S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                          42
                              2015-2016 Regular Sessions
                                 I N  A S S E M B L Y
                                      (PREFILED)
                                    January 7, 2015
                                      ___________
       Introduced  by  M.  of  A. GANTT, MORELLE, PEOPLES-STOKES, PERRY -- read
         once and referred to the Committee on Education
       AN ACT to amend the education law and the public health law, in relation
         to the powers of the boards of education for the city school districts
         of Rochester and Buffalo to  arrange  and  provide  integrated  health
         services to the school community directly and/or through contractors
         THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section 1.  Legislative intent. The legislature finds:
    2    1. Two trends, one sociological and one political, underpin a need for
    3  the fiscally dependent school districts of the cities of  Rochester  and
    4  Buffalo  to obtain express authority to develop and operate programs for
    5  integrated health services within  the  districts,  in  a  manner  which
    6  embraces  the  best  and most economic available technologies, and which
    7  harnesses the health care resources of their respective  communities  in
    8  the  most  effective  possible  manner.  It  is found, further, that the
    9  public interest is served by permitting those districts to provide  such
   10  services  directly,  and/or  by  the  use  of contractors, including the
   11  boards of cooperative educational services,  which  shall  be  expressly
   12  authorized to contract to provide some or all of such services; and that
   13  the costs of assuming such services be ameliorated by authorizing subsi-
   14  dy  and/or  reimbursement for such services on the same basis and in the
   15  same manner as a county health department would  be  eligible  for  such
   16  subsidy or reimbursement for similar school health services.
   17    2.  During  the first two decades of the twentieth century, exercising
   18  police powers, city health  departments  in  the  cities  of  New  York,
   19  Rochester  and  Buffalo as an element of municipal health and sanitation
   20  efforts began providing health services within  city  schools.  Starting
   21  with  vaccinations  and  milk  stations to provide pasteurized milk, the
   22  programs evolved into providing school physicians and nurses and medical
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02376-01-5
       A. 42                               2
    1  inspections. When "medical inspection" was codified under State  law  in
    2  1913,  in what is now section nine hundred one of the education law, the
    3  city school districts in the cities of New York, Rochester and  Buffalo,
    4  in  which  the  city  health departments were actively engaged in school
    5  health services, were excepted from the legislation. The  term  "medical
    6  inspection"  in  that  statute  has  been replaced with the term "school
    7  health services," under chapter 477 of the laws of 2004. Over time,  the
    8  school  health  function  for the city school districts of Rochester and
    9  Buffalo devolved from city  health  departments  to  the  county  health
   10  departments  in the counties of Monroe and Erie, by resolution and char-
   11  ter, as authorized by section one thousand seventeen-a of  the  optional
   12  county government law. The county of Monroe and the county of Erie ther-
   13  eupon  provided and funded school health services for decades. The coun-
   14  ties have determined that even with available reimbursement, they are no
   15  longer able to  provide  school  health  services  to  the  city  school
   16  districts.  The  county of Monroe eliminated staffing and funding in its
   17  2004 budget; and the county of Erie has eliminated staffing and  funding
   18  in  its  2005  budget.  In December 2004, the Appellate Division, Fourth
   19  Department of the New York State Supreme Court affirmed that the  county
   20  of  Monroe  had  the  authority  to  withdraw from providing and funding
   21  school health services to the city school district of Rochester.
   22    3. Within the cities of Rochester and Buffalo, there exists  a  marked
   23  concentration  of  poverty, of racial concentration or isolation, and of
   24  limited English language capacity, which together increase the risk that
   25  school age children do not have access to any regular or adequate health
   26  services outside of school; and that unless the  school  districts  have
   27  the  authority to provide such services directly or through contractors,
   28  and to develop an integrated  health  services  network  with  available
   29  community  resources,  the  legislature  finds that many children within
   30  those cities are likely to  continue  to  have  insufficient  access  to
   31  health  care, with the inexorable result that their educational develop-
   32  ment will also be impaired, to the long term detriment of those children
   33  and to the state itself. Census data and other studies in Rochester, for
   34  example, demonstrate that the city school district of Rochester has  the
   35  second highest per capita poverty rate among all school districts in the
   36  state  of  New  York;  and  ranks twelfth in child poverty in the United
   37  States. In the 2001-2002  school  year,  eleven  per  cent  of  incoming
   38  kindergarteners  in  Rochester  had  health  problems  requiring ongoing
   39  medical supervision, while seven per cent of parents reported that their
   40  child starting kindergarten had no primacy care  physician,  and  twenty
   41  per  cent  had  never  seen a dentist. Fifteen per cent of those parents
   42  reported that their child had been hospitalized in a neonatal  intensive
   43  care unit at birth.
   44    4.  Particularly  since  the  city  school  districts of Rochester and
   45  Buffalo are fiscally dependent, the legislature finds that it is in  the
   46  public  interest  to  provide  that  whenever integrated health services
   47  would be subject to reimbursement or subsidy if  provided  by  a  county
   48  health  department then when such services are provided by a city school
   49  district (or by  its  contractors)  which  had  received  school  health
   50  services  from  the  county of Monroe or the county of Erie in the past,
   51  that such city school district shall be deemed to be eligible  for  such
   52  reimbursement  or  subsidy  as if it were a county health department. In
   53  that manner, the economic impact of termination of county school  health
   54  services  will  be  limited  to  the local costs, and the districts will
   55  continue to benefit from state reimbursement to the same degree as  when
   56  school  health  services were provided by the county health departments.
       A. 42                               3
    1  It is the intent of the legislature that school district eligibility for
    2  such reimbursement shall be retroactive to the first day of  the  school
    3  fiscal year in which the county government which had previously provided
    4  funding and staffing for school health services eliminated that aid from
    5  its  budget.  In the case of the city school district of Rochester, such
    6  eligibility shall be  retroactive  to  July  1,  2004.  The  legislature
    7  further  finds  that  it  is  in  the public interest to permit the city
    8  school districts in the cities of Rochester and Buffalo to contract  and
    9  pay for some part or all of its integrated health services programs with
   10  boards  of  cooperative  educational  services  serving  the counties of
   11  Monroe and Erie, and for such boards of cooperative educational services
   12  to provide such health services. This act shall be known  as  the  Inte-
   13  grated Health Services for Fiscally Dependent School Districts Act.
   14    S  2.  Section  901  of  the  education law is amended by adding a new
   15  subdivision 3 to read as follows:
   16    3. IN THE SCHOOL DISTRICTS EXCEPTED FROM THIS  ARTICLE,  WHERE  SCHOOL
   17  HEALTH  SERVICES  ARE  NOT BEING FUNDED OR STAFFED BY THE HEALTH DEPART-
   18  MENTS OF THE CITY OR COUNTY IN WHICH SUCH DISTRICT IS LOCATED; OR IF, IN
   19  THE DISCRETION OF THE BOARD OF EDUCATION, ADDITIONAL  INTEGRATED  HEALTH
   20  SERVICES  ARE  WARRANTED,  THEN  THE  BOARD  OF EDUCATION OF SUCH SCHOOL
   21  DISTRICT SHALL BE AUTHORIZED, BUT NOT REQUIRED TO PROVIDE,  DIRECTLY  OR
   22  BY  ONE  OR  MORE  CONTRACTS SUCH SCHOOL HEALTH SERVICES AS THE BOARD OF
   23  EDUCATION DETERMINES ARE USEFUL OR NECESSARY TO  MEET  THE  CURRENT  AND
   24  EVOLVING   HEALTH   NEEDS   OF   THEIR   SCHOOL  POPULATIONS,  INCLUDING
   25  SCHOOL-BASED AND INTEGRATED SCHOOL-LINKED HEALTH SERVICES WHICH  MAY  BE
   26  LINKED TO COMMUNITY-BASED HEALTH CARE SYSTEMS, AND SERVICES WHICH EMPLOY
   27  TELEMEDICINE  OR  OTHER  EMERGING TECHNOLOGIES. WHERE AN EXCEPTED SCHOOL
   28  DISTRICT PROVIDES SCHOOL HEALTH  SERVICES  WHICH  WOULD  BE  SUBJECT  TO
   29  REIMBURSEMENT OR SUBSIDY IF PROVIDED BY A COUNTY HEALTH DEPARTMENT, THEN
   30  NOTWITHSTANDING  ANY  PROVISION  OF ANY OTHER STATE LAW, THE CITY SCHOOL
   31  DISTRICT SHALL BE ELIGIBLE FOR SUCH SUBSIDY OR REIMBURSEMENT AS WOULD  A
   32  COUNTY  HEALTH  DEPARTMENT.  THIS  ELIGIBILITY  SHALL  APPLY NOT ONLY TO
   33  SERVICES PROVIDED BY SUCH CITY SCHOOL DISTRICT  DIRECTLY,  BUT  ALSO  TO
   34  SERVICES  PROVIDED INDIRECTLY, THROUGH CONTRACTS WITH A BOARD OF COOPER-
   35  ATIVE EDUCATIONAL SERVICES, OR THROUGH ANY OTHER QUALIFIED  PROVIDER  OF
   36  HEALTH  CARE  SERVICES.  SUCH  ELIGIBILITY  SHALL  BE DEEMED TO APPLY TO
   37  DIRECT OR CONTRACT SERVICES PERFORMED BY OR FOR THE CITY SCHOOL DISTRICT
   38  ON OR AFTER THE FIRST DAY OF THE FIRST FISCAL YEAR IN WHICH  THE  COUNTY
   39  IN WHICH SUCH CITY SCHOOL DISTRICT IS LOCATED DID NOT PROVIDE FUNDING OR
   40  STAFFING FOR SCHOOL HEALTH SERVICES.
   41    S  3.  Section  2554 of the education law is amended by adding two new
   42  subdivisions 28  and 29 to read as follows:
   43    28. TO PROVIDE, IN DISTRICTS EXCEPTED FROM THE PROVISIONS OF  SUBDIVI-
   44  SION  ONE OF SECTION NINE HUNDRED ONE OF THIS CHAPTER, SUCH SCHOOL-BASED
   45  OR SCHOOL-LINKED INTEGRATED SCHOOL  HEALTH  SERVICES  AS  THE  BOARD  OF
   46  EDUCATION  MAY, IN ITS DISCRETION DEEM WARRANTED, EITHER DIRECTLY, OR BY
   47  ONE OR MORE CONTRACTS WITH A BOARD OF COOPERATIVE  EDUCATIONAL  SERVICES
   48  AND/OR  WITH  HEALTH  CARE  PROVIDERS SERVING THE COMMUNITY IN WHICH THE
   49  DISTRICT IS SITUATED. BOARDS OF EDUCATION ARE AUTHORIZED AND  ENCOURAGED
   50  TO  DEVELOP  MODELS  FOR HEALTH CARE DELIVERY WHICH ARE TAILORED TO MEET
   51  THE SPECIFIC NEEDS OF THEIR POPULATIONS IN A MANNER WHICH IS AS  ECONOM-
   52  ICAL  AS  POSSIBLE,  BUT  WHICH  EMBODIES EMERGING TECHNOLOGIES AND ALSO
   53  UTILIZES NEW AND ADVANCED MODELS FOR HEALTH SERVICES, AS WELL AS  TRADI-
   54  TIONAL SCHOOL HEALTH MODELS, AND TO ADD, AMEND, SUPPLEMENT, OR ELIMINATE
   55  SPECIFIC  HEALTH  CARE SERVICES BASED UPON EFFECTIVENESS, COST, EVOLVING
   56  NEEDS, OR THE AVAILABILITY OF NEW APPROACHES TO SCHOOL HEALTH  SERVICES.
       A. 42                               4
    1  SERVICES  MAY  BE  SCHOOL-BASED  OR  MAY BE LINKED IN COLLABORATION WITH
    2  LOCAL HOSPITALS, CLINICS, AND HEALTH CARE PROFESSIONALS AND AGENCIES AND
    3  MAY ALSO HAVE CHARACTERISTICS OF  BOTH  SCHOOL-BASED  AND  SCHOOL-LINKED
    4  MODELS,  SUCH  AS  TELEMEDICINE  COMPONENTS  AND  USE  OF MOBILE MEDICAL
    5  SERVICE UNITS.
    6    29. TO SEEK AND APPLY FOR AND RECEIVE, IN DISTRICTS EXCEPTED FROM  THE
    7  PROVISIONS  OF SUBDIVISION ONE OF SECTION NINE HUNDRED ONE OF THIS CHAP-
    8  TER, STATE AID FUNDING WHICH IS  OR  MAY  BECOME  AVAILABLE  TO  MUNICI-
    9  PALITIES UNDER ARTICLE SIX OF THE PUBLIC HEALTH LAW FOR THE SCHOOL-BASED
   10  OR  SCHOOL-LINKED  INTEGRATED  SCHOOL  HEALTH  SERVICES PROVIDED BY SUCH
   11  DISTRICTS, AS DETAILED UNDER SUBDIVISION TWENTY-EIGHT OF  THIS  SECTION.
   12  ANY  APPLICATION  FOR  SUCH  STATE  AID FUNDING UNDER ARTICLE SIX OF THE
   13  PUBLIC HEALTH LAW WOULD BE SUBMITTED IN ACCORDANCE WITH SUCH  PROCEDURES
   14  AS MAY BE PROMULGATED BY THE COMMISSIONER.
   15    S  4.  Section  2566  of  the education law is amended by adding a new
   16  subdivision 10 to read as follows:
   17    10. TO HAVE SUPERVISION AND  DIRECTION  OF  INTEGRATED  SCHOOL  HEALTH
   18  SERVICES  AUTHORIZED BY THE BOARD OF EDUCATION UNDER SUBDIVISION TWENTY-
   19  EIGHT OF SECTION TWENTY-FIVE HUNDRED FIFTY-FOUR OF THIS CHAPTER.
   20    S 5. Subdivision 4 of section 1950 of the education law is amended  by
   21  adding a new paragraph oo to read as follows:
   22    OO. TO ENTER INTO CONTRACTS WITH CITY SCHOOL DISTRICTS PROVIDING INTE-
   23  GRATED  SCHOOL  HEALTH  SERVICES UNDER SUBDIVISION THREE OF SECTION NINE
   24  HUNDRED ONE OF THIS CHAPTER, AND WHICH ARE LOCATED WITHIN OR ADJACENT TO
   25  THE SUPERVISORY DISTRICT OF A BOARD OF COOPERATIVE EDUCATIONAL  SERVICES
   26  AND/OR  THE  TERRITORY  SERVED  BY  A  BOARD  OF COOPERATIVE EDUCATIONAL
   27  SERVICES, TO PROVIDE ALL OR PART OF THE SERVICES REQUESTED BY  THE  CITY
   28  SCHOOL  DISTRICT  UPON  MUTUALLY AGREEABLE TERMS.  BOARDS OF COOPERATIVE
   29  EDUCATIONAL SERVICES ARE HEREBY  AUTHORIZED  AND  EMPOWERED  TO  DO  AND
   30  PERFORM  ANY  AND  ALL  ACTS  NECESSARY  OR DESIRABLE IN RELATION TO THE
   31  PERFORMANCE OF ANY SUCH CONTRACTS.
   32    S 6. Section 600 of the public health law, as amended by section 14 of
   33  part E of chapter 56 of the laws of 2013, is amended to read as follows:
   34    S 600. State aid; general requirements. 1. In order to be eligible for
   35  state aid under this title, a municipality shall be required to  do  the
   36  following in accordance with the provisions of this article:
   37    [1.] A. submit an application to the department for state aid which is
   38  approved  by the commissioner in accordance with section six hundred one
   39  of this title;
   40    [2.] B. provide core public health services, as defined in section six
   41  hundred two of this title, in accordance with an application  for  state
   42  aid submitted by the municipality and approved by the commissioner;
   43    [3.]  C.  submit  a  community  health  assessment  in accordance with
   44  section six hundred two-a of this title;
   45    [4.] D. establish, collect and report fees and  revenue  for  services
   46  provided by the municipality, in accordance with section six hundred six
   47  of this title; and
   48    [5.]  E.  appropriate  or  otherwise make funds available to finance a
   49  prescribed share of the cost of public health services.
   50    2. A SCHOOL DISTRICT WHICH IS EXCEPTED FROM THE PROVISIONS OF SUBDIVI-
   51  SION ONE OF SECTION NINE HUNDRED ONE OF THE EDUCATION LAW SHALL ALSO  BE
   52  ELIGIBLE FOR STATE AID FUNDING WHICH IS OR MAY BECOME AVAILABLE TO MUNI-
   53  CIPALITIES  UNDER  THIS  TITLE  FOR  THE  SAME  OR  SIMILAR SERVICES, AS
   54  PROVIDED FOR BY THE PROVISIONS OF  SUBDIVISION  TWENTY-NINE  OF  SECTION
   55  TWENTY-FIVE  HUNDRED  FIFTY-FOUR OF THE EDUCATION LAW. THE PROVISIONS OF
   56  THIS ARTICLE REGULATING THE DEVELOPMENT, APPROVAL,  IMPLEMENTATION,  AND
       A. 42                               5
    1  FEE  ASSESSMENT  OF  MUNICIPAL  PUBLIC  HEALTH  PLANS SHALL NOT APPLY TO
    2  SCHOOL DISTRICTS, WHICH SHALL SUBMIT  APPLICATIONS  IN  ACCORDANCE  WITH
    3  SUCH PROCEDURES AS MAY BE PROMULGATED BY THE COMMISSIONER OF EDUCATION.
    4    S  7.  This  act  shall take effect immediately and shall apply to all
    5  contracts entered into on or after such effective date; provided, howev-
    6  er, that for purposes  of  a  subsidy  or  reimbursement  authorized  by
    7  section  two  of  this act, a school district in which county funding or
    8  staffing was not made available for the 2004-2005 school year  shall  be
    9  entitled to receive such reimbursement or subsidy for any health service
   10  rendered  by  the  school district on or after (i) July 1, 2004, or (ii)
   11  the first day of the first school district  fiscal  year  in  which  the
   12  county did not fund or staff such school district, whichever is earlier.