House of Representatives
Office of Program Research
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: Concerning the access to baby and child dentistry program for children with disabilities.
Sponsors: Senate Committee on Ways & Means (originally sponsored by Senators Rolfes, Kuderer and Walsh).
Hearing Date: 2/29/20
Staff: Meghan Morris (786-7119).
The Health Care Authority (Authority) administers the Medicaid program, which is a state-federal program paying health care costs 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, which 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. 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.
In 2018 the Legislature passed Substitute Senate Bill 6549, requiring the Authority to expand the ABCD program to include children with disabilities as eligible clients through age 12. The legislation required dentists and hygienists to complete a course on treating children with disabilities to receive the enhanced ABCD fee for providing services to eligible children with disabilities.
Summary of Bill:
The eligibility for the program is revised to require that eligible children meet clinical criteria established by the Authority. Primary care providers must complete a course on treating eligible children, as defined by the Authority in rule, to receive the enhanced ABCD fee for providing services to eligible children.
Fiscal Note: Available.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.