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