AN ACT Relating to the department of
corrections health care costs; creating new sections; and declaring an
emergency.
BE
IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1.
The legislature finds that Washington state government purchases approximately
one-fourth of all the health care state-wide. In addition to this huge
expenditure, the state also faces health care inflation rates, far exceeding
the growth rate of the economy as a whole and the general inflationary rate.
Together these factors are straining state resources beyond our capability to
pay.
The legislature finds that the department of
corrections is responsible for providing health care to a large and growing
number of offenders. It is also facing rapidly escalating medical, dental, and
mental health care expenditures. As a result of this, the department must
review its entire inmate health care system and take steps to reduce health
care expenditures.
The legislature further finds that efforts to
achieve state-wide health care reform should also include the department of
correction's health care facilities. In this light, the department must
develop an appropriate plan that will correspond to the changing health care
environment.
NEW SECTION. Sec. 2.
(1) The department of corrections shall conduct a comprehensive review and
analysis of their offender health care system including all its corresponding
expenditures during the 1991-93 biennium.
(2) The department shall review, analyze, and
provide a report of all departmental health services quarterly reports
beginning from 1988 through the most current one. The report shall provide
data indicating the cost and encounter trends of all medical, dental, mental
health, and ancillary services provided for offenders within the division of
offender programs, division of prisons, and division of community corrections.
The trend data shall, to the extent possible, include, but not be limited to:
(a) Total service hours and encounters for consultant/contract services
delivered within a department facility or program; (b) medical encounters by
department staff; (c) encounters conducted off-site; (d) total medication line
visits; (e) inpatient days for department inpatient services and community
facilities; (f) dental off-site and on-site encounters; (g) full mental health
utilization data; (h) total prescriptions ordered for each facility and
overall; (i) total laboratory services for each facility and overall; (j) total
radiological procedures for each facility and overall; and (k) to the extent
possible, the total ICD-9 codes for encounters specific to off-site hospital
services or any other sources that provide such data. The analysis required in
(a) through (k) of this subsection shall include, to the extent possible, a
breakdown for each of the above categories by facility and include prerelease
and work release facilities.
(3) The department shall describe in the report
its current health information system capabilities. The report shall include,
but not be limited to, its offender health information systems reporting
capabilities, data sources, and principal limitations of the current system.
To the extent possible and within existing resources, the description shall
contain an action plan for developing and implementing a basic, yet fully
integrated, health care and financial information system for all department of
corrections facilities and for all offender health care. The basic offender
health care data system should be able to identify cost centers, utilization
patterns, pharmaceuticals and supplies ordering, and tracking by patient and by
cost center, encounter specific diagnosis data, both contract and noncontract
provider and off-site hospital practice patterns, and all procedure costs. The
action plan shall include, to the extent possible, basic information systems
configurations, basic hardware specifications, the total estimated cost for
hardware, software, maintenance, and personnel, the estimated time line for
installation and live use, and the potential and expected system development
obstacles.
The department shall also investigate the
potential for: (a) Integrating its offender health information system with the
existing health information systems at western state hospital or any other
state-supported facilities willing and able to share their health care
information system software and expertise; (b) sharing software and/or hardware
using current modem technology; and (c) using and modifying nonproprietary
software for use in a state-wide offender data base and on-line health
information system.
(4) The department shall report its progress to
date and estimated or potential saving on: (a) The development of purchasing
any offenders health services through preferred contract providers state-wide;
(b) the consolidated purchasing of high technology services; (c) the
coordination of bulk purchasing of equipment, supplies, and pharmaceuticals;
(d) the use of generic pharmaceuticals; (e) the extent to which the department
has coordinated with the department of health and the department of social and
health services to develop health promotion and prevention care, substance
abuse treatment, and mental health treatment including the development of pilot
programs using federal grant assistance for training, research, or program
implementation; (f) the extent the department has developed protocols for
utilization review for assessing the medical necessity and appropriateness of
care purchased from contracted or fee for service community-based providers and
for the appropriate level of provider contracted in-house; (g) the feasibility
of involving other state or federal programs in picking up the costs for
offender health care; (h) the current and potential relationships between the
department and the two mental health hospitals operated by the division of
mental health, and any other state-owned or operated institutions, agencies, or
departments, including but not limited to the University of Washington medical
school, Harborview hospital, and Eastern Washington University; (i) the
feasibility of developing a preferred provider contract with the state's
community health care clinic consortium; (j) an estimate of the number of
offenders in need of chronic long-term care, their ages, offense, level of
incarceration, level of security risk, protocols if developed for managing the
health care and security of these offenders, and any other cost saving
recommendations for managing offenders in need of chronic long-term care; (k)
the degree to which the department can recover health care costs from the
offender through their wages while working in correctional industries, or
directly through their own resources or insurance, or through their spouse's
insurance.
(5) The department of corrections shall submit
an initial copy of the report to the health care authority, the department of
health, and the department of social and health services, for their written
comments regarding recommendations for departmental coordination or
cooperation, or any other cost savings recommendations by September 1, 1993.
The department shall provide a final copy of the report, including any comments
provided by the departments, to the appropriate committees of the senate and
the house of representatives by December 12, 1993.
NEW SECTION. Sec. 3.
The department of corrections shall consult with the state health care
authority to identify how the department of corrections shall develop a working
plan to correspond to the health care reform measures that require all
departments to place all state purchased health services in a community-rated,
single risk pool under the direct administrative authority of the state
purchasing agent by July 1, 1997. The department of corrections shall report
the findings to the chairs of the house of representatives health care
committee and committee on corrections and the chairs of the senate committee
on health and human services and the law and justice committee by December 12,
1993.
NEW SECTION. Sec. 4.
This act is necessary for the immediate preservation of the public peace,
health, or safety, or support of the state government and its existing public
institutions, and shall take effect immediately.
