What's happening
This bill ensures school-based health center services for Medicaid recipients are provided outside managed care programs in New York.
Why it matters
Guarantees direct access to school-based health center (SBHC) services for Medicaid recipients. by keeping these services outside the managed care system, which can reduce administrative barriers and interruptions in care for students.
Ensures continuity of care at SBHCs. , allowing students—especially those from low-income families—to continue receiving medical, mental health, and preventive services at school without disruptions that might arise if services were managed by insurance plans.
Protects funding and operational stability for SBHCs. , as these centers often face challenges when required to contract with multiple managed care organizations; this amendment shields them from additional bureaucracy and potential payment delays or denials.
May help address health disparities among children and adolescents. by maintaining a proven model that delivers accessible, community-based care directly on school campuses, especially in underserved communities.
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Who cares
Headline styles
Fund School Health Clinics
Plain English, a few words. Used as the page title.
Sponsors
History
- Vetoed memo.45
- Delivered to governor
- Returned to senate
- Passed assembly
- Ordered to third reading rules cal.707
- Substituted for A957
- Referred to ways and means
- Delivered to assembly
- Passed senateVote 59–0
- Advanced to third reading
- 2nd report cal.
- 1st report cal.485
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.
Protect School Health Center Coverage
Assembly Floor Calendar · Sponsor Amy Paulin
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1224
2025-2026 Regular Sessions
IN SENATE
January 8, 2025
Introduced by Sens. RIVERA, FERNANDEZ, JACKSON, MAY, OBERACKER, WEBB -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 coverage for services provided by school-based health centers for medical assistance recipients
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 3 of section 364-j of the social services law is amended by adding a new paragraph (d-4) to read as follows:
(d-4) Services provided in school-based health centers shall not be provided to medical assistance recipients through managed care programs established pursuant to this section and shall continue to be provided outside of managed care programs.
§ 2. This act shall take effect immediately and shall be deemed to have been in full force and effect on and after April 1, 2025; provided, however, that the amendments to section 364-j of the social services law made by this act shall not affect the repeal of such section and shall be deemed repealed therewith.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00465-01-5
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 coverage for services provided by school-based health centers for medical assistance recipients
Purpose or general idea of bill
To permit school-based health centers (SBHC) to remain out of Medicaid managed care.
SUMMARY OF SPECIFIC PROVISIONS:.
Section 1 of the bill amends section 364-j of the Social Services relat- ing to managed care programs, to provide that school-based health center (SBHC) services remain carved out from Medicaid managed care.
Section 2 of the bill establishes an effective date.
Justification
School-based health centers (SBHCs) provide comprehensive physical, chronic, and mental health services to over 250,000 underserved youth in rural, urban, and suburban areas of the State and an additional 100,000 kids receive essential dental services through SBHCs. regardless of insurance status or ability to pay. SBHCs are a proven model for increasing access to health and mental health services, reducing ethnic and racial disparities in the communities they serve, and improving school attendance and performance. They have a proven track record of reducing healthcare costs by offering preventative care and an alterna- tive to unnecessary hospitalizations and emergency room visits.
Since 1985, SBHCs have been "carved-out" of the Medicaid managed care program, being paid under fee-for-service. However, the Department of Health (DOH) has repeatedly attempted and then delayed ending the carve- out. Recently, DOH announced the State's intent to move SBHCs under Medicaid to managed care on April 1st, 2025.
If carved in, SBHCs will be required to negotiate the terms and condi- tions of payment through managed care plans, with prior authorization and utilization review, delaying care for New York children who rely on these centers and adding to their administrative burdens. Already, SBHCs have suffered from nearly 30% in cuts to funding since 2008, though their patient population has grown. This bill ends the years of attempts and delays by making the carve-out permanent and providing stability to this vital public health service.
Prior legislative history
2024: S7840 Rivera/A8863 Palin - Vetoed memo. 81
2023: S2339 Rivera/A6029 Paulin - Vetoed memo. 58
2022: S8447 Rivera/A9288 Gottfried - Vetoed memo .154
Fiscal implications
None.
Effective date
Immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.