Requires financial assistance from the office of victim services for HIV post-exposure prophylaxis treatment for victims of sexual assault.
Ayes (31): DeFrancisco, Johnson, Alesi, Bonacic, Farley, Flanagan, Fuschillo, Golden, Griffo, Lanza, Larkin, LaValle, Little, Marcellino, Nozzolio, Robach, Saland, Seward, Young, Krueger, Breslin, Diaz, Dilan, Gianaris, Montgomery, Peralta, Perkins, Rivera, Stavisky, Stewart-Cousins, Squadron
Ayes W/R (1): Duane
Nays (1): Parker
Excused (2): Hannon, Oppenheimer
TITLE OF BILL: An act to amend the public health law and the executive law, in relation to financial assistance from the office of victim services for post-exposure prophylaxis treatment for victims of sexual assault
PURPOSE: To amend the public health law to enable survivors of sexual assault who have undergone a forensic rape exam to receive the full Course of HIV post exposure prophylaxis (PEP) treatment regardless of ability to pay.
SUMMARY OF PROVISIONS: This legislation provides for a simplification of payment procedures for survivors of sexual assault who are found by medical examiners conducting the Forensic Rape Exam (FRE) to be at risk for HIV/AIDS, and therefore, in need of PEP as follows: at the time of exam, survivors deemed at risk will be given a 9-day starter pack of the PEP. The emergency department where the exam is conducted will bill and be reimbursed by the OVS as they are currently. The OVS will be billed for the remaining 21 days of treatment by the appropriate clinic or in rural areas, as defined by statute, the county health department.
JUSTIFICATION: It is imperative to provide treatment to all survivors designated by Forensic Rape Examiners as at risk for HIV/AIDS. The costs of treating this HIV/AIDS fall upon the state nearly 90 percent of all cases, resulting in a dollar amount, per case, that exceeds preventive treatment by hundreds of thousands of dollars. Removing the obstacles that stand between sexual assault survivors and PEP treatment will decrease those individuals' chances of becoming infected with HIV/AIDS. The recommended time to begin treatment is within 36 hours of exposure.
Currently, some survivors who have been deemed at risk for HIV/AIDS do not complete PEP treatment for a number of reasons including: inability to cover the cost of medication while awaiting reimbursement from the OVS; inability to fill out requisite paperwork within three days as a result of paralyzing trauma caused by the assault; inadequate time between current 3-day starter pack and appointment with follow-up provider.
By streamlining the process and increasing outreach to assault survivors who have undergone a forensic exam, this law would make PEP treatment more accessible. This facilitation of long-term, preventive care could save the state millions of dollars in treatment costs by stemming potential HIV/AIDS cases.
LEGISLATIVE HISTORY: 2011: S.3200 Passed Senate, Died in Assembly 2009-2010: S.2680 (Morahan) 2008: S.7306 Passed Senate, Delivered to Governor, Veto Memo #96, Tabled
FISCAL IMPLICATIONS: Under the current system, the ova covers costs of PEP treatment in most cases. The funding comes from restitution funds and federal grant dollars. This funding does not come from the state budget. However it is the state that ends up paying for over 85 percent of the treatment to those who become HIV positive, as that is the percentage that qualifies for medical care that is state subsidized. The total cost for PEP under the FRE provision for the most recent available year was $180,000. The FRE universe is less than 4,000 persons per year. A very small percentage of those survivors begin treatment. There is no reason to anticipate a huge jump in those opting for the PEP treatment.
EFFECTIVE DATE: This act shall take effect on the one hundred eightieth day after it shall become law.
STATE OF NEW YORK ________________________________________________________________________ 3200--A 2011-2012 Regular Sessions IN SENATE February 11, 2011 ___________Introduced by Sens. HANNON, JOHNSON, KRUEGER, MONTGOMERY, OPPENHEIMER, PARKER, SAVINO, SERRANO -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- recommitted to the Committee on Health in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law and the executive law, in relation to financial assistance from the office of victim services for post- exposure prophylaxis treatment for victims of sexual assault THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph (c) of subdivision 1 of section 2805-i of the public health law, as amended by section 39 of part A-1 of chapter 56 of the laws of 2010, is amended to read as follows: (c) offering and making available appropriate HIV post-exposure treat- ment therapies in cases where it has been determined, in accordance with guidelines issued by the commissioner, that a significant exposure to HIV has occurred, and informing the victim that payment assistance for such therapies
[may be]IS available from the office of victim services pursuant to the provisions of article twenty-two of the executive law; PROVIDED, HOWEVER, THAT A FORENSIC RAPE EXAMINATION SHALL INCLUDE A NINE DAY STARTER PACK TO BE PROVIDED BY THE HOSPITAL EMERGENCY ROOM AT THE TIME OF THE FORENSIC RAPE EXAMINATION. THE HOSPITAL EMERGENCY ROOM SHALL DETERMINE WHICH CLINIC WITHIN THE HOSPITAL OR IF MORE CONVENIENT FOR THE VICTIM, ANOTHER HOSPITAL OR CLINIC, WHERE FOLLOW-UP CARE SHALL BE PROVIDED. IN RURAL COUNTIES PURSUANT TO SUBDIVISION TWELVE OF SECTION TWO HUNDRED THIRTY-EIGHT OF THIS CHAPTER, WHERE HOSPITALS DO NOT HAVE THE APPROPRIATE FACILITY TO ACCOMMODATE FOLLOW-UP CARE, THE HOSPITAL EMERGENCY ROOM DEPARTMENT SHALL REFER THE VICTIM TO THE COUNTY DEPART- MENT OF HEALTH, WHICH, IN TURN SHALL PROVIDE REFERRAL SERVICES FOR SUCHEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD03995-03-2 S. 3200--A 2
FOLLOW-UP CARE. THE HOSPITALS, CLINICS, AND RURAL COUNTY HEALTH DEPART- MENTS AS REFERENCED ABOVE ARE THE BILLING ENTITIES. S 2. Subdivision 13 of section 631 of the executive law, as amended by section 22 of part A-1 of chapter 56 of the laws of 2010, is amended and a new subdivision 13-a is added to read as follows: 13. Notwithstanding any other provision of law, rule, or regulation to the contrary, when any New York state accredited hospital, accredited sexual assault examiner program, or licensed health care provider furnishes services to any sexual assault survivor, including but not limited to a health care forensic examination in accordance with the sex offense evidence collection protocol and standards established by the department of health, such hospital, sexual assault examiner program, or licensed healthcare provider shall provide such services to the person without charge and shall bill the office directly. The office, in consultation with the department of health, shall define the specific services to be covered by the sexual assault forensic exam reimbursement fee, which must include at a minimum forensic examiner services, hospi- tal or healthcare facility services related to the exam, and related laboratory tests and pharmaceuticals.
[Follow-up HIV post-exposure prophylaxis costs shall continue to be reimbursed according to estab- lished office procedure. The office, in consultation with the department of health, shall also generate the necessary regulations and forms for the direct reimbursement procedure.]The rate for reimbursement shall be the amount of itemized charges not exceeding eight hundred dollars, to be reviewed and adjusted annually by the office in consultation with the department of health. The hospital, sexual assault examiner program, or licensed health care provider must accept this fee as payment in full for these specified services. No additional billing of the survivor for said services is permissible. A sexual assault survivor may voluntarily assign any private insurance benefits to which she or he is entitled for the healthcare forensic examination, in which case the hospital or healthcare provider may not charge the office. A hospital, sexual assault examiner program or licensed health care provider shall, at the time of the initial visit, request assignment of any private health insurance benefits to which the sexual assault survivor is entitled on a form prescribed by the office; provided, however, such sexual assault survivor shall be advised orally and in writing that he or she may decline to provide such information regarding private health insurance benefits if he or she believes that the provision of such information would substantially interfere with his or her personal privacy or safety and in such event, the sexual assault forensic exam fee shall be paid by the office. [Such sexual assault survivor shall also be advised that providing such information may provide additional resources to pay for services to other sexual assault victims.]If he or she declines to provide such health insurance information, he or she shall indicate such decision on the form provided by the hospital, sexual assault examiner program or licensed health care provider, which form shall be prescribed by the office. 13-A. NOTWITHSTANDING ANY OTHER PROVISIONS OF LAW, RULE, OR REGULATION TO THE CONTRARY, WHEN ANY BILLING ENTITY PROVIDES PROPHYLACTIC TREATMENT FOR SIGNIFICANT POSSIBLE EXPOSURE TO HIV TO A VICTIM OF SEXUAL ASSAULT AS PRESCRIBED BY A LICENSED HEALTHCARE PROVIDER, SUCH TREATMENT SHALL BE PROVIDED TO THE PERSON WITHOUT CHARGE AND THE PHARMACY SHALL BILL THE OFFICE DIRECTLY. THE OFFICE, IN CONSULTATION WITH THE DEPARTMENT OF HEALTH, SHALL GENERATE THE NECESSARY REGULATIONS AND FORMS FOR THE DIRECT REIMBURSEMENT PROCEDURE. THE RATE FOR REIMBURSEMENT SHALL BES. 3200--A 3
ESTABLISHED AND REVIEWED AND ADJUSTED AT LEAST ANNUALLY BY THE OFFICE IN CONSULTATION WITH THE DEPARTMENT OF HEALTH. THE BILLING ENTITY MUST ACCEPT THIS FEE AS PAYMENT IN FULL FOR THE SPECIFIED POST-EXPOSURE PROPHYLACTIC TREATMENT THERAPIES. NO ADDITIONAL BILLING OF THE SURVIVOR FOR SAID MEDICATIONS IS PERMISSIBLE. A SEXUAL ASSAULT SURVIVOR MAY VOLUNTARILY ASSIGN ANY PRIVATE INSURANCE BENEFITS TO WHICH SHE OR HE IS ENTITLED FOR THE PROPHYLACTIC MEDICATIONS, IN WHICH CASE THE BILLING ENTITY MAY NOT CHARGE THE OFFICE. A BILLING ENTITY SHALL, AT THE TIME OF THE INITIAL VISIT, REQUEST ASSIGNMENT OF ANY PRIVATE HEALTH INSURANCE BENEFITS TO WHICH THE SEXUAL ASSAULT SURVIVOR IS ENTITLED ON A FORM PRESCRIBED BY THE OFFICE; PROVIDED, HOWEVER, SUCH SEXUAL ASSAULT SURVI- VOR SHALL BE ADVISED ORALLY AND IN WRITING THAT HE OR SHE MAY DECLINE TO PROVIDE SUCH INFORMATION REGARDING PRIVATE HEALTH INSURANCE BENEFITS IF HE OR SHE BELIEVES THAT THE PROVISION OF SUCH INFORMATION WOULD SUBSTAN- TIALLY INTERFERE WITH HIS OR HER PERSONAL PRIVACY OR SAFETY AND, IN SUCH EVENT, THE PROPHYLACTIC TREATMENT FEE SHALL BE PAID BY THE OFFICE. IF HE OR SHE DECLINES TO PROVIDE SUCH HEALTH INSURANCE INFORMATION, HE OR SHE SHALL INDICATE SUCH DECISION ON THE FORM PROVIDED BY THE BILLING ENTITY, WHICH FORM SHALL BE PRESCRIBED BY THE OFFICE. THE NINE DAY STARTER PACK PROVIDED TO THE VICTIM PURSUANT TO PARAGRAPH (C) OF SUBDI- VISION ONE OF SECTION TWENTY-EIGHT HUNDRED FIVE-I OF THE PUBLIC HEALTH LAW SHALL BE CONSIDERED PART OF THE FORENSIC RAPE EXAMINATION AND BILLED ACCORDINGLY. FOR THE REMAINING TWENTY-ONE DAYS OF TREATMENT, THE APPRO- PRIATE CLINIC OR IN A RURAL AREA, THE COUNTY DEPARTMENT OF HEALTH, SHALL BILL THE OFFICE OF VICTIM SERVICES AND BE REIMBURSED BY SUCH OFFICE. IF THE VICTIM IS NOT SEEKING REIMBURSEMENT FROM THE OFFICE, SUCH VICTIM CAN CHOOSE FOLLOW-UP CARE BY ATTENDING THE APPROPRIATE CLINIC OR SEEKING A PROVIDER OF HIS OR HER CHOICE. S 3. Paragraph (b) of subdivision 2 of section 631-a of the executive law, as amended by section 27 of part A-1 of chapter 56 of the laws of 2010, is amended to read as follows: (b) These regulations shall also provide for services including, but not limited to: (i) assistance to claimants seeking crime victims compensation bene- fits; (ii) referrals, crisis intervention and other counseling services; (iii) services to elderly victims and to child victims and their fami- lies; (iv) transportation and household assistance; and (v) outreach to the community and education and training of law enforcement and other criminal justice officials to the needs of crime victims; (VI) PROPHYLACTIC TREATMENT THERAPIES IN CASES WHERE IT HAS BEEN DETERMINED THAT A SIGNIFICANT EXPOSURE TO HIV HAS OCCURRED; AND (VII) IDENTIFYING HEALTH CARE PROVIDERS ACROSS THE STATE WHO CAN PROVIDE FOLLOW-UP CARE FOR VICTIMS INCLUDING BUT NOT LIMITED TO HOW AND WHERE TO ACCESS HIV POST-EXPOSURE PROPHYLAXIS. S 4. This act shall take effect on the one hundred eightieth day after it shall have become a law.