S-0419.1 _______________________________________________
SENATE BILL 5597
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State of Washington 52nd Legislature 1991 Regular Session
By Senators West, Snyder, Barr and Jesernig.
Read first time February 11, 1991. Referred to Committee on Health & Long‑Term Care.
AN ACT Relating to rural hospital services; and creating new sections.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1. In most rural areas in Washington state, hospitals provide access to essential medical services for local residents as well as urban and out-of-state visitors. The services include emergency services, acute care services normally performed in a hospital setting, and primary care services normally performed in clinics or physicians' offices in urban areas. The legislature finds and declares that a central policy objective for this state is to maintain access in rural areas to these essential hospital and primary care services.
The legislature further finds and declares that many hospitals providing essential health care services in rural areas are in extremely poor financial condition and in danger of closing if immediate action is not taken to improve payment levels of state programs.
Specifically, the legislature finds that: Primary care in rural areas is often unavailable to medical assistance patients except in hospital emergency rooms and outpatient clinics because of the shortage of physicians and the reluctance of some practitioners to accept patients from this program; current medical assistance payments do not pay the full costs of emergency room and outpatient care, which penalizes hospitals for treating all persons without regard to ability to pay; and a large part of the financial crisis for rural hospitals is due to the combination of a high proportion of state and federally assisted patients and the failure of these programs to pay the full costs of treatment.
NEW SECTION. Sec. 2. The department of social and health services' medical assistance program shall develop a plan that would provide rural hospitals reasonable payments for the delivery of essential access services to medical assistance clients in rural areas to be submitted to the legislature by December 31, 1991. Essential health care services must be designated in the plan and, at a minimum, shall include outpatient and inpatient services for pregnant women, their infants, and children and youth; emergency room services including ancillary diagnostic procedures and emergency room physician coverage; and inpatient treatments, and diagnostic and therapeutic procedures that are most appropriately provided at local facilities within reasonable travel times. The department shall work with the department of health to identify the scope of the definition of rural hospitals for the purposes of this act.
NEW SECTION. Sec. 3. The state health care authority shall evaluate the extent to which other health care purchasing practices of this state conflict with the state's policy goal of preserving access to essential health care services in rural areas. The authority shall recommend to other agencies ways to resolve any conflicts and shall provide a status report to the legislature by December 31, 1991.