WSR 02-07-113

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)

[ Filed March 20, 2002, 10:27 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 00-22-083.

Title of Rule: New WAC 388-535-1245 Access to baby and child dentistry (ABCD) program; and repeal of WAC 488-535-1300.

Purpose: To clarify existing policy. The ABCD program was originally a demonstration project in limited areas; the department is planning to implement this program in targeted areas statewide.

Statutory Authority for Adoption: RCW 74.08.090, 74.090.35 [74.09.035], 74.09.500.

Statute Being Implemented: RCW 74.09.035, 74.09.520, 42 U.S.C. 1396d(a), 42 C.F.R. 440.100 and 440.225.

Summary: The department is implementing on a statewide basis a limited demonstration project that provides dental services to eligible children through age six. The rules define client eligibility and responsibilities, clarify provider requirements, and state the services provided under the program.

Reasons Supporting Proposal: To increase access to dental services in targeted areas for Medicaid-eligible infants, toddlers, and preschoolers.

Name of Agency Personnel Responsible for Drafting: Ann Myers, 925 Plum Street S.E., Olympia, WA 98501, (360) 725-1345; Implementation and Enforcement: Carree Moore, 649 Woodland Loop Road, Lacey, WA 98507, (360) 725-1653.

Name of Proponent: Department of Social and Health Services, governmental.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: The rule implements on a statewide basis, a limited-area demonstration project for children's dental services that was available only in one county.

The program is designed to increase access to dental services in targeted areas for Medicaid-eligible infants, toddlers, and preschoolers.

The anticipated effects are increased access to dental services for targeted clients.

Proposal Changes the Following Existing Rules: The rule described above defines client eligibility and responsibilities and provider responsibilities under the ABCD dental program.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has analyzed the proposed rule and concludes that it will have a no more than minor impact on businesses affected by it, therefore preparation of a comprehensive small business economic impact statement is not required.

RCW 34.05.328 does not apply to this rule adoption. The department has analyzed the proposed rule and concludes that it does not meet the definition of a "significant legislative rule." Therefore, an analysis of the probable costs and probably benefits is not required. See RCW 34.04.328 [34.05.328] (5)(b)(vii).

Hearing Location: Blake Office Park (behind Goodyear Courtesy Tire), 4500 10th Avenue S.E., Rose Room, Lacey, WA 98503, on April 23, 2002, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator, by April 19, 2002, phone (360) 664-6094, TTY (360) 664-6178, e-mail fernaax@dshs.wa.gov.

Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, e-mail fernaax@dshs.wa.gov, by 5:00 p.m., April 23, 2002.

Date of Intended Adoption: No sooner than April 24, 2002.

March 5, 2002

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3045.1ABCD 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) Training in correct office behavior, including 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) Teeth cleaning 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