBHCs will be required to negotiate the terms and conditions of reimbursement with the health plans and receive payment from them. A report by the Children's Defense Fund found that this transition to managed care would result in a loss of $16.2 million in funds to SBHCs.
School-Based Health Centers will not be financially viable if funds are reduced for the services that they provide. In the SFY 2017-18 Budget, direct funding for services to children and adolescents was reduced by $3.9 million, a 20% cut. This brings the total reduction in funds for SBHCs since 2008 to $7.3 million or nearly 30%.
This bill will preserve access to physical, mental, chronic, and dental health services for underserved children and adolescents in New York State by supporting the continued financial viability of SBHCs. It will enhance the delivery care to over 200,000 children that rely on SBHCs by authorizing NYS DOH to develop a standard memorandum of understanding to be entered into by sponsoring organizations and MMC plans to provide for the delivery of coordinated care and participation in quality improvement initiatives.
Legislative history
New bill.
Fiscal implications
Preservation of SBHCs saves the State money because they have a proven track record of reducing health care costs including unnecessary hospitalizations and emergency room visits.
Effective date
Immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.