Legislative Gazette: Lawmakers and educators push to save school based health centers

By Thomas Pudney, November 1

Lawmakers and health care and education experts are urging Gov. Andrew Cuomo to sign legislation they say will ease financial burdens on school based health centers.

The legislation, sponsored in the Assembly by Richard Gottfried, D–Manhattan, and in the Senate by James Seward, R–Oneonta, would maintain the current system, by which SBHC are directly reimbursed by Medicaid which allows the clinics to keep overhead and administrative costs low.

The state Department of Health is planning to change the reimbursement system as of July 1, 2018 when SBHCs will be required to negotiate the terms and conditions of payment through managed care plans. A report by the Children’s Defense Fund found that this transition will cost SBHCs over $16 million in lost revenue. Already, SBHCs have suffered over $7 million, or nearly 30 percent in funding cuts since 2008, while their patient population has grown.

Without this “carve out,” centers would be forced to negotiate deals with individual Medicaid managed health plans, increasing the cost of operating these centers.

School Based Health Centers are clinics that provide students with no cost preventative dental, vision, nutritional and mental health care without the student needing to miss classes. They currently serve more than 230,000 underserved youth in rural, urban and suburban areas of the state, regardless of insurance status or ability to pay.

“Forcing School Based Health Centers into Medicaid managed care plans will wreck a model that works. School health centers increase access to primary and preventative health care and mental health care for children and adolescents,” said Assemblyman Richard Gottfried, chair of the Assembly Health Committee. “They make kids healthier and more attached to their school, save the Medicaid program money, promote healthier living, reduce adolescent pregnancy, improve school performance and help reduce racial and ethnic disparities.”

Unless the bill, S.6012/A.7866 is signed into law by the governor, SBHCs would be forced to negotiate reimbursements with Medicaid managed care health plans, adding a layer of red tape and administrative bureaucracy that is viewed as too costly for the 252 SBHCs to withstand.

“As a longtime supporter of School Based Health Centers, I want to ensure their continued availability as a means of low-cost, quality healthcare for thousands of New York students,” said Seward, chair of the Senate Insurance Committee. “The bi-partisan legislation that Assemblyman Gottfried and I advanced earlier this year will preserve access to healthcare for children at an affordable cost for families and the state.

“I urge the governor to sign the legislation and protect the long-term health of our school based health centers,” Seward said.

There is widespread bipartisan support for the SBHC system, not just within the Legislature, but from health care and education advocates as well.

“New York State’s 252 School Based Health Centers play a vital role in protecting the health of more than 200,000 students in neighborhoods that don’t have primary, mental, dental or preventative services,” said New York State United Teachers President Andy Pallotta. “School based health clinics reduce the number of children suffering from complications of chronic illnesses like diabetes and asthma. These clinics are a vital resource that we cannot afford to lose.”

SBHC provide care in communities, both rural and urban, that are undeserved by traditional health care infrastructure. Providing not just necessary, but preventative care that can save the healthcare system money in the long term.

This importance was echoed by Sarah Murphy, executive director of the New York School-Based Health Alliance.

“State health department data confirms that SBHC reach children who would otherwise go without care,” said Murphy. “At a time when the future of Medicaid, Child Health Plus and the Affordable Care Act programs and the safety net itself are threatened, SBHC will be needed even more.”

As of June 19 the legislation had passed both houses, and lawmakers are now calling for Gov. Cuomo to put pen to paper and sign the legislation to maintain the current system.