FINAL BILL REPORT

 

 

                                   SHB 1324

 

 

                                   FULL VETO

 

 

BYHouse Committee on Health Care (originally sponsored by Representatives Brooks, Valle, Pruitt, Braddock, Hankins, Betrozoff, Kremen, Beck, Wood, Dellwo, Bowman, Haugen, Winsley, Brekke, Walker, Horn, Nelson, Moyer, Fraser, D. Sommers, Van Luven, Cooper, R. Meyers, Jesernig, Miller, May, Rust, Sprenkle, Brumsickle, Grant, Cole, Chandler, Prince, Holland, Doty, Silver, Belcher, Scott, Rasmussen, Hine, Baugher, Dorn, Walk, Rayburn, Gallagher, Schoon, Sayan, Heavey, Vekich, Patrick, Fuhrman, Leonard, Bristow, Schmidt, Morris, Jones, Basich, R. Fisher, Wineberry, Todd, Prentice, Nealey, Ferguson, McLean, R. King, P. King, Wolfe, Nutley, K. Wilson, Cantwell, Brough, Anderson, Smith, Hargrove, Day, Crane, Rector, G. Fisher, Appelwick, H. Myers, Ebersole, Inslee, Spanel and Tate; by request of Governor Gardner)

 

 

Creating a department of health.

 

 

House Committe on Health Care

 

 

House Committe on Appropriations

 

 

Senate Committee on Health Care & Corrections

 

 

                             AS PASSED LEGISLATURE

 

BACKGROUND:

 

Like many states at statehood, Washington gave its health administration responsibilities to a Board of Health. This body, with a part-time membership of five physicians, was the only state agency officially responsible for the health of the citizens.  The original purpose of the board was to respond to emergent short term problems, such as epidemics, with specific remedies.  As the board evolved and a greater need for public health oversight developed, the board became responsible for new on-going functions, including inspection of ships for communicable diseases, safety of milk, food sanitation, oyster bed inspections, and the collection of vital statistics.  These new functions required cooperation at the local level to enforce the state health regulations.  To meet this need, the Legislature authorized for the establishment of local boards of health, which eventually created local health departments.

 

As the state's population and the public health sector responsibilities grew, more continuous supervision and management at the state level was needed. Because of its part-time nature, the Board of Health could no longer effectively administer the increasingly complex public health system.  To provide the needed public health administration, a Department of Health was created in 1921.  The board maintained certain rule making authority, while the new department assumed general administrative authority.

 

The Department of Health continued its independent existence until 1970, when it was included, along with several other state departments, in the Department of Social and Health Services (DSHS), the state's umbrella human services agency.  DSHS was formed as a result of a national movement toward "comprehensive" and "integrated" human service systems.  Between 1969 and 1974, 26 states established umbrella agencies. However, since then most of those state umbrella agencies, like Washington's, have undergone numerous reorganizations in the areas of administration, service delivery, decentralization, and scope of services.  Complaints are frequently made that umbrella agencies are too big to be responsive to client needs, and that individual programs have lacked visibility and accountability because they are "buried" within the bureaucracy.

 

The first proposal to recreate a Department of Health was made in 1986 in the report of the Joint Select Committee on Public Health.  The committee identified several areas in which DSHS functions were duplicated by the Department of Ecology (DOE).  This duplication had prevented efficient administration, especially in the areas of drinking water quality, on-site sewage control, radiation control, and shellfish protection.  The committee also concluded that modern day public health problems, such as AIDS and environmental protection, are of such magnitude that the related programs require departmental level attention.  The committee's recommendations mainly focused on consolidating the Division of Health of DSHS with DOE to form an independent agency. During the 1986 sessions, bills were introduced in both the Senate and House of Representatives to accomplish this goal by the creation of a Department of Public Health and Environment.  The measure was passed by Senate, but failed to receive House approval.  Similar bills introduced in the 1987 and 1988 sessions did not pass the Legislature.

 

On December 1, 1988, the Governor announced his intention to seek legislation creating a Department of Health to improve leadership and management in the area of health.

 

SUMMARY:

 

The Department of Health (DOH) is created as an independent state agency.  Its primary focus is public health, quality of care, and health policy development.

 

DOH continues the specific existing functions transferred from the following agencies:  the Department of Social and Health Services (DSHS), the Department of Licensing (DOL), and the State Health Coordinating Council (SHCC).

 

The functions transferred from DSHS include:  Office on AIDS; sexually transmitted disease control and prevention; epidemiology; environmental health services; public laboratories; communicable disease control and prevention; vital statistics and other health data collection; licensure of emergency medical personnel and services, hospitals, boarding homes, and maternity homes; and, effective July 1, 1991, the parent and child health services.

 

Transferred from the SHCC is the review of health professional licensure and mandated health benefits.  The following health professional licensure functions are transferred from DOL.  The RCW chapter is referenced.

 

18.06     Acupuncture

18.19     Counselors

18.22     Podiatry

18.25     Chiropractic

18.26     Chiropractic Disciplinary Board

18.29     Dental Hygienist

18.32     Dentistry

18.34     Dispensing Opticians

18.35     Hearing Aids

18.36A    Naturopathy

18.50     Midwifery

18.52     Nursing Home Administrators

18.52A    Nursing Assistants - Training Program

18.52B    Nursing Assistants

18.52C    Nursing Pools

18.53     Optometry

18.54     Optometry Board

18.55     Ocularists

18.57     Osteopathy

18.57A    Osteopathic Physicians' Assistants

18.59     Occupational Therapy

18.71     Physicians

18.71A    Physicians' Assistants

18.72     Medical Disciplinary Board

18.74     Physical Therapy

18.78     Practical Nurses

18.83     Psychologists

18.84     Radiologic Technologists

18.88     Registered Nurses

18.89     Respiratory Care Practitioners

18.92     Veterinary Medicine, Surgery & Dentistry

18.108    Massage Practitioners

18.135    Health Care Assistants

18.138    Dietitians and Nutritionists

 

Although the funeral directors and embalmers licensure remains within the Department of Licensing, the Director of the Department of Licensing is required to study this program for possible modification.

 

To implement a health policy development focus, the SHCC is terminated and the health planning function, in a modified form, is transferred to the State Board of Health.  The new health planning process requires the board to develop a state health report biennially.  The report shall: consider citizen input gathered through public forums; be developed with the assistance and input of local health departments and state health agency administrators; be used by these administrators in the development of their respective agency's budgets and be submitted to the Governor for approval.

 

To support these functions, DOH is designated as the primary collection agency for existing health data collection.  State agencies are required to provide appropriate data to DOH.  The State Board of Health and DOH are required to develop a health care research agenda.  The Secretary of Health shall use this data to improve health care services.

 

The head of DOH is the Secretary of Health, who is appointed by the Governor.  The secretary must appoint a State Health Officer who will also be the deputy secretary; both appointments must be approved by the Senate.

 

The secretary and each of the health professional and disciplinary boards are required to adopt joint working agreements, by rule.  The rules shall address administrative support activities, budgets, and personnel.

 

An Office of Health Consumer Assistance is created, with a statewide hotline to receive consumer complaints.

 

 

VOTES ON FINAL PASSAGE:

 

      House 96   0

      Senate    43     3

 

FULL VETO:  (See VETO MESSAGE)