Bill Focus: SB 5593 Suspect and Inmate Guarding

March 9, 2015

Overview of the Week

The caucus and floor action continues as we approach this week’s cutoff for bills to be voted on and passed by their house of origin. Since most of the work is being done on the floor, no WSHA members testified at hearings last week, and we are not scheduled to testify at any hearings this week (March 9-13).

Hearings or not, bills continue to move. Below, we report out on the bills that have already received a floor vote. We are glad to see that many of the bills that are important to us are continuing to move forward, and that many of the bills we oppose have died.

Next week, once all the living bills have passed into the opposite house, the hearing schedule will begin again in earnest. As bills get scheduled for hearings, we will be in touch with you about testifying. Your stories are powerful, and they are essential in ensuring that our state’s health care laws preserve the public’s access to high quality care.


Bill Focus: SB 5593 Suspect and Inmate Guarding

The question of guarding inmates and suspects as well as payment for their care has been a contentious ones in years past, both at the local level and at the state legislative level.

Last year, we raised the issue of adequate guarding in response to incidences of a violent suspect or inmate injuring other hospital patients and hospital staff. In some cases, violent suspects were brought to the hospital without adequate security or notification about risk.

Some law enforcement agencies routinely guard patients who are suspected or convicted of a violent or sexual crime, but there is no statewide standard.

At the same time, hospitals and local agencies faced challenges around the billing and payment for suspects and inmates. What local contracts existed were individually negotiated and varied.

Last year, we advocated for legislation that would have required that all jails, prisons and law enforcement agencies provide security when a hospital patient had been convicted or detained due to a suspicion of a violent or sexual crime. At the same time, law enforcement agencies proposed legislation mandating that Medicaid be the payment level for hospital services for people in their custody. Each association opposed the others’ bill and neither bill passed, but the stand-off did open up conversations between the associations.

Through the interim, we worked with the association representing local law enforcement to address both the security and payment issues in order to create reliable standards in both areas. Both sides are very pleased with the results of the negotiations. Law enforcement agencies will provide security for potentially dangerous patients, with important and reasonable exceptions and protections. In cases where the hospital and jurisdiction do not have separately negotiated rates, hospitals will accept Labor and Industries-level rates. This will provide transparency and predictability for law enforcement.

In introducing the bill to the Senate Law and Justice Committee, Sen. Bruce Dammeier (R-25) said, “This process … represents what the legislative process can be about…. (I looked into the issue of violence in emergency rooms and) that led to the dropping of a bill in a previous session to start the dialogue. We got some very good constructive dialogue going among our law enforcement, our municipalities and our hospitals and what you have in front of you is the result of that coordination.” (See the hearing here—bill discussion starts at 1:45.)

What’s more, both groups have been working together to increase the number of suspects and inmates enrolled in Medicaid. This will help ensure that people can get access to health services outside of jail, as well as inside. All involved in this work hope that ensuring access to more regular health care will increase health status and decrease criminal recidivism.

Read our 2015 Issue Brief here.

SB 5593 passed the Senate unanimously, and we are hopeful the bill will bill progress through the House. We appreciate the commitment to a mutual solution by our partner organizations in this work, specifically the Washington Association of Sheriffs and Police Chiefs and Association of Washington Cities. (Andrew Busz, 206/-216-2533)

Bills Voted Out by Full House of Origin, Still Alive


Bill Number Description and Floor Vote WSHA
HB 1078 Strengthens data breach notification requirements when consumer data is hacked. Passed 97-0 Amended to Neutral
HB 1503

HB 1732

Requires third parties collecting on behalf of lien-holders to be licensed debt collectors in order to collect on a lien. This bill was amended so that hospitals and providers do not need to be licensed debt collectors. Also requires lien-holders to disclose use of liens in billing and collection practices. Upon settlement and patient request, lien-holders must provide release of lien rights to patient.   Passed 97-1

Mandates rest breaks and overtime rules; eliminates flexibility for nurses; could result in postponed procedures and threats to patient safety.
Passed 52-46

Amended to neutral

Strongly oppose

SB 5175 Requires commercial and Medicaid health plans to reimburse providers for health care services delivered through telemedicine audio and video technology. Passed 46-0


Strong Support
SB 5460 Allows practitioners to prescribe and distribute prepackaged emergency medications to emergency room patients when a pharmacy is not available. Passed 48-0


Strong Support
SB 5557 Directs health plans to cover services performed by a licensed pharmacist if: 1) the service is within their scope of practice and 2) the benefit would have been covered had it been performed by another practitioner. Passed 48-0


Strong Support
SB 5593 Clarifies guarding responsibility and payment for health care services for hospitals for inmates and persons detained by law enforcement. Passed 49-0


Strong Support
SB 5600 Seeks to identify the “improper” use of restraints as abuse.Some of the definitions in the original bill were not appropriate for a medical setting, where restraints are sometimes needed for patient safety, and are used under strict guidelines and closer supervision. WSHA sought amendments and they were made. Passed 48-0


Amended to be Neutral
SB 5645 Require the state to keep records of patients in need of psychiatric detention. Passed 48-0




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Washington State Hospital Association
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