Today, the Senate released its proposed 2019-21 operating budget, following the release of its capital budget earlier in the week. The Senate’s budget contains similar themes as the House budget, increasing funding for behavioral health and making investments to move patients from Western and Eastern State hospitals into the community.
The big picture highlights of the Senate budget include:
- No direct cuts to hospitals or health systems, nor provider-based clinics.
- Significant investments in behavioral health, including operating and capital funding to support increasing capacity for long-term civil commitment services.
- Some funding for partial hospitalization and intensive outpatient programs. WSHA is pleased, but needs to better understand why it is not fully funded.
- Investment of $75 million in the capital budget for behavioral health capacity. Of this amount, $21.4 million is earmarked for three community hospitals to help increase their capacity to serve long-term civil commitment patents. There is also $21.3 million for competitive grants for facilities seeking to increase behavioral health capacity.
- A large risk for Medicaid in assumed savings from “program integrity” changes for the managed care plans, hospitals and providers that will come in the form of fraud and abuse audit recoveries. WSHA is concerned that Medicaid, which already pays hospitals and providers well below the cost of care, would have to put forward cuts in programs if the assumed amount of fraudulent activity is not found. The savings assumed are more than $101 million in state funds and $351 million in total funds.
The Senate’s proposed budget raises $500 million in the 2019-21 biennium, which is $500 million less in new revenue than the House budget and $1.7 billion less over the next four years. The Senate proposes to raise this new revenue from a graduated real estate excise tax and closing some tax loopholes. It is unclear what the Senate plans to do on the capital gains tax, which was contained in the House revenue assumptions.
SHB 1155 — Contact your legislators about nurse staffing legislation
SHB 1155, mandating uninterrupted meal and rest breaks and restricting overtime and on-call, had a public hearing this week in the Senate Committee on Ways & Means, and it will next be up for an executive session in Ways & Means Wednesday, April 3. WSHA is very concerned about the impacts this bill would have on patient care.
Please tell your legislators to oppose this legislation, as it would have unintended consequences for patient care. We have developed letters that are ready to be sent — whether you are a nurse manager, staff nurse, executive leader or a physician — making it easier than ever to make your voice heard. (Lauren McDonald)
Final agreement reached on balance billing amendments — 2SHB 1065
WSHA, the Washington State Medical Association (WSMA) and insurance carriers have reached a final agreement on amendments to 2SHB 1065, which is the Office of the Insurance Commissioner’s bill to protect patients from unexpected out-of-network charges in certain situations. The bill, with the agreed-upon changes, passed out of committee this morning, March 29. We believe the bill will ultimately be passed by the legislature.
The bill has undergone significant improvement through our efforts, and our Out of Network Task Force provided us with valuable member input during this process. Overall, the bill restricts balance billing for out-of-network emergency services and certain out-of-network services provided at an in-network facility and establishes a dispute resolution process between carriers and providers for out-of-network services on disputed claims.
Up for hearings next week
SSB 5163 — Wrongful death
WSHA opposes SSB 5163, which would broadly expand who may sue when a loved one dies because of the act of another (“wrongful death”) and what types of damages they may recover. The bill will be heard in the House Committee on Appropriations Monday, April 1, and it is scheduled for an executive session Wednesday, April 3.
SHB 1406: Encouraging investments in affordable and supportive housing
WSHA supports SHB 1406, which would authorize counties and cities to choose to implement a local sales tax to fund affordable or supportive housing. The proceeds may be used to increase the amount of affordable housing or rental assistance for small cities and counties. The bill passed the House and the Senate policy committee. The bill will be heard Wednesday, April 3 in the Senate Committee on Ways & Means. (Shirley Prasad)
WSHA Legislative Testimony: April 1-5
WSHA is testifying on the following bills this week:
Monday, April 1
- House Appropriations
- SSB 5163 (see wrongful death article above, Jaclyn Greenberg)
Wednesday, April 3
- Senate Ways & Means
- SHB 1406 (see affordable and supportive housing article above, Shirley Prasad)