S-1482.1  _______________________________________________

 

                         SENATE BILL 5746

          _______________________________________________

 

State of Washington      53rd Legislature     1993 Regular Session

 

By Senators Winsley, Moyer, Prentice, Talmadge and Wojahn

 

Read first time 02/11/93.  Referred to Committee on Health & Human Services.

 

Revising family planning service provisions.


    AN ACT Relating to family planning services; and amending RCW 74.09.770, 74.09.790, and 74.09.800.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

 

    Sec. 1.  RCW 74.09.770 and 1989 1st ex.s. c 10 s 2 are each amended to read as follows:

    (1) The legislature finds that Washington state and the nation as a whole have a high rate of infant illness and death compared with other industrialized nations.  This is especially true for minority and low-income populations.  Premature and low weight births have been directly linked to infant illness and death.  The availability of adequate maternity care throughout the course of pregnancy has been identified as a major factor in reducing infant illness and death.  Further, the investment in preventive health care programs, such as maternity care, contributes to the growth of a healthy and productive society and is a sound approach to health care cost containment.  The legislature further finds that access to maternity care for low-income women in the state of Washington has declined significantly in recent years and has reached a crisis level.

    (2) It is the purpose of this ((chapter [subchapter])) subchapter to provide, consistent with appropriated funds, maternity care necessary to ensure healthy birth outcomes for low-income families.  To this end, a maternity care access system is established based on the following principles:

    (a) The family is the fundamental unit in our society and should be supported through public policy.

    (b) Access to maternity care for eligible persons to ensure healthy birth outcomes should be made readily available in an expeditious manner through a single service entry point.

    (c) Unnecessary barriers to maternity care for eligible persons should be removed.

    (d) Access to preventive and other health care services should be available for low-income children.

    (e) Each woman should be encouraged to and assisted in making her own informed decisions about her maternity care.

    (f) Unnecessary barriers to the provision of maternity care by qualified health professionals should be removed.

    (g) The system should be sensitive to cultural differences among eligible persons.

    (h) To the extent possible, decisions about the scope, content, and delivery of services should be made at the local level involving a broad representation of community interests.

    (i) The maternity care access system should be evaluated at appropriate intervals to determine effectiveness and need for modification.

    (j) Maternity care services should be delivered in a cost-effective manner.

    (k) Information and counseling regarding family planning methods and technologies, including Norplant, should routinely be made available to women served by the maternity care access system.

 

    Sec. 2.  RCW 74.09.790 and 1990 c 151 s 4 are each amended to read as follows:

    Unless the context clearly requires otherwise, the definitions in this section apply throughout RCW 74.09.760 through 74.09.820 and 74.09.510:

    (1) "At-risk eligible person" means an eligible person determined by the department to need special assistance in applying for and obtaining maternity care, including pregnant women who are substance abusers, pregnant and parenting adolescents, pregnant minority women, and other eligible persons who need special assistance in gaining access to the maternity care system.

    (2) "County authority" means the board of county commissioners, county council, or county executive having the authority to participate in the maternity care access program or its designee.  Two or more county authorities may enter into joint agreements to fulfill the requirements of this chapter.

    (3) "Department" means the department of social and health services.

    (4) "Eligible person"  means a woman in need of maternity care or a child, who is eligible for medical assistance pursuant to this chapter or the prenatal care program administered by the department.

    (5) "Maternity care services" means inpatient and outpatient  medical care, case management, and support services necessary during prenatal, delivery, and postpartum periods.

    (6) "Support services" means, at least, public health nursing assessment and follow-up, health and childbirth education, psychological assessment and counseling, outreach services, nutritional assessment and counseling, needed vitamin and nonprescriptive drugs, transportation, and child care.  Support services may include alcohol and substance abuse treatment for pregnant women who are addicted or at risk of being addicted to alcohol or drugs to the extent funds are made available for that purpose.

    (7) "Family planning services" means planning of the number of one's children by use of birth-control techniques.

 

    Sec. 3.  RCW 74.09.800 and 1989 1st ex.s. c 10 s 5 are each amended to read as follows:

    The department shall, consistent with the state budget act, develop a maternity care access program designed to ensure healthy birth outcomes as follows:

    (1) Provide maternity care services to low-income pregnant women and health care services to children in poverty to the maximum extent allowable under the medical assistance program, Title XIX of the federal social security act;

    (2) Provide maternity care services to low-income women who are not eligible to receive such services under the medical assistance program, Title XIX of the federal social security act;

    (3) By January 1, 1990, have the following procedures in place to improve access to maternity care services and eligibility determinations for pregnant women applying for maternity care services under the medical assistance program, Title XIX of the federal social security act:

    (a) Use of a shortened and simplified application form;

    (b) Outstationing department staff to make eligibility determinations;

    (c) Establishing local plans at the county and regional level, coordinated by the department; and

    (d) Conducting an interview for the purpose of determining medical assistance eligibility within five working days of the date of an application by a pregnant woman and making an eligibility determination within fifteen working days of the date of application by a pregnant woman;

    (4) Establish a maternity care case management system that shall assist at-risk eligible persons with obtaining medical assistance benefits and receiving maternity care services, including transportation and child care services;

    (5) Within available resources, establish appropriate reimbursement levels for maternity care providers;

    (6) Implement a broad-based public education program that stresses the importance of obtaining maternity care early during pregnancy;

    (7) ((Study the desirability and feasibility of implementing the presumptive eligibility provisions set forth in section 9407 of the federal omnibus budget reconciliation act of 1986 and report to the appropriate committees of the legislature by December 1, 1989; and

    (8))) Refer persons eligible for maternity care services under the program established by this section to persons, agencies, or organizations with maternity care service practices that primarily emphasize healthy birth outcomes; and

    (8)(a) Family planning services, including information about Norplant, shall be provided to women who were receiving medical assistance under the maternity care access program or who were eligible only for emergency labor and delivery services at the time the pregnancy ended.

    (b) Coverage for family planning services shall continue through the last day of the sixth month following the month pregnancy ends.

 


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