Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Health Care & Wellness Committee

SSB 6549

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Description: Expanding the access to baby and child dentistry program to serve children with disabilities.

Sponsors: Senate Committee on Ways & Means (originally sponsored by Senators Rolfes, Cleveland, Conway, Saldaña and Sheldon).

Brief Summary of Substitute Bill

  • Expands the Access to Baby and Child Dentistry program to provide services and benefits to children with disabilities up to 13 years old.

Hearing Date: 2/21/18

Staff: Chris Blake (786-7392).

Background:

The Health Care Authority (Authority) administers the Medicaid program which is a state-federal program that pays for health care for low-income state residents who meet certain eligibility criteria. Benefits under the program vary according to a person's eligibility category which is determined by several factors, including income, age, health condition, and disability status. Dental services for Medicaid clients are provided through a fee-for-service arrangement in which the dentist bills the Authority directly.

Children under six years old who are enrolled in Medicaid may participate in the Access to Baby and Child Dentistry (ABCD) program at the Authority. The ABCD program provides enhanced fees to participating health care providers who provide additional services to participating children. The Washington Dental Service Foundation provides management services, funding, technical assistance, and provider recruitment and training for the ABCD program. The objective of the ABCD program is to identify and remove obstacles related to early preventive treatment such as transportation and language interpretation barriers. The additional services include family oral health education, application of fluoride, oral evaluations, restorations, therapeutic pulpotomies, amalgam and resin restoration on primary teeth, and services related to crowns. Participating providers include ABCD program-certified dental providers and other health care providers who have been approved by the Authority, including physicians, osteopathic physicians, advanced registered nurse practitioners, physician assistants, and osteopathic physician assistants.

Summary of Bill:

The Access to Baby and Child Dentistry (ABCD) program is expanded, subject to appropriated funds, to provide services and benefits to children with disabilities up to 13 years old. The Health Care Authority (Authority) must pay enhanced fees to dentists and dental hygienists for ABCD program services provided to enrolled children with disabilities. The dentist or dental hygienist must be certified by the Authority to provide ABCD program services to children with disabilities. To become certified, the provider must be licensed as either a dentist or dental hygienist and complete a course on treating children with disabilities.

The Authority must submit reports to the health care and fiscal committees of the Legislature by December 15, 2018, and December 15, 2019. The reports must address the number of dentists and dental hygienists participating in the ABCD program and the number of children with disabilities who received treatment through the ABCD program.

Children with disabilities include children under 13 years old with specified disabilities and who are eligible for low-income health coverage programs. The identified disabilities include those attributable to intellectual disability, cerebral palsy, epilepsy, autism, or other neurological conditions closely related to an intellectual disability. In addition, the term includes conditions that require treatment similar to that required for persons with intellectual disabilities, which has continued or can be expected to continue indefinitely, and that constitutes a substantial limitation to a person.

Appropriation: None.

Fiscal Note: Available.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.