BILL REQ. #:  S-5108.2 

READ FIRST TIME 02/7/06.   

     AN ACT Relating to community-based health care solutions; creating new sections; and providing an expiration date.

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

NEW SECTION.  Sec. 1   The legislature finds that:
     (1) Despite sustained efforts at the federal and state level, too many people in Washington remain without access to appropriate health care. Particularly alarming is the increase in the number of small business employees who are uninsured. Without a health home, many low-income and other vulnerable populations are left to inefficiently navigate a fragmented treatment system that fails to support their long-term well-being.
     (2) In recent years, numerous community-based organizations have emerged around the state to address health care concerns at a local level. Through innovation and public/private collaboration, they have demonstrated great success and show even greater promise in improving health care access for local residents. Less remote than state and federal agencies, these organizations have built on local relationships to increase the availability and affordability of services, and coordinate care, making efficient use of a wide variety of community resources to meet community needs.
     (3) Many of these organizations have relied on grants from the healthy communities access program, an initiative of the United States department of health and human services that provided funding and technical assistance to support collaborative efforts at the local level to coordinate and strengthen health services for the uninsured and underinsured. The program, however, was recently discontinued, placing these local efforts at risk.
     It is therefore the intent of the legislature to enhance and support the development of collaborative community-based organizations working at the local level to increase access to health care for Washington residents.

NEW SECTION.  Sec. 2   (1) The community health care collaborative grant program is established to further the efforts of community-based organizations to increase access to appropriate, affordable health care for Washington residents, particularly employed low-income persons who are uninsured and underinsured, through local programs addressing one or more of the following: (a) Access to medical treatment; (b) the efficient use of health care resources; or (c) quality of care.
     (2) Grants of up to five hundred thousand dollars per organization shall be awarded pursuant to sections 3 and 4 of this act by a board consisting of: (a) The administrator of the health care authority; (b) the secretary of the department of health; (c) the assistant secretary of the health and recovery services administration within the department of social and health services; (d) the insurance commissioner; and (e) one other member, appointed by the governor, who shall act as chair.
     (3) The health care authority shall provide administrative support for the program.

NEW SECTION.  Sec. 3   Eligibility for grants shall be limited to nonprofit organizations established to serve a defined substate geographic region and having a formal collaborative governance structure and decision-making process for improving access. The nature and format of the application, and the application procedure, shall be determined by the board. At a minimum, each application shall: (1) Identify the geographic region served by the organization; (2) show how the structure and operation of the organization reflects the interests of, and is accountable to, this region; (3) indicate the size of the grant being requested, and how the money will be spent; and (4) include sufficient information for the board to evaluate the application based on the criteria established in section 4 of this act.

NEW SECTION.  Sec. 4   (1) Grants shall be awarded on a competitive basis based on the board's determination of which applicant organization will best serve the purposes of the grant program. In making this determination, the board shall consider the extent to which:
     (a) The programs to be supported by the grant are likely to address, in a measurable fashion, documented health care access needs within the region to be served;
     (b) An applicant organization can be expected to successfully implement these programs, including the extent to which the application reflects formal, active collaboration among key community members such as local governments, school districts, large and small businesses, nonprofit organizations, carriers, private health care providers, and public health agencies;
     (c) The applicant organization will match the grant with funds from other sources. Grants may be awarded only to organizations providing at least two dollars in matching funds for each grant dollar awarded;
     (d) The grant will enhance the long-term capacity of the applicant organization and its partners to serve the region's documented health care access needs, including the sustainability of the programs to be supported by the grant;
     (e) The programs to be supported by the grant reflect creative, innovative approaches which complement and enhance existing efforts to address the needs of the uninsured and underinsured and, if successful, could be replicated in other areas of the state; and
     (f) The programs to be supported by the grant make efficient and cost-effective use of available funds through administrative simplification and improvements in the structure and operation of the health care delivery system.
     (2) The board shall endeavor to disburse grant funds throughout the state, supporting organizations and programs of differing sizes and scales, and serving differing populations.

NEW SECTION.  Sec. 5   One-half the total amount of any award shall be disbursed to an organization upon its selection as a grant recipient. The remaining half shall be disbursed one year later only upon receipt by the board of a progress report from the organization, and a determination by the board that the organization is satisfactorily serving the purposes of the grant program and meeting the objectives identified in its application regarding: (1) Access to medical treatment; (2) the efficient use of health care resources; or (3) quality of care.

NEW SECTION.  Sec. 6   By July 1, 2008, the board shall provide the governor and the legislature with an evaluation of the community health care collaborative grant program, describing the organizations and programs funded and the results achieved. Particularly successful programs shall be highlighted with recommendations on whether, and how, the programs could be replicated statewide. The evaluation shall also summarize any recommendations from the participating organizations regarding ways to improve the grant program and for the state to otherwise support community-based organizations working to improve access to health care for Washington residents, including any changes in state statutes or regulations.

NEW SECTION.  Sec. 7   The health care authority may adopt rules to implement this act.

NEW SECTION.  Sec. 8   The community health care collaborative account is created in the custody of the state treasurer. Expenditures from the account may be used only for the purposes set forth in this act. The account is subject to allotment procedures under chapter 43.88 RCW, but an appropriation is not required for expenditures.

NEW SECTION.  Sec. 9   This act expires June 30, 2009.