SENATE BILL REPORT

SB 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.

As Reported by Senate Committee On:

Health & Long Term Care, February 1, 2018

Ways & Means, February 6, 2018

Title: An act relating to expanding the access to baby and child dentistry program to serve children with disabilities.

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

Sponsors: Senators Rolfes, Cleveland, Conway, Saldaña and Sheldon.

Committee Activity: Health & Long Term Care: 1/30/18, 2/01/18 [DP-WM].

Ways & Means: 2/05/18, 2/06/18 [DPS].

Brief Summary of First Substitute Bill

The Health Care Authority (Authority) must expand the Access to Baby and Child Dentistry (ABCD) to include children with disabilities as eligible clients through age 12.

SENATE COMMITTEE ON HEALTH & LONG TERM CARE

Majority Report: Do pass and be referred to Committee on Ways & Means.

Signed by Senators Cleveland, Chair; Kuderer, Vice Chair; Rivers, Ranking Member; Bailey, Becker, Conway, Fain, Keiser, Mullet and Van De Wege.

Staff: Evan Klein (786-7483)

SENATE COMMITTEE ON WAYS & MEANS

Majority Report: That Substitute Senate Bill No. 6549 be substituted therefor, and the substitute bill do pass.

Signed by Senators Rolfes, Chair; Frockt, Vice Chair; Braun, Ranking Member; Bailey, Becker, Billig, Brown, Carlyle, Conway, Darneille, Fain, Hasegawa, Hunt, Keiser, Mullet, Palumbo, Pedersen, Ranker, Rivers, Schoesler, Van De Wege, Wagoner and Warnick.

Staff: Sandy Stith (786-7710)

Background: The 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 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.

Summary of Bill (First Substitute): The Authority must expand the ABCD program to include children with disabilities as eligible clients through age 12. Dentists and hygienists must complete a course on treating children with disabilities in order to receive the enhanced ABCD fee for providing services to eligible children with disabilities.

The Authority in consultation with any organizations administering the program must report to the Legislature on the outcomes of the program by December 15 of each year.

EFFECT OF CHANGES MADE BY WAYS & MEANS COMMITTEE (First Substitute):

Allows dental hygienists, along with dentists, to receive enhanced fees through the ABCD program for providing services to eligible children with disabilities.
Requires dental hygienists seeking to participate in the program to receive the same training as dentists, on treating children with disabilities.
Makes the program subject to appropriations.
Requires the Health Care Authority to report on program outcomes in December 2018 and 2019.

Appropriation: None.

Fiscal Note: Requested on January 24, 2018.

Creates Committee/Commission/Task Force that includes Legislative members: No.

Effective Date: Ninety days after adjournment of session in which bill is passed.

Staff Summary of Public Testimony on Original Bill (Health & Long Term Care): PRO: Dental hygienists practice in community settings, including clinics, group homes, and other facilities that treat children with disabilities, and would be an appropriate provider to be added to this bill. The ABCD program has increased utilization and ABCD patients are more likely to seek care before problems arise. The focus on prevention has made the ABCD program cost effective. This population has special care needs and the support in the program will ensure practitioners with adequate training are available to support the population. The ABCD model is nationally recognized, and it makes sense to build on this model to provide access to dentists for other vulnerable populations in the state.

Persons Testifying (Health & Long Term Care): PRO: Melissa Johnson, Washington Dental Hygienists Association; John Gibbons, DMD, Washington State Dental Association, Washington State Academy of Pediatric Dentistry; Emily Lovell, Washington State Dental Association; Alison Mondi, Arcora Foundation.

Persons Signed In To Testify But Not Testifying (Health & Long Term Care): No one.

Staff Summary of Public Testimony on Original Bill (Ways & Means): The committee recommended a different version of the bill than what was heard. PRO: Since the program began, utilization has doubled. The ABCD program seeks to provide dental care before significant needs arise. This helps to reduce costs in the long-run. This program provides comprehensive dental benefits, a dental home, and a lifetime of good dental habits. This program has increased access to dental care. It is a nationally recognized program. It gives providers the needed experience to work with this population. Since its inception, the Dental Association has invested over $30 million in the program. Oral disease can lead to adverse overall health of an individual. This program helps to prevent that.

Persons Testifying (Ways & Means): PRO: Alison Mondi, Arcora Foundation; Mellani McAleenan, Washington State Dental Association.

Persons Signed In To Testify But Not Testifying (Ways & Means): No one.