House Bill 2128 2009 Apple Health for Kids Act

House Bill 2128 – 2009 Apple Health for Kids Act

The Washington state legislature has passed HB 2128, a bill that strengthens the Apple Health for Kids program by taking full advantage of federal funds, encouraging improved enrollment and renewal procedures, and creating a buy-in coverage option for families with incomes over 300% FPL. The new law also requires monitoring and reporting on children’s health status to ensure that their health is improving with coverage.

Bill Summary

Section / Effect
Section 1
Declares goals of the Apple Health for Kids program / Declares that continued steps are necessary to sustain progress toward the goals of health insurance for all children, and improvement of child health outcomes.
Intends that the Apple Health for Kids program be managed actively within DSHS and other state and local agencies, with clear accountability.
Declares that the Department of Social and Health Services(DSHS) will utilize the program identity of Apple Health for Kids as appropriate.
Section 2
Single integrated program for all children
Section 2
Single integrated program for all children (con’t.) / Program Administration
DSHS outreach, application, and renewal activities shall be conducted with the following goals:
* Achieving annual improvements in enrollment and renewal rates
* Identification of potentially eligible children via existing program databases
* Streamline the renewal process
* Maximizing federal investment in the form of enhanced match and outreach funds available through the federal Children's Health Insurance Program Reauthorization Act of 2009.
A report on these activities will be provided to the Legislature by September 30, 2009, to include status of the department efforts, anticipated impact on enrollment and associated costs.
Outreach
DSHS will continue proactive outreach and education efforts.($850,000 in state funds is allocated for this in the biennial budget, which will be leveraged toward a two-thirds match from the federal government for a total of approximately $2 million)
Coverage
Purchase of health care coverage shall primarily be through managed health care systems, subject to conditions, limitations, and appropriations provided in the biennial budget.
Buy-in over 300% FPL
Beginning no later than January 1, 2010, families with incomes greater than 300% of the federal poverty level may purchase coverage for children via an unsubsidized program that does not receive an explicit state subsidy.
Benefits offered through the unsubsidized program should be substantially similar to that offered in the Apple Health program, but may differ in design features including cost-sharing, application of pre-existing conditions and waiting periods.
Any fiscal impact resulting for pooling of program enrollees must be identified and brought to the Legislature for consideration.1
Section 3
Designation of an Apple Health for Kids point-person
NOTE: This section was vetoed by Governor Gregoire on May 12, 2009. / DSHS must, within existing resources, identify a staff position to serve as the single point of contact for Apple Health for Kids.
Duties of this staff position include:
* Ensuring planning and coordination of all aspects of Apple Health for Kids between agencies and stakeholders
* Facilitating collection, reporting, and analysis of data identified in Sections 2 and 4
* Strive to provide transparency and accountability for the Apple Health for Kids program
Section 4
Measuring Health Outcomes / Incorporates into current law additional indicators that may be used to assess the health status of enrolled children.Newly added performance measures which may be used include behavioral and oral health screenings at well-child visits and other nationally accepted developmental screening tools, visual acuity and eye health, and mental health status. These measures must be monitored each biennium.
DSHS must also develop criteria for alternative payment methods.
DSHS shall provide a report to the Governor and Legislature biennially, regarding provider performance on these measures beginning in September 2010. DSHS shall provide an update on these activities to the Legislature by September 30, 2009.
Section 5
Program name / Declares that this act may be known and cited as the Apple Health for Kids act.

1This language states that if, after implementation of the unsubsidized buy-in program, there are any costs to the state, the Legislature will be notified of these costs. This will not impact the planned start-date of the buy-in program, which is set for January 1, 2010.

• 800-854-KIDS • 718 Sixth Ave S • Seattle, WA98104 • 206.324.0340

For more information, please contact Lan Nguyen at 206.324.0340 x15 or