Inside Olympia: Public option for health care coverage, CN exemption for psychiatric beds & more

January 28, 2019

HB 1523: Public option for health care coverage

HB 1523 would offer Washingtonians the option to purchase lower-costing health insurance coverage on the Health Benefit Exchange (the individual market). WSHA supports expanding access to health care coverage, but we have concerns with this bill, as the payment rate to providers and hospitals for these plans would be the same as the payment rate for Medicare, which is less than the cost of care. This low payment rate would make it difficult for providers to sustain caring for patients on these plans.

Creating a public option plan is complicated and no other states offer a public health insurance option to residents. California is currently studying the impacts of a public health care coverage option. (Shirley Prasad)

HB 1394: CN exemption for psychiatric beds & Involuntary Treatment Act concerns

WSHA strongly supports HB 1394 to continue the Certificate of Need (CN) exemption for psychiatric beds. CN has been identified as a challenge to increasing inpatient psychiatric services, and WSHA supports more access to these services. The bill will be heard this week in the House Health Care and Wellness Committee. The bill also contains language to give statutory permission to hospitals to contract to care for patients on 90- and 180- day commitments. (Shirley Prasad)

The Senate Behavioral Health Subcommittee to Health & Long Term Care will also hold a hearing on changes to the Involuntary Treatment Act. WSHA strongly supports increased investments in the behavioral health continuum. WSHA opposes pieces of this bill to allow single bed certifications to be used for substance use disorder commitments under Ricky’s Law. Ricky’s Law requires significant investment in new secure withdrawal facilities, not a Band Aid approach that doesn’t solve the underlying problems tied to the underfunding of the system.

Further, WSHA has concerns with a confusing standard to allow hospitals to file initial detention paperwork (currently performed by the designated crisis responder), as well as expanding the detention period. The bill proposes to move the deadline for a court hearing from 72 hours to five days – potentially further aggravating bed capacity shortages, and impacting patients needing services. The Involuntary Treatment Act allows people to be detained and committed involuntarily if they are a danger to themselves or others as a result of a mental illness or substance use disorder. (Jaclyn Greenberg)

HB 1450/SB 5478: Noncompete agreements

HB 1450 and SB 5478 place significant restrictions on hospitals’ ability to use noncompete agreements to protect their investments in their staff, which may result in fewer resources and less access to care for patients. WSHA is opposed to the bill’s current form.

The bill would prohibit the use of noncompete agreements for any employee making less than $185,000 and any independent contractors making less than $250,000. It would prohibit their use outright for local governments, including public hospital districts, creating a significant inequity. It would also prohibit anti-moonlighting policies, implicating staff scheduling issues.

Hospitals, health systems and physician groups in Washington State invest substantial funds into bringing health care professionals to the community. Investments include student debt relief, income guarantees, assistance with moving expenses, and costs related to licensure and certifications. These costs often reach hundreds of thousands of dollars, and it can help bring much needed health care services to a community.

Hospitals, health systems and physician groups — both urban and rural — may use noncompete clauses in their contracts with these professionals to protect their investments in this highly competitive, workforce-challenged environment. (Jaclyn Greenberg)

HB 1515/SB 5513: Independent contractors

HB 1515/SB 5513 would change the legal definition of “independent contractor” in a way that would effectively preclude the use of this type of work relationship in Washington State. WSHA opposes this bill and has significant concerns for how this impacts hospital workforces. The definition would impose a six-part test, and anyone who does not meet that definition would be an employee and subject to receiving benefits and access to state programs affiliated with an employee-employer relationship. Employers who willfully mischaracterize an employee as an independent contract would be subject to significant regulatory penalties and private rights of actions, and people connected to the employer could be joint and severally liable. (Jaclyn Greenberg)

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 lorim@wsha.org to let us know if you can attend.

WSHA Legislative Testimony: January 28 – February 1

WSHA is testifying on the following bills this week:

Monday, January 28

  • Senate Labor & Commerce

Tuesday, January 29

  • House Health Care & Wellness
    • HB 1331 concerns opioid use disorder treatment, prevention and related services, (Lauren McDonald)
    • HB 1394 (see CN exemption for psychiatric beds article above, Shirley Prasad)
  • House Labor & Workplace Standards
  • Senate Labor & Commerce

Wednesday, January 30

  • House Health Care & Wellness

Friday, February 1

  • Senate Health & Long Term Care
    • SB 5256 concerns the use of the term “birth center.” (Lauren McDonald)
  • Senate Behavioral Health Subcommittee to Health & Long Term Care 
    • Draft bill amending the Involuntary Treatment Act (see ITA article above, Jaclyn Greenberg)

Thank you for testifying!

Thank you to everyone who testified this past week in support of WSHA’s legislative efforts:

  • Patrick Ahearne, St. Clare’s in Lakewood
  • Jennifer Burkhardt, Olympic Medical Center
  • Jen Duran, St. Joseph Hospital
  • Jeannie Eylar, Pullman Regional Hospital
  • Jesse Holcomb, Pullman Regional Hospital
  • Tim Holmes, MultiCare Health System
  • Liga Mezaraups, Providence Regional Medical Center Everett
  • Jim Wade, Legacy Salmon Creek

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