HOUSE BILL REPORT

                 ESHB 2396

                       As Passed House

                      February 9, 1994

Title:  An act relating to medical care for inmates.

Brief Description:  Requiring prisoners to make a five dollar payment for each medical visit.

Sponsors:  By House Committee on Corrections (originally sponsored by Representatives Orr, Morris, Sommers, Dellwo, Padden, Conway, Linville, Kremen, Chandler, Foreman, Lisk, Long, Johanson, Silver, Cothern, Kessler, J. Kohl, Chappell, Romero, Holm, Jones, Sheldon, Eide, Rayburn, L. Johnson, Springer and H. Myers).

Brief History:

Reported by House Committee on:

Corrections, January 24, 1994, DPS;

Passed House, February 9, 1994, 91-3.

HOUSE COMMITTEE ON CORRECTIONS

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass.  Signed by 7 members:  Representatives Morris, Chair; Long, Ranking Minority Member; Edmondson, Assistant Ranking Minority Member; G. Cole; L. Johnson; Moak; and Ogden.

Staff:  Antonio Sanchez (786-7383).

Background:

Department of Corrections Health Care

One of the most significantly rising costs in our prison system is inmate health care.  Since 1986, the health care expenditures for inmates in prison have doubled, from $10.97 million in 1986 to $22.23 million in 1992.  In 1992 alone, health care costs increased by 14 percent.   These costs are expected to continue to rise as medical costs inflate, the prison population grows, and an increasing number of inmates become older and need additional health and long-term care.

Currently the Department of Corrections' policy is to "provide, at a minimum, a degree of care which is designed to reasonably respond to an inmate's serious medical and dental needs."  The department is required to pay for all the health care needs of inmates attended to under this policy.  Health care provided by the Department of Corrections can be grouped into four types of care as follows:

(1) medical care to meet inmates' serious medical needs;

(2) basic dental care;

(3) mental health treatment and counselling; and

(4) drug and alcohol rehabilitation.

Medical co-payments have been found to reduce health care expenditures by discouraging over-utilization and inappropriate use of health care services and are an important part of both state and national health care reform. 

Currently, inmates who receive health care in state prison are not required to pay in part or in full for their health care. They are also not required to pay co-payments for each medical visit.

Summary of Bill:  All inmates in state prisons are required to pay a five dollar co-payment each time they receive health care.  The co-payment will cover the original visit and any other subsequent visits ordered by the health care provider which are related to the original diagnosis.  Mental health, health care visits made to pick up prescribed pharmaceuticals, and encounters for readily apparent injuries or traumas are excluded from co-payments.  Inmates can pay by having the one dollar deducted from their personal accounts, or they can pay in person.

No medical services can be withheld from an inmate due to lack of funds.

Fiscal Note:  Available.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  Medical co-payments have shown to reduce health care costs. 

Testimony Against:  None.

Witnesses:  Kurt Sharar, Washington State Association of Counties (Pro).