HB 1911

Brief Description: Concerning health care services for inmates in city, county, and regional jails.

Sponsors: Representatives Alexander and Cody.

Hearing Date: 2/26/13

Staff: Alex MacBain (786-7288).

Background:

Health Care Services for Jail Offenders and Community Supervision Violators.

An offender who is convicted and receives a sentence of confinement of less than one year must serve that term of confinement in a local correctional facility (jail). Cities, counties, and/or groups of counties are responsible for the operation and maintenance of jails. Upon booking of an inmate into jail, general information concerning the inmate's ability to pay for medical care is identified. To the extent that the offender is unable to be financially responsible for medical care and is ineligible for Medicaid or medical care programs offered through the Health Care Authority (HCA), the jail is responsible to pay for the offender's health care costs. Necessary medical services cannot be denied or delayed because of disputes over the cost of medical care or a determination of financial responsibility.

The Department of Corrections (DOC) contracts with 60 local jurisdictions to provide jail beds, including necessary health care services, for DOC offenders who violate the terms of community supervision (violators). The maximum allowable daily rate for incarceration is published in the biennial operating budget. When a DOC violator receives medical care while incarcerated in a county or city jail, the DOC must reimburse the local entity for health care costs, either through a medical care rate that exceeds the daily rate or on a reimbursement basis.

In the 2012 session, the Legislature took steps to assist DOC in containing health care costs by establishing standardized payment rates and requiring hospitals to contract with the DOC for offender health care as a condition of licensure. In addition, the 2012 Supplemental Operating Budget required the DOC to convene a workgroup to review and evaluate health care cost containment strategies at jail facilities and to make recommendations to committees of the Legislature by October 1, 2013. This workgroup includes jail administrators, the Washington State Patrol, the Washington Association of Sheriffs and Police Chiefs, and the Washington Association of Counties. Standardizing hospital rates and paying hospitals through a central administrative organization are recommendations of this workgroup.

Regulation of Hospitals.

Hospitals in Washington must be licensed by the Department of Health (DOH). The DOH establishes standards for the construction, maintenance, and operation of hospitals, including standards for the care and treatment of patients. The DOH issues, denies, and revokes licenses; conducts surveys and inspections of hospitals; determines sanctions for violations of DOH standards; and receives regular reports on each hospital's governance and finances, as well as certain patient care measures.

Provider One.

Provider One is the federally certified statewide Medicaid payment processing system in Washington. It interfaces with client eligibility data, authorizes services, and issues payments to health care providers.

Summary of Bill:

Hospitals licensed and regulated by the Department of Health must, as a condition of licensure, contract with jails for inpatient, outpatient, and ancillary services if deemed appropriate by the jail. Jails may only reimburse a provider of hospital services at a rate no more than the amount payable under the Medicaid reimbursement structure plus a percentage increase that is determined in the state operating budget. Through contracts with the DOC, jails may participate in the Provider One system operated by HCA.

Appropriation: None.

Fiscal Note: Preliminary fiscal note available.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.