Superior Court hears WSHA’s legal challenge to DOH charity care reinterpretation

January 4, 2024

On Friday, Jan. 5, the Thurston County Superior Court will hear argument on WSHA’s legal challenge to the Department of Health’s (DOH’s) reinterpretation of the state’s charity care law to disallow all geographic limits. Like its members, WSHA has serious concerns about the potential adverse effects of this reinterpreted policy on hospital capacity, the cost of care and access to care for Washingtonians. We believe the new policy is contrary to the intent and structure of the charity care statute as promoting access to affordable care for Washingtonians.

We were disappointed in DOH’s briefing on the issue, including its arguments that WSHA does not have standing to represent its members and that hospitals must be cited for violating the law before they can bring the issue to the court for a ruling on the correct interpretation of the law (arguments that only delay a decision on the merits). DOH’s brief was filled with citations to outdated statutes; suggestions that the Department’s letters to hospitals threatening enforcement of policy changes were mere “technical assistance” and that those hospitals that have changed their policies have done so voluntarily; unrealistic assessments about how a regulator interacts with those it regulates; suggestions that hospital leaders are not competent to opine on their health care operations; and unsubstantiated theories about how easy it is to create more health care capacity in Washington State.

We were particularly troubled by the DOH’s suggestion that it only recently became aware of geographic restrictions when the Department had approved such policies for decades. We spent a great deal of time over the holidays refuting these ideas in our response brief.

To counter arguments included in DOH’s briefing, hospital leaders from UW Medicine and Seattle Children’s dug through archives over a holiday week to surface old charity care policies with the intent of refreshing DOH’s memory on just far back the policies with geographic restrictions go. Island Hospital submitted additional information to clarify that DOH’s actions have been demands, not technical assistance on voluntary policy revisions. Thank you to these member leaders for representing the whole of our membership.

We will keep members updated about the court action.


Taya Briley, RN, MN, JD

Executive Vice President and General Counsel



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