5127-S2 AMH FIN AMH-3150

5127-S2 AMH FIN AMH-3150.1

2SSB 5127 - H COMM AMD

By Committee on Finance

ADOPTED AS AMENDED 4/11/97

Strike everything after the enacting clause and insert the following:

"NEW SECTION. Sec. 1. A new section is added to chapter 70.168 RCW to read as follows:

The department shall establish by rule a grant program for designated trauma care services. The grants shall be made from the emergency medical services and trauma care system trust account and shall require regional matching funds. The trust account funds and regional match will be in a seventy-five to twenty-five percent ratio.

Sec. 2. RCW 70.168.040 and 1990 c 269 s 17 are each amended to read as follows:

The emergency medical services and trauma care system trust account is hereby created in the state treasury. Moneys shall be transferred to the emergency medical services and trauma care system trust account from the public safety education account or other sources as appropriated, and as collected under RCW 46.63.110(6). Disbursements shall be made by the department subject to legislative appropriation. Expenditures may be made only for the purposes of the state trauma care system under this chapter, including emergency medical services, trauma care services, rehabilitative services, and the planning and development of related services under this chapter and for reimbursement by the department of social and health services for trauma care services provided by designated trauma centers.

Sec. 3. RCW 46.63.110 and 1993 c 501 s 11 are each amended to read as follows:

(1) A person found to have committed a traffic infraction shall be assessed a monetary penalty. No penalty may exceed two hundred and fifty dollars for each offense unless authorized by this chapter or title.

(2) The supreme court shall prescribe by rule a schedule of monetary penalties for designated traffic infractions. This rule shall also specify the conditions under which local courts may exercise discretion in assessing fines and penalties for traffic infractions. The legislature respectfully requests the supreme court to adjust this schedule every two years for inflation.

(3) There shall be a penalty of twenty-five dollars for failure to respond to a notice of traffic infraction except where the infraction relates to parking as defined by local law, ordinance, regulation, or resolution or failure to pay a monetary penalty imposed pursuant to this chapter. A local legislative body may set a monetary penalty not to exceed twenty-five dollars for failure to respond to a notice of traffic infraction relating to parking as defined by local law, ordinance, regulation, or resolution. The local court, whether a municipal, police, or district court, shall impose the monetary penalty set by the local legislative body.

(4) Monetary penalties provided for in chapter 46.70 RCW which are civil in nature and penalties which may be assessed for violations of chapter 46.44 RCW relating to size, weight, and load of motor vehicles are not subject to the limitation on the amount of monetary penalties which may be imposed pursuant to this chapter.

(5) Whenever a monetary penalty is imposed by a court under this chapter it is immediately payable. If the person is unable to pay at that time the court may, in its discretion, grant an extension of the period in which the penalty may be paid. If the penalty is not paid on or before the time established for payment the court shall notify the department of the failure to pay the penalty, and the department shall suspend the person's driver's license or driving privilege until the penalty has been paid and the penalty provided in subsection (3) of this section has been paid.

(6) In addition to any other penalties imposed under this section and not subject to the limitation of subsection (1) of this section, a person found to have committed a traffic infraction shall be assessed a fee of twenty dollars per infraction. Under no circumstances shall this fee be reduced or waived. Revenue from this fee shall be forwarded to the state treasurer for deposit in the emergency medical services and trauma care system trust account under RCW 70.168.040. The public safety and education assessment imposed under RCW 3.62.090 does not apply to the fee imposed under this subsection.

NEW SECTION. Sec. 4. The legislature finds as follows:

Emergency medical services and trauma care are provided to all residents of the state regardless of a person's ability to pay. Historically, hospitals and health care providers have been able to recover some of their financial losses incurred in caring for an uninsured or underinsured person by charging persons able to pay more. In recent years, the health care industry has undergone substantial changes. With the advent of managed health care programs and the adoption of new cost control measures, some hospitals and health care providers assert that it is difficult to shift costs for uninsured and underinsured patients onto insured patients.

In 1990 the legislature established a coordinated trauma care system. Part of the 1990 legislation included funding for a study to determine the extent to which trauma care is uncompensated and undercompensated. This study focused exclusively on trauma care. The legislature finds that, as a prerequisite to determining the amount of state aid that may be necessary to assist health care providers and facilities, it is necessary to examine trauma care losses within the context of a health care provider or facility's total financial operations.

NEW SECTION. Sec. 5. The committees on finance and health care of the house of representatives shall conduct a joint interim study on trauma care services funding.

(1) The study shall:

(a) Review how health care providers and facilities determine which patients are classified as trauma care patients;

(b) Examine actual trauma care services information for fiscal year 1997 to determine how the four million six hundred thousand dollars appropriated from the state's general fund for trauma care was spent and whether the appropriation was sufficient to reimburse all eligible trauma care services for treating medically indigent persons who had a trauma index severity score of sixteen or higher;

(c) Determine if reimbursement at the medicaid rate covers, on average, the actual costs of trauma care services for treating a medically indigent person. If reimbursement at the medicaid rate does not cover actual costs, then the study shall determine by how much the reimbursement at the medicaid rate fails to cover actual costs;

(d) Review grants, contributions, and other income received by trauma center facilities that are not third-party reimbursements;

(e) Compare and contrast financial information for trauma care service providers to determine if the overall financial condition of such providers has worsened, improved, or held constant over the last five years; and

(f) Analyze any other information which assists the committees to better understand the amount of funding needed for trauma care services.

(2) The office of program research shall provide staff support for the study. The department of health, the department of social and health services, and the emergency medical services and trauma care steering committee shall provide information and technical support as needed.

(3) For the purposes of this section "trauma care services" means verified ambulance services, designated trauma services, and related services provided by a physician who is an active member of a trauma service team at a designated facility.

NEW SECTION. Sec. 6. Sections 1 through 3 of this act take effect January 1, 1998."

Correct the title accordingly.