SENATE BILL REPORT

SB 5177

BYSenators Barr, Conner, Patterson, Metcalf, McMullen, Sellar, Benitz, Vognild, Anderson, West, Bauer, Warnke and Kreidler

Establishing the rural health system project.

Senate Committee on Health Care & Corrections

Senate Hearing Date(s):January 26, 1989; February 2, 1989

Majority Report:  That Substitute Senate Bill No. 5177 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.

      Signed by Senators West, Chairman; Smith, Vice Chairman; Amondson, Niemi, Wojahn.

Senate Staff:Scott Plack (786-7409)

                  February 3, 1989

Senate Committee on Ways & Means

Senate Hearing Date(s):March 2, 1989; March 3, 1989

Majority Report:  That Second Substitute Senate Bill No. 5177 be substituted therefor, and the second substitute do pass.

      Signed by Senators McDonald, Chairman; Craswell, Vice Chairman; Amondson, Bailey, Bluechel, Cantu, Gaspard, Hayner, Johnson, Lee, Matson, Moore, Newhouse, Niemi, Owen, Saling, Smith, Talmadge, Warnke, Wojahn.

Senate Staff:W. Featherstone Reid (786-7715)

                  March 15, 1989

AS REPORTED BY COMMITTEE ON WAYS & MEANS, MARCH 3,  1989

BACKGROUND:

Changes in the demand for health care services, in the reimbursement policies of public and private payers, as well as changes in economic conditions, threaten access to affordable basic health care services to rural citizens.  The Washington Rural Health Care Commission was authorized by the Legislature to identify current problems associated with assuring continued access to health care in rural areas and to make recommendations for changes in state policy.

The commission identified many factors that inhibit needed changes in the delivery of rural health care services.  They include outdated or rural-inappropriate regulatory laws, aging and inefficient health care facilities, an absence or ineffective local planning and coordination of services and a lack of state health policy objectives.

The commission recommended that a partnership be established between the state and rural communities where the state provides general health policy direction and rural communities take an active role in reorganizing the delivery of health care services.

SUMMARY:

The rural health system delivery project is created in the Department of Social and Health Services (DSHS).  The project provides technical assistance and limited financial assistance to six rural participant communities and technical assistance to another six participant communities.  Participants are required to evaluate local health care needs, determine appropriate health care objectives and design strategies to assure continued access to affordable basic health care services.  Communities may contract with consultants to help with specialized needs such as recruitment of primary care physicians, conversion of the local hospital to an alternative health care facility, and improved coordination of service delivery among existing local health care providers.

The secretary is directed to appoint a project administrator.  The project administrator will assist communities in:  identifying technical assistance resources; administering funding; identifying local health care outcome objectives; and serving as an advisor to the secretary on rural health care. 

EFFECT OF PROPOSED SUBSTITUTE:

The administrator of the project shall report directly to the secretary.  The department, rather that the administrator, shall adopt rules to implement the project.  Clarifying language is added to assure the appropriation transfers with the program to the Department of Health if the new department is created.

EFFECT OF PROPOSED SECOND SUBSTITUTE:

The word "basic" is stricken where it appears seven times in connection with health services in sections 1, 2 and 3.  The word "paramount" is stricken from the first sentence of the declarations of public purpose and intent in section 1.

The appropriation of $500,000 is stripped out, leaving any funding level to the eventual passage of both this measure and the operating budget for the next biennium.

Appropriation:    none

Revenue:    none

Fiscal Note:      available

Senate Committee - Testified: HEALTH CARE & CORRECTIONS:  Dr. John Anderson Commission WRHA (pro), Dr. Stephen Kriebel, Washington State Medical Association; Jeff Mero, State Hospital Association (pro); Verne Gibbs, Department of Social and Health Services (pro); Eldon E. Jacobsen, SHCC; Tom Martin, Lincoln Hospital District (pro); Mary C. Selecky, Rural Health Commission (pro)

Senate Committee - Testified: WAYS & MEANS:  Senator Scott Barr; Senator James West; Representative Steve Fuhrman; Sharon Case, Washington State Primary Care Association; Charlotte Hardt, Ritzville Memorial Hospital; Jeff Mero, Washington State Hospital Association; Jackie L. McFayden, Washington State Association of Counties; Dan Rubin, Department of Social and Health Services; Gail Toraason, Washington State Nurses Association; Ron Wagner, Washington State Medical Association