BILL REQ. #:  H-2056.1 

READ FIRST TIME 03/03/03.   

     AN ACT Relating to improving health care professional and health care facility patient safety practices; amending RCW 43.70.110 and 43.70.250; adding new sections to chapter 43.70 RCW; adding a new section to chapter 7.70 RCW; and creating a new section.

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

NEW SECTION.  Sec. 1   The legislature finds that thousands of patients are injured each year in the United States as a result of medical errors, and that a more comprehensive approach than looking only at the fault of individual practitioners is needed to effectively reduce the incidence of medical errors in our health care system. Incentives should be available to encourage health care providers, facilities, and health carriers to engage in proven patient safety and medical error reduction efforts. Investments in proven strategies can reduce medical errors, and thereby potentially reduce the need for disciplinary actions against licensed health care professionals and facilities, and the frequency and severity of medical malpractice claims. Through the adoption of a patient safety fee to fund proven patient safety and medical error reduction strategies, the legislature intends to positively influence the safety and quality of care provided in Washington state's health care system.

Sec. 2   RCW 43.70.110 and 1993 sp.s. c 24 s 918 are each amended to read as follows:
     (1) The secretary shall charge fees to the licensee for obtaining a license. After June 30, 1995, municipal corporations providing emergency medical care and transportation services pursuant to chapter 18.73 RCW shall be exempt from such fees, provided that such other emergency services shall only be charged for their pro rata share of the cost of licensure and inspection, if appropriate. The secretary may waive the fees when, in the discretion of the secretary, the fees would not be in the best interest of public health and safety, or when the fees would be to the financial disadvantage of the state.
     (2) Except as provided in section 4 of this act, fees charged shall be based on, but shall not exceed, the cost to the department for the licensure of the activity or class of activities and may include costs of necessary inspection.
     (3) Department of health advisory committees may review fees established by the secretary for licenses and comment upon the appropriateness of the level of such fees.

Sec. 3   RCW 43.70.250 and 1996 c 191 s 1 are each amended to read as follows:
     It shall be the policy of the state of Washington that the cost of each professional, occupational, or business licensing program be fully borne by the members of that profession, occupation, or business. The secretary shall from time to time establish the amount of all application fees, license fees, registration fees, examination fees, permit fees, renewal fees, and any other fee associated with licensing or regulation of professions, occupations, or businesses administered by the department. In fixing said fees, the secretary shall set the fees for each program at a sufficient level to defray the costs of administering that program and the patient safety fee established in section 4 of this act. All such fees shall be fixed by rule adopted by the secretary in accordance with the provisions of the administrative procedure act, chapter 34.05 RCW.

NEW SECTION.  Sec. 4   A new section is added to chapter 43.70 RCW to read as follows:
     (1) For calendar years 2004 and 2005, the secretary shall increase the licensing fee established under RCW 43.70.110 for health care professionals and facilities designated in subsection (2) of this section by one percent of the amount of the applicable annual licensing fee. Proceeds of the patient safety fee must be dedicated to patient safety and medical error reduction efforts that have been proven to improve the quality of care provided by health care professionals and facilities.
     (2) Health care professionals and facilities subject to the one percent patient safety fee include:
     (a) Health care professionals licensed under Title 18 RCW; and
     (b) Hospitals licensed under chapter 70.41 RCW and psychiatric hospitals licensed under chapter 71.12 RCW.
     (3) Patient safety fee proceeds shall be administered by the department of health, in consultation with established patient safety coalitions. Proceeds will be distributed in the form of grants, loans, or other appropriate arrangements to support strategies that have been proven to reduce medical errors and enhance patient safety. In developing criteria for the award of grants, loans, or other funding arrangements under this section, the department shall:
     (a) Consult with established patient safety coalitions and health care workers engaged in direct patient care activities; and
     (b) Rely heavily upon evidence-based practices that have been shown to improve patient safety and have been identified and recommended by governmental and private organizations, including but not limited to:
     (i) The federal agency for health care quality and research;
     (ii) The federal institute of medicine;
     (iii) The joint commission on accreditation of health care organizations; and
     (iv) The national quality forum.

NEW SECTION.  Sec. 5   A new section is added to chapter 7.70 RCW to read as follows:
     (1) One percent of the present value of the settlement or judgment in any action for damages based upon injuries resulting from health care that is paid to an injured claimant in calendar year 2004 or 2005 shall be deducted from the settlement or judgment as a patient safety set aside. Proceeds of the patient safety set aside will be distributed by the department of health in the form of grants, loans, or other appropriate arrangements to support strategies that have been proven to reduce medical errors and enhance patient safety as provided in section 4 of this act.
     (2) Patient safety set asides shall be transmitted to the secretary of the department of health for deposit into the patient safety account established in section 7 of this act.
     (3) The supreme court shall by rule adopt procedures to implement this section.

NEW SECTION.  Sec. 6   A new section is added to chapter 43.70 RCW to read as follows:
     The secretary may solicit and accept grants or other funds from public and private sources to support patient safety and medical error reduction efforts under this act. Any grants or funds received may be used to enhance these activities as long as program standards established by the secretary are maintained.

NEW SECTION.  Sec. 7   A new section is added to chapter 43.70 RCW to read as follows:
     The patient safety account is created in the custody of the state treasurer. All receipts from the fees and set aside established in sections 4 and 5 of this act must be deposited into the account. Expenditures from the account may be used only for the purposes of this act. Only the secretary or the secretary's designee may authorize expenditures from the account. The account is subject to allotment procedures under chapter 43.88 RCW, but an appropriation is not required for expenditures.

NEW SECTION.  Sec. 8   A new section is added to chapter 43.70 RCW to read as follows:
     By December 1, 2006, the department shall report the following information to the governor and the health policy and fiscal committees of the legislature:
     (1) The amount of patient safety fees and set asides deposited to date in the patient safety account;
     (2) The criteria for distribution of grants and loans under this act; and
     (3) A description of the medical error reduction and patient safety grants and loans distributed to date, including their desired objectives, activities, timelines, and any available information on outcomes.