Report Title:

QUEST; Coverage for Post-Pregnancy Interconception Care; Appropriation

Description:

Expands QUEST coverage for post-pregnancy interconception care to up to six months.  Appropriates funds for this purpose.

THE SENATE	S.B. NO.	2137
TWENTY-FOURTH LEGISLATURE, 2008
STATE OF HAWAII

A BILL FOR AN ACT

relating to PUBLIC ASSISTANCE.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that it is in the State's best interests to ensure that women receive appropriate interconception care following a pregnancy.  In a report presented to the Hawaii women's legislative caucus, interconception care was defined as "a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman's health or pregnancy outcome through prevention and management."  Interconception care refers to the set of care services between pregnancies.

     By improving the health of women before the next pregnancy, preconception and interconception care can improve the health of the woman and her infant(s).  Among other department of health pregnancy risk assessment monitoring system data analysis findings presented to the Hawaii women's legislative caucus:

     (1)  Women on QUEST are three times less likely to access prenatal care in their first trimester of pregnancy;

     (2)  Compared to women with other health coverage, women with QUEST coverage are 1.5 times more likely to have an unintended pregnancy, three times more likely to smoke during their last trimester of pregnancy, and three to four times more likely to use illicit drugs;

     (3)  Compared to recently-delivering women with other health coverage, women with QUEST coverage are twice as likely to experience postpartum sadness or depression and ten per cent more likely to have a low birthweight or prematurely born infant;

     (4)  Compared to recently-delivering women with other health coverage, women on QUEST were at three to four times higher risk of experiencing intimate partner violence while pregnant; and

     (5)  Compared to recently-delivering women with other health coverage, women on QUEST were just as likely to have their infants receive their first well-baby check, but were two times more likely not to have received the recommended post-partum check for new mothers.

This data indicates that women with QUEST coverage are at increased risk for poor pregnancy outcomes for their current, as well as their future offspring.  Improving interconception health can result in improved reproductive health outcomes, with potential for reducing societal costs as well.  Interconception care is intended to promote the health of women of reproductive age before their next pregnancy, which can improve pregnancy-related outcomes.

     The State's QUEST program presently serves over 3,300 pregnant women a year, and covers the pregnant women for up to sixty days after delivery.  The legislature believes that it would be in the best interests of the State for QUEST coverage to be extended for six months following a pregnancy.

     The purpose of this Act is to expand the period of coverage under QUEST for interconception care services for six months post-pregnancy.

     SECTION 2.  Chapter 346, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§346‑   Interconception care coverage. The department shall provide comprehensive coverage to pregnant QUEST recipients for interconception care for a period of up to six months post-pregnancy.

The department shall administer this benefit in a manner that meets federal requirements that are a condition of the receipt of federal funds by the State.

For purposes of this section:

"Comprehensive coverage" means the full scope of preventive and primary care services for women following a pregnancy.

"Interconception care" means a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman's health or pregnancy outcome through prevention and management."

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $           or so much thereof as may be necessary for fiscal year 2008-2009 to expand the QUEST coverage for interconception care for pregnant women for six months post-pregnancy.

     The sum appropriated shall be expended by the department of human services for the purposes of this Act.

     SECTION 4.  New statutory material is underscored.

     SECTION 5.  This Act shall take effect on July 1, 2008.

INTRODUCED BY:

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