Directs the commissioner of health to do a comprehensive assessment of the existing methodology used to determine payment for early intervention screenings, evaluations, services and service coordination; directs recommendations on reimbursement methodology as well as needs under the program.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A10175
SPONSOR: Rules (Paulin) TITLE OF BILL:
An act to amend the public health law, in relation to a review and
recommendations of reimbursement adequacy and other matters relating to
early intervention
PURPOSE:
To review reimbursement adequacy for early intervention services.
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 amends the public health law by adding section 2559-c as it
relates to early intervention services. This section directs the commis-
sioner to review the reimbursement rates for early intervention
programs. The review shall include: a comprehensive assessment of exist-
ing methods to determine reimbursement rates; analysis of salary levels
for individuals within the discipline; analysis of provider cost for the
program; and recommendations for updating or maintaining reimbursement
methods. The review will also include an assessment of the efficacy of
program models for the provision of early intervention services and it
will also include a comprehensive assessment of the utilization of each
model and configuration. This section also directs the commission to
submit findings of the report and the recommendations to elected offi-
cials and to post them on the department's website.
Section 2 provides the effective date.
JUSTIFICATION:
The early intervention (EI) program provides services for babies and
toddlers (0-3 years old) with developmental delays and disabilities. EI
services help many children meet developmental milestones they would
otherwise miss. Most EI services are provided in each individual fami-
ly's home and some are provided in groups and centers.
EI reimbursement rates as a whole have not been raised since the 1990s.
Individual providers and provider agencies have been steadily leaving
the program because they cannot afford to keep providing the services at
the State's payment rates. In some parts of the State, there is an utter
lack of providers qualified to provide EI services. In areas without an
overall provider shortage, there is still a shortage of EI providers
because they can make a more sustainable living by serving people
through other programs and institutions. Even in areas that have a pool
of available EI providers, families in certain neighborhoods are unable
to find a provider who will come to their home. From New York City to
Rochester and throughout the State, babies with disabilities are waiting
months to receive the time-sensitive services they need and deserve.
Since EI is only available to children until their third birthdays, a
delay in services is a denial of services.
Despite years of raising the issue of low reimbursement and the result-
ing provider shortage, no serious effort has been made to evaluate the
true costs of providing EI services, or to compare the salaries of the
same type of provider in and out of the EI program. The reimbursement
rates were not high in 1990 and they are certainly not adequate now. The
State needs to reevaluate its payment methodologies and ensure that all
children eligible for EI are able to access the services they need
before it's too late.
LEGISLATIVE HISTORY:
2021-2022: S5676/ A6579 Gottfried Vetoed
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
This act shall take effect immediately.
STATE OF NEW YORK
________________________________________________________________________
10175
IN ASSEMBLY
May 10, 2024
___________
Introduced by COMMITTEE ON RULES -- (at request of M. of A. Paulin) --
read once and referred to the Committee on Health
AN ACT to amend the public health law, in relation to a review and
recommendations of reimbursement adequacy and other matters relating
to early intervention
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The public health law is amended by adding a new section
2 2557-a to read as follows:
3 § 2557-a. Early intervention program review. 1. The commissioner shall
4 conduct a comprehensive study and review of the early intervention
5 program including the models of service delivery and the rates of
6 reimbursement for each such service and model made through the early
7 intervention program for efficacy, adequacy and effectiveness of service
8 delivery and the full implementation of individualized family service
9 plans. The review shall include:
10 (a) a comprehensive assessment of the existing methodology used to
11 determine payment for early intervention screenings, evaluations,
12 services and service coordination, including but not limited to:
13 (i) analysis of early intervention rules, regulations, and policies,
14 including policies, processes, and revenue sources;
15 (ii) analysis of costs to providers participating in the early inter-
16 vention program, including time and cost of travel, service provision,
17 and administrative activities; and
18 (iii) analysis by discipline and labor region of salary levels for
19 individuals providing early intervention services compared to the salary
20 levels for individuals in the same disciplines and labor regions provid-
21 ing services other than in the early intervention program;
22 (b) recommendations for maintaining or changing reimbursement method-
23 ologies. Recommendations under this paragraph shall be consistent with
24 federal law and shall include recommendations for appropriate changes in
25 state law and regulations. The recommendations shall consider appropri-
26 ate payment methodologies and rates for in-person and telehealth early
27 intervention evaluations and services to address barriers in timely
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD03582-03-4
A. 10175 2
1 service provision as well as racial and socioeconomic disparities in
2 access, with consideration of factors including, but not limited to,
3 payment for bilingual services, travel time, geographic variability,
4 access to and cost of technology, cost of living, and other barriers to
5 timely service provision;
6 (c) the projected number of children who will need early intervention
7 services in the next five years disaggregated by county;
8 (d) the workforce needed to provide services in the next five years to
9 all children eligible for early intervention services, disaggregated by
10 county; and
11 (e) opportunities for stakeholder input on current rate methodologies.
12 2. Such review shall also include an assessment of the efficacy of
13 program models for the provision of early intervention services, includ-
14 ing, but not limited to group services, individual services, facility
15 based services and home-based services and the configurations of such
16 service models. Such review shall include a comprehensive assessment of
17 the utilization of each model and configuration, including barriers to
18 fuller utilizations, and utilization disaggregated by clinical service.
19 3. Within one year after the effective date of this section, the
20 commissioner shall submit a report of the findings and recommendations
21 under this section to the governor, the temporary president of the
22 senate, the speaker of the assembly, and the chairs of the senate and
23 assembly committees on health, and shall post the report on the depart-
24 ment's website.
25 § 2. This act shall take effect immediately.
