N.Y. Social Services Law § 367-x: Payment for violence prevention programs

§ 367-x. Payment for violence prevention programs. 1. As used in this

section, the following terms shall have the following definitions:

(a) "Community violence" means intentional acts of interpersonal

violence committed by individuals who are not intimately related to the

victim.

(b) "Community violence prevention services" means evidence-informed,

trauma-informed, culturally responsive, supportive and

non-psychotherapeutic services provided by a qualified violence

prevention professional for the purpose of promoting improved health

outcomes, trauma recovery, and positive behavioral change, preventing

injury recidivism and reducing the likelihood that individuals who are

victims of community violence will commit or promote violence

themselves. "Community violence prevention services" may include the

provision of peer support and counseling, mentorship, conflict

mediation, crisis intervention, targeted case management, referrals to

certified or licensed health care professionals or social services

providers, case management, community and school support services,

patient education or screening services to victims of community

violence.

(c) "Prevention professional" means an individual who works in

programs aimed to address specific patient needs, such as suicide

prevention, violence prevention, alcohol avoidance, drug avoidance, and

tobacco prevention. The goal of such individual's work is to reduce the

risk of relapse, injury, or re-injury of the patient.

(d) "Qualified violence prevention professional" means a prevention

professional who meets all of the conditions specified in subdivision

five of this section.

2. Within thirty days of the effective date of this section, the

commissioner shall apply to the federal government for approval of an

amendment to the Medicaid state plan to make community violence

prevention services available, to the extent permitted by federal law,

to any Medicaid beneficiary who has:

(a) been exposed to community violence, or has a personal history of

injury sustained as a result of an act of community violence; and

(b) been referred by a certified or licensed health care provider or

social services provider to receive community violence prevention

services from a qualified violence prevention professional, after such

provider determines such beneficiary to be at elevated risk of a violent

injury or retaliation resulting from another act of community violence.

3. The commissioner shall seek any federal approvals necessary to

implement this section, including, but not limited to, any state plan

amendments or federal waivers by the federal Centers for Medicare and

Medicaid Services.

4. Once federal approval has been appplied for, the commissioner,

shall, in consultation with violence intervention organizations and

local community-based and hospital-based violence prevention programs:

(a) issue guidance on the use of community violence prevention

services for beneficiaries who access these services under the medical

assistance program; and

(b) determine maximum allowable rates for community violence

prevention services based upon the medical assistance program

fee-for-service outpatient rates for the same or similar services, or

any other data deemed reliable and relevant by the commissioner.

5. Any prevention professional seeking certification as a qualified

violence prevention professional shall:

(a) complete at least six months of full-time equivalent experience in

providing community violence prevention services or youth development

services through employment, volunteer work or as part of an internship

experience;

(b) complete a training and certification program approved by the

department of health for qualified violence prevention professionals,

approved in accordance with subdivision six of this section, by a

provider approved by the commissioner;

(c) complete annually at least four hours of continuing education, by

a provider approved by the commissioner, in the field of community

violence prevention services;

(d) complete prevention professionals training for the population of

patients with whom they work; and

(e) satisfy any other requirements established by the commissioner,

for certification as a qualified violence prevention professional.

6. Within ninety days of the effective date of this section, the

department of health shall approve at least one governmental or

nongovernmental accrediting body with expertise in community violence

prevention services to review and approve training and certification

programs for qualified violence prevention professionals. The

accrediting body shall approve programs that such body determines, in

its discretion, will adequately prepare individuals to provide community

violence prevention services to individuals who are victims of community

violence. Such programs shall include at least thirty-five hours of

training, collectively addressing all of the following:

(a) the profound effects of trauma and violence and the basics of

trauma-informed care; and

(b) community violence prevention strategies, including, but not

limited to, conflict mediation and retaliation prevention related to

community violence; case management and advocacy practices; and patient

privacy and the federal Health Insurance Portability and Accountability

Act of 1996, P.L. 104-191, as amended from time to time, (HIPAA).

7. Any entity that employs or contracts with a qualified violence

prevention professional to provide community violence prevention

services shall:

(a) maintain documentation that the qualified violence prevention

professional has met all of the conditions described in subdivision six

of this section; and

(b) ensure that the qualified violence prevention professional is

providing community violence prevention services in compliance with any

applicable standards of care, rules, regulations and governing law of

the state or federal government.

8. Nothing in this section shall alter the scope of practice for any

health care professional or authorize the delivery of health care

services in a setting or in a manner that is not currently authorized.

9. This section shall be implemented only to the extent that federal

financial participation is available, and any necessary federal

approvals have been obtained.