Directs the commissioner of health to authorize additional reimbursement to providers of health and dental care primarily serving individuals with intellectual…

◆ The sponsor's argument

Why Patricia Fahy says this is needed

Historically, little consideration has been given to the barriers that exist for Individuals with Intellectual and Developmental Disabilities (IDD) when seeking health and dental care. Very few providers in the buildings and clinic space. In order to serve an individual with IDD in a wheelchair; for example, that patient must be transferred from. the wheelchair to an exam table. This generally requires the use of a Boyer lift and two staff members for safe transfer, and can take as long as 15 minutes of an appointment. After an examination or treatment, the patient must be transferred back into the wheelchair, adding up to another 15 minutes to an appointment and, again, use of two staff members. Additionally, in many cases, patients are unable to undress or re-dress themselves, requiring addi- tional time and staff to accomplish this both before and after treat- ment. Another example would include needing four staff for a woman with IDD to get a pap smear, two stabilizing the legs, and two stabilifing the head and upper body, plus the clinician. Many patients have behavioral issues which can disrupt a medical or dental exam or treatment, and which need to be addressed, requiring more staff than would be necessary for a typical patient, who can cognitively understand what is happening and why. This is particularly true with respect to dental work, where patient stabilization methods, such as sedation and physical restraints, are often necessary to limit a patient's freedom of movement to decrease the risk of injury and permit, the safe completion of treatment. This can be as simple as having staff hold a patient's hand to prevent the patient from swatting away a professional trying to conduct treatment or even to provide comfort and reassurance to calm a patient with a disability. Again, even the simplest methods require additional staff. Moreover, many individuals with IDD are on a higher number of medica- tions due to co-morbidity issues or seizure activity, and the State of New York requires more frequent medication reviews for individuals with IDD that also require additional unreimbursed physician and nursing staff time. These are only a few examples of the services necessary to support patients with IDD. As a result of the need for additional time, use of staff, and services that are necessary to support treatment of a patient as a result of the patient's physical, intellectual, or developmental disability, which is currently uncompensated by Medicaid, additional Medicaid reimbursement is needed for providers serving this population. Clinics serving the IDD population are struggling financially and many are in jeopardy of ceas- ing operations, which would leave this population without appropriate access to primary care.

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.