2019 budget priorities #

The legis­la­ture passed its final 2019 – 21 operating budget on April 28. The final budget was largely good for health care. Of WSNA’s three budget prior­i­ties, it is notable that only school nurses did not receive new funding.

WSNA priorityBudget amountDescription
Nursing Education Funding: Nurse Educator Salary Increase$40 MillionFunding is provided solely to increase nurse educator salaries at Community and Technical Colleges.
Public Health Funding:Ongoing Foundational Public Health Services (FPHS)$22 MillionOngoing funding is provided to state and local public health to implement FPHS.
FPHS: Youth Tobacco/Vapor Prevention$1 MillionOne-time funding is provided, as part of Foundational Public Health Services, to support local health jurisdictions provide youth tobacco and vapor prevention programs, including the necessary outreach and education for the provisions under Tobacco 21.

Other budget items of interest #

ItemBudget amountDescription
Fruit and Vegetable Incentives$2.5 MillionFunding is provided pursuant to Substitute House Bill 1587 (increasing access to fruits and vegetables), which establishes the Food Insecurity Nutrition Incentives Program in the Department of Health.
Maternal Mortality Review$344,000Funding is provided for the biennial maternal mortality review report and to align state policy with national best practices.
NCQAC Increased Legal Costs$150,000The Nursing Care Quality Assurance Commission (NCQAC) regulates over 122,000 nurses in Washington State. In the past four years, the number of licensed nurses increased 16.3 percent, and complaints against nurses increased 106 percent. Complaints include patient deaths, serious harm, and abuse. Funding is provided to NCQAC to address the complaint backlog and to investigate the growing number of complaints received. Performance measures and legally mandated timelines for these activities are being met.
Prescription Monitoring Program$330,000Funding is provided for additional staffing to coordinate the integration of the Prescription Monitoring Program data into federally-certified electronic health systems statewide.
Office of Equity$300,000Funding is provided for the Governor's Interagency Coordinating Council on Health Disparities to establish a task force to develop a proposal for the creation of an office of equity.
Long-Term Care Workforce$100,000Funding is provided to the Department of Health for the Nursing Care Quality Assurance Commission to continue the work group related to nurses in long-term care settings.
Lead Testing in Schools$1 MillionFunding is provided for the Department of Health (DOH) for lead testing in public schools. DOH must determine which school districts have the highest priority and test those districts first, as well as communicate to parents, educators, school staff and the public regarding the test results and their potential consequences.
Pesticide Application Safety Committee$264,000Funding is provided pursuant to Second Substitute House Bill 1725 (pesticide application safety) for the Department of Health to provide staff support to the Pesticide Application Safety Committee.
Sexual Misconduct Notice$207,000Funding is provided pursuant to Substitute House Bill 1198 (sexual misconduct notification), which requires a health care provider to notify a patient if the provider has been sanctioned by a disciplining authority for acts of unprofessional conduct involving sexual misconduct and is subject to an order or stipulation issued by a disciplining authority.
Suicide Prevention Task Force$583,000Funding is provided for the Suicide-Safer Task Force (Task Force) to develop a plan to provide resources to professions, industries, and work places impacted by high rates of suicide; distribute locking devices to 12 rural communities; to develop and distribute a tool kit for suicide prevention and a curriculum for firearms safety instructors; and to deliver materials developed by the Task Force to firearms dealers. The Pharmacy Quality Assurance Commission must distribute suicide awareness materials developed by the Task Force to licensed pharmacists and survey licensed pharmacists regarding gap between suicide awareness and prevention training and practice. The expiration of the Task Force is extended to July 1, 2021. Funding is also provided PQAC to make suicide awareness and prevention materials electronically available to licensed pharmacies.
Suicide Prevention$3.08 MillionFunding is proposed to implement the State Action Alliance for Suicide Prevention recommendations for the performance and administration of clinical services for suicide assessment, treatment, and management of suicide prevention grants to community groups and coalitions throughout Washington State.
Vaccine Preventable Diseases$44,000Funding is provided pursuant to Engrossed House Bill 1638 (vaccine preventable diseases), which prohibits exemptions from the measles, mumps, or rubella vaccines, based upon philosophical or personal objection.
Tribal Evaluation Treatment Center$150,000One-time funding is provided for the Health Care Authority (Authority) to build the infrastructure to develop and support a tribal evaluation and treatment facility that provides culturally appropriate services and coordinates with patients' Indian health care providers.
Involuntary Treatment Procedures$72,000Funding is provided for conducting increased firearms background checks pursuant to Substitute Senate Bill 5181 (Involuntary treatment procedures).
Children’s Mental Health$2.16 MillionFunding is provided for one FTE and additional support to develop a statewide plan to implement evidence based specialty care programs that provide early identification and intervention for individuals experiencing psychosis pursuant to Second Substitute Senate Bill 5903 (Children's mental health). This includes funding to increase the number of teams providing these services from five to ten by October 1, 2020.
Community Long-Term Inpatient Beds$88.95 MillionServices for individuals on 90-day and 180-day commitments are traditionally provided in the state hospitals. Funding is provided for 71 new community beds in FY 2020 increasing to 119 new beds by FY 2021. The proposed outlook assumes that the number of new community beds will grow to 227 by FY 2023. It is assumed that these beds will be done in a mix of community hospital and evaluation and treatment center settings.
Mental Health Drop-in Facilities$1.5 MillionFunding is provided for five mental health peer respite centers to divert individuals from crisis services as well as a pilot program to provide mental health drop-in center services pursuant to Second Substitute House Bill 1394 (Behavioral health facilities). The HCA must conduct a survey of peer mental health programs and submit reports to the Legislature on the results of the survey and of the pilot program.

2019 policy priorities #

Breaks and Overtime Protec­tions – PASSED
The breaks and overtime protec­tions bill was WSNA’s top priority in 2019. Two bills were intro­duced: SB 5190 in the Senate and HB 1155 in the House. The Senate version was killed on the Senate floor when more than 30 amend­ments were proposed by those opposing the bill. HB 1155 passed the House (63 – 34) with bipar­tisan support. In the Senate, HB 1155 the bill was amended on the floor – including an amend­ment to restricted nurses to an 8‑hour workday, and an amend­ment to exclude Critical Access Hospi­tals from the bill. The House refused to concur with these amend­ments, sending the bill to confer­ence committee. The confer­ence report (final version of the bill) removed the 8‑hour limit language, delayed imple­men­ta­tion for techs, and included Critical Access Hospi­tals and sole commu­nity hospi­tals with a two-year imple­men­ta­tion delay. This final version of the bill passed the Senate (32 – 16) and the House (70 – 24) and was signed into law by the Governor on May 8. This bill takes effect for most hospi­tals on January 1, 2020, and for Critical Access Hospi­tals and sole commu­nity hospi­tals on July 1, 2021. This victory marks the culmi­na­tion of years of hard work and action by nurses across the state. 

Workplace Violence Preven­tion – PASSED
HB 1931 updates our state’s workplace violence in health care statute to provide more speci­ficity about what hospi­tals must include in their required workplace violence preven­tion plans and requires those plans to be updated every three years, with an annual review of any violent incidents informing that plan. This bill also updates training require­ments with more speci­ficity to ensure that hospi­tals are providing uniform and effec­tive training around the state – currently, some hospi­tals provide excel­lent hands-on training, while others use an online module that allows workers to pre-test” out. This new law will ensure that quality, hands-on training is avail­able in all hospitals.This bill passed the House (97 – 0) and the Senate (48 – 0) unani­mously in the first year it was intro­duced. The Governor signed this bill into law on May 21. It takes effect on January 1, 2020.

Surprise Billing (Medical Debt) – PASSED
HB 1065 addresses the practice of balanced billing” or surprise billing” occurs when a patient goes to an in-network hospital and doesn’t realize that they may be seen by an out-of-network provider even though they were consci­en­tious about being seen in an in-network facility. In these cases, the patient has been charged for the differ­ence of seeing an out-of-network provider to balance the bill”. This practice has resulted in patients receiving surprise medical bills of hundreds to tens of thousands of dollars. This bill passed the House (95 – 0) and the Senate (47 – 0). It was signed into law by the Governor on May 21.

Access to Mental Health – PASSED
HB 1593 creates the Behav­ioral Health Innova­tion and Integra­tion campus within the Univer­sity of Washington School of Medicine (UWSOM). Requires the UWSOM to create a plan to develop and site a teaching facility that provides inpatient care and workforce training with the input of allied health programs, including the UW School of Nursing. This bill passed the House (95 – 0) and Senate (48 – 0) unani­mously. It was signed into law by the Governor on May 9.

Nursing Educa­tion Funding – PASSED
HB 2158 provides just over $40 million dollars to increase salaries for nurse educa­tors. These salary increases will help retain and recruit nurse educa­tors in Commu­nity and Technical Colleges, where current nurse educa­tors holding Master’s degrees make less than the first year nurses they are gradu­ating with a two-year Regis­tered Nurse degree. Currently, the nursing faculty shortage means that 800 quali­fied nursing school appli­cants are turned away from Washington’s nursing programs each year. This bill passed the Senate (25 – 22) and the House (52 – 46). It was signed into law on May 21.

Founda­tional Public Health Services – PASSED
HB 1497 codifies Founda­tional Public Health Services and requires the Washington State Depart­ment of Health, local health juris­dic­tions, and sover­eign tribal nations work together to deter­mine how state allocated public health funds are to be used. This bill passed the House (94 – 4) and the Senate (44 – 1). It was signed into law by the Governor on April 3.


2019 other bills WSNA supported / opposed #

NURSING #

Increasing SANE Educa­tion in Rural and Under­served Areas – DEAD
HB 1942 requires Washington State Univer­sity (WSU) College of Nursing to estab­lish a program to provide nurses with sexual assault nurse examiner (SANE) online and clinical training. It also requires WSU College of Nursing to estab­lish a regional SANE leader pilot program to gather infor­ma­tion and develop recom­men­da­tions to increase the number of SANEs in rural and under­served commu­ni­ties. This bill died in the policy committee. WSNA supported this bill.

Services Provided by Health Care Profes­sional Students – PASSED
HB 1726 permits pharmacy students, allopathic and osteo­pathic medical students, and nursing students to perform tasks under the super­vi­sion of a licensed pharma­cist, licensed allopathic or osteo­pathic physi­cian, regis­tered nurse, or advanced regis­tered nurse practi­tioner, so long as those tasks fall within the scope of practice of both the student and the super­visor and certain other condi­tions are met. This bill passed the House (95 – 0) and Senate (48 – 0) and was signed into law by the Governor on May 7. 

Health Profes­sion Fees PASSED
HB 1753 requires the State Depart­ment of Health or certain disci­plining author­i­ties, that set or adjust fees affecting health profes­sions, to prepare a state­ment of inquiry under chapter 34.05 RCW regarding the admin­is­tra­tive proce­dure act. Currently, DOH is not required to take any stake­holder input when proposing a licensing fee increase; DOH announces the fee increase and holds a public hearing. HB 1753 requires DOH to treat proposed licensing fee increases like any other proposed rule, with time allowed for stake­holder input beforethe fee is proposed. This would allow WSNA and other stake­holders to weigh in with DOH on any proposed licensing fee increase for nurses.This bill passed the House (98 – 0) and Senate (48 – 0) unani­mously and was signed into law by the Governor on May 8. 

Nurse Licen­sure Compact – DEAD
HB 1882/ SB 5460 estab­lishes the inter­state nurse licen­sure compact of 2019. This bill creates and estab­lishes a joint public entity known as the inter­state commis­sion of nurse licen­sure compact admin­is­tra­tors which is an instru­men­tality of the party states. It requires the Nursing Care Quality Assur­ance Commis­sion to: 1) Obtain finger­prints from each appli­cant for a multi­state license and submit them through the Washington state patrol to the federal bureau of inves­ti­ga­tion for criminal background checks; and, 2) Use the results of the record search in making multi­state licen­sure decisions. WSNA opposed this bill due to imple­men­ta­tion concerns both from other states that have imple­mented the compact and specif­i­cally related to imple­men­ta­tion in Washington state.

Hospital Privi­leges for ARNPs and PAs – PASSED
HB 1432 requires hospi­tals or health care facil­i­ties to collect infor­ma­tion from physi­cian assis­tants (PAs) and advanced regis­tered nurse practi­tioners (ARNPs) before granting or renewing clinical privi­leges or associ­a­tions with the hospital, and requires PAs or ARNPs to provide that infor­ma­tion. It requires hospi­tals or facil­i­ties to notify the Nursing Care Quality Assur­ance Commis­sion or Medical Quality Assur­ance Commis­sion of any denied privi­leges. This bill passed the House (98 – 0) and passed the Senate (46 – 0) unani­mously. It was signed into law by the Governor on April 23. 

PREVENTION #

Tobacco 21 – PASSED
EHB 1074 raises the legal age to 21 years for the lawful sale or distri­b­u­tion of tobacco and vapor products. This bill also autho­rizes the Governor, in recog­ni­tion of the sover­eign authority of tribal govern­ments, to seek govern­ment-to-govern­ment consul­ta­tions with tribes regarding raising the minimum legal age of sale in certain compacts. This bill passed the House (66 – 30) and Senate (33 – 12) and was signed into law by the Governor on May 7. 

Opioid Use Disorder Treat­ment and Preven­tion – PASSED
SSB 5380 declares that opioid use disorder is a public health crisis. This bill also requires state agencies to: (1) Increase access to evidence-based opioid use disorder treat­ment services; (2) Promote coordi­na­tion of services within the substance use disorder treat­ment and recovery support system; (3) Strengthen partner­ships between opioid use disorder treat­ment providers and their allied commu­nity partners; (4) Expand the use of the state prescrip­tion drug monitoring program; and (5) Support compre­hen­sive school and commu­nity-based substance use preven­tion services. Addition­ally, it requires agencies that admin­ister state purchased health care programs to: (1) Coordi­nate activ­i­ties to imple­ment this act and the state inter­a­gency opioid working plan; (2) Explore oppor­tu­ni­ties to address the opioid epidemic; and (3) Provide status updates as directed by the joint legisla­tive execu­tive committee on health care oversight to promote legisla­tive and execu­tive coordi­na­tion. This bill passed the House (97 – 0) and Senate (45 – 1) and was signed into law by the Governor on May 8. 

Fruits and Vegeta­bles Access – PASSED
SHB 1587 estab­lishes the Fruit and Vegetable Incen­tives Program at the State Depart­ment of Health (DOH). This program consists of three compo­nents: 1) Farmers’ Market Basic Food Incen­tives which gives additional funding that may be used by a recip­ient of Basic Food benefits to purchase fruits and vegeta­bles at a farmers’ market autho­rized by DOH; 2) Grocery Store Basic Food Incen­tives which may be used by a recip­ient of Basic Food benefits to purchase fruits and vegeta­bles at a grocery store autho­rized by DOH; and, 3) Fruit and Vegetable Vouchers which are cash-value vouchers that may be distrib­uted by a health profes­sional to a patient who is eligible for Basic Food and has a quali­fying health condi­tion, as defined by DOH, or who is food insecure (the vouchers may be redeemed at a partic­i­pating retailer, including an autho­rized farmers’ market or grocery store). This bill passed the House (84 – 10) and Senate (47 – 1) and was signed into law by the Governor on April 29. 

Maternal Mortality Reviews PASSED
SB 5425 changes the compo­si­tion and duties of the maternal mortality review panel. It autho­rizes the State Depart­ment of Health to request and receive data for specific maternal deaths from the State Depart­ment of Children, Youth, and Families and its licensees and providers. The bill also requires hospi­tals and licensed birth centers to make an effort to report deaths that occur during pregnancy or within 42 days of the end of pregnancy to the local coroner or medical examiner. It also requires a county to be reimbursed from the death inves­ti­ga­tions account, if the county bears the cost of an autopsy related to maternal mortality. This bill passed the Senate (47 – 0) and House (98 – 0) unani­mously and was signed into law by the Governor on May 8. 

HEALTH CARE #

Sexual Assault Kit Notice – PASSED
HB 1016 requires hospi­tals that do not provide sexual assault evidence kit collec­tions, or have appro­priate providers avail­able to provide the collec­tion at all times, to develop a plan by July 1, 2020, to assist individ­uals with obtaining kit collec­tion. Requires hospi­tals that do not provide kit collec­tion or have appro­priate providers avail­able to: 1) Provide notice, within two hours of a request, to an individual who presents in the emergency depart­ment and requests a collec­tion that the hospital does not perform these services or have the appro­priate providers avail­able; and 2) coordi­nate care with the local commu­nity sexual assault agency and assist the patient in finding a facility with appro­priate provider avail­able. This bill passed the House (96 – 0) and Senate (46 – 0) unani­mously and was signed into law by the Governor on May 7. 

Health Care Whistle­blowers – PASSED
SHB 1049 provides a civil remedy to non-employee whistle­blowers at health care facil­i­ties who have been subject to retal­ia­tory action. It also estab­lishes standards for the sanction process against medical staff. This bill passed the House (97 – 0) and Senate (47 – 0) and was signed into law by the Governor on April 19.

Hospital Safety Net Assess­ment – PASSED
SSB 5734 extends the Hospital Safety Net Assess­ment (HSNA) program through July 1, 2023. It continues to allow funds from the HSNA program to be used in lieu of State General Fund payments for Medicaid hospital services through the 2021 – 23 biennium. It also continues to allow funds from the HSNA program to be used for integrated evidence-based psychi­atry and family residency programs through the 2021 – 23 biennium. Finally, this bill allows the Health Care Authority to make offsets to payments to hospi­tals failing to make assess­ment payments within 90 days of the due date. This bill passed the Senate (96 – 1) and House (48 – 1) and was signed into law by the Governor on May 8. 

Afford­able Care Act Protec­tions – PASSED
HB 1870 codifies certain provi­sions of the federal Afford­able Care Act in state law. These include topics such as protec­tions for pre-existing condi­tions, defining the ten essen­tial health benefits, putting in place out-of-pocket maximums, and restricting lifetime coverage limits for essen­tial health benefits. This bill passed the House (56 – 35) and Senate (28 – 17) and was signed into law by the Governor on April 17.

Health Network Adequacy PASSED
HB 1099 requires the Insur­ance Commis­sion­er’s rules to be amended to require each health carrier to include in its electronic provider direc­tory a notation of any mental health or substance abuse provider whose practice is closed to new patients, and it requires the Insur­ance Commis­sioner to publish an annual report on consumer complaints regarding network access to mental health treat­ment and substance abuse treat­ment providers. It also requires a health carrier to publish certain infor­ma­tion about network access on its website. Both WSNA and AAPPN supported this bill. It passed the House (97 – 0) and Senate (45 – 0) unani­mously and was signed into law by the Governor on April 3.

Informed Consent for Pelvic Exams – DEAD
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. This bill was never brought to the Senate floor and died in the Senate Rules Committee. WSNA supported this bill. 

Indian Health Improve­ment PASSED
SB 5415 estab­lishes the Washington Indian health improve­ment act. It creates the gover­nor’s Indian health advisory council and directs the council to: (1) Adopt the biennial Indian health improve­ment advisory plan; (2) Address policies or actions that have tribal impli­ca­tions that are not able to be resolved or addressed at the agency level; and (3) Provide oversight of certain service organi­za­tions or entities to address their impacts on services to American Indians and Alaska Natives and relation­ships with Indian health care providers. It also, creates the reinvest­ment committee of the council and requires the committee, with assis­tance from the state health care authority, the American Indian health commis­sion for Washington state, and other member entities of the advisory council, to prepare a biennial Indian health improve­ment advisory plan. Creates the Indian health improve­ment reinvest­ment account. This bill was supported by WSNA. It passed the House (96 – 0) and Senate (42 – 0) unani­mously and was signed into law by the Governor on May 7.

Individual Health Insur­ance Market (Public Option) PASSED
ESSB 5526 requires the state health benefit exchange, in consul­ta­tion with the insur­ance commis­sioner, the state health care authority, an indepen­dent actuary, and other stake­holders, to estab­lish up to three standard­ized health plans for each of the bronze, silver, and gold levels. It also requires the state health care authority, in consul­ta­tion with the state health benefit exchange, to contract with one or more health carriers to offer silver and gold quali­fied health plans on the state health benefit exchange for plan years begin­ning in 2021. This bill requires the state health benefit exchange, in consul­ta­tion with the state health care authority and the insur­ance commis­sioner, to develop a plan to imple­ment and fund premium subsi­dies for individ­uals whose modified adjusted gross incomes are less than five hundred percent of the federal poverty level and who are purchasing individual market coverage on the health care exchange. This bill passed the Senate (36 – 13) and the House (54 – 38). It was signed into law by the Governor on May 13.

Prescrip­tion Drug Trans­parency PASSED
HB 1224 requires health carriers, pharmacy benefit managers, pharmacy services admin­is­tra­tive organi­za­tions, and drug manufac­turers to report certain prescrip­tion drug pricing data to the Health Care Authority (HCA). It also requires manufac­turers to provide advance notice to HCA before increase the price of certain drugs, and it requires HCA to analyze the data and provide an annual report to the Legis­la­ture. This bill passed the House (92 – 5) and the Senate (48 – 0). It was signed into law by the Governor on May 9 and takes effect on July 28, 2019.

OCCUPATIONAL AND ENVIRONMENTAL HEALTH #

Preventing Toxic Pollu­tion – PASSED
SSB 5135 directs the Depart­ment of Ecology to identify priority consumer products for at least five priority chemi­cals every five years, with the first process begin­ning in 2020. This bill autho­rizes Ecology to take regula­tory actions with respect to priority consumer products containing priority chemi­cals, including restricting or prohibiting the manufac­ture, sale, or use of a priority chemical in a priority consumer product, or requiring a manufac­turer to disclose certain infor­ma­tion about the use of a priority chemical in a priority consumer product. It also autho­rizes Ecology to require manufac­turers to provide certain infor­ma­tion about their use of a chemical to support the identi­fi­ca­tion of priority consumer products containing priority chemi­cals. This bill passed the Senate (27 – 22) and passed the House (60 – 37) and was signed into law by the Governor on May 8.


2019 successful bills the Association of Advanced Practice Psychiatric Nurses supported / opposed #

CHILDREN’S MENTAL HEALTH
#

Children’s Mental Health Bill – PASSED
SB 5903 requires the devel­op­ment of a funding model for Partner­ship Access Line activ­i­ties. It directs school districts to use a profes­sional learning day for training in behav­ioral health topics. This bill also expands residen­cies in child and adoles­cent psychi­atry and requires statewide coordi­nated specialty care for early identi­fi­ca­tion and inter­ven­tion for psychosis. It etablishes mental health consul­tants to support child care providers and coaches. AAPPN supported this bill. This bill passed the Senate (48 – 1) and passed the House (87 – 9) and was signed into law by the Governor on May 9.

BEHAVIORAL HEALTH #

Behav­ioral Health Facil­i­ties – PASSED
HB 1394 estab­lishes inten­sive behav­ioral health treat­ment facil­i­ties and provides for the licensing and certi­fi­ca­tion of these facil­i­ties by the Depart­ment of Health and estab­lishes a pilot program for mental health drop-in centers and requires the Health Care Authority to submit reports on the results to the Governor and the appro­priate commit­tees of the Legis­la­ture by December 1, 2020, and December 1, 2021. This bill directs the Health Care Authority to assess the capacity of hospi­tals and evalu­a­tion and treat­ment facil­i­ties to become creden­tialed to provide long-term mental health place­ments and to contract with those hospi­tals and evalu­a­tion and treat­ment facil­i­ties that choose to provide such services. It suspends certifi­cate of need require­ments for certain hospi­tals that are either adding new psychi­atric beds, changing the use of current beds to psychi­atric uses, or constructing new psychi­atric hospi­tals. This bill also estab­lishes mental health peer respite centers to be creden­tialed by the Depart­ment of Health as peer-operated programs. It requires the Depart­ment of Social and Health Services to track and monitor certain infor­ma­tion about clients of the Devel­op­mental Disabil­i­ties Admin­is­tra­tion who are taken to a hospital. AAPPN supported this bill. It passed the House (96 – 0) and passed the Senate (48 – 0) unani­mously and was signed into law by the Governor on May 9.

Behav­ioral Health Integra­tion – PASSED
SB 5432 deals with fully imple­menting behav­ioral health integra­tion for January 1, 2020, by removing Behav­ioral Health Organi­za­tions from law; clari­fying the roles and respon­si­bil­i­ties among the Health Care Authority, Depart­ment of Social and Health Services, and Depart­ment of Health, and the roles and respon­si­bil­i­ties of Behav­ioral Health Admin­is­tra­tive Services Organi­za­tions and Medicaid Managed Care Organi­za­tions; and making technical correc­tions related to the behav­ioral health system. AAPPN supported this bill. It passed the Senate (49 – 0) and the House (95 – 0) and was signed in the law by the Governor on May 9.

SUBSTANCE USE DISORDER
#

Substance Use Disorder Profes­sional Practice PASSED
HB 1786 revises standards and proce­dures governing protec­tion orders, no-contact orders, and restraining orders, including standards governing the surrender of firearms, dangerous weapons, and any concealed pistol license (CPL) under these orders. It requires any protec­tion order, no-contact order, or restraining order that includes an order to surrender firearms, dangerous weapons, and a CPL to be served by a law enforce­ment officer. This bill also estab­lishes a proce­dure for surrender of firearms, dangerous weapons, and any CPL to law enforce­ment, and autho­rizes courts to issue a warrant to seize firearms and dangerous weapons where there is probable cause to believe the respon­dent has failed to comply with the order. It also makes it Unlawful Posses­sion of a Firearm when a respon­dent possesses a firearm in viola­tion of a quali­fying order that meets certain criteria and that includes an order to surrender firearms and a prohi­bi­tion on possessing firearms. AAPPN supported this bill. It passed the House (26 – 21) and passed the Senate (55 – 40) and was signed into law by the Governor on May 7.

Substance Use Disorder Treat­ment System PASSED
HB 1907 limits the amount of time that an agency-affil­i­ated counselor (AAC) working as a peer counselor in a behav­ioral health agency must spend in a substance abuse monitoring program to one year. It prohibits the Depart­ment of Health (DOH) and certain employers from automat­i­cally denying employ­ment to an appli­cant for a position as an AAC in certain instances if the appli­cant has a past convic­tion for a disqual­i­fying offense, and encour­ages a pathway for dual licen­sure as both an evalu­a­tion and treat­ment facility and a secure withdrawal manage­ment and stabi­liza­tion facility. This bill requires the Health Care Authority (HCA) to produce an update to the desig­nated crisis responder statewide proto­cols to address issues related to behav­ioral health integra­tion and the applic­a­bility of commit­ment criteria to individ­uals with substance use disor­ders by December 1, 2019. This bill also directs the HCA to certify substance use disorder (SUD) peer counselors and include reimburse­ment for SUD peer services in the Medicaid state plan. It directs the DOH to conduct sunrise reviews to evaluate the transfer of the current peer support counselor certi­fi­ca­tion from the HCA to the DOH and the need for the creation of an advanced peer support specialist creden­tial. And it removes the 60-day provi­sional time period for an appli­cant who applies for regis­tra­tion as an AAC and allows the appli­cant to work while their appli­ca­tion is pending with the DOH, as long as required documen­ta­tion is provided within reason­able time limits set by the DOH. AAPPN supported this bill. It passed the House (94 – 0) and passed the Senate (48 – 0) and was signed into law by the Governor on May 21.

MENTAL HEALTH – LEGAL AND LAW ENFORCEMENT
#

Invol­un­tary Treat­ment Proce­dures – PASSED
SB 5181 imposes a six-month suspen­sion on a person’s right to possess a firearm where the person is detained under the Invol­un­tary Treat­ment Act on the grounds of likeli­hood of serious harm and not subse­quently committed for invol­un­tary treat­ment. It allows a person whose firearm rights are suspended for six months to petition for restora­tion of firearm rights upon release from deten­tion and imposes the burden of proof on the state to estab­lish the person does not meet restora­tion criteria. The bill also estab­lishes require­ments for entering infor­ma­tion on a person whose firearm rights are suspended into the National Instant Criminal Background Check System and removing the infor­ma­tion when the right is restored, and creates proce­dures for a six-month suspen­sion of the person’s concealed pistol license. AAPPN supported this bill. It passed the Senate (25 – 20) and passed the House (54 – 42) and was signed into law by the Governor on May 7.

STUDENT LOAN REPAYMENT
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Washington Health Corps – PASSED
HB 1668 estab­lishes the Washington Health Corps to encourage health care profes­sionals to work in under­served areas by providing student loan repay­ment. It also estab­lishes the Behav­ioral Health Loan Repay­ment Program to provide student loan repay­ment to health care profes­sionals who serve in under­served behav­ioral health areas. AAPPN supported this bill. It passed the House (93 – 1) and passed the Senate (48 – 0) and was signed into law by the Governor on May 8.


2019 successful bills the School Nurse Organization of Washington supported / opposed #

NOTE: SNOW also supported the children’s mental health bills listed in the AAPPN section above.

VACCINE PREVENTABLE DISEASES
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Promoting Immunity Against Vaccine Preventable Diseases – PASSED
EHB 1638 prohibits a philo­soph­ical or personal objec­tion from being used to exempt a child from the measles, mumps, and rubella vaccine. SNOW and WSNA supported this bill. It passed the House (56 – 40) and the Senate (25 – 22) and was signed into law by the Governor on May 10.

MEDICATIONS IN SCHOOLS #

Admin­is­tra­tion of Marijuana to Students for Medical Purposes – PASSED
HB 1095 requires a school district to permit a student who meets certain require­ments to consume marijuana concen­trates for medical purposes on school grounds, aboard a school bus, or while attending a school-sponsored event. This bill requires the board of direc­tors of a school district, upon request of a parent or guardian who meets certain require­ments, to adopt a policy that autho­rizes parents or guardians to admin­ister marijuana concen­trates to a student for medical purposes while the student is on school grounds, aboard a school bus, or attending a school-sponsored event. SNOW opposed this bill. It passed the House (79 – 16) and the Senate (41 – 4) and was signed into law by the Governor on April 30.

SCHOOL SAFETY
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Non-Firearm Measures to Increase School Safety and Student Well-Being – PASSED
HB 1216 requires each Educa­tional Service District to estab­lish a Regional School Safety Center with certain duties, subject to state funding. It requires school districts to estab­lish a School-Based Threat Assess­ment Program that meets certain require­ments, by the begin­ning of the 2020 – 21 school year. This bill codifies the School Safety Center and the Student Wellbeing Advisory Committee, and makes the duties subject to state funding. It requires the Office of the Super­in­ten­dent of Public Instruc­tion to monitor certain safety-related programs and plans, subject to state funding. This bill also directs the Joint Legisla­tive Audit and Review Committee to complete a study on the first responder mapping infor­ma­tion system by January 21, 2020. The bill further adds a repre­sen­ta­tive of OSPI to the Emergency Manage­ment Council and directs the Council to consult with certain organi­za­tions on issues that involved early learning, K‑12, or higher educa­tion. The bill also includes require­ments for safe school plans and school safety drills. This bill also estab­lishes require­ments for optional school district School Resource Officer (SRO) programs related to SRO training and law enforce­ment-school district agree­ments. It creates a grant program to fund training for SROs and makes SRO training materials avail­able, subject to state funding. SNOW supported this bill. It passed the House (81 – 15) and the Senate (47 – 0) and was signed into law by the Governor on May 9.