State regulations have a big impact on hospitals, health systems and their patients. WSHA tracks rulemaking activity throughout the state and works closely with regulatory agencies, as well as other groups, to advocate for a reasonable regulatory environment. All statewide rulemaking activity is published in the Washington State Register.
(Updated: April 29, 2021)
There are several regulatory issues at the top of WSHA’s priority list for May, including:
Telemedicine Practice– The Washington Medical Commission (WMC) is developing rules concerning the practice of telemedicine. WSHA is currently gathering feedback from member hospitals on the proposed rules and will hold a Telemedicine Workgroup Meeting on May 11, 2021 in preparation for WMC’s next rules workshop. Registration for WSHA’s meeting and additional information is available here. (David Streeter)
PMP-EHR Integration Waiver– The Department of Health (DOH) issued its proposal for the prescription monitoring program-electronic health record integration hardship waiver required by SB 5380 (2019). WSHA submitted a comment letter during the stakeholder period, and we are pleased to see that some of our recommendations are reflected in the proposal. We will continue to recommend DOH expand the economic hardship waiver to include hospitals serving a minimum of 30% Medicaid patients in order to provide a safety valve for hospitals that may need to prioritize resources to support direct patient care activities, rather than technological upgrades. (David Streeter)
Pharmacy Modification Inspection Policy– The Pharmacy Quality Assurance Commission issued a policy statement regarding inspection requirements for pharmacy modifications or remodels. The policy statement says:
Pharmacies that undergo any modifications or remodels as described in WAC 246-945-230(3)(a) must notify the commission, pay a facility inspection fee, and receive an inspection. ‘A modification or remodel of a pharmacy location includes changes to a previously approved area, room or pharmacy building which result in changes to the pharmacy that affects security, square footage, access to drugs, compounding or necessitates temporary relocation of pharmacy services’ (WAC 246-945-230(3)(a)).
The statement also addresses changes to drug storage areas, stating that “changes to a medication storage room or cabinet location or feature does not require submission of a remodel application provided that the storage room or cabinet maintains an equivalent level of security and accessibility. Changes made will be assessed during the next routine inspection.” (David Streeter)
Upcoming WMC Rule Workshops– WMC will be hosting rule workshops on several topics in May and June that may be of interest to hospitals. Rule workshops include:
- International medical graduates on May 5, 2021 (draft language) (Alicia Eyler)
- Opioid prescribing patient exemptions on June 2, 2021 (draft language) (David Streeter)
- Collaborative drug therapy on June 7, 2021 (draft language) (David Streeter)
Please visit WMC’s rule page for the latest meeting information, including the latest draft language and registration links.
L&I Administrative Policies– The Department of Labor & Industries is currently drafting new administrative procedures governing (1) employment relationships and (2) hours worked. The Employment Relationships document, which includes items such as L&I’s interpretation of joint employer relationship, independent contractors, and more, is brand new guidance. The Hours Worked document is a revision of the most recent version that was issued in 2008. WSHA is planning to raise hospital-specific concerns with L&I by the May 31, 2021 comment deadline. Please share feedback on the proposed policies with David Streeter. (David Streeter)
Self-Insurance Financial Rules– L&I issued proposed rules to modernize the financial qualifications for self-insured employers. The rules require additional financial document disclosures to L&I to prove the employer has sufficient resources to cover workers’ compensation liabilities. The proposal also grants L&I the discretion to require surety bonds from self-insured employers to cover liabilities, which may represent an additional cost for self-insured employers. Self-insured hospitals should review the proposed rules and cost-benefit analysis to determine if changes will need to be made to their self-insurance plans to comply. L&I will hold a public hearing on the rules on May 11, 2021 and will accept comments until May 14, 2021. The final rules will take effect as early as June 22, 2021. (David Streeter)
Unemployment During a Public Health Emergency– The Washington State Legislature passed SB 5061 in February 2021, which made changes to the Unemployment Insurance system in response to the COVID-19 pandemic. Among the bill’s many provisions is a new eligibility for workers to leave their jobs during a declared public health emergency if they or an individual living with them have an underlying health condition that is identified as a risk factor for the disease that necessitates the emergency. The provision applies to all workers, including hospital employees. To implement the bill, the Employment Security Department issued emergency rules that establish the verification criteria for individuals seeking to claim unemployment benefits under the new provision. The emergency rules took effect April 5, 2021, with permanent rulemaking to follow later this year. (David Streeter)
Clean Buildings Info Session– WSHA will be hosting the Department of Commerce on May 19, 2021 at 11 AM for a webinar on the Clean Buildings Standard. The webinar will cover mandatory requirements, compliance paths, customer support and the early adopter incentive program. After the presentation, Commerce staff will be available to answer questions about compliance with the new standard. This will be a hospitals-only event that provides opportunities to ask questions specific to hospitals and health care facilities. Registration for the webinar is available here.