AN ACT Relating to prenatal care; amending RCW 74.09.510; and adding a new chapter to Title 74 RCW.

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

NEW SECTION. Sec. 1. The legislature finds that early and continuous comprehensive prenatal care is a major factor in assuring healthy, full-term infants. Inadequate prenatal care is associated with stillbirths and low birthweight in infants and is the leading cause of neonatal and infant mortality, as well as continuing health and developmental problems during childhood and adulthood. Early comprehensive prenatal care will result in reduced human suffering, improved life quality, and reduced social service and education costs. Public funds invested in comprehensive prenatal care will result in corresponding, but greater reductions in hospital costs for delivery and perinatal care.

The legislature therefore establishes a comprehensive prenatal care program to increase participation in early care for low-income women, many of whom do not qualify for full financial support under medical assistance or private insurance programs. The legislature further finds it in the public interest to provide public education on the benefits of early and continuous prenatal care and healthy lifestyles during pregnancy. It is the intent of the legislature that comprehensive prenatal care services be provided to eligible persons within the limits of funds appropriated for that purpose.

NEW SECTION. Sec. 2. Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Comprehensive prenatal care" means the continuum of services which have been shown to be effective in promoting mother and infant health. Services may include but are not limited to: Providing or arranging for prenatal, delivery, and postpartum care; health, childbirth, and parenting education; psychosocial assessment and when appropriate referral to counseling; and nutrition assessment and, when appropriate, referral to food supplement and breast feeding programs.

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

(3) "Local health agency" means a health department, primary care clinic, private nonprofit agency, or other public or private agency that either has an appropriately qualified physician on staff or subcontracts with one or more physicians and is willing to coordinate comprehensive prenatal care within a designated geographic area.

(4) "Low income" means up to one hundred eighty-five percent of the federal poverty income guidelines revised annually by the federal department of health and human services.

NEW SECTION. Sec. 3. The department shall establish a comprehensive prenatal care program for low-income women within the limits of funds appropriated for that purpose. In implementing the program, the department has the authority to:

(1) Establish eligibility standards, minimum standards for services to be provided, indicators and methods for measuring effectiveness, reimbursement methods, reporting, and other policies or guidelines as the department deems appropriate.

(2) Contract with local health agencies to provide comprehensive prenatal care services meeting the minimum standards required by the department.

(3) Provide technical assistance to local health agencies and encourage locally designed, cost-effective systems that coordinate with existing programs and promote community and provider participation in the delivery of prenatal care services under this chapter.

(4) Provide or arrange for public education programs emphasizing the benefits of early and continuous prenatal care and healthy lifestyles, with particular attention directed to high-risk populations such as teenagers and certain minority groups.

(5) Develop and implement a data system to monitor the rates of low birthweight and perinatal and infant mortality and evaluate effects of the services provided. The department shall ensure that information regarding client characteristics, use of services, and individual outcomes is provided as required by local contractors in a manner which preserves client confidentiality.

(6) Adopt rules under chapter 34.04 RCW to carry out the purposes of this chapter.

Sec. 4. Section 4, chapter 30, Laws of 1967 ex. sess. as last amended by section 2, chapter 5, Laws of 1985 and RCW 74.09.510 are each amended to read as follows:

Medical assistance may be provided in accordance with eligibility requirements established by the department of social and health services, including the prohibition under RCW 74.09.532 through 74.09.536 against the knowing and wilful assignment of property or cash for the purpose of qualifying for such assistance, as defined in the social security Title XIX state plan for mandatory categorically needy persons and: (1) Individuals who would be eligible for cash assistance except for their institutional status; (2) individuals who are under twenty-one years of age, who would be eligible for aid to families with dependent children, but do not qualify as dependent children and who are in (a) foster care, (b) subsidized adoption, (c) an intermediate care facility or an intermediate care facility for the mentally retarded, or (d) inpatient psychiatric facilities; (3) the aged, blind, and disabled who: (a) Receive only a state supplement, or (b) would not be eligible for cash assistance if they were not institutionalized; (4) individuals who would be eligible for but choose not to receive cash assistance; (5) pregnant women who would be eligible for aid to families with dependent children if the child had been born and was living with the mother during the month of the payment, and the pregnancy has been medically verified; (6) individuals who are enrolled in managed health care systems, who have otherwise lost eligibility for medical assistance, but who have not completed a current six-month enrollment in a managed health care system, and who are eligible for federal financial participation under Title XIX of the social security act; ((~~and~~)) (7) other individuals eligible for medical services under RCW 74.09.035 and 74.09.700 for whom federal financial participation is available under Title XIX of the social security act; and (8) to the extent of available funds, other pregnant women and children for whom federal financial participation is available under Title XIX of the social security act.

NEW SECTION. Sec. 5. Sections 1 through 3 of this act shall constitute a new chapter in Title 74 RCW.