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City Council
Filed (End of Session)
City Council
Referred to Comm by Council
City Council
Introduced by Council
Res. No. 113
 
 
Resolution calling on the State Legislature to pass and the Governor to sign A.5148-A/S.4253-A, an act to amend the social services law to add certain school based health services to the list of services which need not be provided by a managed care program.
 
 
By Council Members Johnson, Dromm, Chin, Koo, Rose and Mendez
 
Whereas, School-based health centers (SBHC) provide on-site primary care to students and are largely located in areas with limited access to health care services; and
Whereas, Research shows that SBHCs can decrease absenteeism from school and parents' time away from work, as well as reduce hospitalizations and trips to the emergency room; and
Whereas, For over 20 years, SBHCs have kept students in school and healthy, equipping them for academic success; and
Whereas, There are 222 SBHCs in New York State and 129 SBHCs serving 293 schools in the five boroughs of New York City; and
Whereas, Since 1998, school-based health centers have directly billed New York State for services provided to children on Medicaid through a waiver provided by the Administration of former Governor George Pataki; and
Whereas, This waiver has offered SBHCs a streamlined, simplified billing methodology that allowed reimbursements to occur expeditiously and at an adequate rate; and
Whereas, In 2010, Governor Andrew Cuomo created the Medicaid Redesign Team (MRT), which created a number of initiatives to reform health care in New York State and control rising Medicaid costs; and
Whereas, The MRT seeks to reallocate spending through managed care organizations rather than a fee-for-service payment structure and October 1, 2014 is the scheduled transition for school-based health centers; and
Whereas, Shifting to a billing method that would involve processing claims through a large pool of managed care organizations, rather than billing the State directly, would be unnecessarily complex and potentially cause delays in payments; and
Whereas, SBHCs would now have to negotiate reimbursement rates with managed care organizations; and
Whereas, According to a report by the Children's Defense Fund, managed care organizations have organized payment rates that are inherently lower than the existing rates that SBHCs receive through the current fee-for-service payment methodology; and
Whereas, The Children's Defense Fund Report also states that Medicaid reimbursements comprise more than 89% of SBHCs' third-party revenue in New York and any delays or reductions in reimbursements will compromise the sustainability of these vital centers; and
Whereas, A.5148-A/S.4253-A, sponsored by Assembly Member Richard Gottfried and State Senator Velmanette Montgomery, would add certain school based health services to the list of services which need not be provided by a managed care program; and
Whereas, This legislation would allow SBHCs to retain their current system of reimbursement, stabilizing a large portion of their funding stream; now, therefore, be it
Resolved, That the Council of the City of New York calls on the State Legislature to pass and the Governor to sign A.5148-A/S.4253-A, an act to amend the social services law to add certain school based health services to the list of services which need not be provided by a managed care program.
 
CP
LS# 654
2/28/14