HOUSE BILL REPORT

HB 2566

BYRepresentatives Kirby, Wolfe, Rayburn, Baugher, Brooks, Moyer, Fuhrman, Grant, Jesernig, Rector, Dellwo, Bowman, Scott, Sayan, Jones, Haugen, Miller, Kremen, Ballard, Spanel, Silver, Schoon, Doty, H. Myers, Brumsickle, Youngsman, Todd, Inslee, Rasmussen, McLean and Prentice; by request of Governor Gardner

Expanding rural health care opportunities.

House Committe on Health Care

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass.  (11)

      Signed by Representatives Braddock, Chair; Day, Vice Chair; Brooks, Ranking Republican Member; Cantwell, Chandler, Morris, Prentice, D. Sommers, Sprenkle, Vekich and Wolfe.

House Staff:Bill Hagens (786-7131)

Rereferred House Committee on Appropriations

Majority Report:  The substitute bill by Committee on Health Care be substituted therefor and the substitute bill do pass.  (26)

      Signed by Representatives Locke, Chair; Grant, Vice Chair; Silver, Ranking Republican Member; Youngsman, Assistant Ranking Republican Member; Appelwick, Belcher, Bowman, Braddock, Brekke, Dorn, Doty, Ebersole, Hine, Inslee, May, McLean, Nealey, Padden, Peery, Rust, Sayan, Spanel, Sprenkle, Valle, Wang and Wineberry.

House Staff:      Maureen Morris (786-7152)

AS REPORTED BY COMMITTEE ON APPROPRIATIONS FEBRUARY 3, 1990

BACKGROUND:

Many rural communities are unable to finance local health services or establish effective local health care organizations.  For example, frequently, rural women have to travel long distances to receive maternity care.  This has resulted in poor health outcomes in some communities.  Because of the inability of these communities to organize and finance their health care system, much of a resident's health dollar is spent outside of the community.

The problems of limited health access in rural areas are exacerbated by the limited ability to recruit needed health care providers, especially maternity care providers, to these communities on a temporary or permanent basis.

SUMMARY:

SUBSTITUTE BILL:  To address the financing and organizational problems, this bill permits the creation of "rural health care service arrangements" (RHCSA) for rural communities, beginning January 1, 1991.  Like health care service contractors, these new entities are subject to the regulation of the insurance commissioner.  RHCSAs may offer a full range of health benefits.  Reserve requirements are set at 25 percent of the aggregate contributions of the current fiscal year, or 25 percent of the claims paid in the current fiscal year, whichever is greater.  At least 51 percent of a RHCSA's board must be elected by adult consumers.

To help address the health provider shortage, the Department of Health is required to establish a health professional temporary substitute resource pool to provide, on a short- term basis, physicians, physician assistants, and nurse practitioners to rural areas.

In addition, the Department of Health is required to establish the "rural physician and midwife scholarship program," which will provide support for training in return for a commitment to serve in rural communities or midwife shortage areas for at least three years.  A penalty and payback provision is required if the commitment is not met.  The University of Washington School of Medicine is required to establish a preference for admission policy for these scholarships.  The secretary of Health must review the continued need for this program and report to the Legislature by September 1, 1995.

SUBSTITUTE BILL COMPARED TO ORIGINAL:  The requirement that the University of Washington School of Medicine designate a set number of admissions for the scholarship is replaced by a preference for admissions requirement.

CHANGES PROPOSED BY COMMITTEE ON APPROPRIATIONS:  None.

Fiscal Note:      Available.

Effective Date:The bill takes effect on May 1, 1990.

House Committee ‑ Testified For:    (Health Care)  Bob Crittenden, Governor's Office; Keith Baldwin; Ed Myers, Lake Chelan Community Hospital; Jean Roberts, Mark Reed Hospital; Tom Trompeter, WSPCA; Pete McGough, Washington State Medical Association; Jim Blue; Kathy Carr, Midwives Association of Washington State; and JoAnne Myers, Seattle Midwifery School.

(Appropriations)  No one.

House Committee - Testified Against:      (Health Care)  Mel Sorensen, Washington Physicians Service and Blue Cross.

(Appropriations)  None.

House Committee - Testimony For:    (Health Care)  These programs are needed to provide health services in the rural areas.

(Appropriations)  No one.

House Committee - Testimony Against:      (Health Care)  RHCSA may not be financially viable, which could leave rural areas without health services.

(Appropriations)  None.