Inside Olympia: Nurse staffing to get hearings this week

January 21, 2019

The legislature is off and running in its second week. Several bills of interest for hospitals and health systems have hearings in their respective committees.

SB 5190/HB 1155: Uninterrupted nurse meal and rest breaks

SB 5190 and HB 1155, promoted by the nursing unions, would require hospitals to provide completely uninterrupted meal and rest breaks for nurses and certain technicians and technologists, regardless of patient need. It would also place rigid constraints on a hospital’s ability to use prescheduled on-call and overtime for nurses and certain types of technologists and technicians, which currently support hospital staffing needs and provide high-quality care to patients.

WSHA continues to strongly opposes this proposal for many reasons:

  • It can stifle the flow of critical patient information, because interrupting a break, even to communicate patient information, would not be allowed under the law.
  • This proposal could limit patient access to care, as hospitals rely on the flexibility of prescheduled on-call to staff their hospitals. This would be felt even more in rural facilities.
  • It removes a nurse’s ability to use clinical judgement on when to take a break (based on their patients’ needs).
  • Restrictions on the use of overtime could delay care that is important though does not meet the definition of an emergency. For example, cancer-related surgeries and procedures – mastectomies or chemotherapy port placements – are critically important to patients but would not qualify as emergencies.

Hospitals must always be ready to provide the care their patients need, and this proposal would make it difficult to do so. Read our issue brief. (Lauren McDonald)

HB 1135/SB 5163: Concerning actions for wrongful injury or death

These bills would expand existing law on who may sue when a loved one dies because of the act of another (“wrongful death”), and what types of damages they may recover. These bills are largely the same as a 2018 bill that came in the wake of a tragic Ride-the-Ducks vehicle crash in 2015. That accident identified the unfairness of the existing law’s requirement that one must be a US resident to sue. The bill greatly expands the law, though it goes well beyond the residency requirement.

Changes to the wrongful death statute should be limited to the removal of the residency requirement. WSHA is very concerned about, and opposes, broadly expanding the basis for recovery and the categories of damages that may be recovered beyond the residency requirements.

State law currently maintains a strong and stable structure for health-care-related liability. Certain family members and those who are financially dependent may be compensated for their loss, but the law also recognizes that hospitals cannot face unending liability. Under Washington law, hospitals face the potential exposure for the entire cost of a wrongful death award, even if they are only found to be 1 percent at fault.

Expanding the law on wrongful death damages dramatically expands liability for hospitals. This may spike premiums for liability insurance, and in turn, could make it more difficult for hospitals to provide patients access to services, particularly in more rural areas.

Read our issue brief. (Jaclyn Greenberg)

HB 1016/HB 1166: Sexual assault forensic evidence collection

Most hospitals in Washington State provide sexual assault forensic evidence examinations and collection via trained medical providers, including Sexual Assault Nurse Examiners.

HB 1016 would require any hospital that does not provide sexual assault evidence kit collection (or does not always have appropriate providers available to provide the service) to develop a plan with a local sexual assault agency to assist survivors with obtaining an evidence collection kit. The bill would require hospitals to notify patients within two hours if it is unable to perform an evidence collection kit examination. A hospital would be subject to a $2,000 fine if it does not comply.

WSHA is supportive of the bill. However, we remain concerned about the bill’s penalty and feel it is unnecessary since hospitals already have existing rules and laws tied to their licensure for noncompliance. Penalties are not the right approach to maintain robust access to this important service. We also believe the bill should make clear that costs associated with a sexual assault evidence exam, including any transportation, should continue to be covered by the state Crime Victims Compensation Fund.

HB 1166 is an omnibus bill that addresses issues related to sexual assault. Among other things, the bill places a one-year moratorium on the destruction of unreported sexual assault kits (kits collected from a survivor who has not made a police report) and requires the legislative Sexual Assault Forensic Evidence Best Practices Taskforce to develop policies and recommendations on the storage, retention and destruction of unreported sexual assault kits. The bill also creates specific rights for sexual assault survivors. WSHA supports the bill. Read our issue brief. (Zosia Stanley)

HB 1175: Health care decision making for patients who lack capacity

Hospitals want to help patients make sure their health care decisions are honored. Currently, state law only allows a few types of family members to act as a surrogate to make medical decisions for an incapacitated loved one. WSHA strongly supports HB 1175, which seeks to improve decision making for incapacitated patients. The bill does so by expanding who can be a surrogate decision maker and making it easier to use advance directives, which are legal documents stating a patient’s wishes for their care near the end of life. The bill would allow notaries to acknowledge an advance directive and allow a witness to verify the identity of a person executing an advance directive. Read our issue brief. (Zosia Stanley)

Hospital Advocacy Day in Olympia Thursday, Feb. 7

WSHA will host Hospital Advocacy Day in Olympia on Thursday, Feb. 7. We will spend the day advocating for our priority initiatives, talking with legislators and telling the hospital story. Please plan to join us, tell your story and help us advocate for health care improvements in Washington State.

Please RSVP to Advocacy Program Manager Lori Martinez at to let us know if you can attend.

WSHA Legislative Testimony: January 21-25

WSHA is testifying on the following bills this week:

Monday, January 21

  • House Labor & Workplace Standards
  • Senate Labor & Commerce

Tuesday, January 22

  • House Health Care & Wellness
  • House Public Safety

Wednesday, January 23

  • House Civil Rights & Judiciary
  • House Health Care & Wellness
    • HB 1065 concerns protecting consumers from charges for out-of-network health care services. (Andrew Busz)
    • HB 1215 prohibits the use of balance billing by health care providers (Andrew Busz)
  • Senate Health & Long Term Care
    • SB 5047 concerns diverting veterans from involuntary commitment by increasing coordination between the veteran’s administration and the department of social and health services. (Jacyln Greenberg)

Thursday, January 24

  • Senate Labor & Commerce
    • SB 5373 requires uninterrupted breaks for nurses and certain technologist/technicians and includes increased penalties and compensation for missed breaks. (Lauren McDonald)
    • SB 5374 requires employers to provide uninterrupted breaks covered under the Labor & Industries rules. (Lauren McDonald)

Friday, January 25

  • House Civil Rights & Judiciary
    • HB 1175 (see article above on decision making for patients who lack capacity, Zosia Stanley)


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