Relates to coverage for services provided by school-based health centers for medical assistance recipients

• Democratic31
• Republican1

◆ The sponsor's argument

Why Gustavo Rivera says this is needed

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.

This is the sponsor's own case for the bill, quoted from their memorandum. It is not Agora's description of what the bill does.