S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  5672

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 25, 2011
                               ___________

Introduced by M. of A. BRONSON, SCHROEDER -- Multi-Sponsored by -- M. of
  A.  BOYLAND,  PHEFFER  --  read  once and referred to the Committee on
  Health

AN ACT to amend the public health law, the insurance law and the  social
  services  law,  in  relation  to  the provision of child abuse medical
  services at child advocacy centers and reimbursement therefor

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.   Short title. This act shall be known and may be cited as
the "child abuse medical services act".
  S 2.  Legislative intent. The legislature hereby  finds  and  declares
that  a child or adolescent who has been sexually abused needs immediate
medical attention and treatment. It is critical, therefore, that a child
or adolescent victimized by sexual assault, misconduct, or  exploitation
has  direct  access  to  a  medical provider who is specially trained to
evaluate, diagnose, and treat children and  adolescents  who  have  been
sexually  abused.  Furthermore,  medical  services  must be specifically
tailored to the health, mental health, and social  needs  of  an  abused
child  or adolescent. Child advocacy centers, accredited by the National
Children's Alliance and recognized by the New York state office of chil-
dren and family services, provide such specialized medical  services  to
abused  and  maltreated children and adolescents. Child advocacy centers
provide trained and experienced medical providers who are members  of  a
multi-disciplinary  team located in a facility dedicated to children and
adolescents who have  been  abused  or  maltreated  where  children  and
adolescents  can find timely, complete, sensitive medical help, therapy,
and support. To ensure abused children and adolescents direct access  to
child  abuse  medical providers at child advocacy centers and the avail-
ability of such services, the legislature hereby enacts the child  abuse
medical services act.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07914-02-1

              

A. 5672                             2

  S  3.  The public health law is amended by adding a new section 4406-f
to read as follows:
  S  4406-F.  ACCESS  TO CHILD ABUSE MEDICAL PROVIDERS AT CHILD ADVOCACY
CENTERS. 1. FOR THE PURPOSES OF THIS SECTION, THE FOLLOWING TERMS  SHALL
HAVE THE FOLLOWING MEANINGS:
  A.  "CHILD  ABUSE  MEDICAL  PROVIDER" MEANS A PHYSICIAN LICENSED UNDER
ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, NURSE  PRACTITIONER
CERTIFIED  UNDER SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW, OR
PHYSICIAN ASSISTANT OR SPECIALIST ASSISTANT LICENSED UNDER  ARTICLE  ONE
HUNDRED  THIRTY-ONE-B  OF  THE EDUCATION LAW TO PRACTICE IN THE STATE OF
NEW YORK WHO HAS COMPLETED A  CHILD  ABUSE  MEDICAL  PROVIDER  EDUCATION
PROGRAM  AND  PROVIDES  MEDICAL ASSESSMENT AND SERVICES TO CHILDREN, WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED, AT A CHILD ADVOCACY CENTER.
  B. "CHILD ABUSE MEDICAL PROVIDER EDUCATION PROGRAM" MEANS A PROGRAM OF
EDUCATION DEVELOPED AND IMPLEMENTED OR APPROVED BY  THE  DEPARTMENT,  IN
CONSULTATION  WITH  THE  OFFICE OF CHILDREN AND FAMILY SERVICES, SPECIF-
ICALLY TO TRAIN  PHYSICIANS,  NURSE  PRACTITIONERS,  AND  PHYSICIAN  AND
SPECIALIST  ASSISTANTS  LICENSED  TO PRACTICE PURSUANT TO TITLE EIGHT OF
THE EDUCATION LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT  OF  ABUSED
AND MALTREATED CHILDREN.
  C. "CHILD ADVOCACY CENTER" MEANS A LOCAL OR REGIONAL MULTIDISCIPLINARY
TEAM  FULLY  ACCREDITED BY THE NATIONAL CHILDREN'S ALLIANCE AND APPROVED
BY THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR THE PURPOSE OF  INVES-
TIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  D. "CHILD SEXUAL ABUSE" MEANS ANY OF THE OFFENSES DESCRIBED IN ARTICLE
ONE  HUNDRED  THIRTY,  TWO HUNDRED THIRTY, OR TWO HUNDRED SIXTY-THREE OF
THE PENAL LAW WHEN COMMITTED AGAINST A PERSON LESS THAN  EIGHTEEN  YEARS
OF AGE.
  E. "MEDICAL ASSESSMENT" MEANS THE EVALUATION, DIAGNOSIS, AND TREATMENT
OF  A CHILD BY A CHILD ABUSE MEDICAL PROVIDER, WHICH INCLUDES BUT IS NOT
LIMITED TO A THOROUGH MEDICAL HISTORY AND COMPLETE PHYSICAL  AND  MENTAL
HEALTH EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD HAS BEEN SEXUALLY
ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY APPROPRIATE FOLLOW-UP
FOR  THE  CHILD  PURSUANT  TO  A  PROTOCOL APPROVED BY THE DEPARTMENT IN
CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES.
  2. NO CHILD WHO HAS BEEN OR MAY HAVE BEEN  SEXUALLY  ABUSED  SHALL  BE
DENIED  DIRECT ACCESS TO A CHILD ABUSE MEDICAL PROVIDER AT A CHILD ADVO-
CACY CENTER. A HEALTH MAINTENANCE ORGANIZATION SHALL NOT  DENY  A  CHILD
DIRECT  ACCESS  TO  A  CHILD  ABUSE MEDICAL PROVIDER AT A CHILD ADVOCACY
CENTER FOR A MEDICAL ASSESSMENT OR LIMIT SUCH ACCESS WHEN:
  A. A CHILD DISCLOSES SEXUAL ABUSE TO A PARENT,  OTHER  PERSON  LEGALLY
RESPONSIBLE  FOR  THE  CARE  OF THE CHILD AS DEFINED BY THE FAMILY COURT
ACT, OR A PERSON OR OFFICIAL REQUIRED TO REPORT SEXUAL ABUSE OF A  CHILD
PURSUANT TO SECTION FOUR HUNDRED THIRTEEN OF THE SOCIAL SERVICES LAW;
  B. A PARENT, OTHER PERSON LEGALLY RESPONSIBLE FOR CARE OF THE CHILD AS
DEFINED  BY  THE  FAMILY  COURT ACT, OR A PERSON OR OFFICIAL ACTING IN A
PROFESSIONAL CAPACITY REQUIRED TO REPORT SEXUAL ABUSE OF A CHILD  PURSU-
ANT  TO  SECTION  FOUR  HUNDRED  THIRTEEN OF THE SOCIAL SERVICES LAW HAS
REASONABLE CAUSE TO SUSPECT THAT THE CHILD HAS BEEN  OR  MAY  HAVE  BEEN
SEXUALLY ABUSED;
  C.  A  CHILD  PROTECTIVE  AGENCY,  AS  DEFINED IN SECTION ONE THOUSAND
TWELVE OF THE FAMILY COURT ACT, HAS REASONABLE CAUSE TO BELIEVE  THAT  A
CHILD IN ITS CUSTODY HAS BEEN OR MAY HAVE BEEN SEXUALLY ABUSED; OR
  D. A COURT ORDER DIRECTS A MEDICAL ASSESSMENT OF A CHILD.
  3.  IT SHALL BE THE DUTY OF THE ADMINISTRATIVE OFFICER OR OTHER PERSON
IN CHARGE OF EACH HEALTH MAINTENANCE ORGANIZATION TO:

A. 5672                             3

  A. ADVISE EACH  ENROLLEE,  IN  WRITING,  OF  THE  PROVISIONS  OF  THIS
SECTION, AND
  B.    ESTABLISH,  AND  DISCLOSE TO ALL ENROLLEES, PARTICIPATING HEALTH
CARE PROVIDERS, THE COMMISSIONER, AND THE SUPERINTENDENT  OF  INSURANCE,
METHODS  OF  ENSURING THAT A CHILD COVERED UNDER THE PLAN WHO HAS OR MAY
HAVE BEEN SEXUALLY ABUSED HAS  DIRECT  ACCESS  TO  CHILD  ABUSE  MEDICAL
PROVIDERS AT CHILD ADVOCACY CENTERS.
  4.  THE  AMOUNT  OF  REIMBURSEMENT  WHICH  SHALL BE PAID FOR A MEDICAL
ASSESSMENT OF A CHILD BY A CHILD ABUSE MEDICAL PROVIDER AT A CHILD ADVO-
CACY CENTER SHALL EQUAL THE AMOUNT THAT WOULD BE  PAID  TO  A  QUALIFIED
PROVIDER  WITHIN  THE  PLAN.  THERE  SHALL  BE NO ADDITIONAL COST TO THE
INSURED BEYOND  WHAT  THE  INSURED  WOULD  OTHERWISE  PAY  FOR  SERVICES
RECEIVED WITHIN THE NETWORK.
  S 4. Subdivision 1 of section 4408 of the public health law is amended
by adding a new paragraph (p-2) to read as follows:
  (P-2) NOTICE THAT A CHILD ENROLLEE WHO HAS BEEN OR MAY HAVE BEEN SEXU-
ALLY  ABUSED  SHALL HAVE DIRECT ACCESS TO A CHILD ABUSE MEDICAL PROVIDER
AT A CHILD ADVOCACY CENTER;
  S 5. Subsection (i) of section 3216 of the insurance law is amended by
adding a new paragraph 28 to read as follows:
  (28) (A) EVERY POLICY WHICH PROVIDES COVERAGE FOR HOSPITAL,  SURGICAL,
OR  MEDICAL  CARE  SHALL PROVIDE THE FOLLOWING COVERAGE FOR CHILD SEXUAL
ABUSE PURSUANT TO THIS PARAGRAPH.
  (B) FOR THE PURPOSES OF THIS PARAGRAPH, THE FOLLOWING TERMS SHALL HAVE
THE FOLLOWING MEANINGS:
  (I) "CHILD ABUSE MEDICAL PROVIDER" MEANS A  PHYSICIAN  LICENSED  UNDER
ARTICLE  ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, NURSE PRACTITIONER
CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW,  OR
PHYSICIAN  ASSISTANT  OR SPECIALIST ASSISTANT LICENSED UNDER ARTICLE ONE
HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW TO PRACTICE IN  THE  STATE  OF
NEW  YORK  WHO  HAS  COMPLETED  A CHILD ABUSE MEDICAL PROVIDER EDUCATION
PROGRAM AND PROVIDES MEDICAL ASSESSMENT AND SERVICES  TO  CHILDREN,  WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED, AT A CHILD ADVOCACY CENTER.
  (II)  "CHILD ABUSE MEDICAL PROVIDER EDUCATION PROGRAM" MEANS A PROGRAM
OF EDUCATION DEVELOPED AND IMPLEMENTED OR APPROVED BY THE DEPARTMENT  OF
HEALTH, IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES,
SPECIFICALLY TO TRAIN PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN AND
SPECIALIST  ASSISTANTS  LICENSED  TO PRACTICE PURSUANT TO TITLE EIGHT OF
THE EDUCATION LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT  OF  ABUSED
AND MALTREATED CHILDREN.
  (III) "CHILD ADVOCACY CENTER" MEANS A LOCAL OR REGIONAL MULTIDISCIPLI-
NARY  TEAM  FULLY  ACCREDITED  BY  THE  NATIONAL CHILDREN'S ALLIANCE AND
APPROVED BY THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR  THE  PURPOSE
OF INVESTIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  (IV) "CHILD SEXUAL ABUSE" MEANS ANY OF THE OFFENSES DESCRIBED IN ARTI-
CLE  ONE  HUNDRED THIRTY, TWO HUNDRED THIRTY, OR TWO HUNDRED SIXTY-THREE
OF THE PENAL LAW WHEN COMMITTED AGAINST  A  PERSON  LESS  THAN  EIGHTEEN
YEARS OF AGE.
  (V)  "MEDICAL  ASSESSMENT" MEANS THE EVALUATION, DIAGNOSIS, AND TREAT-
MENT OF A CHILD BY A CHILD ABUSE MEDICAL PROVIDER, WHICH INCLUDES BUT IS
NOT LIMITED TO A THOROUGH MEDICAL  HISTORY  AND  COMPLETE  PHYSICAL  AND
MENTAL  HEALTH  EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD HAS BEEN
SEXUALLY ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY  APPROPRIATE
FOLLOW-UP  FOR  THE CHILD PURSUANT TO A PROTOCOL APPROVED BY THE DEPART-
MENT OF HEALTH IN CONSULTATION WITH THE OFFICE OF  CHILDREN  AND  FAMILY
SERVICES.

A. 5672                             4

  (C)  NO  POLICY  SHALL  DENY  TO A CHILD WHO HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED DIRECT ACCESS TO A CHILD ABUSE  MEDICAL  PROVIDER  AT  A
CHILD  ADVOCACY  CENTER  FOR  A  MEDICAL ASSESSMENT OR LIMIT SUCH ACCESS
WHEN:
  (I)  A  CHILD DISCLOSES SEXUAL ABUSE TO A PARENT, OTHER PERSON LEGALLY
RESPONSIBLE FOR THE CARE OF THE CHILD AS DEFINED  BY  THE  FAMILY  COURT
ACT,  OR A PERSON OR OFFICIAL REQUIRED TO REPORT SEXUAL ABUSE OF A CHILD
PURSUANT TO SECTION FOUR HUNDRED THIRTEEN OF THE SOCIAL SERVICES LAW;
  (II) A PARENT, OTHER PERSON LEGALLY RESPONSIBLE FOR CARE OF THE  CHILD
AS  DEFINED IN THE FAMILY COURT ACT, OR A PERSON OR OFFICIAL ACTING IN A
PROFESSIONAL CAPACITY REQUIRED TO REPORT SEXUAL ABUSE OF A CHILD  PURSU-
ANT  TO  SECTION  FOUR  HUNDRED  THIRTEEN OF THE SOCIAL SERVICES LAW HAS
REASONABLE CAUSE TO SUSPECT THAT THE CHILD HAS BEEN  OR  MAY  HAVE  BEEN
SEXUALLY ABUSED;
  (III)  A  CHILD  PROTECTIVE AGENCY, AS DEFINED IN SECTION ONE THOUSAND
TWELVE OF THE FAMILY COURT ACT, HAS REASONABLE CAUSE TO BELIEVE  THAT  A
CHILD IN ITS CUSTODY HAS BEEN OR MAY HAVE BEEN SEXUALLY ABUSED; OR
  (IV) A COURT ORDER DIRECTS A MEDICAL ASSESSMENT OF A CHILD.
  S 6. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 17 to read as follows:
  (17) (A) EVERY INSURER DELIVERING A GROUP OR BLANKET POLICY OR ISSUING
A  GROUP  OR  BLANKET  POLICY  FOR DELIVERY IN THIS STATE WHICH PROVIDES
COVERAGE FOR HOSPITAL, SURGICAL,  OR  MEDICAL  CARE  SHALL  PROVIDE  THE
FOLLOWING COVERAGE FOR CHILD SEXUAL ABUSE PURSUANT TO THIS PARAGRAPH.
  (B) FOR THE PURPOSES OF THIS PARAGRAPH, THE FOLLOWING TERMS SHALL HAVE
THE FOLLOWING MEANINGS:
  (I)  "CHILD  ABUSE  MEDICAL PROVIDER" MEANS A PHYSICIAN LICENSED UNDER
ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, NURSE  PRACTITIONER
CERTIFIED  UNDER SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW, OR
PHYSICIAN ASSISTANT OR SPECIALIST ASSISTANT LICENSED UNDER  ARTICLE  ONE
HUNDRED  THIRTY-ONE-B  OF  THE EDUCATION LAW TO PRACTICE IN THE STATE OF
NEW YORK WHO HAS COMPLETED A  CHILD  ABUSE  MEDICAL  PROVIDER  EDUCATION
PROGRAM  AND  PROVIDES  MEDICAL ASSESSMENT AND SERVICES TO CHILDREN, WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED, AT A CHILD ADVOCACY CENTER.
  (II) "CHILD ABUSE MEDICAL PROVIDER EDUCATION PROGRAM" MEANS A  PROGRAM
OF  EDUCATION DEVELOPED AND IMPLEMENTED OR APPROVED BY THE DEPARTMENT OF
HEALTH, IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES,
SPECIFICALLY TO TRAIN PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN AND
SPECIALIST ASSISTANTS LICENSED TO PRACTICE PURSUANT TO  TITLE  EIGHT  OF
THE  EDUCATION  LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT OF ABUSED
AND MALTREATED CHILDREN.
  (III) "CHILD ADVOCACY CENTER" MEANS A LOCAL OR REGIONAL MULTIDISCIPLI-
NARY TEAM FULLY ACCREDITED  BY  THE  NATIONAL  CHILDREN'S  ALLIANCE  AND
APPROVED  BY  THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR THE PURPOSE
OF INVESTIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  (IV) "CHILD SEXUAL ABUSE" MEANS ANY OF THE OFFENSES DESCRIBED IN ARTI-
CLE ONE HUNDRED THIRTY, TWO HUNDRED THIRTY, OR TWO  HUNDRED  SIXTY-THREE
OF  THE  PENAL  LAW  WHEN  COMMITTED AGAINST A PERSON LESS THAN EIGHTEEN
YEARS OF AGE.
  (V) "MEDICAL ASSESSMENT" MEANS THE EVALUATION, DIAGNOSIS,  AND  TREAT-
MENT OF A CHILD BY A CHILD ABUSE MEDICAL PROVIDER, WHICH INCLUDES BUT IS
NOT  LIMITED  TO  A  THOROUGH  MEDICAL HISTORY AND COMPLETE PHYSICAL AND
MENTAL HEALTH EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD  HAS  BEEN
SEXUALLY  ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY APPROPRIATE
FOLLOW-UP FOR THE CHILD PURSUANT TO A PROTOCOL APPROVED BY  THE  DEPART-

A. 5672                             5

MENT  OF  HEALTH  IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY
SERVICES.
  (C)  NO  POLICY  SHALL  DENY  TO A CHILD WHO HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED DIRECT ACCESS TO A CHILD ABUSE  MEDICAL  PROVIDER  AT  A
CHILD  ADVOCACY  CENTER  FOR  A  MEDICAL ASSESSMENT OR LIMIT SUCH ACCESS
WHEN:
  (I) A CHILD DISCLOSES SEXUAL ABUSE TO A PARENT, OTHER  PERSON  LEGALLY
RESPONSIBLE  FOR  THE  CARE  OF THE CHILD AS DEFINED BY THE FAMILY COURT
ACT, OR A PERSON OR OFFICIAL REQUIRED TO REPORT SEXUAL ABUSE OF A  CHILD
PURSUANT TO SECTION FOUR HUNDRED THIRTEEN OF THE SOCIAL SERVICES LAW;
  (II)  A PARENT, OTHER PERSON LEGALLY RESPONSIBLE FOR CARE OF THE CHILD
AS DEFINED IN THE FAMILY COURT ACT, OR A PERSON OR OFFICIAL ACTING IN  A
PROFESSIONAL  CAPACITY REQUIRED TO REPORT SEXUAL ABUSE OF A CHILD PURSU-
ANT TO SECTION FOUR HUNDRED THIRTEEN OF  THE  SOCIAL  SERVICES  LAW  HAS
REASONABLE  CAUSE  TO  SUSPECT  THAT THE CHILD HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED;
  (III) A CHILD PROTECTIVE AGENCY, AS DEFINED IN  SECTION  ONE  THOUSAND
TWELVE  OF  THE FAMILY COURT ACT, HAS REASONABLE CAUSE TO BELIEVE THAT A
CHILD IN ITS CUSTODY HAS BEEN OR MAY HAVE BEEN SEXUALLY ABUSED; OR
  (IV) A COURT ORDER DIRECTS A MEDICAL ASSESSMENT OF A CHILD.
  S 7. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (hh) to read as follows:
  (HH)  (1)  A MEDICAL EXPENSE INDEMNITY CORPORATION, A HOSPITAL SERVICE
CORPORATION OR A HEALTH SERVICE CORPORATION WHICH PROVIDES COVERAGE  FOR
HOSPITAL, SURGICAL, OR MEDICAL CARE SHALL PROVIDE THE FOLLOWING COVERAGE
FOR CHILD SEXUAL ABUSE.
  (2) FOR THE PURPOSES OF THIS SUBSECTION THE FOLLOWING TERMS SHALL HAVE
THE FOLLOWING MEANINGS:
  (A)  "CHILD  ABUSE  MEDICAL PROVIDER" MEANS A PHYSICIAN LICENSED UNDER
ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, NURSE  PRACTITIONER
CERTIFIED  UNDER SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW, OR
PHYSICIAN ASSISTANT OR SPECIALIST ASSISTANT LICENSED UNDER  ARTICLE  ONE
HUNDRED  THIRTY-ONE-B  OF  THE EDUCATION LAW TO PRACTICE IN THE STATE OF
NEW YORK WHO HAS COMPLETED A  CHILD  ABUSE  MEDICAL  PROVIDER  EDUCATION
PROGRAM  AND  PROVIDES  MEDICAL ASSESSMENT AND SERVICES TO CHILDREN, WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED, AT A CHILD ADVOCACY CENTER.
  (B) "CHILD ABUSE MEDICAL PROVIDER EDUCATION PROGRAM" MEANS  A  PROGRAM
OF  EDUCATION DEVELOPED AND IMPLEMENTED OR APPROVED BY THE DEPARTMENT OF
HEALTH, IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES,
SPECIFICALLY TO TRAIN PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN AND
SPECIALIST ASSISTANTS LICENSED TO PRACTICE PURSUANT TO  TITLE  EIGHT  OF
THE  EDUCATION  LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT OF ABUSED
AND MALTREATED CHILDREN.
  (C) "CHILD ADVOCACY CENTER" MEANS A LOCAL OR  REGIONAL  MULTIDISCIPLI-
NARY  TEAM  FULLY  ACCREDITED  BY  THE  NATIONAL CHILDREN'S ALLIANCE AND
APPROVED BY THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR  THE  PURPOSE
OF INVESTIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  (D)  "CHILD SEXUAL ABUSE" MEANS ANY OF THE OFFENSES DESCRIBED IN ARTI-
CLE ONE HUNDRED THIRTY, TWO HUNDRED THIRTY, OR TWO  HUNDRED  SIXTY-THREE
OF  THE  PENAL  LAW  WHEN  COMMITTED AGAINST A PERSON LESS THAN EIGHTEEN
YEARS OF AGE.
  (E) "MEDICAL ASSESSMENT" MEANS THE EVALUATION, DIAGNOSIS,  AND  TREAT-
MENT OF A CHILD BY A CHILD ABUSE MEDICAL PROVIDER, WHICH INCLUDES BUT IS
NOT  LIMITED  TO  A  THOROUGH  MEDICAL HISTORY AND COMPLETE PHYSICAL AND
MENTAL HEALTH EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD  HAS  BEEN
SEXUALLY  ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY APPROPRIATE

A. 5672                             6

FOLLOW-UP FOR THE CHILD PURSUANT TO A PROTOCOL APPROVED BY  THE  DEPART-
MENT  OF  HEALTH  IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY
SERVICES.
  (3)  NO  POLICY  SHALL  DENY  TO A CHILD WHO HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED DIRECT ACCESS TO A CHILD ABUSE  MEDICAL  PROVIDER  AT  A
CHILD  ADVOCACY  CENTER  FOR  A  MEDICAL ASSESSMENT OR LIMIT SUCH ACCESS
WHEN:
  (I) A CHILD DISCLOSES SEXUAL ABUSE TO A PARENT, OTHER  PERSON  LEGALLY
RESPONSIBLE  FOR  THE  CARE  OF THE CHILD AS DEFINED BY THE FAMILY COURT
ACT, OR A PERSON OR OFFICIAL REQUIRED TO REPORT SEXUAL ABUSE OF A  CHILD
PURSUANT TO SECTION FOUR HUNDRED THIRTEEN OF THE SOCIAL SERVICES LAW;
  (II)  A PARENT, OTHER PERSON LEGALLY RESPONSIBLE FOR CARE OF THE CHILD
AS DEFINED IN THE FAMILY COURT ACT, OR A PERSON OR OFFICIAL ACTING IN  A
PROFESSIONAL  CAPACITY REQUIRED TO REPORT SEXUAL ABUSE OF A CHILD PURSU-
ANT TO SECTION FOUR HUNDRED THIRTEEN OF  THE  SOCIAL  SERVICES  LAW  HAS
REASONABLE  CAUSE  TO  SUSPECT  THAT THE CHILD HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED;
  (III) A CHILD PROTECTIVE AGENCY, AS DEFINED IN  SECTION  ONE  THOUSAND
TWELVE  OF  THE FAMILY COURT ACT, HAS REASONABLE CAUSE TO BELIEVE THAT A
CHILD IN ITS CUSTODY HAS BEEN OR MAY HAVE BEEN SEXUALLY ABUSED; OR
  (IV) A COURT ORDER DIRECTS A MEDICAL ASSESSMENT OF A CHILD.
  S 8. Paragraphs 16 and 17 of subsection (a) of section 3217-a  of  the
insurance  law, as added by chapter 705 of the laws of 1996, are amended
and a new paragraph 18 is added to read as follows:
  (16) notice of all appropriate mailing addresses and telephone numbers
to be utilized by insureds seeking information or authorization; [and]
  (17) where applicable, a listing by specialty, which may be in a sepa-
rate document that is updated annually, of the name, address, and  tele-
phone  number  of all participating providers, including facilities, and
in addition, in the case of physicians, board certification[.]; AND
  (18)  WHERE  APPLICABLE,  NOTICE  OF  THE  PROVISIONS   OF   PARAGRAPH
TWENTY-EIGHT  OF  SUBSECTION  (I)  OF SECTION THREE THOUSAND TWO HUNDRED
SIXTEEN AND PARAGRAPH SEVENTEEN OF SUBSECTION (K) OF SECTION THREE THOU-
SAND TWO HUNDRED TWENTY-ONE OF THIS ARTICLE AND OF METHODS  OF  ENSURING
THAT  A  CHILD  COVERED  UNDER  THE POLICY WHO HAS BEEN OR MAY HAVE BEEN
SEXUALLY ABUSED HAS DIRECT ACCESS TO CHILD ABUSE  MEDICAL  PROVIDERS  AT
CHILD ADVOCACY CENTERS.
  S  9.  Paragraphs  17  and 18 of subsection (a) of section 4324 of the
insurance law, as added by chapter 705 of the laws of 1996, are  amended
and a new paragraph 19 is added to read as follows:
  (17) where applicable, a listing by specialty, which may be in a sepa-
rate  document that is updated annually, of the name, address, and tele-
phone number of all participating providers, including  facilities,  and
in addition, in the case of physicians, board certification; [and]
  (18)  a description of the mechanisms by which subscribers may partic-
ipate in the development of the policies of the corporation[.]; AND
  (19) WHERE APPLICABLE, NOTICE OF THE PROVISIONS OF SUBSECTION (HH)  OF
SECTION FOUR THOUSAND THREE HUNDRED THREE OF THIS ARTICLE AND OF METHODS
OF  ENSURING  THAT  A CHILD COVERED UNDER THE POLICY WHO HAS BEEN OR MAY
HAVE BEEN SEXUALLY ABUSED HAS  DIRECT  ACCESS  TO  CHILD  ABUSE  MEDICAL
PROVIDERS AT CHILD ADVOCACY CENTERS.
  S  10.  Subdivision  1  of section 364-j of the social services law is
amended by adding five new paragraphs (z), (aa), (bb), (cc) and (dd)  to
read as follows:
  (Z) "CHILD ABUSE MEDICAL PROVIDER". A PHYSICIAN LICENSED UNDER ARTICLE
ONE  HUNDRED  THIRTY-ONE OF THE EDUCATION LAW, NURSE PRACTITIONER CERTI-

A. 5672                             7

FIED UNDER SECTION SIXTY-NINE HUNDRED  TEN  OF  THE  EDUCATION  LAW,  OR
PHYSICIAN  ASSISTANT  OR SPECIALIST ASSISTANT LICENSED UNDER ARTICLE ONE
HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW TO PRACTICE IN  THE  STATE  OF
NEW  YORK  WHO  HAS  COMPLETED  A CHILD ABUSE MEDICAL PROVIDER EDUCATION
PROGRAM AND PROVIDES MEDICAL ASSESSMENT AND SERVICES  TO  CHILDREN,  WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED, AT A CHILD ADVOCACY CENTER.
  (AA)  "CHILD  ABUSE  MEDICAL PROVIDER EDUCATION PROGRAM". A PROGRAM OF
EDUCATION DEVELOPED AND IMPLEMENTED OR APPROVED  BY  THE  DEPARTMENT  OF
HEALTH, IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES,
SPECIFICALLY TO TRAIN PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN AND
SPECIALIST  ASSISTANTS  LICENSED  TO PRACTICE PURSUANT TO TITLE EIGHT OF
THE EDUCATION LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT  OF  ABUSED
AND MALTREATED CHILDREN.
  (BB)  "CHILD  ADVOCACY  CENTER". A LOCAL OR REGIONAL MULTIDISCIPLINARY
TEAM FULLY ACCREDITED BY THE NATIONAL CHILDREN'S ALLIANCE  AND  APPROVED
BY  THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR THE PURPOSE OF INVES-
TIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  (CC) "CHILD SEXUAL ABUSE". ANY OF THE OFFENSES  DESCRIBED  IN  ARTICLE
ONE HUNDRED THIRTY, TWO HUNDRED THIRTY OR TWO HUNDRED SIXTY-THREE OF THE
PENAL  LAW  WHEN  COMMITTED AGAINST A PERSON LESS THAN EIGHTEEN YEARS OF
AGE.
  (DD) "MEDICAL ASSESSMENT". THE EVALUATION, DIAGNOSIS, AND TREATMENT OF
A CHILD BY A CHILD ABUSE MEDICAL PROVIDER, WHICH  INCLUDES  BUT  IS  NOT
LIMITED  TO  A THOROUGH MEDICAL HISTORY AND COMPLETE PHYSICAL AND MENTAL
HEALTH EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD HAS BEEN SEXUALLY
ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY APPROPRIATE FOLLOW-UP
FOR THE CHILD PURSUANT TO A  PROTOCOL  APPROVED  BY  THE  DEPARTMENT  OF
HEALTH IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES.
  S  11. Subparagraphs (ix) and (x) of paragraph (e) of subdivision 3 of
section 364-j of the social services law, as amended by chapter  648  of
the  laws of 1999, are amended and a new paragraph (xi) is added to read
as follows:
  (ix) HIV COBRA case management; [and]
  (x) other services as determined by the commissioner of health[.]; AND
  (XI) MEDICAL ASSESSMENT OF A CHILD WHO HAS BEEN OR MAY HAVE BEEN SEXU-
ALLY ABUSED, WHICH ASSESSMENT SHALL INSTEAD BE REFERRED IMMEDIATELY  AND
DIRECTLY TO A CHILD ABUSE MEDICAL PROVIDER AT A CHILD ADVOCACY CENTER.
  S  12.  Subparagraphs (ii) and (iii) of paragraph (a) of subdivision 4
of section 364-j of the social services law, as amended by section 14 of
part C of chapter 58 of the laws of 2004,  clause  (E)  of  subparagraph
(iii)  as  added  and  clause (F) of subparagraph (iii) as relettered by
chapter 37 of the laws of 2010, are amended and a new subparagraph  (iv)
is added to read as follows:
  (ii)  provided, however, if a major public hospital, as defined in the
public health law, is designated by the  commissioner  of  health  as  a
managed  care provider in a social services district the commissioner of
health shall designate at least one other managed care provider which is
not a major public hospital or  facility  operated  by  a  major  public
hospital; [and]
  (iii)  under  a  managed  care program, not all managed care providers
must be required to provide the same set of medical assistance services.
The managed  care  program  shall  establish  procedures  through  which
participants  will  be assured access to all medical assistance services
to which they are otherwise entitled, other  than  through  the  managed
care provider, where:

A. 5672                             8

  (A)  the  service  is  not reasonably available directly or indirectly
from the managed care provider,
  (B) it is necessary because of emergency or geographic unavailability,
or
  (C) the services provided are family planning services; or
  (D)  the services are dental services and are provided by a diagnostic
and treatment center licensed under article twenty-eight of  the  public
health  law which is affiliated with an academic dental center and which
has been granted an operating certificate pursuant  to  article  twenty-
eight  of  the  public  health law to provide such dental services.  Any
diagnostic and treatment center providing dental  services  pursuant  to
this  clause shall prior to June first of each year report to the gover-
nor, temporary president of the senate and speaker of  the  assembly  on
the  following:  the  total  number of visits made by medical assistance
recipients during the immediately preceding calendar year; the number of
visits made by medical  assistance  recipients  during  the  immediately
preceding  calendar year by recipients who were enrolled in managed care
programs; the number of visits made  by  medical  assistance  recipients
during  the  immediately  preceding calendar year by recipients who were
enrolled in managed care programs that  provide  dental  benefits  as  a
covered  service;  and the number of visits made by the uninsured during
the immediately preceding calendar year; or
  (E) the services are optometric services, as defined  in  article  one
hundred forty-three of the education law, and are provided by a diagnos-
tic  and  treatment  center  licensed  under article twenty-eight of the
public health law which is affiliated with the college of  optometry  of
the state university of New York and which has been granted an operating
certificate pursuant to article twenty-eight of the public health law to
provide  such  optometric  services. Any diagnostic and treatment center
providing optometric services pursuant to this  clause  shall  prior  to
June  first  of each year report to the governor, temporary president of
the senate and speaker of the assembly on  the  following:    the  total
number  of visits made by medical assistance recipients during the imme-
diately preceding calendar year; the number of visits  made  by  medical
assistance  recipients during the immediately preceding calendar year by
recipients who were enrolled in managed care  programs;  the  number  of
visits  made  by  medical  assistance  recipients during the immediately
preceding calendar year by recipients who were enrolled in managed  care
programs  that provide optometric benefits as a covered service; and the
number of visits made by the uninsured during the immediately  preceding
calendar year; or
  (F) other services as defined by the commissioner of health[.]; AND
  (IV) MEDICAL ASSESSMENT OF A CHILD WHO HAS BEEN OR MAY HAVE BEEN SEXU-
ALLY  ABUSED SHALL BE REFERRED IMMEDIATELY AND DIRECTLY TO A CHILD ABUSE
MEDICAL PROVIDER AT A CHILD ADVOCACY CENTER.
  S 13. The social services law is amended by adding a new section 368-g
to read as follows:
  S 368-G. REIMBURSEMENT FOR CHILD SEXUAL ABUSE MEDICAL  ASSESSMENT.  1.
FOR  THE  PURPOSES  OF  THIS SECTION, THE FOLLOWING TERMS SHALL HAVE THE
FOLLOWING MEANINGS:
  (A) "CHILD ABUSE MEDICAL PROVIDER" MEANS A  PHYSICIAN  LICENSED  UNDER
ARTICLE  ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, NURSE PRACTITIONER
CERTIFIED UNDER SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCATION LAW,  OR
PHYSICIAN  ASSISTANT  OR SPECIALIST ASSISTANT LICENSED UNDER ARTICLE ONE
HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW TO PRACTICE IN  THE  STATE  OF
NEW  YORK  WHO  HAS  COMPLETED  A CHILD ABUSE MEDICAL PROVIDER EDUCATION

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PROGRAM AND PROVIDES MEDICAL ASSESSMENT AND  SERVICES  TO  CHILDREN  WHO
HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED AT A CHILD ADVOCACY CENTER.
  (B)  "CHILD  ABUSE MEDICAL PROVIDER EDUCATION PROGRAM" MEANS A PROGRAM
OF EDUCATION DEVELOPED AND IMPLEMENTED OR APPROVED BY THE DEPARTMENT  OF
HEALTH, IN CONSULTATION WITH THE OFFICE OF CHILDREN AND FAMILY SERVICES,
SPECIFICALLY TO TRAIN PHYSICIANS, NURSE PRACTITIONERS, AND PHYSICIAN AND
SPECIALIST  ASSISTANTS  LICENSED  TO PRACTICE PURSUANT TO TITLE EIGHT OF
THE EDUCATION LAW ABOUT EVALUATION, DIAGNOSIS, AND TREATMENT  OF  ABUSED
AND MALTREATED CHILDREN.
  (C)  "CHILD  ADVOCACY CENTER" MEANS A LOCAL OR REGIONAL MULTIDISCIPLI-
NARY TEAM FULLY ACCREDITED  BY  THE  NATIONAL  CHILDREN'S  ALLIANCE  AND
APPROVED  BY  THE OFFICE OF CHILDREN AND FAMILY SERVICES FOR THE PURPOSE
OF INVESTIGATING REPORTS OF SUSPECTED CHILD ABUSE OR MALTREATMENT.
  (D) "CHILD SEXUAL ABUSE" MEANS ANY OF THE OFFENSES DESCRIBED IN  ARTI-
CLE  ONE HUNDRED THIRTY, TWO HUNDRED THIRTY, AND TWO HUNDRED SIXTY-THREE
OF THE PENAL LAW WHEN COMMITTED AGAINST  A  PERSON  LESS  THAN  EIGHTEEN
YEARS OF AGE.
  (E)  "MEDICAL  ASSESSMENT" MEANS THE EVALUATION, DIAGNOSIS, AND TREAT-
MENT OF A CHILD BY A CHILD ABUSE MEDICAL PROVIDER, WHICH INCLUDES BUT IS
NOT LIMITED TO A THOROUGH MEDICAL  HISTORY  AND  COMPLETE  PHYSICAL  AND
MENTAL  HEALTH  EXAMINATION TO DETERMINE WHETHER OR NOT A CHILD HAS BEEN
SEXUALLY ABUSED, DIAGNOSE AND TREAT THE CHILD, AND IDENTIFY  APPROPRIATE
FOLLOW-UP  FOR  THE CHILD PURSUANT TO A PROTOCOL APPROVED BY THE DEPART-
MENT OF HEALTH IN CONSULTATION WITH THE OFFICE OF  CHILDREN  AND  FAMILY
SERVICES.
  2.  A  SOCIAL  SERVICES DISTRICT SHALL REIMBURSE A CHILD ABUSE MEDICAL
PROVIDER AT A CHILD CARE CENTER ELIGIBLE FOR FUNDING AS A  COMPREHENSIVE
HEALTH SERVICES PROGRAM AT THE MAXIMUM REIMBURSEMENT THAT THE DEPARTMENT
OF HEALTH MAY PAY FOR PROVIDING OR ARRANGING FOR MEDICAL ASSESSMENT OF A
CHILD  WHO  HAS BEEN OR MAY HAVE BEEN SEXUALLY ABUSED IN ACCORDANCE WITH
THE FEDERAL SOCIAL SECURITY ACT AND REGULATIONS PROMULGATED THEREUNDER.
  3. CHILD ADVOCACY CENTERS THAT ARE NOT ELIGIBLE FOR FUNDING AS COMPRE-
HENSIVE HEALTH SERVICES PROGRAMS  SHALL  BE  RESPONSIBLE  FOR  PROVIDING
MEDICAL  ASSESSMENTS  AND SERVICES TO CHILDREN WHO HAVE BEEN OR MAY HAVE
BEEN SEXUALLY ABUSED PURSUANT TO A PROTOCOL APPROVED BY  THE  DEPARTMENT
OF  HEALTH  IN  CONSULTATION  WITH  THE  OFFICE  OF  CHILDREN AND FAMILY
SERVICES, WHICH SHALL INCLUDE BUT NOT BE LIMITED TO:
  (A) MEDICAL EVALUATION, DIAGNOSIS, AND TREATMENT OF  THE  CHILD  BY  A
CHILD  ABUSE  MEDICAL  PROVIDER,  WHICH INCLUDES BUT IS NOT LIMITED TO A
THOROUGH MEDICAL HISTORY AND COMPLETE PHYSICAL EXAMINATION TO  DETERMINE
WHETHER OR NOT A CHILD HAS BEEN SEXUALLY ABUSED;
  (B) DIAGNOSIS AND TREATMENT OF THE CHILD;
  (C) IDENTIFICATION OF APPROPRIATE FOLLOW-UP FOR THE CHILD; AND
  (D)  COORDINATION  OF  THE MEDICAL ASSESSMENT WITH A MULTIDISCIPLINARY
INVESTIGATION AND FOLLOW-UP OF SUCH CHILD.
  4. NOTWITHSTANDING ANY OTHER PROVISION OF LAW, THE PER  UNIT  RATE  OF
PAYMENT FOR MEDICAL ASSESSMENT AND SERVICES FURNISHED BY THE CHILD ADVO-
CACY  CENTERS TO CHILDREN WHO HAVE BEEN OR MAY HAVE BEEN SEXUALLY ABUSED
AND WHO ARE ELIGIBLE FOR PAYMENTS MADE BY  STATE  GOVERNMENTAL  AGENCIES
SHALL  BE INCREASED TO AN AMOUNT EQUAL TO ONE HUNDRED TWENTY DOLLARS PER
UNIT.
  S 14. This act shall take effect on  the  one  hundred  twentieth  day
after  it  shall  have  become  a  law; provided that the departments of
health, insurance and family assistance are authorized to promulgate any
and all rules and regulations and take any other measures  necessary  to
implement  this  act  on  its effective date on or before such date; and

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provided further that the amendments to  subdivisions  1,  3  and  4  of
section  364-j  of  the social services law made by sections ten, eleven
and twelve of this act shall not affect the repeal of such  section  and
shall be deemed repealed therewith.