SENATE BILL REPORT

ESHB 1324

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

Rereferred House Committee on Appropriations

Senate Committee on Health Care & Corrections

Senate Hearing Date(s):March 21, 1989; March 23, 1989

Majority Report:  Do pass.

      Signed by Senators West, Chairman; Smith, Vice Chairman; Amondson, Johnson, Niemi, Wojahn.

Senate Staff:Don Sloma (786-7414)

                  March 23, 1989

AS REPORTED BY COMMITTEE ON HEALTH CARE & CORRECTIONS, MARCH 23, 1989

BACKGROUND:

A Department of Health was first created in Washington in 1921 by transferring the administrative responsibilities of the state Board of Health.  The Department of Health continued until 1970 when it was merged into the Department of Social and Health Services (DSHS).  The new umbrella agency was formed to integrate and decentralize services.  Repeated efforts to realize the goals for DSHS met with only limited success.  Many now claim that services are not adequately integrated, that programs are not adequately decentralized, and accountability is hampered by an unnecessarily complex organization.  Advocates for the traditional purposes of public health (i.e. disease and illness prevention, control of epidemics, etc.) state that DSHS places a low priority on public health purposes within the umbrella agency.

In 1986, the Legislature considered a proposal by the Joint Select Committee on Public Health to create a separate state department of public health and environment, by removing traditional public health functions from DSHS and merging them with health related functions housed in the Department of Ecology.  Enabling legislation passed the Senate, but has failed in the House for several years.

SUMMARY:

A Department of Health (DOH) is created to provide leadership in assuring the quality of health care, protect the general population's health and develop state health policies.  Organizational principals for the department are articulated.

The Governor must appoint a Secretary of Health with the consent of the Senate.  The secretary must appoint the Deputy Secretary of Health, with the consent of the Senate.

The Deputy Secretary of Health must be the State Health Officer and must have a masters degree in public health or equivalent training or experience.

The Secretary of Health must structure the department in a manner consistent with the organizational principles established in the act.

All assistant secretaries, deputy secretaries, division directors, bureau directors, office chiefs and five additional personnel are exempt from civil service protections.

Biennial reviews and determinations regarding continuation of all advisory structures within the department must be made by the secretary.

The new department merges the health professional licensure functions of the Department of Licensing (DOL) and the traditional public health functions, the mandated health benefit review, new health professional credentialing review, and health planning functions of the Department of Social and Health Services.

Traditional public health functions transferred from DSHS include:

      Environmental health protection programs including radiation, drinking water, toxic substances, on-site sewage, recreational water contact facilities, food service sanitation, and shellfish;

      Personal health protection programs including immunizations, tuberculosis, sexually transmitted diseases, AIDS, diabetes control, primary health care, hypertension, kidney disease, regional genetic services, newborn metabolic screening, sentinel birth defects, communicable disease epidemiology, and chronic disease epidemiology;

      The public health laboratory;

      Public health support services, including vital records, health data, and health education and information;

      Selected health facilities licensure authority including hospitals, maternity homes, boarding homes, abortion facility approval, emergency medical services, transient accommodations, home health and hospice care, and private establishments.

Parent and Child Health Services programs are transferred from DSHS to DOH effective July 1, 1991.

The Board of Health is transferred to the Department of Health, designated as the primary entity for state health policy development and required to produce a biennial state health report which sets forth the state's health priorities.  Mechanisms for public involvement are authorized through local health departments and ad hoc advisory groups.

The Governor must approve, disapprove, or modify the state health report by September 1 of each even-numbered year.

Two staff in addition to an executive director and a secretary must be employed by the Board of Health.

The Board of Health is authorized to recommend means for obtaining citizen and professional involvement in all health policy formulation and other matters regarding the Department of Health's duties.

The Board of Health is removed from making recommendations regarding new proposals for mandated benefit offerings in insurance laws.

The Legislature intends that DOH promote, assess and assure quality in health care.  The department is designated as the primary agency to collect data related to illness and injury prevention, health promotion, and the quality of health care.  Safeguards against improper use of data are established.  The department must develop a state research agenda as part of the biennial state health report.  Research and other studies may be undertaken only in accordance with the research agenda and procedures established for study approval and funding.  The secretary must use study results as appropriate to improve health quality.

An Office of Health Consumer Assistance is established and must include a hotline.

A study of present statutes and programs to assure quality in health care professional practices must be completed by the department.

The Secretary of Health and each professional licensure board must develop agreements regarding their respective responsibilities which must be set in rule.

Funeral directors and embalmers regulation is retained within the Department of Licensing, and DOL must recommend legislation by 1990 to eliminate any statutory barriers to this retention.

Funds and employees for DSHS public health functions, DSHS health planning, DOL health professions licensure functions, and the Board of Pharmacy are transferred to the Department of Health.

The State Health Coordinating Council, regional health planning councils and related health planning duties as authorized under Chapter 70.38 RCW are abolished.

Appropriation:    none

Revenue:    none

Fiscal Note:      available

Senate Committee - Testified: Bob Crittenden, Governor's Office; Lars Hennum, Pharmacists of Washington (pro); Don Williams, Pharmacy Board (pro); Harv C. Miles, SHCC (pro); Dr. Bud Nicola, Seattle-King County Health Department (pro); Jack McFayden, Association of Counties (pro); John Thayer, Environmental Health Directors Group (pro); Bobbie Evans, Seattle-King County Health Department (pro); Patty Joynes, Washington State Nurses Association (pro); Len Eddinger, Washington State Medical Association (pro); Robb Menaul, Hospital Association (pro)