5949.E AMH APP H2765.2

ESB 5949 - H COMM AMD

By Committee on Appropriations

ADOPTED 04/17/2003

Strike everything after the enacting clause and insert the following:

"NEW SECTION. Sec. 1. A new section is added to chapter 70.41 RCW to read as follows:

(1) A hospital shall provide emergency services twenty-four hours per day, seven days per week in a designated area of the hospital. A hospital shall meet all the requirements for emergency facilities that are established by the department and shall provide emergency services in a manner that meets the requirements established by federal law for the medical screening and stabilization of patients, including women in active labor, who present to the hospital for emergency services.

(2) A hospital providing emergency services under this section shall have, at a minimum, the following:

(a) A physician who is qualified to provide emergency services immediately available in the hospital;

(b) A roster of on-call medical staff members; and

(c) Procedures to stabilize a patient until the patient is transported or transferred to another hospital if emergency services cannot be provided at the hospital to meet the needs of the patient in an emergency. A specialty hospital providing emergency services under this section shall maintain a transfer agreement with a general hospital that establishes the process for patient transfers in a situation in which the specialty hospital cannot provide continuing care for a patient because of the specialty hospital's scope of services.

(3) This section does not apply to:

(a) A specialty hospital that provides only psychiatric, pediatric, long-term acute care, or rehabilitative services;

(b) A hospital that was licensed under chapter 70.41 RCW prior to January 1, 2003; or

(c) A hospital designated as a critical access hospital under the provisions of Part A Title XVIII of the Social Security Act Section 1820, 42 U.S.C., 1395i-4.

(4) For the purposes of this section:

(a) "Emergency services" means health care services medically necessary to evaluate and treat a medical condition that manifests itself by the acute onset of a symptom or symptoms, including severe pain, that would lead a prudent layperson acting reasonably to believe that a health condition exists that requires immediate medical attention, and that the absence of immediate medical attention could reasonably be expected to result in serious impairment to bodily functions or serious dysfunction of a bodily organ or part, or would place the person's health (or in the case of a pregnant woman, the health of the woman or her unborn child) in serious jeopardy;

(b) "General hospital" means a hospital that provides general acute care services, including emergency services;

(c) "Specialty hospital" means a subclass of hospital that either provides hospital services within a specific branch of medicine or limits admission according to age, sex, type of disease, or medical condition;

(d) "Transfer agreement" means a written agreement providing an effective process for the transfer of a patient requiring emergency services to a general hospital providing emergency services and for continuity of care for that patient.

(5) This section expires July 1, 2004.

NEW SECTION. Sec. 2. (1) The department of health, in consultation with affected stakeholders such as hospitals, physicians, and nurses, shall study the establishment of specialty hospitals, the requirements of this act, and the impact that specialty hospitals have on the delivery of health care. At a minimum the study shall include but not be limited to evaluating the following issues as they pertain to specialty hospitals:

(a) The availability and delivery of health care services;

(b) Patient safety;

(d) The provision of emergency services, including the effect of the presence or absence of an emergency department in specialty hospitals;

(e) Staffing of any existing hospitals in the community served by a specialty hospital, including the effect of specialty hospitals on health care professional shortages, nursing staffing, and the availability of specialty physicians to provide on-call emergency services; and

(f) The provision of charity care, medicare and medicaid services, services for medically indigent patients, uncompensated care, community service, and access to health care services by medically underserved populations.

(2) The study also shall include an evaluation of whether requirements for establishing specialty hospitals should be addressed through certificate of need or hospital licensing requirements.

(3) For the purposes of the study, "specialty hospitals" does not include specialty hospitals that provide only psychiatric, pediatric, long-term acute care, or rehabilitative services.

(4) The department of health shall prepare and present a report to the legislature regarding the study no later than December 1, 2003. The legislature shall reevaluate the requirements of this act based upon the study.

NEW SECTION. Sec. 3. The reasonable costs of the study described in section 2 of this act shall be financed by a one-time fee assessment charged to each hospital with one hundred fifty beds or more and licensed under this chapter as of January 1, 2003, in the amount of eight dollars for each bed space within the licensed bed capacity of the hospital as determined in accordance with existing department regulations regarding bed spaces for the purposes of hospital license fees. The fee assessment shall be paid between October 1, 2003, and December 1, 2003."

ESB 5949 - H COMM AMD

By Committee on Appropriations

ADOPTED 04/17/2003

On page 1, line 1 of the title, after "services;" strike the remainder of the title and insert "adding a new section to chapter 70.41 RCW; creating new sections; and providing an expiration date."

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