FINAL BILL REPORT

SSB 5976

C 242 L 20

Synopsis as Enacted

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).

Senate Committee on Ways & Means

House Committee on Appropriations

Background: The Health Care Authority (HCA) 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 HCA 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 HCA. This 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. 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 HCA, including physicians, osteopathic physicians, advanced registered nurse practitioners, physician assistants, and osteopathic physician assistants.

In 2018, the Legislature passed SSB 6549, requiring the HCA 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: The definition of who is eligible for this program is updated to include language that eligible children must meet clinical criteria established by the HCA. Primary care providers must complete a course on treating eligible children, as defined by the HCA in rule, to receive the enhanced ABCD fee for providing services to eligible children.

Votes on Final Passage: