BILL NUMBER: S7259

SPONSOR: BRISPORT
 
TITLE OF BILL:

An act to amend the social services law, in relation to requiring social
services districts to distribute educational materials pertaining to
sexual health to individuals enrolled in Medicaid

 
SUMMARY OF PROVISIONS:

Section one amends the social services law to authorize the commissioner
of social services to establish a sexual health education program for
the purpose of providing knowledge to individuals enrolled in Medicaid
plans about pre-exposure prophylaxis.

Section two sets forth the effective date.

 
JUSTIFICATION:

Although significant strides have been made in the treatment and
prevention of HIV, low income individuals and those with limited
              

resources are still disproportionately at risk of contracting the virus.
Far too often, new infections stem from lack of education regarding HIV
prevention and treatment options or lack of access to care. Currently,
many people at higher risk for HIV are eligible for Medicaid, and/or
members of mainstream Medicaid health plans.  Nonetheless, many Medicaid
health plan members are not receiving sexual health and HIV prevention
education services that address PEP and PrEP. Populations at higher risk
of becoming HIV+, including young same gender loving/MSM/gay/bi men of
color, transgender women of color and women of color, will benefit from
additional information about HIV preventative measures.

As it currently stands, only Medicaid eligible transgender persons who
are HIV negative or persons who are homeless are eligible to choose an
HIV Special Needs Plan where more robust PrEP education is occurring.
The New York State Department of Health (NYSDOH) AIDS Institute has
estimated that to end the HIV epidemic in New York State, access to PEP
and PrEP within the Medicaid program must increase from current access
by 6,000 Medicaid members to 30,000 Medicaid members who may end up
using PEP and PrEP. In addition, recent increases from 3,000 to 6,000
Medicaid members accessing PrEP has occurred largely amongst gay white
men, so it appears that furthering information access among other popu-
lations would increase use.

PEP and PrEP education have the potential for significant Medicaid cost
savings - For every averted HIV transmission, NYSDOH/Medicaid saves
approximately $400,000-$500,000 in lifetime costs of HIV treatment.
NYSDOH/Medicaid has already negotiated for supplemental manufacturer
discounts on all HIV medications, regardless of the intended use (treat-
ment or prevention). As such, costs for new PrEP scripts are already
covered. NYSDOH/Medicaid could seek deeper discounts associated with the
increased volume anticipated in Medicaid use of PEP and PrEP.

It is also extremely important that, as we seek to let as many people as
possible know about and access PEP and PrEP, it is critical that we
protect the privacy of individuals considered part of high risk popu-
lations, as well as every individual's medical history. Both within
Medicaid, and when it comes to informing patients about their options,
those administering education campaigns must be mindful to do so in a
sensitive, culturally appropriate manner.

 
PRIOR LEGISLATIVE HISTORY:

2021-22: S7618. 2022-23: S5903

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect on the ninetieth day after it shall have
become law.