Inside Olympia: WSHA’s nurse staffing bill to get hearing this week

February 11, 2019

Thank you for joining us for advocacy day!

Thank you all who joined WSHA’s hospital advocacy day last week! We had a great turnout with about 75 hospital leaders joining us for about 80 legislative visits.

This week is a busy week in Olympia with many bills of interest up for hearings. This is also a first for many of us at WSHA – multiple hearings have been cancelled and rescheduled due to snow. The legislature is known for powering through regardless of weather conditions. Many lobbyists who have been around since the early 1990s, including WSHA’s, have never seen anything like it. What it may mean is more hearings being added and less time for those that are still needing a hearing. On Feb. 22, policy bills that fail to advance from their committee are considered “dead” unless they are necessary to implement the budget (contain key funding and budget impact).

SB 5344: WSHA’s nurse staffing bill

SB 5344, WSHA’s bill aimed at addressing nurse fatigue, will have a hearing Friday, Feb. 15 in the Senate Committee on Health & Long Term Care. SB 5344 would resolve complaints about missed meal and rest breaks through nurse staffing committees, address nurse fatigue by capping direct patient care to no more than 60 hours per week across all employers and require hospitals to work to find a replacement for fatigued nurses if they are called in immediately before or after a regularly scheduled 12-hour shift.

Resolving complaints through nurse staffing committees was the method agreed to by the unions and hospitals in 2017 to address variations in staffing plans. Adding a regular review of missed meal and rest breaks and the ability for nurses to bring complaints about missed breaks to the staffing committees would be a new focus for nurse staffing committees. When complaints are not resolvable at the local level, the Department of Health may investigate them. Limits to direct patient care hours are not unlike practices used in other industries concerned with worker fatigue, such as the aviation and trucking industries. These industries have federal standards to ensure workers can recharge. (Lauren McDonald)

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

WSHA strongly opposes HB 1155 and SB 5190, which are promoted by the nursing unions and 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.

HB 1155 will be heard Wednesday, Feb. 13 in the House Committee on Appropriations, and SB 5190 will be heard the same day in the Senate Committee on Ways & Means. Read more about these bills in the Jan. 21 edition on Inside Olympia. (Lauren McDonald)

HB 1607: Mergers and affiliations

WSHA opposes HB 1607, which would require health care entities to provide written information of any “material” transactions to the state attorney general before the transaction is complete. This bill would be a step toward curtailing the ability of Washington hospitals and health systems to merge or affiliate, which could harm patient access to important health care services. The bill singles out health care entities for pre-transaction notice, but excludes insurance carriers, which can have a substantial impact on the cost of health care. (Zosia Stanley)

HB 1810: WSHA-promoted rural payment reform bill

HB 1810 is a WSHA-promoted bill that provides guardrails for a new rural multi-payer model that is being considered by the Health Care Authority and CMS to ensure the long-term sustainability of the rural health system and maintain local community decision making. It will have a hearing in the House Committee on Appropriations on Wednesday, Feb. 13.

We believe transformation is crucial to ensure our hospitals can continue to deliver high-quality, local care. Rural hospitals vary in size, and each rural community is unique. The challenges they face are complex. Some rural hospitals are struggling financially. Any new payment system must work for all rural hospitals. Read WSHA’s policy brief. (Jacqueline Barton True)

SB 5734: Safety net assessment

WSHA supports SB 5734, which renews the Hospital Safety Net Assessment program, which is crucial to protecting our state’s most vulnerable hospitals by augmenting Medicaid payments. WSHA strongly supports extending the program, which is set to expire July 1, 2021. The program provides significant revenue to the state’s operating budget and requires no state funding to operate, as it is funded by hospital self-assessments and federal matching funds. Further, it supports family practice residencies and training for integrated behavioral health care. Read WSHA’s policy brief. (Andrew Busz)

HB 1608 & SB 5542: Protecting patient care

WSHA opposes HB 1608, which would prohibit hospitals and health care facilities from appropriately managing the types and quality of services they provide. This would negatively impact the quality, safety and cost of care. The bill will be heard Tuesday, Feb. 12 in the House Committee on Health Care & Wellness.

Hospitals are committed to providing patients with the right care at the right place and time. This includes both emergency, lifesaving treatment and accurate, comprehensive information. A facility may not be able to provide all aspects of care for every patient. In those cases, health care providers give patients information about locations that provide care and a referral, where possible and appropriate. Read WSHA’s policy brief. (Zosia Stanley)

From D.C.: Sen. Cantwell, Rep. Newhouse send letter to CMS, urge rural model to focus on patient wellbeing

WSHA strongly supports the efforts of Sen. Maria Cantwell and Rep. Dan Newhouse, who took the lead on drafting and sending a letter to the Centers for Medicare and Medicare Services Administrator Seema Verma after hearing from WSHA. Their letter urged that any new models for delivering health care services in rural areas “take into account Washington State’s unique health care delivery system, geography and the specific needs of our rural hospitals and the residents they serve.”

Specifically, they wrote that any model must focus on the health and wellbeing of patients; ensure access to care in all areas of the state; recognize rural workforce shortages and unique staffing approaches used by rural, low-volume hospitals; account for significant cost variance that occurs in small hospitals year-over-year; appropriately calibrate risk-sharing; and provide adequate Medicare technical assistance to support delivery system reform.

Sen. Murray and Reps. Schrier, McMorris Rodgers, Kilmer, Herrera Beutler, DelBene, Heck and Larson signed the letter as well. WSHA thanks these lawmakers for their support. (Jacqueline Barton True)

WSHA Legislative Testimony: Feb. 11-15

WSHA is testifying on the following bills this week:

Monday, Feb. 11 – hearings cancelled due to snow
Tuesday, Feb. 12

  • House Health Care & Wellness
    • HB 1608 (see protecting patient care article above, Zosia Stanley)
  • House Innovation, Technology & Economic Development
  • House Labor & Workplace Standards
    • HB 1931 concerning workplace violence in health settings (Lauren McDonald)

Wednesday, Feb. 13

Thursday, Feb. 14

  • Senate Behavioral Health Subcommittee to Health & Long Term Care
    • SB 5431 concerns community facilities needed to ensure a continuum of care for behavioral health patients (Shirley Prasad)
  • Senate Labor & Commerce
    • SB 5169 ensuring the neutrality of public employers and state contractors with regard to employees exercising their rights to collectively bargain (Jaclyn Greenberg)

Friday, Feb. 15

  • House Innovation, Technology & Economic Development
  • Senate Health & Long-term Care

Thank you for testifying!

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

  • Melanie Smith, PeaceHealth Southwest Medical Center
  • Kim Cummins, MultiCare Health System


Contact Us

Washington State Hospital Association
999 Third Avenue
Suite 1400
Seattle, WA 98104

Map / Directions

206.281.7211 phone
206.283.6122 fax

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