SENATE BILL REPORT

 

 

                                   ESHB 2603

 

 

BYHouse Committee on Health Care (originally sponsored by Representatives Vekich, Prentice, Brooks, Dellwo, O'Brien, Heavey, Basich, G. Fisher, Valle, Jacobsen, Wineberry, Leonard, Pruitt, Wang, Phillips, Winsley, Sprenkle, Kremen, Holland, Haugen, Hine, Wood, R. King, Moyer, Jones, Ebersole, Scott, Brekke, Morris, Todd and Spanel; by request of Governor Gardner)

 

 

Enhancing availability of medical care for children.

 

 

House Committe on Health Care

 

 

Rereferred House Committee on Appropriations

 

 

Senate Committee on Health & Long-Term Care

 

      Senate Hearing Date(s):February 20, 1990

 

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

      Signed by Senators West, Chairman; Smith, Vice Chairman; Johnson, Kreidler, Niemi, Wojahn.

 

      Senate Staff:Don Sloma (786-7417)

                  February 22, 1990

 

 

Senate Committee on Ways & Means

 

      Senate Hearing Date(s):February 26, 1990

 

Majority Report:  Do pass as amended by Committee on Health & Long-Term Care.

      Signed by Senators McDonald, Chairman; Craswell, Vice Chairman; Amondson, Bailey, Bauer, Bluechel, Cantu, Gaspard, Hayner, Johnson, Lee, Matson, Moore, Newhouse, Niemi, Owen, Saling, Smith, Warnke, Williams, Wojahn.

 

      Senate Staff:Randy Hodgins (786-7715)

                  February 27, 1990

 

 

          AS REPORTED BY COMMITTEE ON WAYS & MEANS, FEBRUARY 26, 1990

 

BACKGROUND:

 

Children of families with low incomes are less likely to have access to preventive health care for a variety of reasons.  Families must balance their needs for health care against their basic needs for housing, food, and clothing.  Additional risk factors associated with both poor health and low-income families include poor nutrition, inadequate housing, and problems with transportation.

 

Other barriers to health care affect most of our state's citizens, but affect people with low incomes to a greater extent.  A majority of medical students are choosing to study specialty medicine rather than primary care, which includes family practice and pediatrics.  There are a limited number of physicians practicing in financially depressed areas and a limited number of physicians accepting patients who have low incomes or are in poverty.  There is a general lack of knowledge about good personal health habits, such as the importance of good nutrition, exercise, and preventive health care.

 

Material provided by the Office of Financial Management asserts that these barriers are contributing to a declining state of children's health.  The material states that an investment in preventive health care programs will contribute not only to the health of individuals, but also to the benefit of all citizens and is a sound approach to health care cost containment.

 

SUMMARY:

 

A new program is established within the Department of Social and Health Services (DSHS) to be known as the "children's health program."  Through this new program all children under the age of 18, with a household income at or below 100 percent of the federal poverty level ($12,100 a year for a family of four) will be provided medical coverage in the same manner and scope as Medicaid.  The eligibility process must be determined by DSHS and must be easily understood.  Eligibility determination and time lines must be the same as for Medicaid.

 

The program encourages communities to make health services more accessible to children in poverty.  Technical assistance and public funds are made available to help communities experiencing significant problems with access to health services for children. DSHS, in coordination with the Department of Health (DOH), must identify, based on a set of indicators, counties and tribal jurisdictions that are experiencing significant problems with access to health care for low-income children.  DSHS must notify counties and tribal jurisdictions of this identified status and advise them of ways to obtain funds and technical assistance.  Counties and tribal jurisdictions not so identified can independently seek funds and technical assistance from DSHS.  DSHS and DOH are required to evaluate the requests against set criteria.

 

DSHS and DOH must reevaluate the state of access of health care services for children and report to the State Board of Health for possible inclusion in the state health report.

 

Current law is amended to permit the state to provide health care services to children (under age 18) up to 100 percent of the federal poverty level.

 

The evaluation process for the maternity care access program (First Steps) is modified to permit bidders other than nonprofit entities to bid. The reporting date is changed from December 1, 1990, to November 1, 1991.

 

Appropriation:    none

 

Revenue:    none

 

Fiscal Note:      requested January 18, 1990

 

Effective Date:The bill contains an emergency clause and takes effect immediately.

 

 

SUMMARY OF PROPOSED SENATE HEALTH & LONG-TERM CARE AMENDMENT:

 

General findings regarding access to health care for children are deleted.

 

Applications for the children's health program must, to the extent possible, be available in schools.

 

The process for providing grants and technical assistance to solve children's health services access problems is modified as follows:  A committee appointed by the Secretary of Social and Health Services to implement the maternity care access program must (1) provide data to all counties on specified indicators of children's health services access problems, (2) identify counties experiencing access problems, (3) review requests from counties requesting assistance, (4) recommend projects for funding, and (5) provide technical assistance to counties.  If a county notified of an access problem does not request assistance within 120 days, providers in that county may request and receive assistance directly.  DSHS must provide grants as recommended by the committee.

 

The evaluation process for the maternity care access program is modified to increase its emphasis on determining the effect of specialized services at increasing the delivery of prenatal care.  Emphasis on determining the effect of prenatal care on birth outcomes is reduced.  In addition, the Legislative Budget Committee is directed to monitor the evaluation and provide recommendations regarding its plan and budget.  These changes to the evaluation take effect immediately.

 

An effective date of July 1, 1990 is established for the remainder of the act.

 

Senate Committee - Testified: HEALTH & LONG-TERM CARE:  Representative Vekich, sponsor, Beverly Jacobsen, Pediatric Partnership; Pat Thibaudeau, Washington Women United and Washington Community Mental Health; Tim Brown, DSHS; Patty Jones, WSNA

 

Senate Committee - Testified: WAYS & MEANS:  No one