1408-S

1408-S.E AMS HHS S2899.1

ESHB 1408 - S COMM AMD

By Committee on Health & Human Services

Strike everything after the enacting clause and insert the following:

"NEW SECTION. Sec. 1. FINDINGS AND STATE POLICY. (1) The legislature finds that:

(a) Each year in Washington approximately fifteen thousand teenage girls become pregnant;

(b) The public cost of adolescent pregnancy is substantial. Eighty percent of teen prenatal care and deliveries are publicly funded. Over fifty percent of the women on public assistance became mothers as teenagers; and

(c) The personal costs of adolescent pregnancy can be socially and economically overwhelming. These too young mothers are often unable to finish high school. Their economic potential is diminished, their probability of dependence on public assistance increases, and their children are more likely to grow up in poverty. The cycle of teen mothers raising children in poverty jeopardizes their future educational opportunity and economic viability of future generations.

(2) The legislature therefore declares that in the interest of health, welfare, and economics, it is the policy of the state to reduce the incidence of unplanned teen pregnancy. To reduce the rate of teen pregnancy in Washington, the legislature hereby:

(a) Establishes four-year projects to prevent teen pregnancy;

(b) Initiates a teen pregnancy prevention media campaign;

(d) Expands medicaid eligibility for postpartum family planning services.

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

(1) "Community" means an individual political subdivision of the state, a group of such political subdivisions, or a geographic area within a political subdivision.

(2) "Department" means the department of health.

NEW SECTION. Sec. 3. TEEN PREGNANCY PREVENTION PROJECTS. There is established in the department a program to coordinate and fund community-based teen pregnancy prevention projects. Selection of projects shall be made competitively based upon compliance with the requirements of sections 4 and 5 of this act. To the extent practicable, the projects shall be geographically distributed throughout the state. Criteria shall be established by the department in consultation with other state agencies and groups involved in teen pregnancy prevention.

NEW SECTION. Sec. 4. TEEN PREGNANCY PREVENTION PROJECTS‑-REQUIREMENTS. (1) Each project shall be designed to reduce the incidence of unplanned teen pregnancy in the defined community, and may include preteens.

(2) At least fifty percent of the funding for teen pregnancy prevention projects shall be community matching funds provided by private or public entities. In-kind contributions such as, but not limited to, staff, materials, supplies, or physical facilities may be considered as all or part of the funding provided by the communities.

(3) The department shall perform evaluations of the projects. Each project shall be evaluated solely on the rate by which the teen pregnancy rates in the community are reduced, measured from the rates prior to the implementation of the project. Projects that demonstrate by empirical evidence that they have been successful in reducing the teen pregnancy rate in their community shall be eligible for consideration if reauthorized funding becomes available.

NEW SECTION. Sec. 5. TEEN PREGNANCY PREVENTION PROJECTS‑- APPLICATIONS. Applications for teen pregnancy prevention project funding shall:

(1) Define the community requesting funding;

(2) Designate a lead agency or organization for the project;

(3) Contain evidence of the active participation of entities in the community that will participate in the project;

(4) Demonstrate the participation of teens in the development of the project;

(5) Describe the specific activities that will be undertaken by the project;

(6) Identify the community matching funds required under section 4 of this act;

(7) Include statistics on teen pregnancy rates in the community over at least the past five years;

(8) Include components that will demonstrate sensitivity to religious, cultural, and socioeconomic differences; and

(9) Include components giving emphasis to the importance of sexual abstinence as a method of pregnancy prevention, as provided in RCW 28A.230.070 and 70.24.210.

The department shall not discriminate against applicants for teen pregnancy prevention project funding based on the type of pregnancy prevention strategies and services included in the applicant's proposal.

NEW SECTION. Sec. 6. REPORT. The department shall submit an annual report on the state's teen pregnancy rates over the previous five years, both state-wide and in the specific communities in which teen pregnancy prevention projects are located, to the appropriate standing committees of the legislature in the years 1995 through 1999.

NEW SECTION. Sec. 7. TEEN PREGNANCY PREVENTION MEDIA CAMPAIGN. The department shall develop a teen pregnancy prevention media campaign in collaboration with major media organizations and other organizations and corporations interested in playing a positive and constructive role in their communities. The media campaign shall be designed to reduce the incidence of teen pregnancies. The media campaign shall be directed to teens, their parents, and individuals and organizations working with teens. The department may subcontract all or part of the activities associated with the media campaign to qualified private, nonprofit organizations.

NEW SECTION. Sec. 8. Sections 1 through 7 of this act shall expire June 30, 1999.

Sec. 9. RCW 74.09.790 and 1990 c 151 s 4 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout RCW 74.09.760 through 74.09.820 and 74.09.510:

(1) "At-risk eligible person" means an eligible person determined by the department to need special assistance in applying for and obtaining maternity care, including pregnant women who are substance abusers, pregnant and parenting adolescents, pregnant minority women, and other eligible persons who need special assistance in gaining access to the maternity care system.

(2) "County authority" means the board of county commissioners, county council, or county executive having the authority to participate in the maternity care access program or its designee. Two or more county authorities may enter into joint agreements to fulfill the requirements of this chapter.

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

(4) "Eligible person" means a woman in need of maternity care or a child, who is eligible for medical assistance pursuant to this chapter or the prenatal care program administered by the department.

(5) "Maternity care services" means inpatient and outpatient medical care, case management, and support services necessary during prenatal, delivery, and postpartum periods.

(6) "Support services" means, at least, public health nursing assessment and follow-up, health and childbirth education, psychological assessment and counseling, outreach services, nutritional assessment and counseling, needed vitamin and nonprescriptive drugs, transportation, family planning services, and child care. Support services may include alcohol and substance abuse treatment for pregnant women who are addicted or at risk of being addicted to alcohol or drugs to the extent funds are made available for that purpose.

(7) "Family planning services" means planning the number of one's children by use of contraceptive techniques.

Sec. 10. RCW 74.09.800 and 1989 1st ex.s. c 10 s 5 are each amended to read as follows:

The department shall, consistent with the state budget act, develop a maternity care access program designed to ensure healthy birth outcomes as follows:

(1) Provide maternity care services to low-income pregnant women and health care services to children in poverty to the maximum extent allowable under the medical assistance program, Title XIX of the federal social security act;

(2) Provide maternity care services to low-income women who are not eligible to receive such services under the medical assistance program, Title XIX of the federal social security act;

(3) By January 1, 1990, have the following procedures in place to improve access to maternity care services and eligibility determinations for pregnant women applying for maternity care services under the medical assistance program, Title XIX of the federal social security act:

(a) Use of a shortened and simplified application form;

(b) Outstationing department staff to make eligibility determinations;

(d) Conducting an interview for the purpose of determining medical assistance eligibility within five working days of the date of an application by a pregnant woman and making an eligibility determination within fifteen working days of the date of application by a pregnant woman;

(4) Establish a maternity care case management system that shall assist at-risk eligible persons with obtaining medical assistance benefits and receiving maternity care services, including transportation and child care services;

(5) Within available resources, establish appropriate reimbursement levels for maternity care providers;

(6) Implement a broad-based public education program that stresses the importance of obtaining maternity care early during pregnancy;

(7) ((Study the desirability and feasibility of implementing the presumptive eligibility provisions set forth in section 9407 of the federal omnibus budget reconciliation act of 1986 and report to the appropriate committees of the legislature by December 1, 1989; and

~~(8)~~)) Refer persons eligible for maternity care services under the program established by this section to persons, agencies, or organizations with maternity care service practices that primarily emphasize healthy birth outcomes;

(8) Provide family planning services including information about the synthetic progestin capsule implant form of contraception, for twelve months immediately following a pregnancy to women who were eligible for medical assistance under the maternity care access program during that pregnancy or who were eligible only for emergency labor and delivery services during that pregnancy; and

(9) Within available resources, provide family planning services to women who meet the financial eligibility requirements for services under subsections (1) and (2) of this section.

NEW SECTION. Sec. 11. Sections 1 through 7 of this act shall constitute a new chapter in Title 70 RCW.

NEW SECTION. Sec. 12. Captions as used in this act constitute no part of the law."

ESHB 1408 - S COMM AMD

By Committee on Health & Human Services

On page 1, line 1 of the title, after "prevention;" strike the remainder of the title and insert "amending RCW 74.09.790 and 74.09.800; adding a new chapter to Title 70 RCW; creating a new section; and providing an expiration date."