BILL NUMBER: S8427
SPONSOR: BROUK
 
TITLE OF BILL:
An act to amend the social services law and the state finance law, in
relation to increasing Medicaid reimbursement rates for certain behav-
ioral health services provided to individuals under the age of twenty-
one
 
PURPOSE:
To adjust rates of Medicaid payment for outpatient behavioral health
services provided to children, including Child and Family Treatment and
Support Services (CFTSS), Home and Community Based Services (HOBS),
Article 31 Clinic Services, and Article 32-822 Clinic Services.
 
SUMMARY OF PROVISIONS:
Section 1: Provides a 35% rate increase for Article 31 and Article
32-822 children's outpatient behavioral health services.
Provides for a $7.50 per member per month care coordination fee for
Article 31 and 32-822 children's outpatient behavioral health services.
Provides a 3.2% trend factor for Article 31 and Article 32-822 chil-
dren's outpatient behavioral health services.
Directs the commissioner of health to submit a state plan amendment
effectuating a $45,000,000 aggregate rate increase for home and communi-
ty based services and child and family treatment and support services.
Directs the commissioner of health to submit a state plan amendment
effectuating' a $7.50 per member per month care coordination fee for
home and community based services and child and family treatment and
support services.
Directs the commissioner of health to submit a state plan amendment
effectuating a 3.2% trend factor for home and community based services
and child and family treatment and support services.
Section 2: Directs a portion of funds from the healthcare stability fund
to support the rate increases established by section one of this bill.
Section 3: Sets forth an immediate effective date.
 
JUSTIFICATION:
There is a national state of emergency for children's mental health.
Demand for children's behavioral health services has skyrocketed while
New York's capacity to provide them continues to shrink. A problem
decades in the making has become so severe it can no longer be ignored.
Serving children - especially the most complex children - requires coor-
dination with multiple service systems, providers, and care managers, as
well as the child's guardian(s). This coordination is essential to
provide quality care, but the work required to do it is not compensated.
Every visit requires substantial unpaid care team labor, which has led
to long wait lists and providers unable to expand capacity to serve
children. Tens of thousands of New York children lack the care, treat-
ment, and support they need to thrive.
A 2023 study commissioned by the Campaign for Healthy Minds Healthy Kids
studied the adequacy of Medicaid rates for the children's outpatient
behavioral health system. The findings were that rates of payment are
not pacing the actual cost of providing care and that rate adjustments
are urgently needed for Child and Family Treatment and Support Services
(CFTSS), Home and Community Based Services (HCBS), Article 31 Clinic
Services, and Article 32-822 Clinic Services. This rate inadequacy has
resulted in a dearth of providers, which in turn leaves many children
and families languishing on wait lists for services that they need
today.
This legislation would make a much-needed investment in the core behav-
ioral health services that children and families need the most.
Increasing reimbursement for these four services will allow providers to
stabilize and grow their workforce, which in turn will allow them to
serve more young people and their caregivers. Specifically, the study
estimates that the $200 million rate investment would allow community
behavioral health providers to hire 1,300 additional clinicians, result-
ing in a system wide capacity expansion to serve 26,000 more children.
Investing in the outpatient system will also ensure that more people are
being served in the community, before a behavioral health issue might be
exacerbated and lead them to seek care in a hospital or emergency
department. Reaching children and their parents early will also help
prevent the most tragic of outcomes - suicide or overdose deaths. This
bill would be a critical first step towards meaningfully expanding
outpatient capacity and filling gaps in the overall continuum of care.
 
LEGISLATIVE HISTORY:
New bill.
 
FISCAL IMPLICATIONS:
This bill would result in an increase of approximately $200 million in
gross Medicaid spending.
 
EFFECTIVE DATE:
This act shall take effect immediately.

Statutes affected:
S8427: 99-ss state finance law, 99-ss(3) state finance law