SENATE BILL REPORT

SB 6414

BYSenators West, Wojahn, Anderson, von Reichbauer, Johnson, Moore, Bailey, Rinehart, Rasmussen, Gaspard, Talmadge, Vognild, Amondson, Smith, Patrick, Warnke, Williams, Murray, McMullen, Niemi, Bauer, Bender and Kreidler; by request of Governor

Enhancing availability of medical care for children.

Senate Committee on Health & Long-Term Care

Senate Hearing Date(s):January 23, 1990; February 1, 1990

Majority Report:  That Substitute Senate Bill No. 6414 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.

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

Senate Staff:Don Sloma (786-7414)

                  February 2, 1990

Senate Committee on Ways & Means

Senate Hearing Date(s):February 15, 1990

Senate Staff:Randy Hodgins (786-7715)

                  February 13, 1990

AS REPORTED BY COMMITTEE ON HEALTH & LONG-TERM CARE, FEBRUARY 1, 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 funded by state funds, which will 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 per year for a family of four) will be provided medical coverage in the same manner and scope as those now eligible for Medicaid.  The eligibility process must be determined by DSHS and must be easily understood.  Eligibility determination and timelines must be the same as for Medicaid.

The department, in coordination with the Department of Health, must identify communities having significant problems with access to health services for children, and must provide technical assistance or grants to improve access within available funds.  The department must reevaluate the state of access to care for children, along with information on implementation of the act on a biennial basis and provide this information to the state Board of Health.

Beginning in 1992, the state health report, prepared by the state Board of Health, must include a section on the state of children's health in Washington.

EFFECT OF PROPOSED SUBSTITUTE:

The medical care program for eligible persons may include services which do not conform to Medicaid services if approved by DSHS.  Grants to counties or disproportionate share payments to providers are included within allowable activities for the children's health program. 

The executive committee formed by DSHS to implement the Maternity Care Access program under Chapter 74.09 RCW must identify counties having significant problems with access to children's health services according to specified criteria, inform all counties of their performance against the criteria, evaluate all county requests for assistance, and recommend projects for funding.

DSHS may provide grants to counties or disproportionate share payments to service providers to improve access.  The requirement for the state health report to contain a section on children's health is deleted.

An effective date of July 1, 1990 is established.

Appropriation:    none

Revenue:    none

Fiscal Note:      available

Effective Date:July 1, 1990

Senate Committee - Testified: HEALTH & LONG-TERM CARE:  Joan Stiggelbout, WSNA (pro); Ned Dolejsi, WSCC (pro); Dr. John Neff, Children's Hospital and Medical Center (pro); Betz Greer, Governor's office