SENATE BILL REPORT

E2SSB 5452

BYSenate Committee on Ways & Means (originally sponsored by  Senators Wojahn, Kiskaddon, Deccio, Johnson, Stratton and Tanner; by request of Department of Social and Health Services)

Providing a prenatal care program.

Senate Committee on Human Services & Corrections

Senate Hearing Date(s):February 17, 1987; February 19, 1987

Majority Report:  That Substitute Senate Bill No. 5425 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.

      Signed by Senators Wojahn, Chairman; Stratton, Vice Chairman; Anderson, Deccio, Johnson, Tanner.

Senate Staff:Carol Pedigo (786-7417)

                  February 20, 1987

Senate Committee on Ways & Means

Senate Hearing Date(s):March 2, 1987

Majority Report:  That Second Substitute Senate Bill No. 5452 be substituted therefor, and the second substitute bill do pass.

      Signed by Senators McDermott, Chairman; Gaspard, Vice Chairman; Bauer, Bluechel, Cantu, Deccio, Fleming, Kreidler, McDonald, Moore, Owen, Rinehart, Talmadge, Vognild, Warnke, Wojahn

Senate Staff:Suzanne Petersen (786-7715)

                  March 17, 1987

AS PASSED SENATE, MARCH 16, 1987

BACKGROUND:

Since 1983 the Department of Social and Health Services (DSHS) has provided prenatal care to women whose income is below 185 percent of the federal poverty level and who would otherwise be unable to qualify for medical assistance or insurance.  These programs are administered by 19 agencies and cover 26 counties.

Prenatal program emphasis is on caring for low income women and teens early in their pregnancy because they are at highest risk for problem pregnancies.  During 1986 2,000 women were served by the program.  A study done by DSHS estimated that only 30 percent of the women in need were served.

The Legislature appropriated $3.4 million in the 1985-87 biennium for prenatal care, and required DSHS to submit a proposal for establishing the prenatal program in statute if funds were to be requested to continue the program in 1987-89.  Proponents of the bill believe the program should be expanded to the 13 counties currently unserved.  They are also alarmed about the fact that the infant mortality rate in Washington has risen from 9.5 deaths per 1,000 in 1983 to 10.6 deaths in 1985.

Federal changes to the Medicaid program in 1986 allow for expansion of services to pregnant women and children with income up to 100 percent of poverty through the federally-matched medical assistance program.

SUMMARY:

The Department of Social and Health Services is given the authority to establish a comprehensive statewide prenatal care program within the limits of appropriated funds.

Responsibility for establishment of eligibility standards, reimbursement methods, program standards, reporting methods and other appropriate guidelines is assigned to DSHS.  Income eligibility standards are lowered to 150 percent of federal poverty level.

The Department is directed to contract with local health agencies after consulting with counties as to the appropriateness of the provider who is to provide the actual prenatal care services.  Each local health agency is encouraged to design a cost effective program, with assistance provided by DSHS.  Public education programs which emphasize both early and continuous prenatal care and healthy lifestyles are required to be part of the program.  DSHS is given the authority to request that, when appropriate, women apply for paternity establishment services.

A data collection system to evaluate the effectiveness of the program must be developed and implemented by the Department.  Client confidentiality must be ensured.

Any money provided for this program not used for these purposes must be returned to the state general fund.

Medical assistance statutes are amended to allow the state, within available funds, to take full advantage of federal matching funds for services to pregnant women and children.

Fiscal Note:      available

Senate Committee - Testified: HUMAN SERVICES & CORRECTIONS:  Patricia K. Wilkins, DSHS; Cynthia Shurtleff, March of Dimes; Ron Snyder, Bellingham-Whatcom County Health District; Patricia Swanson, Thurston County Health Department; Nina Dickinson, Thurston County Health Department; Arnie Whedbee, Evergreen Legal Services; Diane Yelish, Tacoma Pierce County Health Department; Ed Larsen, Washington State Medical Association

Senate Committee - Testified: WAYS & MEANS:  Gerald Reilly, DSHS; Sherilyn Casey, DSHS; Cynthia Shurtleff and Anne Curtis, March of Dimes; Kathy Carson, King County Health Dept.