NoHLA Legislative Summary 2017 - #5
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Northwest Health Law Advocates
Summary of Health Care Access Bills
that Passed the 2017 Washington Legislature
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Bill NameHouse Bill/ main sponsor Senate Bill/ main sponsorSummary Description
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PUBLIC PROGRAMS
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Implementing recommendations from the children's mental health work groupE2SHB 1713 (Senn)Requires recommendations from children's mental health work group be implemented to address systemic barriers children and their families face to access necessary mental health services in order to improve mental health care access for children and their families through the early learning, K-12 education, and healthcare systems. HCA must require provider payment for annual depression screenings for youth ages 12-18 and maternal depression screening for mothers of newborns 0-6 months. Creates a child care consultation program in the Department of Early Learning to link child care providers with evidence-based, trauma informed and best practice resources regarding caring for infants and young children who present behavioral concerns or symptoms of trauma. Requires OSPI to designate two educational service districts to pilot a project for coordinating medicaid billing, creating partnerships with community behavioral health providers, and other activities. Requires Behavioral Health Organizations to pay for behavioral health services provided via telemedicine according to specified criteria. Creates a 24-month child and adolescent psychiatry residency position in eastern Washington. HCA must report annually to legislature on number of children's mental health providers, languages spoken, and percent accepting new patients. Evaluation of the effect of integrating involuntary treatment systems for substance use disorders and mental health is required in 2020, 2021 and 2023. Providers are encouraged to use behavioral health therapies and other therapies that are empirically supported or evidence-based and only prescribe medications for children and youth as a last resort.
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Creating a flexible voluntary program to allow family members to provide personal care services to persons wtih developmental disabilities or long-term care needs under a consumer-directed medicaid service programSB 5867 (Braun)Requires the Joint Legislative Executive Committee on Aging and Disability to develop recommendations on consumer-directed approaches that allow family members of the consumer to provide care that promotes consumer health and safety, ensures caregiver training and support, verifies the quality and appropriateness of care, reduces barriers to care, and mitigates potential liability issues under consumer-directed programs. Tribal members who receive personal care are exempted from the requirement that family caregivers be independent providers rather than employees of a home care agency.
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State health insurance pool 2SHB 1338 Cody Extends the current sunset date of the Washington State Health Insurance Pool (WSHIP) for non-Medicare clients from December 31, 2017 to December 31, 2022.
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PUBLIC HEALTH
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Rapid health information network data reportingSSB 5514 (Rivers)Mandates emergency department syndromic surveillance reporting to the Dept of Health. Patient data may be used for public health purposes so long as patient confidentiality is maintained.
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HEALTH CARE PROVIDERS AND FACILITIES
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Dental health services in tribal settings
SSB 5079 (McCoy) Authorizes dental health aide therapist services provided by Indian tribes, tribal organizations, and urban Indian organizations to promote increased dental care access for persons served in these practice settings. Requires the state to seek federal Medicaid funding for these services.
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Telemedicine locationsSB 5436 (Becker)Amends existing telemedicine statutes. Expands patient access to health services through telemedicine by further defining where a patient may receive the service as home or "any location determined by the individual receiving the service." Applies to Medicaid managed care plans, public employee (PEB) health plans, and other health plans in the state governed by RCW 48.43. Effective 2018.
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Reimbursement for services provided pursuant to community assistance referral and education services programsE2SHB 1358 (Cody)Directs HCA to adopt reimbursement standards for fire departments providing covered health services to Medicaid clients who do not require ambulance transport to an emergency department, and directs the Joint Legislative Audit and Review Committee to conduct a cost-effectiveness review of these reimbursement standards.
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Developmental Disability Respite Providers TrainingEHB 1322 (Kilduff)Reduces training requirements for a person providing respite care services for individuals with developmental disabilitiies who works 300 hours or less in a year.
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HEALTH CARE FINANCING & OVERSIGHT
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Hospital Safety Net AssessmentSB 5815 (Rivers)Extends the expiration date for the hospital safety net assessment from July 1, 2019 to July 1, 2021. Makes changes to formula and hospital payment amounts.
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PATIENT HEALTH INFORMATION, PRIVACY AND CONSENT
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Protecting nonpublic personal health information held by the OICSHB 1043 (Robinson)Nonpublic personal health information (PHI) obtained by, disclosed to, or in the custody of the OIC is confidential and not subject to public disclosure. This information shall not be used by the OIC except in the course of regulatory or legal action as part of the commissioner's official duties. Requires OIC to notify persons filing complaints that their PHI may be shared for investigative purposes and give them the opportunity to opt out when they file their complaint.
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Protecting information obtained to develop or implement an individual health insurance market stability programHB 2222 (Cody)Exempts from public disclosure certain information related to risk adjustment and reinsurance programs that the insurance commissioner obtains from health insurers for purposes of developing or implementing an individual health insurance market stability program, or that WSHIP prepares for these purposes, are confidential and not subject to public disclosure.
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Expanding the scope of entities to whom mental health information and records may be disclosed without the patient's authorizationSSB 5435 (Rivers)Expands the authority to disclose mental health information without a patient's authorization to all health care providers when providing care to a patient. Allows the disclosure of mental health information to certain persons who require it to assure coordinated care and treatment of a patient. Persons who may use or disclose the mental health information must take appropriate steps to protect it.
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Consent for nonemergency, outpatient, primary health care services for unaccompanied homeless youthSHB 1641 (McBride)Provisions re authority for third parties to consent to nonemergency outpatient primary care services for homeless youth are transferred from the school code in 28A.320 RCW to 7.70 RCW, to consolidate them with statutes more generally describing authority to consent for health care. A school nurse, counselor or homeless student liaison may provide informed consent for such treatment for children defined as homeless under the McKinney-Vento Act who are not in the supervision or control of a parent, guardian or DSHS. Individuals authorized to give this consent, as well as their employing school, are immune from administrative or civil liability for consenting or not consenting to care pursuant to this bill. Persons authorized to consent to these types of care for homeless youth under the listed circumstances may be required by a facility or provider to furnish a delaration stating that they have one of the positions that authorizes them to give such consent. Health care providers may rely on the representations or declarations of an individual that they have the listed qualifications to give consent for treatment of this type, if the provider does not have actual notice that these representations are false. Providers may seek payment for care provided to minor patients.
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Disclosure of health-related information with persons with a close relationship with a patientSHB 1477 (Kilduff)Provides circumstances in which a health care provider or facility may disclose health care information to a family member, close friend, or other person identified by the patient, without the patient's consent. Allows disclosure of health information to a person(s) reasonably able to prevent or lessen a serious and imminent threat.
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REPRODUCTIVE HEALTH
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Private health plan coverage of contraceptivesSHB 1234 (Robinson)Requires a health benefit plan that includes coverage for contraceptive drugs to provide reimbursement for a twelve-month refill of contraceptive drugs obtained at one time by the enrollee.
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Promoting healthy outcomes for pregnant women and familiesSSB 5835 (Keiser)Requires employers to provide reasonable work requirements for pregnancy-related conditions. Requires employers with 15 or more employees to provide reasonable accommodation for pregnancy-related conditions unless the accommodation would impose an undue hardship on the employer's business. Requires certain health care facilities to establish maternal-newborn bonding practices. Establishes a Healthy Pregnancies Advisory Committee focused on improving maternal and infant health outcomes.Requires facilities serving Medicaid clients to provide skin-to-skin placement to promote breastfeeding, and post-delivery room-in practices. Requires performance measures for ARNPs and certified nurse midwives. Biennial reporting to Governor and Legislature required will now include compliance with these practices.
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BEHAVIORAL HEALTH - MENTAL HEALTH AND SUBSTANCE USE DISORDERS
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Clarifying obligations under the involuntary treatment act2 ESSB 5106 (O'Ban)An immediate family member, guardian, or conservator may petition for court to detain their family member only within 10 calendar days of an evaluation by a designated mental health professional (DMHP) in which the family member was not detained. If the petition is granted, the DMHP must coordinate with law enforcement in the detention of the respondent to a treatment facility. The order shall contain an advisement of rights to the respondent. Requires petitions for enforcement of less restrictive alternative (LRA) treatment orders under the Involuntary Treatment Act (ITA) to be filed with the court in the county where the person is located. Revises provisions requiring a DMHP to consult with an examining emergency room physician during an initial commitment evaluation. Provides that designated chemical dependency specialists may evaluate and sign a petition for involuntary commitment of a person who may be in need of involuntary substance use disorder treatment, both before and after the State's Integrated Crisis Response System begins operation on April 1, 2018.
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Curricula for persons in long-term care facilities with behavioral health needsESHB 1548 (Schmick)Requires minimum competencies and standards be established for the approval of curricula for facility-based caregivers serving persons with behavioral health needs and geriatric behavioral health workers which includes at least thirty hours of training specific to the diagnosis, care, and crisis management of residents with a mental health disorder, traumatic brain injury, or dementia. Behavioral health conditions are defined as one or more behavioral symptoms specified in Section E of the Minimum Data Set.
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Requirements and oversight of opioid treatment programsESHB 1427 (Cody)Shortens the list of factors that DSHS must consider in reviewing and deciding whether to grant an application for certification of an opioid treatment program. Among other things, DSHS need not demonstrate need for the program to approve its certification. Public hearing requirements are changed to require DSHS to hold a single hearing on the application in the community in which the facility is to be located. Counties and cities cannot require special use permits for citing opioid treatment programs. Removes general 350-patient limit for these programs, although counties may impose a patient limit at or above that level based on specific local conditions. Loosens program oversight and reporting requirements. References to "certification" of a program are changed to "licensing and certification" if SHB 1388 or SSB 5259 are enacted. Requires providers to inform patients of all treatment options available. The provider and the patient must consider alternative treatment options, like abstinence, when developing the treatment plan. Follow up is required if medications are prescribed in order to work towards the goal of abstinence.
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Behavioral health integration in primary careSSB 5779 (Brown)Adds definitions for bidirectional integration, primary care behavioral health, and whole-person care in behavioral health. Defines "bidirectional integration" as integrating behavioral health services into primary care settings and integrating primary care services into behavioral health settings. Defines “primary care behavioral health” as a health care integration model in which behavioral health care is colocated, collaborative, and integrated within a primary care setting. Defines "whole-person care in behavioral health" as a health care integration model in which primary care services are integrated into a behavioral health setting either through colocation or community-based care management. Requires review and adjustment to payment rules to facilitate integration of behavioral health in primary care settings by August 2017. Requires a performance measure be established and integrated into the statewide common measure set which tracks effective integration practices of behavioral health services in primary care settings. The Govenor vetoed one section of the bill due to lack of a budget appropriation. It would have required HCA to increase reimbursement to providers of behavioral health services in primary care settings in order to increase the availability of services and incentivize adoption of the primary care behavioral health model. However, the Governor's veto message says he is directing HCA to recommend an appropriate reimbursement rate and report any projected costs by October 15, 2017 for consideration as part of next year's supplemental budget. This veto does not impact the substance of the bill.
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Reducing certain documentation and paperwork requirements in order to improve children's mental health and safety.E2SHB 1819 (Dent)Requires the department of social and health services and the Health Care Authority to provide a single set of regulations by April 2018 for agencies that provide mental health, substance use disorder, and co-occurring treatment services to follow in order to reduce paperwork and documentation requirements which are inefficient or duplicative for providers of children's mental health services.
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Time-limited exemption of certain hospitals from certificate of need requirements for addition of psychiatric bedsESHB 1547 (Schmick)Reinstates an exemption provided in FY2015 that frees hospitals from the requirement of obtaining a certificate of need (CON) when they convert existing licensed beds to psychiatric beds, including for involuntary treatment. Exemptions are valid for two years, and this provision expires June 30, 2019. Exempt beds must remain psychiatric beds unless elminated due to downsizing or a change is authorized through a CON. Until June 30, 2019, hospitals licensed under RCW 70.41 are exempt from certificate of need requirements for the addition of new psychiatric beds; work to add the beds must begin within two years of the facility's receipt of a notice of CON exemption. Until June 30, 2019, psychiatric hospitals are exempt from CON requirements for a one-time addition of up to 30 new psychiatric beds if the Department of Health determines that it meets listed requirements. Until June 30, 2019, an entity seeking to create a psychiatric hospital with no more than 16 beds is exempt from CON requirements if it agrees that a "portion" of the beds will be used for adults on 90 and 180 day involuntary commitment orders. Work must begin on the project within two years of receipt of the notice of exemption, and the new facility may not have more than 16 beds without a CON.
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OTHER HEALTH CARE ACCESS RELATED BILLS
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Paid family and medical leaveSB 5975 (Fain)Requires employers to provide a paid family and medical leave insurance program, funded by premiums paid by employers and employees and administered by the Employment Security Department. Paid family leave benefits are provided after the birth or placement of a child, because of a family member’s serious health condition, or for a military exigency. Effective 10/19/2017, employees will be able to take up to 12 weeks of paid family leave and 12 weeks of medical leave, with a combined cap of 16 weeks of paid leave. ‘Family member’ includes employee’s child, grandchild, grandparent, parent, parent-in-law, sibling, and spouse. ‘Child’ means a biological, adopted, foster, stepchild, or child to whom employee stands in loco parentis. The benefit is portable and progressive; lower earners receive a larger percentage of their wage, and threshold hours worked to be eligible may be spread between different employers. Employees are entitled to be restored to the same or equivalent job if their employer has 50 or more employees.
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Assistance with Activities of Daily Living in Assisted Living FacilitiesSHB 1671 (Cody)Amends RCW 18.20.310 to define Activities of Daily Living to include medication assistance as defined in RCW 69.41.010.
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Providing public notices of public health, safety and welfare in languages other than EnglishSSB 5046 (Hasegawa)Beginning December 1, 2019, state agencies that provide life safety information in an emergency or disaster must give legislative committees a copy of their current communication plan for notifying significant segments of the population (that have limited English proficiency - LEP) of the emergency/disaster. The agencies must submit annual reports identifyiing when life safety information was not provided during an emergency or disaster in the last year and what strategies were used to provide this information to individuals with limited English proficiency. Local and joint local emergency management organizations must include a comunication plan for notifying significant population segments of life safety information during an emergency, as part of their local comprehensive emergency magagement plans. The law lists factors to be considered in determining the obligation to provide emergency notification to significant population segments. The communication plans must be submitted to the Washington military department emergency management division with the next emergency management plan and updated as required thereafter. Local and joing local organizations conducting after-action reviews must report on specified issues to the military department. The military department must report to the Legislature on December 1, 2019 and every five years thereafter on the status of their communications plans, times when communicating life safety information was technologically infeasible, and recommendations for correcting these difficulties, including the resources required to do so.
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Patients' access to investigational medical productsSSB 5035 (Pedersen)Allows a patient with a serious or life-threatening disease or condition who is unable to participate in clinical trials to request that a drug or device manufacturer make investigational products available to the patient for treatment.
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Northwest Health Law Advocates | 206.325.6464 | nohla@nohla.org
August 3, 2017
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