Prepared by:Coyne, Jesernig, LLC / Thursday, February 7, 2008
The Legislature will move past its first major cutoff at 5:00 p.m. on Friday, February 8th. That cutoff deadline is known as the "House of Origin -- Policy Committee Cutoff". Any bills that have not been voted out of their committee of origin, (and are not "Necessary to Implement the Budget"), will be "dead" for the 2008 Session. This deadline will "kill" the vast majority of the bills that we are tracking.
On Tuesday, February 12th, any of the bills that have made it past the Policy Committee deadline, (but now find themselves in one of the money committees), must be voted out of those money committees, or they will be "dead" for this Session. Any bills that did not have to go to a money committee, (since they have no fiscal impact), and any bills that make their way out of the money committees before next Tuesday's deadline, have until February 19th to be voted out of their House of Origin.
Next week's Update will designate all of the bills that are "dead" for this Session. We will then need to have someone take a hard look at all of the remaining bills to see if there are problems with any of them that we are going to try and work on in the Opposite House. Opposite House Policy Committees will be holding hearings starting on February 20th, since any bills that have been referred to those committees must be voted out by Friday, February 29th. As you can see, the deadlines will continue to crop up quicker and quicker as the Session accelerates to adjournment.
Rob and I met with Jude van Buren, (the Department of Health’s Assistant Secretary for the Epidemiology, Health Statistics and Public Health Laboratories Division), and Pam Lovinger, (the Department of Health’s Senior Adviser for Policy and Business Practices), on Monday, February 4th, to discuss the Department’s Healthcare Associated Infections-- Ambulatory Surgical Facilities Stakeholder Group. This group, (which will be charged with reviewing infection data in surgery centers to determine if there is an infection problem, and if there is one found to come up with solutions), includes the following members:
1)Rob Schwartz – WASCA
2)Christine Hayes—Director – Everett Bone and Joint Ambulatory Surgical Facility
3)Kathy Hills—Clinical Director – Overlake Surgical Center
4)Nancy Molhan -- CEO—SW Washington Regional Surgery Center
5)Pam Novotny – Quality Improvement Coordinator – Bellingham Surgery Center
6)Debbie Perdue – Manager – Minor and James Medical
7)Vonnie Prescott – Clinical Director – Hillside Surgery Center
Hopefully, the Department will work with this group just as thoughtfully as it has worked with the licensure workgroups. We’ll just have to see. They will have their first meeting on March 28th.
The WASCA Board met with Byron Plan at its dinner in Olympia on Monday, February 4th. Byron walked the Board through the timeline for the Department’s ASC licensure rule. He indicated that the Department was unlikely to pursue fee legislation this year. While I know Byron will do everything he can to have this rule work for everyone involved, I am very concerned that his timeline for adopting the rule, (June of 2009), is perilously close to July of 2009, which is when all surgery centers need to be licensed.
My concern is that our members will not have enough time to actually get licensed in only one month, or worse yet, not be able to get licensed at all before the licensure requirement becomes law. If that were to occur, a surgery center that had “surgery center” in its name would actually be illegal. Not a good result. In order to make sure that our members do not get caught in this dilemma, I have already floated the idea with Brian Payton, (the Department’s legislative liaison), that WASCA may pursue an amendment to the Department’s fee bill that would extend the effective date of licensure to January 1st of 2010, rather than the present July 1, 2009. We may never have to “pull the trigger” on that option, but I want to make sure the Department is aware of the fact that we are concerned with this issue.
Finally, the big news this week was that even though HB 2691, (the bill prohibiting practitioner referrals to a facility that they have an ownership interest in), is now officially “dead” for the 2008 Legislative Session, Chair Cody will be holding a work session on this bill next Wednesday, February 13th. In discussions with Rep Cody today, she indicated to me that her main reason for pursuing HB 2691 has to do with in-office imaging and laboratories, not specifically surgery centers. Though I told her that we appreciate the fact her focus had not landed on us directly, her bill as written, (unfortunately), could cause incredible problems for surgery centers. We will have a conference call Monday afternoon to discuss our strategy around this work session.
Bill Tracking SummaryHigh Priority Bills / Sponsor / Position / Status
1415 / Establishing activities to support the certificate of need program. / Cody / Concerns / H, HC/Wellness
ES1809 / Creating the Washington state patient safety act. (DIGEST OF PROPOSED 1ST SUBSTITUTE) / Morrell / Monitor / H, Rules X +
2S2098 / Providing high quality, affordable health care to Washingtonians based on the recommendations of the blue ribbon commission on health care costs and access. (DIGEST OF PROPOSED 2ND SUBSTITUTE) / Cody / Monitor / H, Rules X +
2099 / Establishing activities to support the certificate of need program. / Cody / Oppose / H, Approp +
S2670 / Modifying disclosure provisions under the adverse health events and incident reporting system. (DIGEST OF PROPOSED 1ST SUBSTITUTE) / Campbell / Monitor / H, Rules R
2691 / Regarding the referral of patients by health care practitioners. / Cody / Concerns / H, HC/Wellness
3293 / Regarding the licensing fees for certain professions, occupations, and businesses. / Ericks / Monitor / H, Approp
6225 / Establishing a system for monitoring invasive methicillin resistant staphylococcus aureus. / Keiser / Monitor / S, Hea/L-T Care
6457 / Modifying disclosure provisions under the adverse health events and incident reporting system. / Keiser / Concerns / S, Hea/L-T Care
Medium Priority Bills
2428 / Establishing a system for monitoring invasive methicillin resistant staphylococcus aureus. / Campbell / Monitor / H, HC/Wellness2685 / Regarding hours of labor for nurses. / Green / Monitor / H, Commerce/Lab
2929 / Modifying certificate of need review requirements. / Hinkle / Monitor / H, HC/Wellness
S3123 / Establishing evidence-based nurse staffing in hospitals. (DIGEST OF PROPOSED 1ST SUBSTITUTE) / Morrell / Monitor / H, Approp
3331 / Identifying methicillin-resistant staphylococcus aureus as a presumptive occupational disease affecting firefighters. / Conway / Monitor / H, Commerce/Lab
5941 / Regarding the certification and recertification of health care facilities. / Jacobsen / Monitor / S, Ways & Means
6191 / Requiring disclosure of certain health care information. / Keiser / Monitor / S, Hea/L-T Care
6221 / Establishing the Washington health partnership. / Keiser / Monitor / S, Hea/L-T Care
6334 / Regarding the scope of practice of health care assistants. / Franklin / Monitor / S, Rules 2
6734 / Establishing a process to identify best practices related to patient safety. / Franklin / Monitor / S, Hea/L-T Care
Low Priority Bills
S2475 / Regarding the scope of practice of health care assistants. (DIGEST OF PROPOSED 1ST SUBSTITUTE) / Cody / Monitor / H, 2nd Reading2513 / Concerning radiologist assistants. / Morris / Monitor / H, HC/Wellness
S2536 / Establishing a citizens' work group on health care. (DIGEST OF PROPOSED 1ST SUBSTITUTE) / Cody / Monitor / H, Approp +
2573 / Granting the department of health the authority to grant exceptions to a certificate of need review for qualifying kidney disease treatment centers. / Moeller / Monitor / H, HC/Wellness
2653 / Studying the impact of vendor rates or cost shifting between public and private purchasers of medical services. / Hinkle / Monitor / H, HC/Wellness
S2816 / Regulating certain health care devices and procedures. (DIGEST OF PROPOSED 1ST SUBSTITUTE) / Campbell / Monitor / H, Rules R +
2883 / Improving patient safety through increased regulation of health professionals. / Green / Monitor / H, HC/Wellness
3190 / Concerning radiologist assistants. / Morris / Monitor / H, HC/Wellness
6333 / Establishing a citizens' work group on health care. / Keiser / Monitor / S, Hea/L-T Care
6439 / Concerning radiologist assistants. / Spanel / Monitor / S, Hea/L-T Care
6458 / Improving patient safety through increased regulation of health professionals. / Keiser / Monitor / S, Ways & Means +
Calendar Items
2/11/2008 / 6458 / Patient safety / Ways & Means / TVW / 1:30 PM / SHR 4
2/13/2008 / 2691 / Patient referral / Health Care & Wellness / 8:00 AM / HHR A
Bill Tracking Details
1415 / Certificate of need program / Cody
Representatives Cody, Green, Morrell, Moeller, and Campbell
Declares that a strategic health planning process that is responsive to changing health and social needs and conditions is essential to the health, safety, and welfare of the people of the state. The strategic health planning process must be concerned with the performance of the health system, encompassing health care financing, quality, and the availability of information and services for all residents. The strategic health planning process must ensure the involvement of both consumers and health care providers in the health planning process. The outcomes of the strategic health planning process must be clearly articulated and available for public use and review.
Requires such strategic health planning, when informed by relevant data about the state's health system, shall guide the state in establishing objectives and strategies to: (1) Promote, maintain, and assure the health of all citizens in the state;
(2) Provide accessible health services through the maintenance of an adequate supply of health facilities and an adequate workforce;
(3) Apply specific quality criteria and population health indicators;
(4) Recognize prevention as a high priority in health programs;
(5) Address periodic priority issues including disaster planning, public health threats, and public safety dilemmas;
(6) Coordinate efforts among state agencies including those tasked with facility, services, and professional provider licensing; state and federal reimbursement; health service utilization data systems; and other functions relevant to health planning;
(7) Recognize the close interrelationship of health planning concerns and emphasize health care expenditure control, including cost-effectiveness and cost-benefit analysis;
(8) Integrate criteria for evidence-based medicine; and
(9) Regularly evaluate the impact of capacity management on health service expenditures, access, quality, and innovation.
Creates the office of strategic health resource coordination in the office of the governor. The office shall serve as a coordinating body for public and private efforts to improve quality in health care, promote cost-effectiveness in health care, and plan health facility and health service availability. In addition, the office shall facilitate access to health care data collected by public and private organizations as needed to conduct its planning responsibilities.
Full Text URL: / Bills/1415.pdf
ES1809 / Patient safety act / Morrell
House Committee on Health Care & Wellness (originally sponsored by Representatives Morrell, Campbell, Green, Kenney, Cody, Darneille, Hunt, Conway, Williams, Simpson, Moeller, Santos, and Wood)
Finds that research demonstrates the critical role that registered nurses play in improving patient safety and quality of care. Greater numbers of registered nurses available to care for hospitalized patients are key to reducing errors, complications, and adverse patient care events. Moreover, higher nurse staffing levels result in improved staff safety and satisfaction and reduced incidences of workplace injuries. In addition, health care professional, technical, and support staff comprise vital components of the patient care team, bringing their particular skills and services to ensuring quality patient care.
Provides therefore, in order to protect patients and to support greater retention of registered nurses, to promote evidence-based nurse staffing, and to increase transparency of health care data and decision making, the legislature finds that ensuring sufficient nurse staffing to meet patient care needs is an urgent public policy priority.
Full Text URL: / Bills/1809-s.e.pdf
2S2098 / Blue ribbon comm/health care / Cody
House Committee on Appropriations (originally sponsored by Representatives Cody, Upthegrove, Morrell, Kenney, Conway, Simpson, Hudgins, and Ormsby) / Requested by
Governor Gregoire
Provides a plan to develop high quality, affordable health care to Washingtonians based on the recommendations of the blue ribbon commission on health care costs and access.
Full Text URL: / Bills/2098-s2.pdf
2099 / Certificate of need program / Cody
Representatives Cody, Morrell, and Kenney
Establishes activities to support the certificate of need program.
Full Text URL: / Bills/2099.pdf
2428 / Staphylococcus aureus / Campbell
Representatives Campbell, Green, Wood, Hinkle, Ormsby, and Morrell
Finds that methicillin resistant staphylococcus aureus poses a serious threat to the health of the residents of Washington state.
Intends to establish a system for monitoring invasive methicillin resistant staphylococcus aureus and taking measures to prevent its spread in health care settings and the community.
Requires every laboratory to notify the local health jurisdiction of confirmed cases of invasive methicillin resistant staphylococcus aureus and shall cooperate with public health authorities in any investigation of cases or outbreaks.
Declares that the department of health provide assistance to local health jurisdictions with the establishment of a strategy to support efforts to prevent the spread of multidrug resistant organisms.
Companion Bill: / 6225Staphylococcus aureus / S, Hea/L-T Care
Full Text URL: / Bills/2428.pdf
S2475 / Health care assistants / Cody
House Committee on Health Care & Wellness (originally sponsored by Representatives Cody, Morrell, and Green)
Allows health care assistants to administer vaccines.
Modifies the definition of "health care practitioner" to include a licensed physician assistant or a licensed osteopathic physician assistant.
Modifies the definition of "supervision" to include supervision by a health care practitioner during the administration of vaccines.
Requires each person authorizing the administration of vaccines to maintain a list of the vaccines that he or she has authorized for administration.
Full Text URL: / Bills/2475-s.pdf
2513 / Radiologist assistants / Morris
Representatives Morris and Quall
Creates radiologist assistant provisions.
Companion Bill: / 6439Radiologist assistants / S, Hea/L-T Care
Full Text URL: / Bills/2513.pdf
S2536 / Health care work group / Cody
House Committee on Health Care & Wellness (originally sponsored by Representatives Cody, VanDeWege, Hasegawa, Ormsby, Seaquist, Morrell, Schual-Berke, Upthegrove, and Green)
Establishes a citizens' work group on health care reform. The work group shall present information and seek public input about, direct the economic analysis of, and review various health care proposals.
Full Text URL: / Bills/2536-s.pdf
2573 / Kidney disease treatment / Moeller
Representative Moeller
Authorizes the department of health to grant exceptions to a certificate of need review for qualifying kidney disease treatment centers.
Full Text URL: / Bills/2573.pdf
2653 / Vendor rates/cost shifting / Hinkle
Representatives Hinkle and Cody
Requires the governor's advisory committee on vendor rates to conduct an extensive examination of rates paid to licensed health care providers to determine whether the rates paid by the department of social and health services are reasonable and necessary to ensure that medical program participants have access to accessible, quality services.
Requires vendor rates for medical services purchased by the department to include amounts reasonable and necessary to ensure access to licensed health care providers by all medical program participants by eliminating any cost shifting due to inadequate vendor rates.
Full Text URL: / Bills/2653.pdf
S2670 / Health events/incidents / Campbell
House Committee on Health Care & Wellness (originally sponsored by Representatives Campbell, Hunt, and Kenney) / Requested by
Governor Gregoire
Provides that when a medical facility confirms that an adverse event has occurred, it shall submit to the department of health notification of the event within forty-eight hours and a report regarding the event within forty-five days.
Requires independent entities who report annually to the governor and the legislature on the activities under chapter 70.56 RCW to include information, presented in the aggregate, to inform and educate consumers and providers, on best practices and prevention tools that medical facilities are implementing to prevent adverse events as well as other patient safety initiatives medical facilities are undertaking to promote patient safety.
Provides that the notification of an adverse event under RCW 70.56.020(2)(a), is subject to public disclosure and not exempt from disclosure under chapter 42.56 RCW. Any public disclosure of an adverse event notification must include any contextual information the medical facility chose to provide under RCW 70.56.020(2)(a).
Full Text URL: / Bills/2670-s.pdf
2685 / Nurses hours of labor / Green
Representative Green
Declares that employees of health care facilities shall be allowed scheduled meal and rest periods as specified in rules adopted by the department of labor and industries under this act. Employees of health care facilities are not engaged in the type of work that allows employees to take intermittent rest periods in place of scheduled meal and rest periods.
Requires that in addition to the restrictions of RCW 49.28.140, no employer shall permit any employee of any health care facility to work in excess of twelve hours in any twenty-four hour period. This act does not apply to unforeseeable emergent circumstances.
Provides that the department of labor and industries shall investigate complaints of violations of RCW 49.28.140 and this act.
Full Text URL: / Bills/2685.pdf
2691 / Patient referral / Cody
Representative Cody
Regulates the referral of patients by health care practitioners.
Full Text URL: / Bills/2691.pdf
S2816 / Health care device/procedure / Campbell
House Committee on Health Care & Wellness (originally sponsored by Representatives Campbell, Morrell, and Green)
Authorizes the adoption of rules to identify those instruments or procedures that are prohibited for use by a podiatric physician or surgeon, chiropractor, dentist, naturopath, osteopathic physician or surgeon, osteopathic physician's assistant, physician or surgeon, physician's assistant, physical therapist, or nurse practitioner.
Full Text URL: / Bills/2816-s.pdf
2883 / Patient safety / Green
Representatives Green, Roberts, and Morrell / Requested by