Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Labor & Workplace Standards Committee

SSB 5835

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Description: Promoting healthy outcomes for pregnant women and infants.

Sponsors: Senate Committee on Ways & Means (originally sponsored by Senators Keiser, Baumgartner, Fain, Conway, Cleveland, Rivers, Kuderer, Braun, Rossi, Hasegawa, Hunt and Saldaña).

Brief Summary of Substitute Bill

  • Provides that it is an unfair practice for an employer that employs 15 or more employees to refuse to make reasonable accommodations for an employee's pregnancy and pregnancy-related health conditions.

  • Requires the Attorney General to investigate complaints, and provides a civil cause of action.

  • Requires certain health facilities to establish skin-to-skin contact and room-in policies for newborn infants.

  • Creates the Healthy Pregnancy Advisory Committee to develop a strategy to improve health outcomes for mothers and infants.

Hearing Date: 3/14/17

Staff: Trudes Tango (786-7384).

Background:

State Medical Assistance Program.

The Health Care Authority (HCA) administers the Medicaid program, which is a state-federal program that provides health care for low-income state residents who meet certain eligibility criteria. "Apple Health" is the state's Medicaid program, and the HCA primarily administers the program through contracts with managed care organizations. Apple Health for Kids provides eligible children with health care that includes regularly scheduled health screenings to evaluate a child's growth, development, and general physical and mental health.

The HCA, in collaboration with the Department of Health (DOH), the Department of Social and Health Services, local public health jurisdiction, children's health care providers, and a variety of other stakeholders must establish performance measures to track whether the overall health of enrolled children is improving. The DOH provides performance measure reports to the Governor and the Legislature every two years.

Maternal Mortality Review Panel.

The Maternal Mortality Review Panel (Review Panel) was created in 2016 to conduct comprehensive, multidisciplinary reviews of maternal death in Washington. The Review Panel identifies factors associated with maternal deaths and makes recommendations for changes to improve health care services for women.  The DOH appoints members to the Review Panel.

Washington State Law Against Discrimination.

Under the Washington State Law Against Discrimination (WLAD), the right to be free from discrimination because of certain protected status (such as race, national origin, sex, veteran or military status, sexual orientation, and disability) is considered a civil right. This includes the right to be free from discrimination in employment. It is an unfair practice for an employer to refuse to hire or to fire a person, or discriminate against a person in pay or conditions of employment, because of the person's protected status. Provisions in the WLAD apply to employers who employ eight or more persons, and does not include any nonprofit religious or sectarian organization.

Depending on the circumstances, an employee who believes she has been discriminated against because of her pregnancy may be able to establish a claim of disability discrimination or sex discrimination. Based on a Washington Supreme Court case, pregnancy itself is not considered a disability. However, if a pregnancy-related medical condition results in the employee becoming temporarily disabled, the laws prohibiting discrimination based on disability might apply. Under the WLAD, an employer must provide reasonable accommodation to a disabled worker unless the employer can show that the accommodation would impose an undue hardship. The federal laws prohibiting employment discrimination based on disability apply to employers with 15 or more employees.

Summary of Bill:

Reasonable accommodations for pregnancy and pregnancy-related health conditions.

Provisions are added to the chapter governing the Office of the Attorney General (AG).  It is an unfair practice for an employer to:

"Reasonable accommodation" means:

An employer may request that the employee provide written certification from her treating health care professional regarding the need for reasonable accommodation.  However, written certification is not required, and an employer may not claim undue hardship, for the following accommodations: providing more frequent, longer, or flexible restroom breaks; modifying food or drink policies; providing seating; and limiting lifting over 17 pounds. "Undue hardship" means an action requiring significant difficulty or expense. 

An employer is not required to:

The AG must investigate complaints and enforce the provisions, including by conference and conciliation.  An employee may file a complaint with the AG or bring a civil cause of action in court to enjoin further violations and recover actual damages, costs, and reasonable attorneys' fees or any other appropriate remedy.  In addition, the Department of Labor and Industries must provide online education materials explaining the rights and responsibilities of employers and employees who have a health condition related to pregnancy or childbirth.  Other provisions of law or legal protections relating to sex discrimination, disability discrimination, or pregnancy are not preempted, diminished, limited, or otherwise affected.

State Medical Assistance Program.

Advanced registered nurse practitioners and certified nurse midwives are added to the list of providers the HCA must collaborate with to establish performance measures on children's health under the state Medicaid program.

Effective January 1, 2018, the HCA must require all health care facilities that provide newborn delivery services to medical assistance clients establish policies and procedures for:

The HCA must provide guidelines for hospitals to use in establishing their policies and procedures, including circumstances in which providing skin-to-skin placement or room-in services is not appropriate. The HCA must require managed care organizations to report on the frequency of adhering to their policies and the most common reasons for nonadherence. A summary of the information must be included in the biennial reports on performance measures.

Healthy Pregnancy Advisory Committee.

The Healthy Pregnancy Advisory Committee (Committee) is established to develop a strategy for improving maternal and infant health outcomes.  The Committee must conduct its activities in consultation with the Review Panel and an initiative related to improving maternal and infant outcomes that is established by the largest association representing Washington hospitals.  The DOH must administer the Committee within existing resources.  The Secretary of the DOH (Secretary) must appoint up to 20 members to the Committee from various organizations, including pediatric primary care providers, public health experts, and representatives of low-income women, women of color, and immigrant communities.  The Secretary must also designate a representative from the DOH and invite participation from the HCA, the Department of Social and Health Services, and the Department of Early Learning.  The Committee must meet quarterly and develop a strategy that includes promoting breastfeeding, incentivizing the adoption of baby-friendly designation by hospitals, and reducing barriers to accessing prenatal care. 

The Committee must submit the strategy to the Legislature and the Governor's Council for the Healthiest Next Generation by October 15, 2018.

Appropriation: None.

Fiscal Note: Available. New fiscal note requested on February 24, 2017.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.