NY State Senate Bill 2019-S4601

Senate Bill S4601

2019-2020 Legislative Session

Commissions a study regarding the quality of health care services received by foster children in New York state

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Archive: Last Bill Status - In Senate Committee Children And Families Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 08, 2020	referred to children and families
Mar 15, 2019	referred to children and families

co-Sponsors

2019-S4601 (ACTIVE) - Details

Current Committee:: Senate Children And Families
Law Section:: Social Services
Versions Introduced in Other Legislative Sessions:: 2017-2018: S5638
2021-2022: S5036
2023-2024: S6133

2019-S4601 (ACTIVE) - Summary

Commissions a study regarding the quality of health care services received by foster children in New York state; provides for a report to be submitted by the commissioner of the office of children and family services detailing the findings of such study.

2019-S4601 (ACTIVE) - Sponsor Memo

                                
 
BILL NUMBER: S4601

SPONSOR: PARKER
 
TITLE OF BILL:  An act to commission a study regarding the quality of
health care services received by foster children in New York state

 
PURPOSE:

Commission a study to gather information from State agencies, foster
care agencies, local districts and advocates to better understand how
the Per-Diem, Fee-for Service and Managed Care financing constructs
affect the health outcomes of children in foster care.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section one would require the office of children and family services to
contract with an external organization to conduct an evaluation of the
implementation and effectiveness of New York state's health care deliv-
ery system for children in the custody or guardianship of the state.

Section two would authorize the organization selected to conduct the

evaluation, access to non-identifiable information from the office of
children and family services, department of health and local social
services district and voluntary agencies for the purpose of the study.
Allow for the collection of supplemental information as needed for the
purpose of the study.

Section three would require the office of children and family service by
June 30, 2012 to submit a report to the Governor, temporary president of
the senate, speaker of the assembly, chairperson of the senate committee
on social services and children and families and chairperson of the
assembly committee on children and families, and the chairperson of the
senate and assembly committees on health.

 
JUSTIFICATION:

Studies have shown that in the United States, children entering foster
care have significantly higher rates of chronic and acute medical prob-
lems, developmental delays, and psychological and behavioral disorders
than children within the general population, including children from low
income families. In New York State all children in foster care who are
citizens or permanent residents of the United States, are eligible for
healthcare services including mental health treatment and behavioral
therapies, under Medicaid. New York State has a three tiered system for
providing health care services to foster children under Medicaid: a
per-diem, fee-for-services and managed care system. Approximately 75
percent of voluntary agencies use the per-diem system for children place
under their care. Within the per-diem system a set amount of money is
provided to the voluntary foster care agency to cover the cost of a
foster child's medical care, based upon the number of days that foster
child is placed with the agency. The NEW YORK STATE ASSEMBLY MEMORANDUM
IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule
III, Sec 1(0 per-diem rate also allows agencies .to offer health and
mental health services on site or use the rate to hire other medical
professionals to work part-time on the agency's premises. The remaining
25 percent of foster care agencies opt to use the traditional fee-for
services in lieu of the Medicaid per-diem. The fee for-services Medicaid
system allows beneficiaries to go to any doctor who accepts their Medi-
caid card. The doctor then bills Medicaid directly for the service
provided. Some agencies choose to use both the per-diem, and fee for-
services to access health care services which are either not allowed or
cannot be afforded under the agency's per-diem rate. An alternative to
the per-diem/fee-for-service option for Medicaid services is Medicaid
managed Care which is not available to all foster children.  Managed
care provides a consistent network of medical providers that treat both
health and mental health care issues. Only foster children that are in
the direct care of the local social services districts are able to
enroll into Medicaid Managed Care, however, not those placed in volun-
teer agencies. With the state placing more children in the care of
volunteer agencies, there are a large number of children In care that
are ineligible for Medicaid Managed Care under current state law, and
instead, receive healthcare services through the per-diem system.

Evidence suggests that when foster care agencies use both the Medicaid
per-diem and fee-for-service billing mechanisms children in care receive
inconsistent health and mental health care services. Whether this is due
to an inadequately low per-diem rate or merely a gradual evolution Of
the foster care medical financing construct, this scattered usage of
medical providers and billing arrangements means that it is unknown
whether foster children are receiving all necessary medical services
required by law and regulation. Exploring whether the Medicaid
per-diem/Fee-for-Service system for foster children are effective in
meeting the healthcare needs of New York State's foster children is an
essential first step in identifying a solution. Although it has been
proven that adequate health care for foster children is vital in ensur-
ing that they become healthy and productive adults. Currently, many of
the children's medical needs are going untreated and unaccounted for.
Gathering more information from State agencies, foster care agencies,
local districts and advocates to better understand how the Per-Diem,
Fee-For Service and Managed Care financing constructs affect the health
outcomes of these children in need, will allow policy makers to make
better decisions that will improve the health of children in foster
care.

 
PRIOR LEGISLATIVE HISTORY:

2017-18: 55638 - Referred to Children and Families
A3252 (2015-2016): Referred to Children and Families 1/6/16
A2500 (2013-2014): Referred to Children and Families 1/8/14
A2500 (2013-2014): Referred to Children and Families 1/9/13
A2500 (2011-2012): Referred to Children and Families
A5497 (2009-2010): Vetoed 5/5/10
A11061-A (2007-2008): Referred to Rules 6/5/08

 
FISCAL IMPLICATIONS:
Undetermined

 
EFFECTIVE DATE:
This Act shall take effect immediately

2019-S4601 (ACTIVE) - Bill Text download pdf

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4601
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                              March 15, 2019
                                ___________
 
 Introduced  by  Sens.  PARKER, BAILEY -- read twice and ordered printed,
   and when printed to be committed to  the  Committee  on  Children  and
   Families
 
 AN  ACT  to  commission  a  study  regarding  the quality of health care
   services received by foster children in New York state

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  1.  The commissioner of the office of children and family
 services shall contract with an external research organization to evalu-
 ate the implementation and effectiveness of New York state's health care
 delivery system for children in the care, custody or guardianship of the
 office  of  children  and  family  services  or  local  social  services
 districts  pursuant  to  articles 3, 7 and 10 of the family court act or
 section 358-a, 384-a or 384-b of the social services law.    The  evalu-
 ation shall include recommendations for improving the access to, and the
 quality  of,  health  and behavioral health services for children in the
 care, custody or guardianship of  the  office  of  children  and  family
 services  or the local social services district. Such commissioner shall
 select such research organization pursuant to a  request  for  proposals
 process.  Preference shall be given to an organization based on adequacy
 of  the  proposed  research  design,  research staff qualifications, and
 availability of non-state dollars to  support  the  project,  and  other
 criteria as determined by the commissioner of the office of children and
 family services. The evaluation shall include, but not be limited to, an
 examination of:
   (a)  the  quality of health and behavioral health services provided to
 children in the care, custody or guardianship of the office of  children
 and  family  services  or the local social services district, including,
 but not limited to, whether children are receiving effective  or  neces-
 sary  treatment  in  a  timely  fashion and in accordance with the regu-
 lations of the office of children and family services;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD07707-01-9

 S. 4601                             2
 
   (b) the average length of time from  referrals  for  children  in  the
 care,  custody  or  guardianship  of  the  office of children and family
 services or the local social services district, to receive treatment  to
 the date of initial treatment;
   (c)  whether  sufficient  information  is  provided  to educate foster
 parents on the health care delivery system for foster children,  includ-
 ing identification of providers and appropriate billing arrangements;
   (d) the existence and adequacy of current oversight practice regarding
 health  care  services for children in the care, custody or guardianship
 of the office of children  and  family  services  or  the  local  social
 services  district,  including monitoring or record keeping practices of
 voluntary agencies, social services districts, family courts, the office
 of children and family services and the department of health;
   (e) whether foster children who receive health care coverage under the
 medicaid per-diem system receive adequate health and  behavioral  health
 services;
   (f) whether foster children who receive health care coverage under the
 medicaid  fee-for  service system receive adequate health and behavioral
 health services;
   (g) to what extent the medicaid per-diem is used in  conjunction  with
 direct  billing under fee-for service and whether this practice provides
 foster children with adequate health and behavioral health services;
   (h) whether foster children who receive health care  services  through
 enrollment  in  a medicaid managed care plan receive adequate health and
 behavioral health services;
   (i) whether any difficulties exist in accessing prescription drugs for
 foster children;
   (j) whether foster children or foster parents  are  being  billed  for
 health care services provided to foster children which should be covered
 under medicaid;
   (k) the number of voluntary agencies throughout the state that provide
 health  care  services  to  foster children in their care through health
 care professionals employed by their agency;
   (l) the quality of health care provided by health  care  professionals
 hired  by  voluntary  agencies  and the benefits and drawbacks of having
 health care services provided by voluntary agencies;
   (m) whether children leaving foster  care  or  placement  in  juvenile
 justice  facilities, who would be otherwise eligible for medicaid cover-
 age upon leaving placement, experience difficulty in  accessing  transi-
 tional medicaid coverage or medicaid coverage in the community; and
   (n) what barriers exist for children in the care, custody or guardian-
 ship  of  the office of children and family services or the local social
 services district, to access health care services in the community.
   2. Notwithstanding any other law to the contrary, the selected  organ-
 ization  shall  have access to necessary non-identifiable data collected
 by the office of children and family services, the department of health,
 local social  services  districts  and  voluntary  agencies,  and  shall
 collect supplemental data as needed to conduct a thorough and comprehen-
 sive  evaluation. Data collected shall not reveal the name, social secu-
 rity number or any other information which may be used to  identify  the
 child or the family of the child.
   3.  The  commissioner  of  the  office of children and family services
 shall submit a report detailing the findings of such study to the gover-
 nor, the temporary president of the senate, the speaker of the assembly,
 and the chairperson of the senate committee on social services, children
 and families, the chairperson of the assembly committee on children  and

 S. 4601                             3
 
 families  and  the chairpersons of the senate and assembly committees on
 health on or before June 30, 2020.
   § 2. This act shall take effect immediately.

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Senate Bill S4601

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Sponsored By

Kevin S. Parker