A05672 Summary:

BILL NOA05672
 
SAME ASNo same as
 
SPONSORBronson (MS)
 
COSPNSRSchroeder
 
MLTSPNSRBoyland, Pheffer, Rivera P, Titone
 
Add S4406-f, amd S4408, Pub Health L; amd SS3216, 3221, 4303, 3217-a & 4324, Ins L; amd S364-j, add S368-g, Soc Serv L
 
Enacts the "child abuse medical services act" to ensure that actual and suspected cases of child abuse are handled by properly qualified medical and allied personnel.
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A05672 Actions:

BILL NOA05672
 
02/25/2011referred to health
01/04/2012referred to health
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A05672 Floor Votes:

There are no votes for this bill in this legislative session.
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A05672 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          5672
 
                               2011-2012 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 25, 2011
                                       ___________
 
        Introduced by M. of A. BRONSON, SCHROEDER -- Multi-Sponsored by -- M. of
          A.  BOYLAND,  PHEFFER  --  read  once and referred to the Committee on
          Health
 
        AN ACT to amend the public health law, the insurance law and the  social
          services  law,  in  relation  to  the provision of child abuse medical

          services at child advocacy centers and reimbursement therefor
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.   Short title. This act shall be known and may be cited as
     2  the "child abuse medical services act".
     3    § 2.  Legislative intent. The legislature hereby  finds  and  declares
     4  that  a child or adolescent who has been sexually abused needs immediate
     5  medical attention and treatment. It is critical, therefore, that a child
     6  or adolescent victimized by sexual assault, misconduct, or  exploitation
     7  has  direct  access  to  a  medical provider who is specially trained to
     8  evaluate, diagnose, and treat children and  adolescents  who  have  been
     9  sexually  abused.  Furthermore,  medical  services  must be specifically

    10  tailored to the health, mental health, and social  needs  of  an  abused
    11  child  or adolescent. Child advocacy centers, accredited by the National
    12  Children's Alliance and recognized by the New York state office of chil-
    13  dren and family services, provide such specialized medical  services  to
    14  abused  and  maltreated children and adolescents. Child advocacy centers
    15  provide trained and experienced medical providers who are members  of  a
    16  multi-disciplinary  team located in a facility dedicated to children and
    17  adolescents who have  been  abused  or  maltreated  where  children  and
    18  adolescents  can find timely, complete, sensitive medical help, therapy,
    19  and support. To ensure abused children and adolescents direct access  to
    20  child  abuse  medical providers at child advocacy centers and the avail-
    21  ability of such services, the legislature hereby enacts the child  abuse

    22  medical services act.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD07914-02-1

        A. 5672                             2
 
     1    §  3.  The public health law is amended by adding a new section 4406-f
     2  to read as follows:
     3    §  4406-f.  Access  to child abuse medical providers at child advocacy
     4  centers. 1. For the purposes of this section, the following terms  shall
     5  have the following meanings:
     6    a.  "Child  abuse  medical  provider" means a physician licensed under
     7  article one hundred thirty-one of the education law, nurse  practitioner

     8  certified  under section sixty-nine hundred ten of the education law, or
     9  physician assistant or specialist assistant licensed under  article  one
    10  hundred  thirty-one-B  of  the education law to practice in the state of
    11  New York who has completed a  child  abuse  medical  provider  education
    12  program  and  provides  medical assessment and services to children, who
    13  have been or may have been sexually abused, at a child advocacy center.
    14    b. "Child abuse medical provider education program" means a program of
    15  education developed and implemented or approved by  the  department,  in
    16  consultation  with  the  office of children and family services, specif-
    17  ically to train  physicians,  nurse  practitioners,  and  physician  and

    18  specialist  assistants  licensed  to practice pursuant to title eight of
    19  the education law about evaluation, diagnosis, and treatment  of  abused
    20  and maltreated children.
    21    c. "Child advocacy center" means a local or regional multidisciplinary
    22  team  fully  accredited by the national children's alliance and approved
    23  by the office of children and family services for the purpose of  inves-
    24  tigating reports of suspected child abuse or maltreatment.
    25    d. "Child sexual abuse" means any of the offenses described in article
    26  one  hundred  thirty,  two hundred thirty, or two hundred sixty-three of
    27  the penal law when committed against a person less than  eighteen  years
    28  of age.

    29    e. "Medical assessment" means the evaluation, diagnosis, and treatment
    30  of  a child by a child abuse medical provider, which includes but is not
    31  limited to a thorough medical history and complete physical  and  mental
    32  health examination to determine whether or not a child has been sexually
    33  abused, diagnose and treat the child, and identify appropriate follow-up
    34  for  the  child  pursuant  to  a  protocol approved by the department in
    35  consultation with the office of children and family services.
    36    2. No child who has been or may have been  sexually  abused  shall  be
    37  denied  direct access to a child abuse medical provider at a child advo-
    38  cacy center. A health maintenance organization shall not  deny  a  child

    39  direct  access  to  a  child  abuse medical provider at a child advocacy
    40  center for a medical assessment or limit such access when:
    41    a. a child discloses sexual abuse to a parent,  other  person  legally
    42  responsible  for  the  care  of the child as defined by the family court
    43  act, or a person or official required to report sexual abuse of a  child
    44  pursuant to section four hundred thirteen of the social services law;
    45    b. a parent, other person legally responsible for care of the child as
    46  defined  by  the  family  court act, or a person or official acting in a
    47  professional capacity required to report sexual abuse of a child  pursu-
    48  ant  to  section  four  hundred  thirteen of the social services law has

    49  reasonable cause to suspect that the child has been  or  may  have  been
    50  sexually abused;
    51    c.  a  child  protective  agency,  as  defined in section one thousand
    52  twelve of the family court act, has reasonable cause to believe  that  a
    53  child in its custody has been or may have been sexually abused; or
    54    d. a court order directs a medical assessment of a child.
    55    3.  It shall be the duty of the administrative officer or other person
    56  in charge of each health maintenance organization to:

        A. 5672                             3
 
     1    a. advise each  enrollee,  in  writing,  of  the  provisions  of  this
     2  section, and
     3    b.    establish,  and  disclose to all enrollees, participating health

     4  care providers, the commissioner, and the superintendent  of  insurance,
     5  methods  of  ensuring that a child covered under the plan who has or may
     6  have been sexually abused has  direct  access  to  child  abuse  medical
     7  providers at child advocacy centers.
     8    4.  The  amount  of  reimbursement  which  shall be paid for a medical
     9  assessment of a child by a child abuse medical provider at a child advo-
    10  cacy center shall equal the amount that would be  paid  to  a  qualified
    11  provider  within  the  plan.  There  shall  be no additional cost to the
    12  insured beyond  what  the  insured  would  otherwise  pay  for  services
    13  received within the network.
    14    § 4. Subdivision 1 of section 4408 of the public health law is amended

    15  by adding a new paragraph (p-2) to read as follows:
    16    (p-2) notice that a child enrollee who has been or may have been sexu-
    17  ally  abused  shall have direct access to a child abuse medical provider
    18  at a child advocacy center;
    19    § 5. Subsection (i) of section 3216 of the insurance law is amended by
    20  adding a new paragraph 28 to read as follows:
    21    (28) (A) Every policy which provides coverage for hospital,  surgical,
    22  or  medical  care  shall provide the following coverage for child sexual
    23  abuse pursuant to this paragraph.
    24    (B) For the purposes of this paragraph, the following terms shall have
    25  the following meanings:
    26    (i) "Child abuse medical provider" means a  physician  licensed  under

    27  article  one hundred thirty-one of the education law, nurse practitioner
    28  certified under section sixty-nine hundred ten of the education law,  or
    29  physician  assistant  or specialist assistant licensed under article one
    30  hundred thirty-one-B of the education law to practice in  the  state  of
    31  New  York  who  has  completed  a child abuse medical provider education
    32  program and provides medical assessment and services  to  children,  who
    33  have been or may have been sexually abused, at a child advocacy center.
    34    (ii)  "Child abuse medical provider education program" means a program
    35  of education developed and implemented or approved by the department  of
    36  health, in consultation with the office of children and family services,

    37  specifically to train physicians, nurse practitioners, and physician and
    38  specialist  assistants  licensed  to practice pursuant to title eight of
    39  the education law about evaluation, diagnosis, and treatment  of  abused
    40  and maltreated children.
    41    (iii) "Child advocacy center" means a local or regional multidiscipli-
    42  nary  team  fully  accredited  by  the  national children's alliance and
    43  approved by the office of children and family services for  the  purpose
    44  of investigating reports of suspected child abuse or maltreatment.
    45    (iv) "Child sexual abuse" means any of the offenses described in arti-
    46  cle  one  hundred thirty, two hundred thirty, or two hundred sixty-three
    47  of the penal law when committed against  a  person  less  than  eighteen

    48  years of age.
    49    (v)  "Medical  assessment" means the evaluation, diagnosis, and treat-
    50  ment of a child by a child abuse medical provider, which includes but is
    51  not limited to a thorough medical  history  and  complete  physical  and
    52  mental  health  examination to determine whether or not a child has been
    53  sexually abused, diagnose and treat the child, and identify  appropriate
    54  follow-up  for  the child pursuant to a protocol approved by the depart-
    55  ment of health in consultation with the office of  children  and  family
    56  services.

        A. 5672                             4
 
     1    (C)  No  policy  shall  deny  to a child who has been or may have been

     2  sexually abused direct access to a child abuse  medical  provider  at  a
     3  child  advocacy  center  for  a  medical assessment or limit such access
     4  when:
     5    (i)  a  child discloses sexual abuse to a parent, other person legally
     6  responsible for the care of the child as defined  by  the  family  court
     7  act,  or a person or official required to report sexual abuse of a child
     8  pursuant to section four hundred thirteen of the social services law;
     9    (ii) a parent, other person legally responsible for care of the  child
    10  as  defined in the family court act, or a person or official acting in a
    11  professional capacity required to report sexual abuse of a child  pursu-
    12  ant  to  section  four  hundred  thirteen of the social services law has

    13  reasonable cause to suspect that the child has been  or  may  have  been
    14  sexually abused;
    15    (iii)  a  child  protective agency, as defined in section one thousand
    16  twelve of the family court act, has reasonable cause to believe  that  a
    17  child in its custody has been or may have been sexually abused; or
    18    (iv) a court order directs a medical assessment of a child.
    19    § 6. Subsection (k) of section 3221 of the insurance law is amended by
    20  adding a new paragraph 17 to read as follows:
    21    (17) (A) Every insurer delivering a group or blanket policy or issuing
    22  a  group  or  blanket  policy  for delivery in this state which provides
    23  coverage for hospital, surgical,  or  medical  care  shall  provide  the

    24  following coverage for child sexual abuse pursuant to this paragraph.
    25    (B) For the purposes of this paragraph, the following terms shall have
    26  the following meanings:
    27    (i)  "Child  abuse  medical provider" means a physician licensed under
    28  article one hundred thirty-one of the education law, nurse  practitioner
    29  certified  under section sixty-nine hundred ten of the education law, or
    30  physician assistant or specialist assistant licensed under  article  one
    31  hundred  thirty-one-B  of  the education law to practice in the state of
    32  New York who has completed a  child  abuse  medical  provider  education
    33  program  and  provides  medical assessment and services to children, who
    34  have been or may have been sexually abused, at a child advocacy center.

    35    (ii) "Child abuse medical provider education program" means a  program
    36  of  education developed and implemented or approved by the department of
    37  health, in consultation with the office of children and family services,
    38  specifically to train physicians, nurse practitioners, and physician and
    39  specialist assistants licensed to practice pursuant to  title  eight  of
    40  the  education  law about evaluation, diagnosis, and treatment of abused
    41  and maltreated children.
    42    (iii) "Child advocacy center" means a local or regional multidiscipli-
    43  nary team fully accredited  by  the  national  children's  alliance  and
    44  approved  by  the office of children and family services for the purpose
    45  of investigating reports of suspected child abuse or maltreatment.

    46    (iv) "Child sexual abuse" means any of the offenses described in arti-
    47  cle one hundred thirty, two hundred thirty, or two  hundred  sixty-three
    48  of  the  penal  law  when  committed against a person less than eighteen
    49  years of age.
    50    (v) "Medical assessment" means the evaluation, diagnosis,  and  treat-
    51  ment of a child by a child abuse medical provider, which includes but is
    52  not  limited  to  a  thorough  medical history and complete physical and
    53  mental health examination to determine whether or not a child  has  been
    54  sexually  abused, diagnose and treat the child, and identify appropriate
    55  follow-up for the child pursuant to a protocol approved by  the  depart-

        A. 5672                             5
 

     1  ment  of  health  in consultation with the office of children and family
     2  services.
     3    (C)  No  policy  shall  deny  to a child who has been or may have been
     4  sexually abused direct access to a child abuse  medical  provider  at  a
     5  child  advocacy  center  for  a  medical assessment or limit such access
     6  when:
     7    (i) a child discloses sexual abuse to a parent, other  person  legally
     8  responsible  for  the  care  of the child as defined by the family court
     9  act, or a person or official required to report sexual abuse of a  child
    10  pursuant to section four hundred thirteen of the social services law;
    11    (ii)  a parent, other person legally responsible for care of the child

    12  as defined in the family court act, or a person or official acting in  a
    13  professional  capacity required to report sexual abuse of a child pursu-
    14  ant to section four hundred thirteen of  the  social  services  law  has
    15  reasonable  cause  to  suspect  that the child has been or may have been
    16  sexually abused;
    17    (iii) a child protective agency, as defined in  section  one  thousand
    18  twelve  of  the family court act, has reasonable cause to believe that a
    19  child in its custody has been or may have been sexually abused; or
    20    (iv) a court order directs a medical assessment of a child.
    21    § 7. Section 4303 of the insurance law is  amended  by  adding  a  new
    22  subsection (hh) to read as follows:

    23    (hh)  (1)  A medical expense indemnity corporation, a hospital service
    24  corporation or a health service corporation which provides coverage  for
    25  hospital, surgical, or medical care shall provide the following coverage
    26  for child sexual abuse.
    27    (2) For the purposes of this subsection the following terms shall have
    28  the following meanings:
    29    (A)  "Child  abuse  medical provider" means a physician licensed under
    30  article one hundred thirty-one of the education law, nurse  practitioner
    31  certified  under section sixty-nine hundred ten of the education law, or
    32  physician assistant or specialist assistant licensed under  article  one
    33  hundred  thirty-one-B  of  the education law to practice in the state of

    34  New York who has completed a  child  abuse  medical  provider  education
    35  program  and  provides  medical assessment and services to children, who
    36  have been or may have been sexually abused, at a child advocacy center.
    37    (B) "Child abuse medical provider education program" means  a  program
    38  of  education developed and implemented or approved by the department of
    39  health, in consultation with the office of children and family services,
    40  specifically to train physicians, nurse practitioners, and physician and
    41  specialist assistants licensed to practice pursuant to  title  eight  of
    42  the  education  law about evaluation, diagnosis, and treatment of abused
    43  and maltreated children.
    44    (C) "Child advocacy center" means a local or  regional  multidiscipli-

    45  nary  team  fully  accredited  by  the  national children's alliance and
    46  approved by the office of children and family services for  the  purpose
    47  of investigating reports of suspected child abuse or maltreatment.
    48    (D)  "Child sexual abuse" means any of the offenses described in arti-
    49  cle one hundred thirty, two hundred thirty, or two  hundred  sixty-three
    50  of  the  penal  law  when  committed against a person less than eighteen
    51  years of age.
    52    (E) "Medical assessment" means the evaluation, diagnosis,  and  treat-
    53  ment of a child by a child abuse medical provider, which includes but is
    54  not  limited  to  a  thorough  medical history and complete physical and
    55  mental health examination to determine whether or not a child  has  been

    56  sexually  abused, diagnose and treat the child, and identify appropriate

        A. 5672                             6
 
     1  follow-up for the child pursuant to a protocol approved by  the  depart-
     2  ment  of  health  in consultation with the office of children and family
     3  services.
     4    (3)  No  policy  shall  deny  to a child who has been or may have been
     5  sexually abused direct access to a child abuse  medical  provider  at  a
     6  child  advocacy  center  for  a  medical assessment or limit such access
     7  when:
     8    (i) a child discloses sexual abuse to a parent, other  person  legally
     9  responsible  for  the  care  of the child as defined by the family court

    10  act, or a person or official required to report sexual abuse of a  child
    11  pursuant to section four hundred thirteen of the social services law;
    12    (ii)  a parent, other person legally responsible for care of the child
    13  as defined in the family court act, or a person or official acting in  a
    14  professional  capacity required to report sexual abuse of a child pursu-
    15  ant to section four hundred thirteen of  the  social  services  law  has
    16  reasonable  cause  to  suspect  that the child has been or may have been
    17  sexually abused;
    18    (iii) a child protective agency, as defined in  section  one  thousand
    19  twelve  of  the family court act, has reasonable cause to believe that a
    20  child in its custody has been or may have been sexually abused; or

    21    (iv) a court order directs a medical assessment of a child.
    22    § 8. Paragraphs 16 and 17 of subsection (a) of section 3217-a  of  the
    23  insurance  law, as added by chapter 705 of the laws of 1996, are amended
    24  and a new paragraph 18 is added to read as follows:
    25    (16) notice of all appropriate mailing addresses and telephone numbers
    26  to be utilized by insureds seeking information or authorization; [and]
    27    (17) where applicable, a listing by specialty, which may be in a sepa-
    28  rate document that is updated annually, of the name, address, and  tele-
    29  phone  number  of all participating providers, including facilities, and
    30  in addition, in the case of physicians, board certification[.]; and
    31    (18) where applicable, notice of the provisions of  paragraph  twenty-

    32  eight  of  subsection  (i) of section three thousand two hundred sixteen
    33  and paragraph seventeen of subsection (k) of section three thousand  two
    34  hundred  twenty-one  of  this  article and of methods of ensuring that a
    35  child covered under the policy who has been or may  have  been  sexually
    36  abused has direct access to child abuse medical providers at child advo-
    37  cacy centers.
    38    §  9.  Paragraphs  17  and 18 of subsection (a) of section 4324 of the
    39  insurance law, as added by chapter 705 of the laws of 1996, are  amended
    40  and a new paragraph 19 is added to read as follows:
    41    (17) where applicable, a listing by specialty, which may be in a sepa-
    42  rate  document that is updated annually, of the name, address, and tele-
    43  phone number of all participating providers, including  facilities,  and

    44  in addition, in the case of physicians, board certification; [and]
    45    (18)  a description of the mechanisms by which subscribers may partic-
    46  ipate in the development of the policies of the corporation[.]; and
    47    (19) where applicable, notice of the provisions of subsection (hh)  of
    48  section four thousand three hundred three of this article and of methods
    49  of  ensuring  that  a child covered under the policy who has been or may
    50  have been sexually abused has  direct  access  to  child  abuse  medical
    51  providers at child advocacy centers.
    52    §  10.  Subdivision  1  of section 364-j of the social services law is
    53  amended by adding five new paragraphs (z), (aa), (bb), (cc) and (dd)  to
    54  read as follows:
    55    (z) "Child abuse medical provider". A physician licensed under article

    56  one  hundred  thirty-one of the education law, nurse practitioner certi-

        A. 5672                             7
 
     1  fied under section sixty-nine hundred  ten  of  the  education  law,  or
     2  physician  assistant  or specialist assistant licensed under article one
     3  hundred thirty-one-B of the education law to practice in  the  state  of
     4  New  York  who  has  completed  a child abuse medical provider education
     5  program and provides medical assessment and services  to  children,  who
     6  have been or may have been sexually abused, at a child advocacy center.
     7    (aa)  "Child  abuse  medical provider education program". A program of
     8  education developed and implemented or approved  by  the  department  of

     9  health, in consultation with the office of children and family services,
    10  specifically to train physicians, nurse practitioners, and physician and
    11  specialist  assistants  licensed  to practice pursuant to title eight of
    12  the education law about evaluation, diagnosis, and treatment  of  abused
    13  and maltreated children.
    14    (bb)  "Child  advocacy  center". A local or regional multidisciplinary
    15  team fully accredited by the national children's alliance  and  approved
    16  by  the office of children and family services for the purpose of inves-
    17  tigating reports of suspected child abuse or maltreatment.
    18    (cc) "Child sexual abuse". Any of the offenses  described  in  article
    19  one hundred thirty, two hundred thirty or two hundred sixty-three of the

    20  penal  law  when  committed against a person less than eighteen years of
    21  age.
    22    (dd) "Medical assessment". The evaluation, diagnosis, and treatment of
    23  a child by a child abuse medical provider, which  includes  but  is  not
    24  limited  to  a thorough medical history and complete physical and mental
    25  health examination to determine whether or not a child has been sexually
    26  abused, diagnose and treat the child, and identify appropriate follow-up
    27  for the child pursuant to a  protocol  approved  by  the  department  of
    28  health in consultation with the office of children and family services.
    29    §  11. Subparagraphs (ix) and (x) of paragraph (e) of subdivision 3 of
    30  section 364-j of the social services law, as amended by chapter  648  of

    31  the  laws of 1999, are amended and a new paragraph (xi) is added to read
    32  as follows:
    33    (ix) HIV COBRA case management; [and]
    34    (x) other services as determined by the commissioner of health[.]; and
    35    (xi) medical assessment of a child who has been or may have been sexu-
    36  ally abused, which assessment shall instead be referred immediately  and
    37  directly to a child abuse medical provider at a child advocacy center.
    38    §  12.  Subparagraphs (ii) and (iii) of paragraph (a) of subdivision 4
    39  of section 364-j of the social services law, as amended by section 14 of
    40  part C of chapter 58 of the laws of 2004,  clause  (E)  of  subparagraph
    41  (iii)  as  added  and  clause (F) of subparagraph (iii) as relettered by
    42  chapter 37 of the laws of 2010, are amended and a new subparagraph  (iv)

    43  is added to read as follows:
    44    (ii)  provided, however, if a major public hospital, as defined in the
    45  public health law, is designated by the  commissioner  of  health  as  a
    46  managed  care provider in a social services district the commissioner of
    47  health shall designate at least one other managed care provider which is
    48  not a major public hospital or  facility  operated  by  a  major  public
    49  hospital; [and]
    50    (iii)  under  a  managed  care program, not all managed care providers
    51  must be required to provide the same set of medical assistance services.
    52  The managed  care  program  shall  establish  procedures  through  which
    53  participants  will  be assured access to all medical assistance services
    54  to which they are otherwise entitled, other  than  through  the  managed
    55  care provider, where:

        A. 5672                             8

 
     1    (A)  the  service  is  not reasonably available directly or indirectly
     2  from the managed care provider,
     3    (B) it is necessary because of emergency or geographic unavailability,
     4  or
     5    (C) the services provided are family planning services; or
     6    (D)  the services are dental services and are provided by a diagnostic
     7  and treatment center licensed under article twenty-eight of  the  public
     8  health  law which is affiliated with an academic dental center and which
     9  has been granted an operating certificate pursuant  to  article  twenty-
    10  eight  of  the  public  health law to provide such dental services.  Any
    11  diagnostic and treatment center providing dental  services  pursuant  to
    12  this  clause shall prior to June first of each year report to the gover-
    13  nor, temporary president of the senate and speaker of  the  assembly  on

    14  the  following:  the  total  number of visits made by medical assistance
    15  recipients during the immediately preceding calendar year; the number of
    16  visits made by medical  assistance  recipients  during  the  immediately
    17  preceding  calendar year by recipients who were enrolled in managed care
    18  programs; the number of visits made  by  medical  assistance  recipients
    19  during  the  immediately  preceding calendar year by recipients who were
    20  enrolled in managed care programs that  provide  dental  benefits  as  a
    21  covered  service;  and the number of visits made by the uninsured during
    22  the immediately preceding calendar year; or
    23    (E) the services are optometric services, as defined  in  article  one
    24  hundred forty-three of the education law, and are provided by a diagnos-
    25  tic  and  treatment  center  licensed  under article twenty-eight of the

    26  public health law which is affiliated with the college of  optometry  of
    27  the state university of New York and which has been granted an operating
    28  certificate pursuant to article twenty-eight of the public health law to
    29  provide  such  optometric  services. Any diagnostic and treatment center
    30  providing optometric services pursuant to this  clause  shall  prior  to
    31  June  first  of each year report to the governor, temporary president of
    32  the senate and speaker of the assembly on  the  following:    the  total
    33  number  of visits made by medical assistance recipients during the imme-
    34  diately preceding calendar year; the number of visits  made  by  medical
    35  assistance  recipients during the immediately preceding calendar year by
    36  recipients who were enrolled in managed care  programs;  the  number  of
    37  visits  made  by  medical  assistance  recipients during the immediately

    38  preceding calendar year by recipients who were enrolled in managed  care
    39  programs  that provide optometric benefits as a covered service; and the
    40  number of visits made by the uninsured during the immediately  preceding
    41  calendar year; or
    42    (F) other services as defined by the commissioner of health[.]; and
    43    (iv) medical assessment of a child who has been or may have been sexu-
    44  ally  abused shall be referred immediately and directly to a child abuse
    45  medical provider at a child advocacy center.
    46    § 13. The social services law is amended by adding a new section 368-g
    47  to read as follows:
    48    § 368-g. Reimbursement for child sexual abuse medical  assessment.  1.
    49  For  the  purposes  of  this section, the following terms shall have the
    50  following meanings:

    51    (a) "Child abuse medical provider" means a  physician  licensed  under
    52  article  one hundred thirty-one of the education law, nurse practitioner
    53  certified under section sixty-nine hundred ten of the education law,  or
    54  physician  assistant  or specialist assistant licensed under article one
    55  hundred thirty-one-B of the education law to practice in  the  state  of
    56  New  York  who  has  completed  a child abuse medical provider education

        A. 5672                             9
 
     1  program and provides medical assessment and  services  to  children  who
     2  have been or may have been sexually abused at a child advocacy center.
     3    (b)  "Child  abuse medical provider education program" means a program

     4  of education developed and implemented or approved by the department  of
     5  health, in consultation with the office of children and family services,
     6  specifically to train physicians, nurse practitioners, and physician and
     7  specialist  assistants  licensed  to practice pursuant to title eight of
     8  the education law about evaluation, diagnosis, and treatment  of  abused
     9  and maltreated children.
    10    (c)  "Child  advocacy center" means a local or regional multidiscipli-
    11  nary team fully accredited  by  the  national  children's  alliance  and
    12  approved  by  the office of children and family services for the purpose
    13  of investigating reports of suspected child abuse or maltreatment.
    14    (d) "Child sexual abuse" means any of the offenses described in  arti-

    15  cle  one hundred thirty, two hundred thirty, and two hundred sixty-three
    16  of the penal law when committed against  a  person  less  than  eighteen
    17  years of age.
    18    (e)  "Medical  assessment" means the evaluation, diagnosis, and treat-
    19  ment of a child by a child abuse medical provider, which includes but is
    20  not limited to a thorough medical  history  and  complete  physical  and
    21  mental  health  examination to determine whether or not a child has been
    22  sexually abused, diagnose and treat the child, and identify  appropriate
    23  follow-up  for  the child pursuant to a protocol approved by the depart-
    24  ment of health in consultation with the office of  children  and  family
    25  services.

    26    2.  A  social  services district shall reimburse a child abuse medical
    27  provider at a child care center eligible for funding as a  comprehensive
    28  health services program at the maximum reimbursement that the department
    29  of health may pay for providing or arranging for medical assessment of a
    30  child  who  has been or may have been sexually abused in accordance with
    31  the federal social security act and regulations promulgated thereunder.
    32    3. Child advocacy centers that are not eligible for funding as compre-
    33  hensive health services programs  shall  be  responsible  for  providing
    34  medical  assessments  and services to children who have been or may have
    35  been sexually abused pursuant to a protocol approved by  the  department

    36  of  health  in  consultation  with  the  office  of  children and family
    37  services, which shall include but not be limited to:
    38    (a) medical evaluation, diagnosis, and treatment of  the  child  by  a
    39  child  abuse  medical  provider,  which includes but is not limited to a
    40  thorough medical history and complete physical examination to  determine
    41  whether or not a child has been sexually abused;
    42    (b) diagnosis and treatment of the child;
    43    (c) identification of appropriate follow-up for the child; and
    44    (d)  coordination  of  the medical assessment with a multidisciplinary
    45  investigation and follow-up of such child.
    46    4. Notwithstanding any other provision of law, the per  unit  rate  of

    47  payment for medical assessment and services furnished by the child advo-
    48  cacy  centers to children who have been or may have been sexually abused
    49  and who are eligible for payments made by  state  governmental  agencies
    50  shall  be increased to an amount equal to one hundred twenty dollars per
    51  unit.
    52    § 14. This act shall take effect on  the  one  hundred  twentieth  day
    53  after  it  shall  have  become  a  law; provided that the departments of
    54  health, insurance and family assistance are authorized to promulgate any
    55  and all rules and regulations and take any other measures  necessary  to
    56  implement  this  act  on  its effective date on or before such date; and

        A. 5672                            10
 
     1  provided further that the amendments to  subdivisions  1,  3  and  4  of

     2  section  364-j  of  the social services law made by sections ten, eleven
     3  and twelve of this act shall not affect the repeal of such  section  and
     4  shall be deemed repealed therewith.
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