SENATE BILL REPORT

SB 5976

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.

As Reported by Senate Committee On:

Ways & Means, February 4, 2020

Title: An act relating to the access to baby and child dentistry program for children with disabilities.

Brief Description: Concerning the access to baby and child dentistry program for children with disabilities.

Sponsors: Senators Rolfes, Kuderer and Walsh.

Committee Activity: Ways & Means: 1/30/20, 2/04/20 [DPS].

Brief Summary of First Substitute Bill

Updates the definition of who is eligible to receive services under this program to include language that eligible children must meet clinical criteria established by the Health Care Authority.

SENATE COMMITTEE ON WAYS & MEANS

Majority Report: That Substitute Senate Bill No. 5976 be substituted therefor, and the substitute bill do pass.

Signed by Senators Rolfes, Chair; Frockt, Vice Chair, Operating, Capital Lead; Mullet, Capital Budget Cabinet; Braun, Ranking Member; Brown, Assistant Ranking Member, Operating; Honeyford, Assistant Ranking Member, Capital; Becker, Billig, Carlyle, Conway, Darneille, Dhingra, Hasegawa, Hunt, Keiser, Liias, Muzzall, Pedersen, Schoesler, Van De Wege, Wagoner, Warnick and Wilson, L..

Staff: Sandy Stith (786-7710)

Background: The Health Care Authority (Authority) administers the Medicaid program, which is a state-federal program paying health care costs 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 the Authority directly.

Children under six years old who are enrolled in Medicaid may participate in the Access to Baby and Child Dentistry (ABCD) program at the Authority, which provides enhanced fees to participating health care providers who provide additional services to participating children. The Washington Dental Service Foundation provides management services, funding, 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. 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 the Authority, including physicians, osteopathic physicians, advanced registered nurse practitioners, physician assistants, and osteopathic physician assistants.

In 2018 the Legislature passed SSB 6549, requiring the Authority to expand the ABCD program to include children with disabilities as eligible clients through age 12. The legislation required dentists and hygienists to complete a course on treating children with disabilities to receive the enhanced ABCD fee for providing services to eligible children with disabilities.

Summary of Bill (First Substitute): The definition of who is eligible for this program is updated to include language that eligible children must meet clinical criteria established by the Authority. Primary care providers must complete a course on treating eligible children, as defined by the Authority in rule, to receive the enhanced ABCD fee for providing services to eligible children.

EFFECT OF CHANGES MADE BY WAYS & MEANS COMMITTEE (First Substitute): The dates the Authority must report to the Legislature are updated to December 15, 2020, and December 15, 2021.

Appropriation: None.

Fiscal Note: Available.

Creates Committee/Commission/Task Force that includes Legislative members: No.

Effective Date: Ninety days after adjournment of session in which bill is passed.

Staff Summary of Public Testimony on Original Bill: The committee recommended a different version of the bill than what was heard. PRO: The ABCD program is successful in helping children access dental services. Since this program began, dental services for children between birth and age five have more than doubled. Countless children have been provided with a dental home. Children in this program are more likely to seek care before there is a larger health issue and the program is very cost effective. By expanding the program to include children with disabilities through age 12, we ensure that some of our most vulnerable children have access to preventative dental care and a dental home. ABCD is a nationally recognized model for connecting very young kids on Medicaid with dental care. We have heard from our partners that expanding the program to include children over age five with disabilities is the needed next step to help prevent oral disease before it starts or worsens.

Persons Testifying: PRO: Alison Mondi, Arcora Foundation; Emily Lovell, Washington State Dental Association.

Persons Signed In To Testify But Not Testifying: No one.