End of session report

The legislature passed its final 2019-21 operating budget on April 3. The final budget was largely good for health care. With session ending just at the start of the COVID-19 Pandemic, many of our priorities did not receive funding.

Nurse Licensure Compact – DEAD
HB 2376/ SB 6209 establishes the interstate Nurse Licensure Compact (NLC). Between the 2019 and 2020 legislative session, WSNA spent dozens of hours meeting with proponents of the NLC, other states, and legislators to really understand the components of the NLC and how it is working in participating states. Our research and conversations found that key elements of the NLC need to be changed at the national level – and that the current risks are too great for our members and our state. Legislation joining the NLC must be identical to the legislation passed by all of the other states in the Compact. Because the WA Legislature could not make the changes necessary to make the bill work for our members, WSNA worked to prevent the bill from passing so that the Legislature and other stakeholders could put pressure on the National Council on State Board of Nursing to change the bill. SB 6209 made it to Senate Rules but never made it to the floor. HB 2376 died in the House Health Care Committee.

Sexual Assault Task Force – PASSED
SB 6158 establishes the Sexual Assault Coordinated Community Response Task Force within the Office of the Attorney General. WSNA testified in support of this bill in the Senate and House Health Care committees. Many states have standardized protocols, including Oregon and California. When working in a smaller community or in a critical access hospital, standardized protocols give autonomy to staff caring for those who have been affected by sexual violence. The bill passed out of both chambers unanimously. The Governor signed the bill into law on March 27^th and it goes into effect on June 11^th.

Sexual Assault Training - DEAD
SB 6162 requires the Office of Crime Victims Advocacy to consult with specified interest groups to develop best practices and strategies for forensic nurse examiner access and training by January 1, 2021. This bill made it to Ways & Means but didn’t make it past the first fiscal cut off.

Health System Transparency – DEAD
HB 2036 requires that hospitals provide additional detail regarding expenses and revenues in financial reports to the Department of Health. The bill eliminates the exemption from reporting information about facility fees for off-campus clinics or providers that are located within 250 yards from the main hospital building. The bill also requires that community needs assessments made public by hospitals include an addendum containing certain information about activities identified as community health improvement services. The bill requires hospitals to post information on their websites if they have an ownership interest in a debt collection agency or have certain exchanges of revenue with debt collection agencies. The bill passed out of the House on party lines but did not make it out of the Senate.

ARNP Reimbursement Parity – DEAD
HB 1433 Prohibits a health carrier from reimbursing an advanced registered nurse practitioner in an amount less than he or she would reimburse for the same service if provided by a physician in the same area served. This bill did not gain traction this session and never made it out of its committee of origin.

Military Liaison – PASSED
ESSB 6626 creates the position of the Military Spouse Liaison within the Department of Veterans Affairs. The bill requires the Department of Health to waive all fees related to licensing for military spouses and registered domestic partners. The bill also requires Nursing Care Quality Assurance Commission to develop a plan and timeline to address certain concerns related to the nurse licensure compact. This bill passed both chambers unanimously. The Governor signed the bill into law on April 2^nd and the law went into effect on June 11, 2020.

COVID-19- PASSED
In response to the developing outbreak of COVID-19, both the House and the Senate passed legislation with funding to help support Public Health combat the virus. HB 2965, sponsored by Rep. Cody and Schmick, appropriates $100 million from the Budget Stabilization Account to the Disaster Response Account and appropriates $100 million from the Disaster Response Account and $25 million from the General fund to the Office of Financial Management to provide to state agencies to support COVID-19 response. The bill also authorizes DSHS to determine nursing facility payments to adequately respond to the COVID-19 outbreak. Additionally, the bill states that an individual under quarantine during the COVID-19 outbreak does not need to meet the requirement of being available to work to receive unemployment insurance benefits.

Employee Information Disclosure - PASSED
HB 1888 requires notice to public agency employees when a request has been made for personal information of the employee. Exempts payroll deductions of public agency employees from public disclosure. This bill was a priority for the entire labor community. The Bill passed out of the House on a 91- 5 vote and out of the Senate with a 36-10 vote. The Governor signed the bill on March 25^th and it goes into effect on 6/11/2020.

NURSING

Health Carrier Credentialing – PASSED
HB 1552 prohibits a health carrier from requiring a health care provider to submit credentialing information in a format other than through the database selected under RCW 48.165.035. Decreases the amount of time in which a health carrier must make a determination approving or denying a credentialing application from a health care provider. The bill requires a health carrier that credentials a health care provider in its network to reimburse the health care provider for covered health care services provided to the carrier's enrollees during the credentialing process. The bill passed unanimously out of both chambers and was signed into law by the Governor on March 17th. The bill is effective March 17, 2020.

PREVENTION

Regulating Vapor Products – DEAD
SB 6254 bans the sale of vapor products containing vitamin E acetate and bans the sale of disposable flavored vapor products. The bill bans all online sales of vapor products and imposes a 5 percent excise tax on flavored vapor products and directs the money to the Foundational Public Health Services Account and the Tobacco Prevention and Control Account. Retailers are to verify the age of customers when entering stores restricted to persons 21 years old or older. The bill faced challenges when it was amended in committee to exclude menthol as a flavor. After passing out of Senate by a 35 to 13 vote, the bill died in the House.

Domestic Violence/ Workplace – DEAD (vetoed)
SB 1056 creates a joint legislative task force on domestic violence and workplace resources to identify the role of the workplace in helping to curb domestic violence. Requires the task force to review: (1) The role of the workplace in the lives of individuals experiencing domestic violence; (2) The appropriate role of employers and employees in helping reduce the incidence of domestic violence; and (3) Whether legislation is needed to address the issues. The bill passed both chambers but was vetoed by the Governor on April 3.

HEALTH CARE

Reducing Work-related Musculoskeletal Disorders in Health Care – DEAD
HB 2646 requires Labor & Industries (L&I) to develop best practices to reduce risk factors for work-related muscuskeletal disorders. L&I must involve employees at all levels of management at health care facilities in developing programs to reduce these injuries with ongoing evaluation of these programs. Employers in the health care sector that implement a program with best practices are eligible for a premium discount determined by L&I and health care employees. L&I can provide up to 2% of premiums paid in the prior year from the risk classes for health care providers. WSNA testified in support of the bill in the House Labor Committee. The bill made it to House Rules, but didn’t make it past House of Origin cutoff.

Requiring the Review of Health Insurance Surplus – PASSED
SB 6097 permits the Insurance Commissioner to review the surplus, capital and profits of individual and small group market health insurers in determining the reasonableness of rates. The bill passed out of the Senate unanimously. After adopting several amendments, the bill passed the House 83 to 14. The Senate concurred with the changes with a 37 to 12 vote. The bill was signed into law by the Governor on March 31 and goes into effect on June 11.

Mitigating Inequity in the Health Insurance Market – PASSED
HB 2554 requires health carriers and the Health Benefit Exchange to provide certain notices to consumers when mandatory benefits are excluded from health plans. The bill allows the insurance commissioner to assess a fee on a health carrier that excludes certain mandatory benefits. The bill passed out of both chambers on a party line vote. The Governor signed the bill into law on April 2 and it went into effect on June 11.

Telehealth Payment Parity – PASSED
SB 5385 requires health plans to pay the same rate for a health care service provided through telemedicine as an in-person service. The bill permits hospitals, hospital systems, telemedicine companies, and (carves out new niche of) provider groups of 11 or more to negotiate and agree to a telemedicine reimbursement rate that differs from in-person rates. The bill requires reimbursement for facility fees to be subject to a negotiated agreement and removes the requirement that services provided through store and forward technology have an associated office visit. The bill also directs the Collaborative for the Advancement of Telemedicine to study store and forward technology. The bill passed both chambers with nearly all Legislators voting in favor the bill. The Governor signed the bill into law on March 19 and it went into effect immediately.

Establishing the Health Care Cost Transparency Board – PASSED
HB 2457 Establishes the Health Care Cost Transparency Board to annually calculate the total health care expenditures in Washington and establish a health care cost growth benchmark. The bill passed the Senate with 32-17 vote and passed the House with a 67-29 vote. The Governor signed the bill on April 3. The law goes into effect on June 11.

Extending Medicaid for Postpartum Period – DEAD (vetoed)
SB 6128 requires the Health Care Authority to expand health care coverage to pregnant and postpartum persons from 60 days post pregnancy to 12 months post pregnancy, based on income eligibility that is phased into 193 percent of the federal poverty level (FPL). The bill passed out of both houses with a nearly unanimous vote (only Rep. Kraft voted against the bill). The Governor vetoed the bill on April 3.

Informed Consent for Pelvic Exams – PASSED
SB 5282 prohibits a licensed health care provider from knowingly performing or authorizing a student practicing under their authority to perform a pelvic examination on a patient who is anesthetized or unconscious. WSNA testified in support of this bill. It passed unanimously in both the Senate and the House. The Governor signed the bill into law on March 27 and it goes into effect on June 11.

OCCUPATIONAL & ENVIRONMENTAL HEALTH

Reducing Green House Gas Emissions Associated with Transportation Fuel – DEAD
ESBHB 1110 directs the Department of Ecology to adopt a rule establishing a Clean Fuels Program to limit greenhouse gas emissions per unit of transportation fuel energy to 10 percent below 2017 levels by 2028 and 20 percent below 2017 levels by 2035. The bill Excludes exported fuel, electricity, fuel used by vessels, railroad locomotives, and aircraft, and certain other categories of transportation fuel from the Program's requirements. The bill requires the Program to include processes for tracking compliance obligations and bankable, tradeable credits and annual reporting by Ecology on the Program, as well as an analysis of the Program's first five years by the Joint Legislative Audit and Review Committee. The bill retains the current revenue distribution under the 2015 Transportation revenue package, eliminating changes that would have been triggered as a result of the establishment of a Program. This bill was originally introduced in the 2019 session and then reintroduced and retained its status in the 2020 session. The bill passed out of the house in 2020 with a 52 to 44 vote. The bill never made it out of the Senate.

Chemical Contaminants in Drinking Water – DEAD
HB 1860 requires certain public drinking water systems to test for perfluoroalkyl and polyfluoroalkyl (PFAS) chemicals beginning in 2021. The bill requires the Department of Health (DOH) to establish statewide maximum contaminant levels (MCLs) for PFAS chemicals applicable to group A water systems. It also requires the DOH to submit a report to the Legislature by 2022 regarding PFAS contamination in public water systems. The bill passed out of the House unanimously but did not make it out of Senate Rules.

Restricting Firearms in Certain Locations – PASSED
SB 5434 prohibits possession of firearms on the premises of any licensed childcare center, child care center provided-transportation, or other child care center facility. The bill requires a family day care provider to secure firearms on the premises in a locked gun safe or unloaded in a locked room with a trigger lock or other disabling device. The bill passed on nearly party lines in both chambers. The Governor signed the bill into law on March 27. The bill went into effect on June 11.

Establishing the Sharps Waste Stewardship Program – DEAD
HB 2360 establishes a uniform, effective, statewide system for safe disposal of sharps waste from consumers that is funded and operated by manufacturers of sharps and injectable drugs in order to protect public health and safety and to reduce the improper disposal of sharps in solid waste and recycling systems. The bill did not make it past the house of origin fiscal cutoff.

Protecting Patient Safety – PASSED
SB 2426 establishes additional oversight requirements for certain psychiatric hospitals. Establishes penalties for psychiatric hospitals that fail or refuse to comply with state licensing standards. Requires psychiatric hospitals to report certain deaths and patient elopements occurring on their grounds. The bill passed the House 84 to 14 and passed the Senate unanimously after adopting a striker amendment. The House concurred unanimously, and the Governor signed the bill into law on March 25^th. The bill went into effect immediately.

Involuntary Treatment Act – PASSED
SB 5720 increases the initial detention period under the Involuntary Treatment Act (ITA) from 72 hours to 120 hours beginning January 1, 2021. The bill modifies definitions of likelihood of serious harm, gravely disabled, and violent act under the ITA. The bill expands single-bed certifications on July 1, 2026, to include patients detained due to a substance use disorder and applies certain ITA provisions relating to adults to minors. The bill makes additional revisions to ITA provisions. The bill was originally introduced in 2019 and was reintroduced in its current status during the 2020 session. The bill passed the Senate 44 to 3 and the House 95 to 2. The governor signed the bill into law on April 2^nd.

Opioid Use/Medications – PASSED
SB 6086 allows the license of location for a pharmacy to be extended to a registered remote dispensing site that uses technology to dispense medications approved for the treatment of opioid use disorder and establishes minimum standards for registered remote dispensing sites. The bill passed unanimously out of both chambers and was signed into law on March 31^st. The bill goes into effect on June 11^th.

Substance Use Disorder Coverage – PASSED
HB 2642 establishes minimum coverage times before utilization review may be conducted for withdrawal management or inpatient or residential substance use disorder treatment services. The bill stablishes timelines for behavioral health agencies to submit admissions materials to payers and for payers to make medical necessity determinations. The Health Care Authority is directed to develop an action plan to support improved transitions between different levels of care, including addressing barriers to facilitating transfers to appropriate levels of care. The bill passed the House 94 to 4 and passed the Senate unanimously. The Govenor signed the bill into law on April 3^rd. The bill goes into effect June 11^th.

Telehealth Funding Model – PASSED
SB 2728 Directs the Health Care Authority to implement the Tele-Behavioral Health Call Center/Psychiatry Consultation Line (PCL). The bill establishes a funding model for the Partnership Access Line (PAL) and PCL programs. Changes data and reporting requirements for the PAL, PCL, and PAL for Moms and Kids programs. The bill also creates the Tele-behavioral Health Access Account and directs the Joint Legislative Audit and Review Committee to conduct a review of the PAL for Moms and Kids pilot program. The bill passed the House 56 to 40 and the Senate unanimously with one amendment. The House concurred with the changes with a 90 to 7 vote. The Governor signed the bill into law on April 2^nd and it goes into effect on June 11^th.

Children’s Mental Health Work Group – PASSED
HB 2737 renames the Children’s Mental Health Work Group to Children and Youth Behavioral Health Work Group and outlines the duties of the newly named group. The group is required to provide recommendations to the Governor and Legislature on November 1, 2020. The group now expires on December 30, 2026. The bill passed both chambers unanimously and was signed into law by the Governor on March 25^th.

Tax Preference for BHOs – DEAD (vetoed)
HB 2943 provides a business and occupation tax deduction for behavioral health administrative services organizations and health or social welfare organizations on certain amounts received for government-funded behavioral health care. The bill passed out of the House and Senate unanimously. The bill was vetoed by the Governor on April 3^rd.

Background Checks in Education – PASSED
HB 2259 requires a criminal history record check before certain education entities may hire an employee who receives criminal history record information or personally identifiable information in another employee's record check. The bill passed unanimously out of both chambers. The Governor signed the bill into law on March 18^th and it went into effect on June 11^th.

School Meals at No Cost – PASSED
HB 2660 requires each school with students in grade 8 or below with 62.5% or more of its students eligible for free meals to make meals available to all students at the school for no charge. This bill modifies eligibility requirements for teacher bonuses by allowing for free and reduced-price lunch eligibility to be factored into their bonuses. OSPI is required to convene a monthly meeting on the impact to schools from this change. This bill passed both chambers with only a handful of no votes. The Governor signed the bill into law on April 2^nd and it goes into effect on June 11^th.

Student Concussion Reports – PASSED
HB 2731 directs the Washington Interscholastic Activities Association (WIAA) to require that member schools report information about each head injury sustained by a student in grades nine through twelve during activities overseen by the WIAA, and requires the WIAA to summarize and analyze the reported information annually. The Governor signed the bill into law on April 3^rd. The law goes into effect on June 11^th.

Adverse Childhood Experience – PASSED
SB 6191 requires that questions regarding Adverse Childhood Experiences (ACEs) be added to the Healthy Youth Survey. School Districts are encouraged to use the information about ACEs in their decision making and to help improve services for students. The bill passed out of the Senate with a 43 to 3 vote and out of the house 96 to 1. The Governor signed the bill into law on March 31^st. The law goes into effect on June 11^th.

Optional Benefits Offered by School Districts - PASSED
HB 2458 specifies that school district optional benefits may not compete with any basic or optional benefits offered through the School Employee's Benefits Board. School districts are granted express authority to offer employee-paid, voluntary benefits to school employees that are paid by employees through a payroll deduction and provides examples of those benefits. The bill passed unanimously out of the House and by 47 to 1 vote out of the Senate. The Governor signed the bill into law on March 31^st and it goes into effect on June 11^th.

Suicide Prevention - PASSED
HB 2589 requires elementary, secondary, and postsecondary schools (public and private) that issues student or staff identification cards to have printed on newly issued or replacement cards the following info: the contact information for a national suicide prevention organization; and the contact information for one or more campus, local, state, or national organizations specializing in suicide prevention, crisis intervention, or counseling. The bill was passed unanimously out of the House and by a 42 to 7 vote out of the Senate. The Governor signed the bill into law on March 18^th. The bill goes into effect on June 11^th.

School Modernization Grants - PASSED
SB 5572 creates a small school district modernization grant program for school districts and state-tribal education compact schools with 1,000 or fewer student enrollments. OSPI is directed to form an advisory committee, appointed by the Superintendent of Public Instruction (SPI), to establish prioritization criteria and an evaluation process for the committee to review and rank grant applications. The bill requires the SPI to propose a list of projects to the Governor by September 1 of even-numbered years, as prioritized by the advisory committee. The bill was introduced in 2019 but did not make it out of the Legislature. In 2020 the bill was reintroduced in its status and passed out of the Senate 45 to 1. The bill passed out of the House unanimously. The Governor signed the bill into law on April 2^nd and it goes into effect on June 11^th.