HOUSE BILL REPORT

HB 2603

BYRepresentatives Vekich, Prentice, Brooks, Dellwo, O'Brien, Heavey, Basich, G. Fisher, Valle, Jacobsen, Wineberry, Leonard, Pruitt, Wang, Phillips, Winsley, Sprenkle, Kremen, Holland, Haugen, Hine, Wood, R. King, Moyer, Jones, Ebersole, Scott, Brekke, Morris, Todd and Spanel; by request of Governor Gardner

Enhancing availability of medical care for children.

House Committe on Health Care

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass.  (11)

      Signed by Representatives Braddock, Chair; Day, Vice Chair; Brooks, Ranking Republican Member; Cantwell, Chandler, Morris, Prentice, D. Sommers, Sprenkle, Vekich and Wolfe.

House Staff:Bill Hagens (786-7131)

Rereferred House Committee on Appropriations

Majority Report:  The substitute bill by Committee on Health Care be substituted therefor and the substitute bill do pass.  (26)

      Signed by Representatives Locke, Chair; Grant, Vice Chair; Silver, Ranking Republican Member; Youngsman, Assistant Ranking Republican Member; Appelwick, Belcher, Bowman, Braddock, Brekke, Dorn, Doty, Ebersole, Hine, Holland, Inslee, May, McLean, Nealey, Peery, Rust, Sayan, Spanel, Sprenkle, Valle, Wang and Wineberry.

Minority Report:  Do not pass.  (1)

      Signed by Representative Padden.

House Staff:      Maureen Morris (786-7152)

AS REPORTED BY COMMITTEE ON APPROPRIATIONS FEBRUARY 3, 1990

BACKGROUND:

Despite recent efforts to expand health care services for the uninsured, the number of persons without coverage continues to increase.  This has been a particular problem for children of low-income families, when the family is not eligible for Medicaid or has no sponsored coverage through an employer.

Many communities lack the funds and the technical capability to expand health care coverage to the needed level.  Reimbursement for health care to low-income children is often deemed to be inadequate by providers.

Presently the type of evaluators that can bid for the evaluation of the Maternity Care Access Act (First Steps) is limited to non-profit entities.  The Department of Social & Health Services (DSHS) considers this requirement as too restrictive, excluding many qualified bidders.  The deadline for the completion of the evaluation is presently set at November 1, 1990; this period is too short for an evaluation.

SUMMARY:

SUBSTITUTE BILL:  A new program is established within the Department of Social & Health Services (DSHS) to 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 a year for a family of four) will be provided medical coverage in the same manner and scope of Medicaid coverage.  The eligibility process shall be determined by DSHS and shall be easily understood.  Eligibility determination and time lines shall be the same as for Medicaid.

The program encourages communities to make health services more accessible to children in poverty.  Technical assistance and public funds are made available to help communities experiencing significant problems with access to health services for children. DSHS, in coordination with the Department of Health (DOH), shall identify, based on a set of indicators, counties and tribal jurisdictions that are experiencing significant problems with access to health care for low-income children.  DSHS shall notify counties and tribal jurisdictions of this identified status and advise them of ways to obtain funds and technical assistance.  Counties and tribal jurisdictions not so identified can independently seek funds and technical assistance from DSHS.  DSHS and DOH are required to evaluate the requests against set criteria.

DSHS and DOH shall reevaluate the state of access of health care services for children and report to the State Board of Health for inclusion in the state health report. Current law is amended to permit the state to provide health care services to children (under age 18) up to 100 percent of the federal poverty level.

The evaluation process for the maternity care access program is modified to permit bidders other than non-profit entities. The reporting date is changed from December 1, 1990, to November 1, 1991.

SUBSTITUTE BILL COMPARED TO ORIGINAL:  Numerous grammatical corrections and proper references are made.  The text of the bill is reorganized to make it more readable. Language is added to clarify that the focus of the program is low-income children. Counties and tribal jurisdictions are identified as the key local entities for funding and technical assistance.  An effective date of July 1, 1990, is added.  The provision requiring the state health report to include a separate section on children's health care is deleted.

CHANGES PROPOSED BY COMMITTEE ON APPROPRIATIONS:  None.

Fiscal Note:      Requested January 18, 1990.

Effective Date:(Health Care) Section 10 of the bill contains an emergency clause and takes effect immediately.

(Appropriations)  Section 10 of the bill contains an emergency clause and takes effect immediately.

House Committee ‑ Testified For:    (Health Care)  Bets Greer, Governor's Office; Ned Dolejsi, Washington State Catholic Conference; Dr. Jon Almquist; Tom Trompeter, WSPCA; Willa Fisher; Jesus Rodriguez, Seamar HCC; James Kelly, African-American Affairs Commission; and Hector Gonzalez, Washington State Commission on Hispanic Affairs.

(Appropriations)  Len Edinger, Washington State Medical Association; and Ron Kero, Department of Social & Health Services, Division of Medical Assistance.

House Committee - Testified Against:      (Health Care)  No one.

(Appropriations)  No one.

House Committee - Testimony For:    (Health Care)  This bill is necessary to improve health care for low-income children.

(Appropriations)  This bill enjoys broad support and is necessary to improve health care to low-income children.

House Committee - Testimony Against:      (Health Care)  None.

(Appropriations)  None.