WSR 02-11-136

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)

[ Filed May 21, 2002, 3:37 p.m. ]

Date of Adoption: May 20, 2002.

Purpose: The access to baby and child dentistry (ABCD) program was originally a demonstration project in limited areas; the department is implementing this program in targeted areas statewide. The current WAC 388-535-1300 is repealed and the rule for this program is renumbered as new WAC 388-535-1245 to fit with the department's reorganization of this chapter.

Citation of Existing Rules Affected by this Order: Repealing WAC 388-535-1300 Access to baby and child dentistry (ABCD) program.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.035, 74.09.500, 42 U.S.C. 1396d(a), 42 C.F.R. 440.100 and .225.

Adopted under notice filed as WSR 02-07-113 on March 20, 2002.

Changes Other than Editing from Proposed to Adopted Version: At WAC 388-535-1245 (2)(c), deleted "Training in correct office behavior, including..." and replaced with, "Expectations of the client and family, including the importance of..."

At WAC 388-535-1245 (5)(b), deleted "Teeth cleaning training" and replaced with, "Oral health instruction/training;"

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, Amended 0, Repealed 1.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 1.
Effective Date of Rule: Thirty-one days after filing.

May 20, 2002

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3045.2ABCD DENTAL PROGRAM
NEW SECTION
WAC 388-535-1245   Access to baby and child dentistry (ABCD) program.   The access to baby and child dentistry (ABCD) program is a program established to increase access to dental services in targeted areas for Medicaid-eligible infants, toddlers, and preschoolers. Public and private sectors cooperate to administer the program.

(1) Client eligibility for the ABCD program is as follows:

(a) Clients must be five years of age or younger and reside in targeted areas selected by the medical assistance administration (MAA). Once enrolled in the ABCD program, an eligible client is covered until reaching age six.

(b) Eligible clients enrolled in a managed care plan are eligible for the ABCD program under fee-for-service.

(c) Eligible clients enrolled in the following medical assistance programs are eligible for the ABCD program:

(i) Categorically needy (CN or CNP);

(ii) Limited casualty program/medically needy program (LCP/MNP); and

(iii) Children's health.

(2) Health care providers and community service programs in the targeted areas identify and refer eligible clients to the ABCD program. If enrolled, the client and family may receive:

(a) An ABCD program identification card;

(b) Oral health information;

(c) Expectations of the client and family, including the importance of keeping appointments;

(d) Assistance with obstacles to care, such as lack of transportation; and

(e) Case management services, for families who do not cooperate with the training(s) in this subsection.

(3) Families who do not cooperate with the training(s) in subsection (2) of this section may be disqualified from the ABCD program. The client remains eligible for MAA dental coverage as described in this chapter.

(4) The University of Washington School of Pediatric Dentistry's continuing education program certifies dental providers to furnish ABCD program services.

(5) MAA pays enhanced fees to ABCD-certified participating providers for furnishing ABCD program services. In addition to services provided under MAA's dental care program, the ABCD program provides family oral health education, which is allowed twice per year, per family, and must include:

(a) Risk assessment;

(b) Oral health instruction/training;

(c) Dietary counseling;

(d) Fluoride supplements, if appropriate; and

(e) Documentation in the client's file.

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REPEALER

     The following section of the Washington Administrative Code is repealed:
WAC 388-535-1300 Access to baby and child dentistry (ABCD) program.

Washington State Code Reviser's Office