Background:

Supervision of Inmates Receiving Hospital Care.

No specific statutory standard requires supervision of jail or corrections inmates receiving medical care at a hospital; however, regulations and other policies may apply. For example, Department of Corrections (DOC) administrative regulations permit escorted leave for inmates for purposes of necessary medical or dental care not available in the institution. Inmates on escorted leave must be in visual or auditory contact of an approved correctional staff member at all times and remain in the custody of the DOC.

"Hospitals" are statutorily defined to include institutions or agencies providing accommodations, facilities, and services over a continuous period of 24 hours or more for observation, diagnosis, or care. Hospitals do not include hotels, clinics, physicians' offices, nursing homes, birthing centers, psychiatric hospitals, or other institutions for care of mental illness or intellectual disability.

Disclosure of Medical Information.

Health care providers and health care facilities may disclose health care information without a patient's consent to certain persons and entities, including, among others, previous and successor providers, immediate family members, emergency personnel and law enforcement in certain circumstances, and institutions to which the patient is detained. Permitted disclosure does not include disclosure of information related to sexually transmitted diseases or mental health services. Generally, information may not be shared if the patient has instructed against disclosure in writing.

Payment for Jail Inmate Medical Care.

Upon booking an offender into a 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 other medical care programs offered through the Health Care Authority, the governing unit (meaning the local jurisdiction responsible for operation of the jail) is responsible 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.

Summary of Bill:

Supervision of Inmates Receiving Medical Care.

A person in the custody of a law enforcement officer, corrections officer, or guard supplied by a law enforcement or corrections agency (referred to hereinafter generally as "officer") for a violent offense or sex offense and who is brought to a hospital for care must be accompanied or otherwise secured the officer. This requirement does not apply if:

the person is being supervised by the DOC, and the person is in custody solely due to a sanction imposed by DOC, the Indeterminate Sentence Review Board, or the court, in response to a violation of conditions;
the provider indicates that there is no need to continue accompaniment or supervision; or
the law enforcement officer determines that: (1) the individual does not present an imminent and significant risk to self or others; (2) there is no longer sufficient evidentiary basis to maintain the individual in custody; or (3) an urgent public safety need requires the officer to be present in another location.

Determination by a Medical Care Provider that the Officer's Presence is Unnecessary.

If a medical care provider determines that it is not necessary for the person receiving treatment to be accompanied or secured, the officer has no ongoing duty to accompany or secure the person. The hospital must notify the officer when the person is expected to be released by the hospital. If the person later demonstrates behavior that presents an imminent and significant risk of causing physical harm to the person or others, the hospital may request the presence of an officer.

Determination by the Officer that it is Appropriate for the Officer to Leave.

If the officer accompanying or securing the person receiving care determines, in the officer's best judgment, that the person does not present an imminent and significant risk to self or others or that there is no longer sufficient evidentiary basis to maintain the individual in custody, the officer must notify the medical care provider that the officer is leaving the person unattended or unsecured. The hospital has no duty to notify the officer of the person's release or expected release from the hospital.

If the officer must leave due to an urgent public safety need in another location, the officer must notify the medical care provider, or another hospital staff member if the officer must leave immediately, that the officer leaving the person unattended or unsecured. The officer must make a reasonable effort to ensure a replacement officer or other means of accompanying or securing the person as soon as is reasonably possible under the circumstances. The hospital is required to notify the officer or the officer's designee of the person's release or expected release prior to the officer returning or a replacement arriving.

Priority of Treatment for Accompanied Offenders.

When a person who is accompanied or secured by an officer is waiting for treatment in a hospital emergency department, the hospital must see the patient in as expeditious a manner as possible. The hospital must take consideration of best triage practices and legal obligations regarding appropriate screening and treatment of patients when prioritizing treatment of an accompanied or secured offender.

Disclosure of Health Care Information to Officers.

A health care provider or health care facility may disclose a patient's health care information, other than information related to sexually transmitted diseases and mental health services, to an accompanying officer without the patient's authorization. The disclosure is limited to that which is incidental to the fulfillment of the role of the officer in securing or accompanying the person in custody while the person is receiving hospital care.

Limitations on Liability.

Absent gross negligence or willful misconduct, hospitals and health care providers are immune from civil liability, professional conduct sanctions, and administrative actions resulting from an individual not being accompanied or secured.

No special relationship exception to the public duty doctrine is created by the requirements surrounding accompanying and securing patients in officer custody. Officers and their employing departments and agencies are immune from civil liability arising out of the failure to comply with these requirements absent evidence of gross negligence or bad faith, taken in the context of the totality of the circumstances.

Payment for Medical Services Rendered to Jail Inmates.

With respect to inpatient, outpatient, and ancillary services rendered to jail inmates and not paid by Medicaid, providers of hospital services must accept from the governing unit, as payment in full, the facility's percent of allowed charges rate or fee schedule as determined, maintained, and posted by the Department of Labor and Industries. Other rates may be agreed to by the hospital and the governing unit.

At booking, a jail inmate may be evaluated for Medicaid eligibility and, if deemed potentially eligible, enrolled in Medicaid. To the extent allowed by federal law, a correctional facility or the correctional facility's designee is authorized to act on behalf of a confined person for purposes of applying for Medicaid. Current statutory language is restated allowing, as part of the screening process, collection of general information regarding the inmate's ability to pay for medical care, including insurance or other medical benefits or resources to which the inmate is entitled. Information collected at screening may be made available to the Health Care Authority, governing unit, and provider of services.