The Washington State Legislature passed its supplemental 2021-23 operating budget on March 10, increasing state spending to $64 billion over two years. This is a $5 billion increase from last year’s budget. The Legislature appropriated over $1 billion in unspent federal COVID-19 funding with most of the money going towards public health, schools and housing. The budget included $37 million to continue to address the opioid epidemic. To stabilize the behavioral health workforce, the Legislature appropriated $100 million to go towards one-time payments for community-based Medicaid contracting behavioral health providers. Most notably, the Legislature made a $71 million investment in supporting nursing and health care education programs, which included funding for simulation labs, nurse preceptors and the establishment of new nursing programs.
All dollars reflect General Fund – State operating funds unless otherwise noted.
|WSNA priority||Agency||Description||Final Budget|
|Health care simulation labs||Community & Technical College System||Administer grants for nursing programs to purchase or upgrade simulation laboratory equipment. This will help expand the capacity of simulation laboratories to serve more nursing students. (Workforce Education Investment Account)||$8M|
|Health care simulation labs||Public Schools||Funding is provided for OSPI to administer grants for nursing programs to purchase or upgrade simulation laboratory equipment.||$3.6M|
|Health care simulation labs||Student Achievement Council||The Washington Student Achievement Council will administer grants for nursing programs to purchase or upgrade simulation laboratory equipment. This will help expand the capacity of simulation laboratories to serve more nursing students.||$3.6M|
|Nurse educator loan repayment||Student Achievement Council||Funding is provided to implement House Bill 2007.||$3M|
|Washington student loan program||Student Achievement Council||Funding is provided to implement Engrossed Second Substitute House Bill 1736.||$150M|
|Health workforce grants||Community & Technical College System||Funding is provided for SBCTC to administer grants to help incentivize students to enter the health workforce.||$8M|
|Nursing education||Community & Technical College System||Funding is provided for additional nursing slots and graduates, and to purchase two simulation vans.||$3.8M|
|Community organization support||Community & Technical College System||Funding is provided for grants for each of the 34 community and technical colleges to partner with community-based organizations.||$2.7M|
|Nurse delegation/glucose||Department of Health (DOH)||Funding is provided for Substitute House Bill 1124 (Nurse delegation/glucose), which allows a registered nurse to delegate glucose monitoring and testing to a registered or certified nursing assistant.||$17,000|
|Nurse preceptor grants||DOH||Sets up a grant program to provide funding to nurses who are willing to supervise nursing students in health care settings. The goal of this program is to help reduce a shortage of health care settings for students to conduct their clinical hours and bring more nurses into the field.||$6M|
|Credentialing resources||DOH||Funding is provided for 26 temporary project FTEs to process additional applications for provider credentials and address delays caused by the pandemic. The stated aim of this funding is to issue credentials within seven calendar days of receiving a complete application.||$2.5M|
|Nursing license applications||DOH||The Nursing Care Quality Assurance Commission (NCQAC) is housed at the Department and is charged with regulating nursing standards statewide. Funding is provided for 10 ongoing FTEs to shorten the turnaround time for applications. The biennial budget established a standard for 7-day turnaround. NCQAC is currently turning around licenses in 12 days.||$2M|
|Student support||Western Washington University||Funding is provided for student support services on the Bellingham campus and Western on the Peninsulas campuses. These resources include outreach and financial aid support, retention initiatives, mental health support and initiatives to address learning disruption due to the pandemic. Funding must be used to supplement, not supplant, other funding sources for student support.||$1.3M|
|Master’s in nursing||Western Washington University||Funding is provided to establish a Master of Science in Nursing program.||$461,000|
|RN to Bachelor’s in nursing||Western Washington||Funding is provided for the Registered Nurse (RN) to Bachelor of Science in Nursing program to increase enrollment and align the program tuition rate with other state-supported undergraduate degrees.||$433,000|
|Bachelor of Science in Nursing||Eastern Washington University||Funding is provided to establish a Bachelor of Science in Nursing program||$6.2M|
|Nursing education||University of Washington||Funding is provided for additional nursing slots and graduates in the existing accelerated Bachelor of Science in Nursing program at the Seattle campus. Of the amount provided, $273,000 in FY 2023 is for the School of Nursing and Healthcare Leadership at the Tacoma campus. A coordinated progress report with the Student Achievement Council is due to the Legislature by June 1, 2023, and a final report is expected by December 1, 2024.||$1.2M|
|Sexual Assault Nurse Examiners||Washington State University||Funding is provided to implement House Bill 1622, Increasing the availability of sexual assault nurse examiner education in rural and underserved areas.||$122,000|
|Sexual Assault Nurse Examiners||University of Washington||Funding is provided for additional sexual assault nurse examiner training.||$122,000|
|Sexual Assault Nurse Examiners||DOH||Funding is provided for the DOH to establish a spending program to reimburse certified nurses for eligible costs incurred in training to become a certified sexual assault nurse examiner. Funding is also provided for the Department to establish a grant program to hospitals to obtain the services of a certified sexual assault nurse examiner from other sources if the hospital does not have those services available internally.||$1.1M|
|Sexual Assault Nurse Examiners||Office of the Attorney General||Funding is provided to reconvene the Sexual Assault Forensic Examination Best Practices Advisory Group.||$58,000|
|School nurse funding||Public Schools||Funding is phased in to increase school staffing ratios and allocations for nurses, social workers, psychologists and counselors to support the physical and social-emotional needs of students as required in Second Substitute House Bill 1664.||$91M|
All dollars reflect General Fund – State operating funds unless otherwise noted.
|Budget Item||Agency||Description||Final Budget|
|COVID-19 contain the spread||DOH||Funding will continue supporting the ongoing statewide effort to control the spread of COVID-19 through diagnostic testing, case investigation and contact tracing, care coordination, outbreak response, disease surveillance, public communications, and necessary operational and information technology support.||$58M|
|Continue COVID-19 vaccinations||DOH||Funding is provided for the continuation of COVID-19 vaccine work to address unequal vaccination coverage across the state and among certain demographic groups. Vaccine hesitancy and the increasing threat of variants present significant obstacles for the state to resume normal business operations and move beyond the pandemic.||$67M|
|WA Medical Coordination Center||DOH||Funding will continue the contract with the Washington Medical Coordination Center to provide services that connect all health care facilities, ensure maximum clinical coordination and equitably distribute patients across regions and health care organizations. This will ensure quality patient care during the COVID-19 pandemic.||$1.3M|
|Hospital policies/pathogens||DOH||Funding is provided for House Bill 1739 (hospital policies/pathogens), which requires hospitals to adopt policies for any pathogen of epidemiological concern, rather than just Methicillin-resistant Staphylococcus aureus (MRSA).||$44,000|
|Disaster preparedness and response||Military Department||Additional funding is provided to complete the Pandemic After-Action Review funded in the 2021-23 biennial budget.||$134M|
|Disaster response human services||Military Department||Funding is provided for two staff to provide emergency management and human services support and coordination to people with access and functional needs as defined by the American Disabilities Act.||$438,000|
|Pandemic after- action review||Military Department||Additional funding to the amounts appropriated in the 2021-23 operating budget is provided to complete the task of the After Action Review.||$525,000|
|Infectious disease control||Department of Social & Health Services (DSHS)||Funding is provided for one nurse position, beginning in FY 2023, that is dedicated to prevention and control of infectious diseases among patients and staff in state hospitals.||$390,000|
|Personal protective equipment||DSHS||Personal protective equipment helps contain the spread of COVID-19 and reduce infection rates. Funding is provided to purchase, store and distribute PPE to DSHS employees. This assumes that Federal Emergency Management Agency (FEMA) funding expires in March 2022.||$3.1M|
|Isolation/quarantine wards||DSHS||One-time funds are provided for isolation and quarantine wards to prevent and control the transmission of COVID-19 among patients and staff.||$4M|
|COVID-19 screening stations||DSHS||One-time funds are provided for COVID-19 screening stations to prevent and control the transmission of COVID-19 among patients and staff.||$1.7M|
E2SHB 1868 establishes minimum staffing standards for acute care hospitals for specific patient units. The bill has four critical pieces: 1) safe staffing standards; 2) improves staffing committee functions and accountability mechanisms; 3) improves enforcement of existing laws including meal and rest breaks and mandatory overtime; and 4) provides a private right of action, allowing individual nurses and health care workers or their union to utilize the legal system as another means of accountability. The bill also moves implementation and enforcement of the staffing provisions under the Department of Labor & Industries. The bill passed the House 55 to 43 after it was amended to remove the private right of action clause. The bill made it all the way to the Senate Ways & Means committee but was removed from consideration before it could be passed out.
2SHB 1664 increases funding to school districts for nurses, social workers, psychologists and counselors over three years. The bill also designates certain staff positions as “physical, social, and emotional support staff.” The bill increases funding to school districts so that by the 2024-25 school year elementary schools will have .585 FTE nurse time (formerly .076 FTE), middle schools will have .88 FTE of nurse time (formerly .06 FTE) and high schools will have .824 FTE of nurse time (formerly .096). The amended version of the bill passed the Senate 45 to 2 and the House concurred 74-24. The final budget included $91 million dollars to fund this bill. The bill was signed into law on March 23 of this year.
HB 1622 requires the Washington State University College of Nursing to establish online and clinical training programs for Sexual Assault Nurse Examiners (SANEs). Currently, Harborview in Seattle is the only facility that provides training for Sexual Assault Nurse Examiners. This bill expands access to training to the east side of the state. The bill requires WSU to provide scholarships for nurses interested in completing the training. WSU is required to report annually to the Legislature on the impact of the training. Additionally, the bill creates a regional SANE Leader pilot program. The regional leader is required to gather data on the number of SANEs in the community as well as the educational needs of the community. Each leader must create recommendations based on their findings and develop a community-based action plan for SANE recruitment. The bill passed both the House and Senate unanimously. The bill was signed into law by the Governor on March 24.
SHB 1621 required the Department of Health to establish a stipend program for licensed nurses training to become sexual assault nurse examiners. The bill also required DOH to establish a hospital grant program to increase access to certified SANEs. The bill did not make it to the house floor for a vote. However, the budget included $1.1 million to create this program.
SHB 1124 allows registered nurses to delegate glucose monitoring and testing to a registered or certified nursing assistant or a certified home care aide. HB 1124 was originally introduced in 2021 but did not make it out of the Senate by cutoff. At the start of the 2022 session, HB 1124 was reintroduced on the Senate side in the Health Care committee. The bill passed the Senate unanimously. The bill was signed into law by the Governor on March 11 and goes into effect on June 9 of this year.
HB 2007 establishes a Nurse Educator Loan Repayment Program under the Washington Health Corps. The program is administered by the Washington Student Achievement Council (WSAC) in collaboration with the Department of Health. The maximum loan repayment award is $75,000 for a minimum three-year obligation of full-time employment. WSAC will determine the specific selection criteria for nurse educators to qualify for the program. The bill passed the House 97 to 1 and the Senate unanimously. The bill was signed into law on March 31.
E2SHB 1659 creates the Bridge Grant Pilot Program for students in need of additional financial support for higher education. When originally introduced, this bill created block grants for students to help pay for costs associated with attending college such as tutoring, childcare and transportation. The bill was amended on the Senate floor to establish a pilot program and study instead. The Bridge Grant Pilot Program requires the Washington Student Achievement Council (WSAC) to award $500 bridge grants to students in the 2022-23 academic year. The higher education institutions participating in the pilot program include Eastern Washington University, The Evergreen State College, Highline College, Yakima Valley College, Wenatchee Valley College and Tacoma Community College. Additionally, WSAC is required to conduct a study on the effectiveness of the program by June 1, 2027. The amended version of the bill passed the Senate 38-10 but never came up for a concurrence vote in the House.
SSB 5911 provided health care workers with one-time hazard pay for service during the COVID-19 pandemic. The bill would have used one-time federal funding to provide bonuses across multiple health care job classes. Unfortunately, after hearings in the Senate Health Care and Ways & Means committees, the bill did not move forward.
SHB 5753 changes the member composition and leadership roles of several boards and commissions. The bill changes current law to no longer require that the executive director of the Nursing Care Quality Assurance Commission be currently licensed as a registered nurse. The bill also removes the experience in nursing requirement. The bill also removes the requirement that members of the commission be United States citizens. The final version of the bill passed the House 57 to 41 and the Senate concurred 31 to 18. The bill was signed by the Governor on March 30 and goes into effect on June 9, 2022.
EHB 1837 removes the restriction on the regulation of work-related musculoskeletal disorders and ergonomics. The bill was a response to Initiative 841, which passed in 2003 and repealed a Labor & Industries regulation that required employers to reduce worker exposure to specific workplace hazards that cause or contribute to work-related muskoskeletal disorders. The bill would have limited L&I to adopt only one new standard a year. The bill passed the house 50 to 48 but did not make it out of the Senate.
SHB 1779 requires hospitals and ambulatory care facilities to adopt policies requiring the use of smoke evacuation systems for planned surgical procedures. The bill also creates a Surgical Smoke Evacuation Account for Critical Access Hospitals and sole community hospitals to receive reimbursement for their upgrades. The act takes effect January 1, 2024, for the majority of hospitals and January 1, 2025, for critical access hospitals and sole community hospitals. The amended version of the bill passed the Senate 44 to 5 and the House concurred 81 to 17. The bill was signed into law on March 24 but will not go into effect until January 1, 2024.
SSB 5704 requires health carriers to reimburse ARNPs at the same rate as physicians for the same services. The bill passed out of the Senate Health Care committee but did not receive a hearing in Ways & Means. We expect this bill to be introduced again next year.
SHB 1616 was requested by the Attorney General. Modeled off a recently passed law in Oregon, this bill increases charity care requirements for hospitals. The bill requires hospitals to develop, implement and maintain a sliding-scale fee schedule for providing charity care. Charity care requirements are based on the hospital size with large hospitals required to provide charity care covering the full cost of care for families that are at or below 300% of the federal poverty level. In its final version, the bill passed the Senate 31 to 17 with the House concurring 65 to 33. The Governor signed the bill into law on March 30 and it goes into effect on June 9, 2022.
HB 1761 is a bill that fixes legislation passed in 2021. The bill adds registered and licensed nurses to the types of health care providers who must dispense or distribute opioid overdose reversal medication. The bill passed both chambers unanimously and was signed into law by the Governor on March 11. The law went into effect immediately.
E2HB 1736 creates a student loan program under the Washington Student Achievement Council (WSAC). The program will be administered by the Office of the State Treasurer. The WSAC and the Treasurer are required to design a loan program that has a low interest rate for undergraduate and graduate students. The two organizations along with the State Investment Board will determine the parameters of the loan program. A report on the program is due to the Governor and Legislature by December 1, 2022. The bill was funded in the budget at $150 million. The final version of the bill passed the Senate 27 to 21 and the House concurred 57 to 40. The bill was delivered to the Governor on March 10 and signed into law on March 30. The bill goes into effect on June 9, 2022.
HB 1651 requires health plans to allow providers to bill separately for devices or professional services associated with immediate postpartum contraception. The bill passed the House 95 to 2 and passed the Senate 45 to 2. The bill signed into law on March 24. The bill goes into effect on June 9, 2022.
HB 1805 opens the Washington State Opportunity Scholarship Program to accept students seeking advanced degrees who can demonstrate financial need. The bill also adds registered apprenticeships under the Washington State Opportunity Scholarship Program Professional-Technical Degree and Certificate programs. The bill also makes several changes to the Rural County High Employer Demand Jobs Program including removing the 2.0 grade point average requirement. The final version of the bill passed the Senate unanimously and the house concurred 92 to 5. The bill was signed by the Governor on March 30 and it goes into effect on June 9, 2022.
EHB 1851 seeks to strengthen Washington’s existing laws relating to abortion access. The bill grants specific statutory authorization for physician assistants, ARNPs and other providers acting within their scopes of practice to perform abortions. The bill prohibits the state from acting against an individual based on pregnancy outcomes or for assisting a pregnant individual in exercising their right to reproductive freedom. The final version of the bill passed the Senate 28 to 21 and the House concurred 57 to 41. The bill was signed by the Governor on March 17 and goes into effect on June 9, 2022.
ESHB 1881 creates a voluntary certification process for birth doulas. This is a follow-up to a 2020 budget proviso that required the Health Care Authority to reimburse for maternity support services provided by doulas. The bill passed the Senate unanimously and the House concurred 57 to 41. The bill was signed by the Governor on March 30. The bill goes into effect on June 9, 2022.
SHB 1893 modifies the definition of emergency medical technicians to allow EMTs to provide collaborative medical care. The bill also creates a provisional emergency services provider certification and establishes eligibility criteria and certain corresponding restrictions on employment. The bill passed the Senate unanimously and the House concurred 92 to 6. The bill was signed by the Governor on March 24 and goes into effect on June 9. 2022.
SHB 1646 codifies the Dementia Action Collaborative to assess the current and future impact of Alzheimer’s disease and other dementias. The bill also updates the Washington State Alzheimer’s Plan. The final version of the bill passed both the House and Senate unanimously. The bill was delivered to the Governor for his signature on March 10 and signed into law on March 24. The bill goes into effect on June 9, 2022.
2SHB 1890 creates a strategic advisory group under the Children and Youth Behavioral Health Workgroup (CYBHW). The goal of the advisory group is to develop a behavioral health strategic plan for children, youth transitioning to adulthood and their caregivers. The bill also modifies the CYBHW by adding a member, allowing up to six meetings per year and allowing stipends up to $200 per day for members with lived experience. The final version of the bill passed the Senate unanimously and the House concurred 90 to 8. The bill was signed by the Governor on March 17.
SSB 5883 allows for an unaccompanied minor youth who is a minor patient to provide informed consent for non-emergency, outpatient and primary care services. The bill defines “unaccompanied” and “homeless.” The bill passed the House 57-41 and the Senate concurred 29 to 20. The bill was signed into law on March 30 and will go into effect on June 9, 2022.
SHB 1590 provides enrollment stabilization funds to schools to make up for decreased student enrollment in the 2019-20 and 2021-22 school years. The final version of the bill passed the Senate 28 to 21 and the House concurred 62 to 36. The final budget included $346 million to fund this bill. The bill was delivered to the Governor on March 10 and signed into law on March 23. The bill went into effect immediately.
HB 1834 requires the Superintendent of Public Instruction to categorize a student absence from school for a mental health reason as an excused absence due to illness, health condition or medical appointment. The bill also directs the Superintendent to develop guidelines to implement the student absence rules. The bill requires the creation of an advisory group to help inform decision-making. The bill passed the House and the Senate unanimously. The Governor signed the bill into law on March 11 and it goes into effect on June 9, 2022.