Requires social services districts to distribute educational materials pertaining to sexual health, including information on HIV prevention and pre-exposure prophylaxis to individuals enrolled in Medicaid.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A6729
SPONSOR: Simone TITLE OF BILL:
An act to amend the social services law, in relation to requiring social
services districts to distribute educational materials pertaining to
sexual health to individuals enrolled in Medicaid
PURPOSE:
To educate people who are at risk of becoming HIV positive on the
preventative benefits of PEP and PrEP,
SUMMARY OF PROVISIONS:
Section 1 of the bill amends the social services law to authorize the
commissioner of social services to establish a sexual health education
program for the purpose of providing knowledge to individuals enrolled
in Medicaid plans about pre-exposure prophylaxis.
Section 2 of the bill is the effective date.
JUSTIFICATION:
Although significant strides have been made in the treatment and
prevention of HIV, low income individuals and those with limited
resources are still disproportionately at risk of contracting the virus.
Far too often, new infections stem from lack of education regarding HIV
prevention and treatment options or lack of access to care. Currently,
many people at higher risk for HIV are eligible, for Medicaid, and/or
members of mainstream Medicaid health plans. Nonetheless, many Medicaid
health plan members are not receiving sexual health and HIV prevention
education services that address PEP and PrEP. Populations at higher risk
of becoming HIV+, including young same gender loving/MSM/gay/bi men of
color, transgender women of color and women of color, will benefit from
additional information about HIV preventative measures.
As it currently stands, only Medicaid eligible transgender persons who
are HIV negative or persons who are homeless are eligible to choose an
HIV Special Needs Plan where more robust PrEP education is occurring.
The New York State Department of Health (NYSDOH) AIDS Institute has
estimated that to end the HIV epidemic in New York State, access to PEP
and PrEP within the Medicaid program must increase from current access
by 6,000 Medicaid members to 30,000 medicaid members who may end up
using PEP and PrEP. In addition, recent increases from 3,000 to 6,000
Medicaid members accessing PrEP has occurred largely amongst gay white
men, so it appears that furthering information access among other popu-
lations would increase use.
PEP and PrEP education have the potential for significant Medicaid cost
savings -- For every averted HIV transmission, NYSDOH/Medicaid saves
approximately $400,000-$500,000 in lifetime costs of HIV treatment.
NYSDOH/Medicaid has already negotiated for supplemental manufacturer
discounts on all HIV medications, regardless of the intended use (treat-
ment or prevention). As such, costs for new PrEP scripts are already
covered. NYSDOH/Medicaid could seek deeper discounts associated with the
increased volume anticipated in Medicaid use of PEP and PrEP.
It is also extremely important that, as we seek to let as many people as
possible know about and access PEP and PrEP, it is critical that we
protect the privacy of individuals considered part of high risk popu-
lations, as well as every individual's medical history. Both within
Medicaid, and when it comes to informing patients about their options,
those administering education campaigns must be mindful to do so in a
sensitive, culturally appropriate manner.
LEGISLATIVE HISTORY:
2023-2024: A.4416
2021-2022: A.8819
STATE AND LOCAL FISCAL IMPLICATIONS:
To be determined
EFFECTIVE DATE:.
This act shall take effect on the ninetieth day after it shall have
become law.
STATE OF NEW YORK
________________________________________________________________________
6729
2025-2026 Regular Sessions
IN ASSEMBLY
March 11, 2025
___________
Introduced by M. of A. SIMONE, BURDICK -- read once and referred to the
Committee on Social Services
AN ACT to amend the social services law, in relation to requiring social
services districts to distribute educational materials pertaining to
sexual health to individuals enrolled in Medicaid
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The social services law is amended by adding a new section
2 367-z to read as follows:
3 § 367-z. Sexual health education program. 1. The commissioner is
4 authorized to establish a sexual health education program for the
5 purpose of providing knowledge to members about pre-exposure prophylax-
6 is. Such education program shall require social services districts to
7 produce and annually distribute educational materials pertaining to
8 sexual education, sexual health, HIV prevention, and pre-exposure
9 prophylaxis to individuals enrolled in Medicaid plans.
10 2. Social services districts shall distribute such educational materi-
11 als semi-annually to individuals deemed necessary to receive such educa-
12 tional materials on a semi-annual basis. Such districts shall utilize
13 internal data, including claims data for sexually transmitted diseases
14 and HIV tests, prescriptions for sexually transmitted diseases and other
15 data deemed relevant by such districts to identify individuals to
16 receive such educational materials on a semi-annual basis.
17 3. The AIDS institute shall oversee and monitor the production and
18 distribution of such educational materials.
19 § 2. This act shall take effect on the ninetieth day after it shall
20 have become a law.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD06208-01-5
