SENATE BILL REPORT

SHB 2905

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Summary of Bill

Directs the Health Care Authority (HCA) to develop a local Access to Baby and Child Dentistry (ABCD) program fund allocation formula, key deliverables, and target metrics for increased outreach and provider engagement and support.
Directs HCA to monitor progress toward reducing racial and ethnic disparities in access to care and oral health outcomes and increasing the percentage of Medicaid-enrolled children under the age of two accessing dental care, and to support local ABCD programs and providers.

Background: HCA administers the Medicaid program, which is a state-federal program that pays for health care for low-income state residents who meet certain eligibility criteria. Benefits under the program vary according to a person's eligibility category, which is determined by several factors, including income, age, health condition, and disability status. Dental services for Medicaid clients are provided through a fee-for-service arrangement in which the dentist bills HCA directly.

Children of certain ages enrolled in Medicaid may participate in the ABCD program at HCA. The ABCD program provides enhanced fees to participating health care providers who provide additional services to participating children. The University of Washington's School of Dentistry and the Arcora Foundation provide management services, technical assistance, and provider recruitment and training for the ABCD program. The objective of the ABCD program is to identify and remove obstacles related to early preventive treatment, such as transportation and language interpretation barriers. The additional services include family oral health education, application of fluoride, oral evaluations, restorations, therapeutic pulpotomies, amalgam and resin restoration on primary teeth, and services related to crowns. Participating providers include ABCD program-certified dental providers and other health care providers who have been approved by HCA, including physicians, osteopathic physicians, advanced registered nurse practitioners, physician assistants, and osteopathic physician assistants.

Summary of Bill: HCA must contract with the statewide managing partner of the ABCD program to develop a local ABCD program fund allocation formula, key deliverables, and target metrics for increased outreach and provider engagement and support. HCA must collaborate with stakeholders to monitor progress towards reducing racial and ethnic disparities in access to care and oral health outcomes and increasing the percentage of Medicaid-enrolled children, under the age of two, accessing dental care. HCA must also support local ABCD programs and providers.

Staff Summary of Public Testimony: PRO: Expanding the funding will greatly benefit a well-documented program that is recognized nationwide. The ABCD program focuses on preventing dental problems before they happen. Prevention is more cost effective rather than waiting for more costly dental problems to present. The ABCD program works, but we still have more work to do. Since the program began, utilization for kids under five has more than doubled. However, more than half the kids under six are not seeing a dentist and 1/3 under two are not seeing a dentist. A critical concern is that children of color have higher rates of oral disease. Oral disease is preventable. This bill would add much needed capacity with the goal of reducing disparities. When this program was launched on 19 percent of children on Medicaid were getting dental care. Now it is over 54 percent. This program is currently operating in eight other states. In 2012, you provided funding for five other counties. Now we cover all 39 counties.