Change of Law: Hospital Action Required
|To:||Psychiatric Hospital CEOs and Government Affairs Staff
Please forward to: nurse managers, discharge planners, risk management
|Staff Contact:||Cara Helmer, JD, RN, Policy Director, Legal Affairs, firstname.lastname@example.org, 206-577-1827
Ryan Robertson, Senior Director of Behavioral Health, email@example.com, 206-216-2536
|Subject:||New Discharge Notification Requirements for Freestanding Psychiatric Hospitals|
The purpose of this bulletin is to alert psychiatric hospitals licensed under RCW 71.12 to new requirements to notify Medicaid managed care organizations (MCOs) in advance of patient discharges, and to engage with MCOs in discharge planning for relevant patients. These new requirements, passed under SHB 1860 are effective June 9, 2022.
SHB 1860 applies to all psychiatric hospitals licensed under RCW 71.12.
- Know the law
- Review this bulletin and the changes enacted by SHB 1860 with legal counsel and risk managers to determine the impact on your hospital and any resulting changes that may be required to policies and procedures.
- Update policies and procedures
- Review policies regarding discharge and treatment planning.
- Educate employees
- Help staff understand these changes and ensure employees are aware of appropriate communication protocols with MCOS surrounding patient discharge.
Beginning June 9, 2022, SHB 1860 requires psychiatric hospitals licensed under RCW 71.12 to notify MCOs prior to discharging MCO-enrolled patients and to engage with MCOs in patient discharge planning.
With respect to discharge, psychiatric hospitals must make every effort to notify MCOs of an enrolled patient’s discharge:
- No later than 24 hours prior to a known discharge date or,
- For all other discharges, including if the person leaves against medical advice, no later than the date of discharge or departure from the facility.
WSHA recognizes that many discharges will not be known to hospitals 24 hours in advance. WSHA actively negotiated this bill to provide hospitals greater flexibility for patients whose discharge may not be known until the last minute, including patients who leave against medical advice. WSHA was also successful in negotiating the hospital obligation to “make every effort” to provide notice in the relevant timeframes. This language places an obligation on the hospital while also providing flexibility in cases in which the MCO could not be reached for notification despite appropriate hospital efforts.
SHB 1860 also establishes a new requirement for psychiatric hospitals to engage with MCOs in discharge planning, including “informing and connecting patients to care management resources at the appropriate managed care organization.” This requirement is also effective as of June 9, 2022.
SHB 1860 was proposed as a bill that, in part, required MCOs to coordinate housing services for homeless patients discharging from psychiatric hospitals. Over the course of the legislative session MCOs emphasized that lack of notice about patient discharge from hospitals made housing coordination and other MCO obligations challenging. SHB 1860 was subsequently amended to require psychiatric hospitals to give MCOs 72 hours notice prior to patient discharge, without exception.
WSHA engaged in substantial negotiations with MCOs and legislators, emphasizing the many circumstances in which patient discharge is not foreseeable and therefore advance notice would not be possible. The notice requirement in the bill was ultimately reduced to 24 hours for patients whose discharge is foreseeable, with an exception for “all other discharges” that are not foreseeable, which may be given on the day of discharge or by the time the patient departs the facility.
WSHA’s 2022 New Law Implementation Guide
Please visit WSHA’s new law implementation guide online. The Government Affairs team is hard at work preparing resources and information on the high priority bills that passed in 2022 to help members implement the new laws, as well as links to resources such as this bulletin. In addition, you will find the Government Affairs team’s schedule for release of upcoming resources on other laws and additional resources for implementation.