Hospitals are anchor institutions in Washington state communities, providing both needed services and stable jobs 24 hours a day, 7 days a week, 365 days a year. It’s the mission of the Washington State Hospital Association to ensure that all our state’s communities have access to high-quality health care.
1. Ensure that hospitals can be stable institutions in their communities, long into the future.
- Preserve Medicaid expansion, individual insurance options and the Children’s Health Insurance Program (if Congress fails to act). In the face of possible federal changes, ensure that the more than 725,000 low- and moderate-income working Washingtonians can maintain their coverage. WSHA supports the stabilization of the individual commercial insurance market, especially in rural areas, as long as it is not at the expense of hospitals and other care providers.
- Preserve access to care in communities through partnerships and affiliations. Affiliations and contractual relationships among physician offices, hospitals and health systems can maintain access to care, increase efficiency and improve care coordination. Often these arrangements subsidize the cost of physician practices serving Medicaid patients and allow more standardization of care. New barriers to affiliations do not preserve competition, they may force independent providers to close.
- State budget: Maintain Medicaid funding to hospital-based clinics. Hospital-based clinics provide a substantial portion of primary and specialty care to the Medicaid population. These hospital-based clinics are less expensive than other safety net clinics serving Medicaid clients, provide needed specialty care, and are considerably less expensive than emergency rooms.
2. Within a safety-focused regulatory environment, maintain the flexibility to respond to changing needs and opportunities to improve care.
- Ensure flexibility for nurse meal and rest breaks and pre-scheduled on-call. Hospitals support maintaining the current standards for meal and rest breaks and pre-scheduled on-call arrangements for nurses and technologists. WSHA also opposes mandating nurse to patient ratios. In the 2017 session, hospitals supported expanding nurse staffing committees to develop strategies and process to ensure breaks are provided and annual staffing plans are followed.
- Maintain current licensing standards for ambulatory surgical centers (ASCs). If ASCs want to care for a patient longer than 24 hours, they should comply with hospital licensing standards that include important safety regulations more appropriate for these longer lengths of stays.
- Ensure reasonable standards for pharmacies. WSHA supports efforts to modernize laws around electronic prescriptions and out-of-state pharmacies that send drugs to Washington.
- Protect hospital resources by allowing the use of non-compete agreements in physician contracting. WSHA supports preserving this important contracting option that allows hospitals to invest in recruiting and supporting new providers.
3. Make it easier to meet patient needs in lower-cost and non-hospital settings.
- Pause Ricky’s law for involuntarily committing people with substance use disorders if there is not enough treatment capacity. In April 2018, Ricky’s law takes effect. WSHA has significant concerns about the state not having enough secure detoxification beds to serve patients. If there is not enough capacity, patients will either be released or will be boarded in hospitals without clear legal authority. We support implementing a threshold that would pause or delay the law if data shows the need for beds outstrips the availability. The state already has an avenue for collecting this data.
- State budget: Fund partial hospitalization programs for Medicaid mental health patients. WSHA supports improving the low Medicaid rate for partial hospitalization programs and providing MCOs with the full funding to provide these first-time services that are not currently built into the actuarial rates. Funding request up to $6 million in state funds.
4. Advocate for patients and hospital employees.
- Clarify charity care law. WSHA is interested in working with legislators and advocacy groups to improve and modernize the charity care law so that patients know about and can access financial assistance.
- Improve informed consent laws for patients. Washington State’s law is restrictive on who can make medical decisions for an incapacitated patient. The law should be expanded to allow other adult relatives or close friends of patients to assist in important decisions.
- Increase access to opioid addiction treatment and non-opioid pain management. WSHA supports budget and policy efforts to increase treatment options for those with opioid addiction. It’s also crucial to expand non-opioid treatments so individuals with chronic pain can have their lives back.
- Improve the safety of hospital nurses, doctors and patients through appropriate weapons policy for patients and visitors. WSHA will support efforts to reduce violence in hospitals.
- Allow easier completion of medical advance directives. Allow notaries to witness medical advance directives, as currently allowed in the durable power of attorney law. Also, clarify the requirements for witnesses of advance directives to verify the identity of the person executing the directive.
- Maintain patient privacy around body-worn cameras. WSHA supports maintaining the current law, which limits disclosure of patient information recorded in a medical facility by law enforcement body-worn cameras. This important privacy protection is set to expire in 2019.
- Improve transparency around balance billing. Hospitals support efforts to inform patients that groups of providers offering services in a hospital may not be contracted with their insurer.