Bill Details - HB521 (2019)

HB 521-FN - AS AMENDED BY THE HOUSE

 

27Feb2019... 0543h

2019 SESSION

19-0258

05/01

 

HOUSE BILL 521-FN

 

AN ACT establishing a child abuse specialized medical evaluation program in the department of health and human services.

 

SPONSORS: Rep. Berrien, Rock. 18; Rep. Fothergill, Coos 1; Rep. Wallner, Merr. 10; Rep. Gordon, Graf. 9; Sen. Carson, Dist 14; Sen. Hennessey, Dist 5; Sen. Feltes, Dist 15

 

COMMITTEE: Children and Family Law

 

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ANALYSIS

 

This bill establishes a child abuse specialized medical evaluation program in the department of health and human services.

 

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

27Feb2019... 0543h 19-0258

05/01

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Nineteen

 

AN ACT establishing a child abuse specialized medical evaluation program in the department of health and human services.

 

Be it Enacted by the Senate and House of Representatives in General Court convened:

 

1  Statement of Findings.  The general court hereby makes the following findings regarding the incidence and prevention of child abuse and neglect:

I.  The state of New Hampshire has over 10,000 cases of suspected child abuse or neglect investigated annually.

II.  Standard policies of the American Academy of Pediatrics and accreditation requirements of the National Children’s Alliance, which accredits child advocacy centers, include the specialized evaluation of child victims of abuse and neglect by health care providers trained in such evaluations.

III.  Of 2100 suspected sexually and physically abused children referred to Children’s Advocacy Centers for forensic interview annually, less than 13 percent receive a specialized medical evaluation.

IV.  The state of New Hampshire does not have an established system to medically evaluate children who may have been physically or sexually abused.

V.  The state of New Hampshire Medicaid program pays health care providers inadequately to perform the specialized medical evaluation.

VI.  Therefore, a child abuse specialized medical evaluation program shall be implemented by the department of health and human services in collaboration with existing and future public and private resources and services in New Hampshire.

2  New Subdivision; Child Abuse Specialized Medical Evaluation Program.  Amend RSA 169-C by inserting after section 39-k the following new subdivision:

Child Abuse Specialized Medical Evaluation Program

169-C:39-l  Child Abuse Specialized Medical Evaluation Program Established.  A child abuse specialized medical evaluation program is hereby established in the department.  The program shall include the following elements:

I.  Child protective service workers shall have on-call access, 24 hours a day and 7 days a week, to an experienced health care professional who is trained in and can advise on the standardized diagnostic methods, treatment, and disposition of suspected child sexual abuse and physical abuse.

II.  Department nurses and child protective service workers performing screenings and assessments of reported cases of child abuse shall receive pre-service training in the standardized medical diagnostic methods, treatment, and disposition as well as periodic in-service training by health care providers experienced in child abuse and neglect.

III.  Annually, a limited number of designated health care providers geographically distributed shall be trained in nationally recognized curricula to respond to initial presentations of child sexual abuse, physical abuse, and neglect.

IV.  Health care professionals who participate in the training or are members of a multidisciplinary team, working with the department of health and human services or law enforcement, shall participate in periodic peer or expert reviews of their evaluations and undertake continuing education in the medical evaluation of child abuse and neglect according to professional standards.

V.  The department shall contract with a health care provider with experience in child abuse and neglect to administer the program in collaboration with participating private and public entities.

VI.  Reimbursement rates for health care providers who participate in the program shall reflect the average cost to deliver such services, including the participation in multidisciplinary team activities and associated court proceedings.  The rates shall be periodically reviewed and, if necessary, revised.

VII.  The commissioner of the department shall adopt rules, under RSA 541-A, relative to the medical evaluation program, training and continuing education requirements, and reimbursement rates.

3  Effective Date.  This act shall take effect 60 days after its passage.

 

LBAO

19-0258

Amended 2/28/19

 

HB 521-FN- FISCAL NOTE

AS AMENDED BY THE HOUSE (AMENDMENT #2019-0543h)

 

AN ACT establishing a child abuse specialized medical evaluation program in the department of health and human services.

 

FISCAL IMPACT:      [ X ] State              [    ] County               [    ] Local              [    ] None

 

 

 

Estimated Increase / (Decrease)

STATE:

FY 2020

FY 2021

FY 2022

FY 2023

   Appropriation

$0

$0

$0

$0

   Revenue

$0

$0

$0

$0

   Expenditures

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Funding Source:

  [ X ] General            [    ] Education            [    ] Highway           [ X ] Other - Federal matching funds

 

 

 

 

 

METHODOLOGY:

This bill establishes a Child Abuse Specialized Medical Evaluation Program within the Department of Health and Human Services.  The Department is required to contract with health care providers with on-call availability 24/7 to respond to Child Protective Services Workers and advise on methods, treatment, and disposition of alleged child sexual abuse and physical abuse.  A limited unspecified number of health care providers would also receive nationally recognized training to respond to child sexual abuse, physical abuse, and neglect.  Per the bill, health care providers will administer the program, are required to have experience with child abuse and neglect, and will be reimbursed at a rate which reflects the average cost to deliver such services.  The Department provided the following assumptions:

  • The Department will train Child Protective Service Workers on standardized medical diagnostic methods, treatment, and disposition through contracted health care provider services.
  • Applicability of the program is only for children who are referred to the Department for further assessment and is limited to evaluations not to include additional treatment or services resulting from specialized evaluations.

 

According to the Department, there were 13,766 individual alleged victims with 12,141 assessments accepted for further investigation in FY 2018.  Of these, 5,472 had at least one allegation of medical neglect, physical abuse, or sexual abuse involved in an accepted assessment.  The Department assumes that initially, due to an insufficient provider network, it will be unable to serve the entire population of alleged victims.  In the first two years of implementation, the Department anticipates serving approximately 1,100 (20 percent) of the 5,472 victims annually, with that number growing as capacity increases.  

 

The Department reported it does not have sufficient information to estimate the necessary rate increase to implement the program and reimburse health care providers.  There will be an indeterminable increase to State expenditures which could affect any matching federal funds available for program implementation and administration.

 

AGENCIES CONTACTED:

Department of Health and Human Services

 

 

Docket

Date Status
Jan. 3, 2019 Introduced 01/03/2019 and referred to Children and Family Law HJ 3 P. 18
Feb. 12, 2019 Public Hearing: 02/12/2019 01:00 pm LOB 206
Feb. 19, 2019 Executive Session: 02/19/2019 01:00 pm LOB 206
Committee Report: Ought to Pass with Amendment # 2019-0543h (Vote 16-1; CC)
Feb. 27, 2019 Committee Report: Ought to Pass with Amendment # 2019-0543h for 02/27/2019 (Vote 16-1; CC) HC 13 P. 2
Feb. 27, 2019 Amendment # 2019-0543h: AA VV 02/27/2019 HJ 6 P. 2
Feb. 27, 2019 Ought to Pass with Amendment 2019-0543h: MA VV 02/27/2019 HJ 6 P. 2
Feb. 27, 2019 Referred to Finance 02/27/2019 HJ 6 P. 2
March 4, 2019 Finance Division III Work Session: 03/04/2019 01:00 pm LOB 210-211
March 11, 2019 Finance Division III Work Session: 03/11/2019 01:30 pm LOB 210-211
March 13, 2019 Finance Division III Work Session: 03/13/2019 01:00 pm LOB 210-211
March 22, 2019 Finance Division III Work Session: 03/22/2019 10:00 am LOB 209
March 27, 2019 Executive Session: 03/27/2019 10:00 am LOB 210-211
March 26, 2019 Finance Division III Work Session: 03/26/2019 09:30 am LOB 210-211
March 27, 2019 Executive Session: 03/27/2019 10:00 am LOB 210-211
Retained in Committee

Action Dates

Date Body Type
Feb. 12, 2019 House Hearing
Feb. 19, 2019 House Exec Session
House Floor Vote
Feb. 27, 2019 House Floor Vote
March 27, 2019 House Exec Session
March 27, 2019 House Exec Session

Bill Text Revisions

HB521 Revision: 4779 Date: Feb. 25, 2019, 4:40 p.m.
HB521 Revision: 5388 Date: March 4, 2019, 11:20 a.m.