Inside Olympia: Compromise E2SSB 5236 passes Senate, two key bills WSHA opposed fail to advance

March 16, 2023

After an intense week of negotiations, WSHA and union representatives reached an agreement on compromise language to amend E2SSB 5236. The new language, which removes mandated nurse-to-patient ratios and replaces it with new requirements for hospital staffing committees, passed out of the Senate ahead of the cut-off.

The amendment requires hospitals to meet patient assignments in the hospital’s staffing plan for registered nurses, licensed practical nurses and certified nursing assistants at least 80 percent of the time per month or develop and follow a corrective action plan. Hospitals would face financial penalties for failure to follow such a corrective action plan. Rural hospitals are exempted from the new 80 percent structure.

Two bills strongly opposed by WSHA that passed out of Ways and Means last week failed to pass out of the Senate this week. The bill has a hearing in the House on March 15.

Both SB 5241 (a bill that would significantly restrict health care transactions and mergers) and SB 5393 (a bill that would give insurers more negotiating power over hospitals and health care systems) did not advance out of the Senate by the Wednesday deadline for bills to pass out of their chamber of origin. We were very concerned the merger bill would have made it incredibly challenging for struggling hospitals to continue to deliver care in their communities. It would have also restricted partnerships to bring new services online, such as cancer treatments. While there is still a lot of work to do to advance our legislative priorities, it is worth taking a moment to recognize these successes.

We are pleased to report that many bills WSHA supports continue to advance. The next step is for bills to be considered in the policy committee of the second chamber. House bills still alive go to the Senate for consideration and vice versa.

2SSB 5120: Establishing 23-hour crisis relief centers in Washington State

WSHA strongly supports 2SSB 5120, which create the statutory structure for licensing or certification that organizations could use to establish 23-hour crisis facilities, and it creates a payment model for this type of crisis center. WSHA’s input played a key role in crafting this bill. 2SSB 5120 unanimously passed the Senate and will have public hearing before the House Committee on Health Care & Wellness at 1:30 p.m. Wednesday, March 15. WSHA will testify once again in support. (Cara Helmer)

ESHB 1508: Improving consumer affordability through the health care cost transparency board

WSHA supports efforts to better understand health care costs and curb cost growth but remains strongly opposed to ESHB 1508. The bill significantly expands the Health Care Cost Transparency Board’s powers, including the ability to impose performance improvement plans for exceeding the health care cost growth benchmark, require data reporting and levy fines.
The bill has strong political momentum, so while WSHA remains opposed, we have worked with the Washington State Medical Association to mitigate its impact by advancing the following amendments:

  1. Requiring the Board to create rules on the process by which the health care cost growth benchmark is established.
  2. Extending timelines for performance improvements plans.
  3. Specifying data sources the Board may use for data collection and prohibiting the Board from requiring payers or providers from reporting data if the data is available from existing sources.
  4. Requiring the Board to solicit and consider recommendations from the data and health care stakeholder advisory committees.
  5. Requiring the consideration of additional cost drivers.
  6. Imposing notice requirements and other process improvements.

Despite some improvements, the bill continues to grant unreasonably expanded authority. The Board has only just begun its work and has not demonstrated the evidence or the need for the powers the bill provides.

ESHB 1508 has a hearing in the Senate Health & Long Term Care Committee at 8 a.m. Friday, March 17. WSHA will testify in opposition and will offer amendments to limit the existing penalty language, improve the performance improvement plan process and board administrative processes, and limit data collection requirements to what is necessary for the Board to perform its duties and to ensure payers and providers are not unreasonably burdened. (Katerina LaMarche)

High-priority bills still alive after cutoff

Bills WSHA supports

2SHB 1028 Supporting crime victims and witnesses by promoting victim-centered, trauma-informed responses in the legal system.
ESHB 1073 Amends the medical assistant credentialing statute for hemodialysis technicians and phlebotomists to improve retention of trained health care workers.
HB 1564 Prohibiting the sale of over-the-counter sexual assault kits.
2SHB 1580 Creating a system to support children in crisis.
E2SHB 1694 Addressing home care workforce shortages.
HB 1812 Continuing the business and occupation tax deduction for federal funds received from a Medicaid transformation or demonstration project or Medicaid quality improvement program or standard.
SSB 5103 Concerning payment to acute care hospitals for difficult to discharge Medicaid patients.
2SSB 5120 Establishing 23-hour crisis relief centers in Washington state.
SSB 5499 Concerning the multistate nurse licensure compact.
SSB 5547 Concerning nursing pool transparency. Requires traveler agencies to register and report information by county to the Department of Health.
SSB 5569 Creating temporary exemptions from certificate of need requirements for kidney disease centers.

Bills WSHA opposes

HB 1508 Improving consumer affordability through the health care cost transparency board.

Bills with which WSHA has concerns and is trying to amend

SHB 1320 Concerning access to personnel records.

Bills on which WSHA in neutral and successfully amended

SHB 1155 Addressing the collection, sharing, and selling of consumer health data.
SHB 1255 Reducing stigma and incentivizing health care professionals to participate in a substance use disorder monitoring and treatment program.
HB 1547 Increasing the health care workforce by authorizing out-of-state providers to practice immediately.
SHB 1589 Supporting Washington’s clean energy economy and transitioning to a clean, affordable, and reliable energy future.
ESSB 5179 Increasing access to the provisions of the Washington death with dignity act.
SSB 5236 Concerning hospital staffing standards.
SSB 5440 Providing timely competency evaluations and restoration services to persons suffering from behavioral health disorders.
SSB 5454 Concerning industrial insurance coverage for posttraumatic stress disorders affecting registered nurses.

High-priority bills that did not move before cutoff

Bills WSHA opposed that failed to advance

SB 5059 Concerning prejudgment interest
SB 5241 Concerning material changes to the operations and governance structure of participants in the health care marketplace.
SB 5393 Addressing affordability through health care provider contracting.

Bills WSHA supported that failed to advance

SSB 5057 Creating a work group to evaluate the costs of the state energy performance standard for covered commercial buildings. As amended this bill contains a one-year delay to the “clean buildings” law for tier 1 buildings (those > 50,000 sq ft.) The Department of Commerce now has an emergency rule for a new process on applying for a financial hardship exemption. WSHA will provide more information shortly.
SSB 5503 Establishing requirements for uniform clinical placement hours for nursing education programs.
SB 5498 Creating the nurse student loan repayment assistance program.
SB 5537 Creating the hospital patient care unit staffing innovation collaborative.

WSHA Weighs In: March 13-17

Monday, March 13

  • Senate Labor & Commerce
    • 2SHB 1009: Concerning military spouse employment. (Ashlen Strong)

Tuesday, March 14

  • Senate Health & Long Term Care
    • 2SHB 1452: Establishing a state medical reserve corps. (Ashlen Strong)
    • ESHB 1503: Collecting health care professionals’ information at the time of license application and license renewal. (Katerina LaMarche)
  • Senate Human Services
    • 2SHB 1580: Creating a system to support children in crisis. (Cara Helmer)
  • Senate Labor & Commerce
    • SHB 1068: Concerning injured workers’ rights during compelled medical examinations. (Remy Kerr)
  • House Labor & Workplace Standards
    • ESSB 5217: Concerning the state’s ability to regulate certain industries and risk classifications to prevent musculoskeletal injuries and disorders. (Remy Kerr)
  • Senate Law & Justice
    • SHB 1155: Addressing the collection, sharing, and selling of consumer health data. (Cara Helmer)
  • House Health Care & Wellness
    • SB 5066: Concerning health care benefit managers. (Andrew Busz)
    • SSB 5569: Creating exemptions from certificate of need requirements for kidney disease centers. (Remy Kerr)
  • House Human Services, Youth, & Early Learning
    • ESSB 5124: Supporting guardianships and voluntary placement with nonrelative kin. (Zosia Stanley)

Wednesday, March 15

  • House Labor & Workplace Standards
    • E2SSB 5236 – Public Hearing – Concerning hospital staffing standards. (Ashlen Strong)
  • House Local Government
    • SSB 5604: Concerning county sales and use taxes for mental health and housing. (Zosia Stanley)
  • Senate Early Learning & K-12 Education
  • House Health Care & Wellness
    • 2SSB 5120: Establishing crisis relief centers in Washington state. (Cara Helmer)

Thursday, March 16

  • Senate Labor & Commerce
    • E2SHB 1320: Concerning access to personnel records. (Remy Kerr)
  • Senate Law & Justice
    • 2SHB 1028: Supporting crime victims and witnesses by promoting victim-centered, trauma-informed responses in the legal system. (Jacqueline Barton True)
  • House Regulated Substances & Gaming
    • ESSB 5365: Preventing use of vapor and tobacco products by minors. (Remy Kerr)
  • Senate Health & Long Term Care
    • E2SHB 1357: Modernizing the prior authorization process. (Andrew Busz)
  • House Appropriations
    • SSB 5538: Concerning postretirement employment in nursing positions for a state agency. (Remy Kerr)

WSHA Weighs In: March 6-11

Monday, March 6

  • House Health Care & Wellness
    • ESSB 5179: Increasing access to the provisions of the Washington death with dignity act. (Zosia Stanley)

Wednesday, March 8

  • Senate Law & Justice

Thursday, March 9

  • House Regulated Substances & Gaming
    • ESSB 5365: Preventing use of vapor and tobacco products by minors. (Remy Kerr)
  • Senate Health & Long Term Care
    • ESHB 1073: Concerning medical assistants (Katerina LaMarche)
    • ESHB 1340: Concerning actions by health professions disciplining authorities against license applicants and license holders. (Katerina LaMarche)
  • House Appropriations
    • SB 5122: Extending the expiration date of the ambulance transport fund. (Andrew Busz)

Friday, March 10

  • Senate Health & Long Term Care
  • House Health Care & Wellness
    • SSB 5189: Establishing behavioral health support specialists. (Cara Helmer)


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