H-4525.1          _______________________________________________

                                  HOUSE BILL 2879

                  _______________________________________________

State of Washington              54th Legislature             1996 Regular Session

By Representatives Conway, Dyer, Carrell, Regala, Scheuerman, Cody, R. Fisher, Hatfield and Mitchell

Read first time 01/23/96.  Referred to Committee on Health Care.

Developing a comprehensive, uniform, and responsive designated trauma care system.

     AN ACT Relating to developing a comprehensive, uniform, and responsive designated trauma care system; amending RCW 43.72.900; adding a new section to chapter 70.168 RCW; and creating new sections.

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

NEW SECTION. Sec. 1.  The legislature finds that a successful state-wide trauma care system depends on the voluntary participation of hospitals and health care facilities as designated trauma care centers for the special purpose of providing lifesaving medical care to victims of severe trauma.  The legislature further finds that these services are expensive, and that providing them may create a particular financial burden on designated trauma care services when this care serves patients who cannot pay for it themselves and for whom there is no third party payer.

     It is the intent of the legislature to support the state-wide trauma care system and its designated trauma centers with a fair and equitable funding system that provides reimbursement for uncompensated care.  The legislature intends to provide financial assistance for designated trauma care services on behalf of trauma patients for whom other financial resources are not available.  The legislature further intends to establish a successful state-wide trauma care system that includes an appropriate number of level I and level II designated trauma care centers.

NEW SECTION. Sec. 2.  A new section is added to chapter 70.168 RCW to read as follows:

     (1) A designated trauma care service is eligible for reimbursement from the health services account only for patients who:

     (a) Enter the designated trauma care service after qualifying for trauma services through the trauma triage procedure developed by the department of health; and

     (b) Have an injury severity score (ISS) of sixteen or greater.

     (2) To be eligible for reimbursement, designated trauma care services shall:

     (a) Demonstrate all designation standards defined by the department of health in rule;

     (b) Provide complete trauma care data to the department's trauma care registry according to requirements in WAC 246-976-430;

     (c) Establish an internal quality assurance trauma program that complies with WAC 246-976-880; and

     (d) Enroll medically indigent trauma care patients in the state's basic health plan.

     Sec. 3.  RCW 43.72.900 and 1993 c 492 s 469 are each amended to read as follows:

(1) The health services account is created in the state treasury.  Moneys in the account may be spent only after appropriation.  Moneys in the account may be expended only for maintaining and expanding health services access for low-income residents, maintaining and expanding the public health system, maintaining and improving the capacity of the health care system, containing health care costs, and the regulation, planning, and administering of the health care system.

(2) At least five million dollars from the health services account shall be dedicated annually to reimburse every hospital, facility, or health care provider authorized by the state to provide levels I and II designated trauma services.  The department of social and health services shall disburse this money exclusively to cover reasonable costs of care for patients who meet charity care standards defined in RCW 70.170.020 and to increase the state's payment for medically indigent patients.  Reimbursement shall be provided at a rate that covers reasonable costs for treating patients, but the rate may not exceed the state's medicaid rate.

NEW SECTION. Sec. 4. The department of health shall conduct or cause to be conducted a study on all costs, charges, expenses, and levels of reimbursement associated with providers of trauma care services.  The report must include recommendations for reimbursement of undercompensated and uncompensated trauma care at designated trauma care services state-wide, including special financial incentives for hospitals who voluntarily choose to become level I or level II designated trauma care centers.  The study must also include reimbursement options using Title 19 medicaid funds or any other federal matching funds.  This report must be submitted to the appropriate committees of the legislature by July 1, 1997.

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