AN ACT Relating to rural health care; adding a new chapter to Title 70 RCW; creating a new section; making an appropriation; and providing an expiration date.

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

NEW SECTION. Sec. 1. The purpose of this chapter is to support access for all Washington citizens to basic health care services in rural areas of Washington state.

NEW SECTION. Sec. 2. Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Advisory committee" means the rural health advisory committee.

(2) "Basic health services" means those specific health services that the state health coordinating council determined in its rural access project should be geographically accessible to state residents.

(3) "Board" means the board of directors of the Washington rural health office.

(4) "Office" means the Washington rural health office.

(5) "Rural area" means any area designated as a rural area by the state health coordinating council.

(6) "Rural health provider" means a health care provider in active practice, a licensed health care facility, a public health office, a nonprofit community health center, or other community clinic in operation in a rural area.

NEW SECTION. Sec. 3. (1) There is created a Washington rural health office which shall be operated under a joint agreement of the University of Washington, Washington State University, and the state department of social and health services.

(2) The Washington rural health office shall be directed by a board of directors composed of the president of Washington State University, the president of the University of Washington, the secretary of the department of social and health services, or their designees, and one consumer and one provider elected from among the members of the rural health advisory committee created in section 4 of this act.

(3) The board shall meet at least semiannually. It is the duty of the board to approve office policy, to approve the biennial budget and annual budget amendment, if any, to approve changes in the scope of responsibilities of the office recommended by the advisory committee, and develop a financial plan for the office that will achieve the fifty percent self-funding target.

NEW SECTION. Sec. 4. (1) In carrying out its responsibilities, the office shall be advised by a rural health advisory committee composed of individuals appointed by the board. Initial advisory committee members shall be appointed by the board representatives of the University of Washington, Washington State University, and the department of social and health services.

(2) The advisory committee shall consist of members who are knowledgeable regarding rural health care delivery. These shall be:

(a) Two persons experienced in direct provision of primary care in rural areas. One of these individuals shall be a physician. In making these appointments, consideration shall be given to any recommendations submitted by the state medical, nursing, and allied health professions associations.

(b) One person experienced in the provision of emergency medical services in rural areas. In making this appointment, consideration shall be given to any recommendations submitted by the state emergency medical services advisory committee.

(c) One person experienced in the administration of rural primary care services. In making this appointment, consideration shall be given to any recommendations submitted by the Washington state primary care association.

(d) One person experienced in the administration of a rural hospital. In making this appointment, consideration shall be given to any recommendations submitted by the rural hospital committee of the Washington state hospital association.

(e) One person experienced in the delivery of public health services in rural areas. In making this appointment, consideration shall be given to any recommendations submitted by the Washington state association of local public health officials.

(f) Three persons who are residents of rural areas, who are consumers, and who are not also providers or group purchasers of health services. In these appointments, consideration shall be given to any recommendations submitted by the state health coordinating council and the state council on aging.

(g) One person knowledgeable about state government health policy representing the governor.

(h) Two persons who are both an employer and group purchaser of health services in a rural area.

(3) The advisory committee shall elect a chairperson and vice-chairperson from among its members.

(4) Members of the advisory committee shall be entitled to reimbursement for expenses as provided by RCW 43.03.050 and 43.03.060.

(5) Advisory committee members shall serve staggered two-year terms, to be accomplished by appointing half the original members to three-year terms.

NEW SECTION. Sec. 5. (1) The board may employ a full-time executive director and a confidential secretary who shall be exempt from the civil service law, chapter 41.06 RCW, and who shall perform the duties delegated by the board.

(2) The board shall employ such other staff as are necessary to fulfill the responsibilities of the office.

(3) The board may contract with third parties for services necessary to carry out its activities if this will promote economy, avoid duplication of effort, and make the best use of available expertise. Any such contractor or consultant shall be prohibited from releasing, publishing, or using otherwise any information made available to it under its contractual responsibility without the specific permission of the board.

(4) The board may apply for and accept grants, gifts, and other payments from any governmental or other public or private entity or person to support the purposes set forth in this chapter.

NEW SECTION. Sec. 6. (1) The activities of the office shall include:

(a) Acting as an information and referral source to mobilize rural resources.

(b) Being an advocate for rural health services and, as necessary, promoting legislative initiatives, reimbursement initiatives, and resource allocations to meet identified rural needs.

(c) Promoting and supporting the flexible interpretation and application of state and federal regulatory requirements to allow creative responses to changing circumstances, while maintaining the quality of services needed to protect the public health and safety.

(d) At the request of rural communities, arranging and supporting technical assistance for rural health community development activities, including:

(i) Need assessments and market surveys;

(ii) Community leadership development;

(iii) Aid for facilities desiring to convert to other uses; and

(iv) Assistance to local health care delivery systems to develop ongoing sources of funds.

(e) In collaboration with state colleges and universities and other public and private agencies and organizations, carry out rural health personnel development, recruitment, placement and retention activities.

(f) Conducting rural health planning and data collection activities as needed to fulfill the responsibilities established in (a) through (e) of this subsection.

(g) Carrying out other activities of a like nature as determined by the advisory committee and approved by the board.

(2) The office may charge fees for delivered services consistent with the requirements of section 8 of this act.

NEW SECTION. Sec. 7. The office shall be assisted in performing the functions in section 6 of this act by agencies of state government and by state colleges, universities, community colleges, and other institutions as directed by the legislature. The office shall coordinate these activities and shall make annual reports to the legislature describing the results of cooperative efforts in the previous year, program plans and objectives that entail intragovernmental coordination in the ensuing year, and the relationship of office activities to the provisions of the state health plan.

NEW SECTION. Sec. 8. (1) The office shall prepare biennially for inclusion in the Washington State University budget, a budget for the office that shall include its estimated income and expenditures for administration and operations for the biennium. This office budget shall be submitted for review and comment by the advisory committee.

(2) Expenses of the office may be financed by a combination of state general fund appropriations, rural provider dues, user fees, grants, gifts, and other awards. During the first two years of operation, expenses shall be funded by general fund appropriation of the legislature.

(3) Should funding be continued, beginning the third year, the office shall be funded on a matching basis. The maximum general fund obligation shall decline ten percent per year until it reaches fifty percent. However, the general fund obligation for any year is limited to the amount that is equal to the largest annual allotment during the initial year of operation.

(4) In the event dues are charged, they shall be collected by an equitable method developed by the board. Any amount raised by the collection of dues from rural health providers provided for in this section that is not required to meet appropriations in the budget act for the current year shall be available to the office in succeeding years.

NEW SECTION. Sec. 9. This chapter shall expire June 30, 1992.

NEW SECTION. Sec. 10. Appropriate standing committees of the legislature, in consultation with the board of directors of the Washington rural health office and other consumers and providers of rural health services, shall conduct an evaluation of the Washington rural health office and make recommendations to the legislature by January 1, 1992, regarding reauthorizing its operation for an extended period of time.

NEW SECTION. Sec. 11. Sections 1 through 9 shall constitute a new chapter in Title 70 RCW.

NEW SECTION. Sec. 12. The sum of four hundred thousand dollars, or as much thereof as may be necessary, is appropriated for the biennium ending June 30, 1989, from the general fund to the Washington rural health office for the purposes of this act.