AN ACT Relating to a community clinic assistance program; adding a new chapter to Title 74 RCW; making appropriations; providing an effective date; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. The purpose of this chapter is to increase access to primary health services in communities and other areas which lack adequate affordable health care. To that end, this chapter establishes a community clinic assistance program under which the department shall provide financial aid to nonprofit community clinics to assist in meeting communities' public health needs.

NEW SECTION. Sec. 2. As used in this chapter:

(1) "Clinic" means a migrant health center as defined in 42 U.S.C. Sec. 254b or a community health center as defined in 42 U.S.C. Sec. 254c.

(2) "Department" means the department of social and health services.

(3) "Secretary" means the secretary of social and health services or the secretary's designee.

(4) "Primary health services" has the same meaning as in 42 U.S.C. Sec. 254c(b)(1).

(5) "Federal public health service act" refers to subpart I, part D, subchapter II of chapter 6A, Title 42, United States Code (42 U.S.C. Secs. 254b and 254c).

(6) "Federal community development block grant act" refers to chapter 69, Title 42, United States Code (42 U.S.C. Secs. 5301 through 5320).

(7) "Indigent patient" means a person who is unable to pay for needed primary health services or to pay deductibles or coinsurance amounts required by a third-party payer, as reasonably determined by the clinic providing the services.

(8) "Medical assistance program" means any of the programs defined in RCW 74.09.010 (4), (5), and (6).

NEW SECTION. Sec. 3. Within the limits of appropriated funds, the secretary shall make annual grants to public or private nonprofit entities operating clinics that receive federal financial assistance under the federal public health service act (other than 42 U.S.C. Sec. 254a-1) and/or the federal community development block grant act. The grants shall be in addition to any federal or local assistance otherwise available to the clinics and shall be used only to provide primary and preventive health services to indigent patients. A clinic may not receive funds under this chapter if it (1) fails or refuses to provide medically necessary care on the basis of any patient's inability to pay for the care or lack of third-party coverage, or (2) does not contract with the department to provide care under the medical assistance program.

NEW SECTION. Sec. 4. The secretary shall accept applications from public or private nonprofit entities operating clinics for grants under this chapter and shall award grants annually, taking into consideration at least the following factors:

(1) The unmet need for adequate and affordable primary health services in the geographic area served by each applicant;

(2) The past performance of each applicant in providing adequate and affordable primary health services;

(3) An equitable distribution of affordable primary health services in the state;

(4) The extent of current and prospective community support for each applicant, including consideration of funding and/or in-kind support provided from local tax revenues and/or private charitable contributions;

(5) The number and percentage of indigent patients served and to be served by the clinic; and

(6) The number and percentage of patients served and to be served by the clinic whose health care is covered by the medical assistance program.

NEW SECTION. Sec. 5. Each application for assistance under this chapter shall include the following information:

(1) A description of the geographic area being served by the clinic, the economic and health status of its population, the existing resources available to provide primary health services to the population, and the nature and extent of unmet need for primary health services.

(2) A description of the role played by the applicant clinic in meeting the need for affordable primary health services in its service area, and a description of the changes in that role to be accomplished through a state grant under this chapter.

(3) A description of any agreements or operating arrangements the clinic has with physicians, hospitals, laboratories, dentists, pharmacies, home health services, and other providers and facilities in its service area for referral of patients whose health care needs the clinic cannot meet with its own resources.

(4) A copy of the clinic's operating budgets for the current and preceding clinic fiscal years, including identification of current and prospective funding from federal, state, and local sources, private charitable contributions, and patient payments.

(5) Such further information as the secretary may reasonably require to determine whether and in what amount to provide a state grant under this chapter.

NEW SECTION. Sec. 6. For the purpose of auditing the expenditure of state funds and assuring the use of state funds for the purposes defined in this chapter, the department may have access to the books and records, other than individual patient medical records, of clinics receiving grants under this chapter.

NEW SECTION. Sec. 7. Sections 1 through 6 of this act shall constitute a new chapter in Title 74 RCW.

NEW SECTION. Sec. 8. There is appropriated for the biennium ending June 30, 1987, from the general fund to the medical assistance program of the department of social and health services, the sum of .......... dollars, or so much thereof as may be necessary, for grants to community clinics under this act, and from the general fund to the community services administration program of the department of social and health services, the sum of .......... dollars, or so much thereof as may be necessary, for the administration of the program established under this act.

NEW SECTION. Sec. 9. This act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect July 1, 1985.