H-2950              _______________________________________________

                                                   HOUSE BILL NO. 1225

                        _______________________________________________

State of Washington                              50th Legislature                              1987 Regular Session

By Representatives Brekke, Sayan, Lewis, Braddock, Sprenkle, Nelson, Allen, Jacobsen, Grimm, Appelwick, Wineberry, Hine, Niemi, Hargrove, Bristow, Belcher, Lux and P. King

Read first time 4/10/87 and referred to Committee on Health Care.

AN ACT Relating to dental and dental hygiene services; amending RCW 74.09.010; and adding new sections to chapter 74.09 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1.  A new section is added to chapter 74.09 RCW to read as follows:

          (1) The legislature finds that:

          (a) Good dental hygiene and dental care is important to indigent persons and to the health of the state in general;

          (b) To ensure the availability of good dental hygiene and dental care, efforts should be made to encourage cost consciousness on the part of dental care providers and consumers;

          (c) Managed prepared capitated approaches have been found to be effective in controlling cost while maintaining a good quality of services;

          (d) By enrolling medical assistance recipients in prepaid capitated programs, scarce public resources will be expended in the most efficient way.

          (2) Therefore, it is the intent of the legislature to develop and implement a new approach through the use of prepaid capitated programs in providing dental hygiene and dental care services to medical assistance recipients.

        Sec. 2.  Section 74.09.010, chapter 26, Laws of 1959 as last amended by section 18, chapter 6, Laws of 1981 1st ex. sess. and RCW 74.09.010 are each amended to read as follows:

          As used in this chapter:

          (1) "Department" means the department of social and health services.

          (2) "Secretary" means the secretary of social and health services.

          (3) "Internal management" means the administration of medical assistance, medical care services, and the limited casualty program.

           (4) "Medical assistance" means the federal aid medical care program provided to categorically needy persons as defined under Title XIX of the federal social security act.

          (5) "Medical care services" means the limited scope of care financed by state funds and provided to general assistance recipients.

          (6) "Limited casualty program" means the medical care program provided to medically needy persons as defined under Title XIX of the federal social security act, and to medically indigent persons who are without income or resources sufficient to secure necessary medical services.

          (7) "Nursing home" means nursing home as defined in RCW 18.51.010.

(8) "Managed dental care services" means dental hygiene and dental care services covered under this chapter provided to medical assistance recipients by health care providers licensed under chapters 18.29 and 18.32 RCW on a managed prepaid capitated basis.

NEW SECTION. Sec. 3.  A new section is added to chapter 74.09 RCW to read as follows:

          Within one hundred eighty days of the effective date of this section, the department shall adopt rules pursuant to chapter 34.04 RCW as follows:

          (1) The department shall enter into agreements with health care providers licensed under chapters 18.29 and 18.32 RCW, for managed dental care services, including, but not limited to, preventive care, restoration, sealants, dentures, and related procedures:  PROVIDED, That the department may exempt for the prepaid capitated requirements oral surgical procedures if not practical to include in the managed dental care service structure;

          (2) The department shall, to the extent possible, enter into managed dental care service agreements for dental services defined in RCW 18.29.050(2);

          (3) The department shall use the following schedule for enrolling categorically eligible and medically needy medical assistance recipients in a managed dental care service program:

By January 1, 1989, 20,000 recipients

By January 1, 1991, 40,000 recipients

By January 1, 1993, 60,000 recipients

          (4) The department shall, to the extent possible, ensure that recipients have a choice of programs in which to enroll;

          (5) The department shall aggressively seek any waivers from federal requirements necessary to implement this section;

          (6) The department shall report to the appropriate committees of the legislature by December 1 of 1988, 1990, and 1992, on progress of the implementation of this section, but shall not delay implementation because of these reporting requirements.