Inside Olympia: Surprise amendment to nurse staffing restricts patient care

April 22, 2019

Wednesday, April 17 was the cutoff for all bills to pass through the floor of the opposite chamber, meaning bills that have not advanced have died (unless they are deemed necessary to implement the budget or have been amended onto another bill that is still moving through the process). Those that passed both chambers will either be sent to the governor or will go through a process to settle the differences on the bills between the two chambers. The last day of regular session is Sunday, April 28.

In terms of the budget, it remains unclear if the House and Senate will be able to agree to a budget by the end of regular session. We will see what this upcoming week brings. Stay tuned!

SHB 1155: Surprise amendment limits nurse shifts to 8 hours

SHB 1155 passed the Senate with an amendment from Sen. Maureen Walsh that would limit all nursing shifts to eight hours in a 24-hour period. It would be a strict prohibition on longer shifts, with no exceptions. This amendment came as an unwelcome surprise when it was introduced and adopted on April 16. WSHA had no knowledge of the amendment. We strongly oppose the amendment and have been urging nurses and hospital leaders to contact their legislators on this issue.

The amendment would have wide-sweeping implications for the ability of all hospitals to deliver timely patient care – including emergency services. Nurses could be required to stop work in the middle of a procedure or during a sudden influx in patients.

Not only would this jeopardize patient care, but it would alter the schedule for nurses in the state. Nurses often request to work three 12-hour shifts in a week, and the eight-hour limit would require nurses to work five days a week for full pay. This would also cap their salaries.

The amendment presents especially large challenges in communities that border other states, whose nurses could easily be recruited to hospitals outside of Washington State where they could continue to work 12-hour shifts. WSHA is urging the House not to concur with the amended version of the bill and to send it back to the Senate for further consideration and action. (Lauren McDonald)

SSB 5163: Wrongful death passes

SSB 5163 has passed both chambers and now awaits the governor’s signature to become law. The bill broadly expands who may sue when a loved one dies because of the act of another (“wrongful death”) and what types of damages they may recover. We are disappointed that the bill did not take a balanced approach to this issue, and we are very concerned about the unintended consequences this new law will have. While we agree that those at fault should be held accountable in the event of a wrongful death, the law does not hold defendants liable in a fair manner.

For example, if a hospital was found only partially at fault in a wrongful death lawsuit, it could be forced to pay the entire award. In a most extreme case, a hospital found only 1 percent at fault could end up paying 100 percent of damages. Those found to be at fault for a wrongful death should be held liable, but this law places hospitals in an unfair position, which we’re worried could impact access to health care in communities across our state. (Jaclyn Greenberg)

ESSB 5526: Public option bill heads to conference committee

ESSB 5526 passed through the House floor along party lines. WSHA continues to have significant concerns about this version of the bill because it includes a rate cap based on Medicare. While we support efforts to make health insurance coverage more affordable, this version of the bill would establish a public option plan, offered by interested carriers, with a rate cap for all covered benefits, excluding pharmacy. The rate cap would be set at 150% of the amount Medicare would pay. As with other versions of this bill, provider and carrier participation is not mandatory. Nonetheless, WSHA is concerned about setting a precedent that costs may only be reduced by lowering provider reimbursement rates rather than other factors that drive health care costs.

Additional requirements in the House’s version of bill include establishing reimbursement rates for critical access hospitals at no less than 101% of allowable costs; and for primary care services no less than 135% of the amount Medicare would pay. Also, the Health Care Authority (HCA) must recommend to the legislature by 2022. Whether to link carrier or provider participation in a public option plan to participation in Public Employer Benefit Board, School Employee Benefit Board or Medicaid.

The House’s version of ESSB 5526 is significantly different from the Senate’s version of the bill, which WSHA supported. The Senate refused to concur with the House’s version and asked for a conference committee to settle the differences. Members of this committee have until April 28 — the last day of regular session — to reconcile their differences on this bill or the bill does not move forward this session. (Shirley Prasad)

High-priority bills that passed both chambers

Bills WSHA Supports

HB 1016 Concerning timely access to sexual assault nurse examiners. This bill is in dispute between the two chambers.
2SHB 1166 Supporting sexual assault survivors.
EHB 1175 Concerning health care decision making for patients who lack capacity.
2SHB 1394 Concerning community facilities needed to ensure a continuum of care for behavioral health patients (includes extending the CN exemption for psychiatric beds).
E2SHB 1593 Establishing a behavioral health innovation and integration campus within the University of Washington School of Medicine.
2SHB 1907 Concerning the substance use disorder treatment system.
HB 1931 Concerning prevention of workplace violence in health care settings.
SSB 5380 Concerning opioid use disorder treatment, prevention and related services. This bill is in dispute between the two chambers and a conference committee has been requested.
2SSB 5672 Contracting for adult family home specialty services.

Bills WSHA opposes

SSB 5163 Concerning wrongful death (see article above).
ESSB 5526 Public Option – Increasing the availability of quality, affordable coverage in the insurance market by capping provider rates to Medicare levels. This bill is in dispute between the two chambers and a conference committee has been requested.

Bills on which WSHA is neutral

HB 1049 Concerning health care provider and health care facility whistleblower protections.
HB 1065 Balance billing – creating an arbitration process for out-of-network claims disputes.
SHB 1071 Data breach notification.
ESHB 1450 Noncompete agreements.
SHB 1531 Placing limits on medical debt.
SHB 1602 Placing limits on consumer debt.
SHB 1607 Requiring notice for certain health care transactions.
E2SHB 1874 Regarding parent and family-initiated treatment.
ESSB 5258 Protecting isolated workers. This bill is in dispute between the two chambers.
2SSB 5602 Regarding reproductive health care. This bill is in dispute between the two chambers.

Notable bills that have died

SHB 1406 Encouraging investments in affordable and supportive housing.
HB 1608 & SB 5542 Restricting hospital ability to appropriately manage quality and safety of patient care.
SHB 1686 Posting of hospital certain policies.
HB 1810 Concerning rural hospital payment changes.
HB 1854 Consumer data privacy.
HB 1965 Qui Tam for workplace protection violations.
SB 5295 Concerning labor neutrality and contractor compliance for certain contracted service providers.
2SSB 5376 Consumer data privacy.
SB 5385 Establishing telemedicine payment parity.
E2SSB 5483 Improved services for individuals with developmental disabilities.
E2SSB 5720 Concerning the involuntary treatment act.
2SSB 5822 Providing a pathway to establish a universal health care system for the residents of Washington state.


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