WSR 08-12-074

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

[ Filed June 3, 2008, 2:40 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 07-16-110.

Title of Rule and Other Identifying Information: The department is amending WAC 388-535-1245 Access to baby and child dentistry (ABCD) program.

Hearing Location(s): Blake Office Park East, Rose Room, 4500 10th Avenue S.E., Lacey, WA 98503 (one block north of the intersection of Pacific Avenue S.E. and Alhadeff Lane. A map or directions are available at http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6097), on July 8, 2008, at 10:00 a.m.

Date of Intended Adoption: Not earlier than July 9, 2008.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail schilse@dshs.wa.gov, fax (360) 664-6185, by 5 p.m. on July 8, 2008.

Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS Rules Consultant, by July 1, 2008, TTY (360) 664-6178 or (360) 664-6097 or by e-mail at johnsjl4@dshs.wa.gov.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: This rule making clarifies that the department pays enhanced fees only to ABCD-certified dentists and other department-approved certified providers for furnishing ABCD program services; removes language that an oral health education visit must have a duration of at least twenty minutes; clarifies that an oral health education visit is limited to one visit per day per family, up to two visits per child in a twelve-month period; removes language that an oral health education visit must include topical application of gel or varnish. In addition, the proposed rule clarifies what ABCD program services include.

Reasons Supporting Proposal: See above.

Statutory Authority for Adoption: RCW 74.04.050, 74.08.090.

Statute Being Implemented: RCW 74.04.050, 74.08.090.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Department of social and health services, governmental.

Name of Agency Personnel Responsible for Drafting: Kathy Sayre, 626 8th Avenue, Olympia, WA 98504-5504, (360) 725-1342; Implementation and Enforcement: Dr. John Davis, 626 8th Avenue, Olympia, WA 98504-5506, (360) 725-1748.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has determined that the proposed rule will not create more than minor costs for affected small businesses.

A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Dr. John Davis, P.O. Box 45506, Olympia, WA 98504-5506, phone (360) 725-1748, TYY/TDD 1-800-848-5429, fax (360) 586-1590, e-mail davisjd@dshs.wa.gov.

May 29, 2008

Stephanie E. Schiller

Rules Coordinator

3981.1
AMENDATORY SECTION(Amending WSR 07-06-042, filed 3/1/07, effective 4/1/07)

WAC 388-535-1245   Access to baby and child dentistry (ABCD) program.   The access to baby and child dentistry (ABCD) program is a program established to increase access to dental services for Medicaid-eligible clients ages five and younger.

(1) Client eligibility for the ABCD program is as follows:

(a) Clients must be age five and younger. Once enrolled in the ABCD program, eligible clients are covered until their sixth birthday.

(b) Clients eligible under one of the following medical assistance programs are eligible for the ABCD program:

(i) Categorically needy program (CNP);

(ii) Limited casualty program-medically needy program (LCP-MNP);

(iii) Children's health program; or

(iv) State children's health insurance program (SCHIP).

(c) ABCD program services for eligible clients enrolled in a managed care organization (MCO) plan are paid through the fee-for-service payment system.

(2) Health care providers and community service programs identify and refer eligible clients to the ABCD program. If enrolled, the client and an adult family member may receive:

(a) Oral health education;

(b) "Anticipatory guidance" (expectations of the client and the client's family members, including the importance of keeping appointments); and

(c) Assistance with transportation, interpreter services, and other issues related to dental services.

(3) ((Dentists must be certified through the continuing education program in the University of Washington School of Pediatric Dentistry to furnish ABCD program services.

(4))) The department pays enhanced fees only to ABCD-certified ((participating)) dentists and other department-approved certified providers for furnishing ABCD program services. ABCD program services include, when appropriate:

(a) Family oral health education. An oral health education visit:

(i) ((Must have a duration of at least twenty minutes for each visit;

(ii))) Is limited to one visit per day per family, up to two visits per ((calendar year)) child in a twelve-month period, per provider or clinic; and

(((iii))) (ii) Must include all of the following:

(A) "Lift the lip" training;

(B) Oral hygiene training;

(C) Risk assessment for early childhood caries;

(D) Dietary counseling;

(E) ((Topical application of gel or varnish;

(F))) Discussion of fluoride supplements; and

(((G))) (F) Documentation in the client's file or the client's designated adult member's (family member or other responsible adult) file to record the activities provided and duration of the oral education visit.

(b) ((Comprehensive and)) Periodic oral evaluation, up to two visits per client, per calendar year, per provider or clinic;

(c) Topical application of fluoride varnish;

(d) Amalgam ((and)), resin, and glass ionomer restorations on primary teeth, as specified in current department-published documents;

(((d))) (e) Therapeutic pulpotomy;

(((e))) (f) Prefabricated stainless steel crowns on primary teeth, as specified in current department-published documents;

(((f))) (g) Resin-based composite crowns on anterior primary teeth; and

(((g))) (h) Other dental-related services, as specified in current department-published documents.

(((5))) (4) The client's file must show documentation of the ABCD program services provided.

[Statutory Authority: RCW 74.08.090, 74.09.500, 74.09.520. 07-06-042, 388-535-1245, filed 3/1/07, effective 4/1/07. Statutory Authority: RCW 74.08.090, 74.09.035, 74.09.500, 42 U.S.C. 1396d(a), 42 C.F.R. 440.100 and .225. 02-11-136, 388-535-1245, filed 5/21/02, effective 6/21/02.]

Washington State Code Reviser's Office