BILL REQ. #:  H-4316.1 

Read first time 02/27/12.   Referred to Committee on Ways & Means.

     AN ACT Relating to limiting the rates paid to providers for medical services for incarcerated offenders, increasing the copay on medical services, and authorizing the department of corrections to submit medicaid applications on behalf of incarcerated offenders; amending RCW 72.10.020 and 72.10.030; and adding a new section to chapter 70.41 RCW.

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

Sec. 1   RCW 72.10.020 and 1995 1st sp.s. c 19 s 17 are each amended to read as follows:
     (1) Upon entry into the correctional system, offenders shall receive an initial medical examination. The department shall prepare a health profile for each offender that includes at least the following information: (a) An identification of the offender's serious medical and dental needs; (b) an evaluation of the offender's capacity for work and recreation; and (c) a financial assessment of the offender's ability to pay for all or a portion of his or her health care services from personal resources or private insurance.
     (2)(a) The department may develop and implement a plan for the delivery of health care services and personal hygiene items to offenders in the department's correctional facilities, at the discretion of the secretary, and in conformity with federal law.
     (b) To discourage unwarranted use of health care services caused by unnecessary visits to health care providers, offenders shall participate in the costs of their health care services by paying an amount that is commensurate with their resources as determined by the department, or a nominal amount of no less than ((three)) four dollars per visit, as determined by the secretary. Under the authority granted in RCW 72.01.050(2), the secretary may authorize the superintendent to collect this amount directly from an offender's institution account. All copayments collected from offenders' institution accounts shall be ((deposited into the general fund)) a reduction in the expenditures for offender health care at the department.
     (c) Offenders are required to make copayments for initial health care visits that are offender initiated and, by rule adopted by the department, may be charged a copayment for subsequent visits related to the medical condition which caused the initial visit. ((Offenders are not required to pay for emergency treatment or for visits initiated by health care staff or treatment of those conditions that constitute a serious health care need.))
     (d) No offender may be refused any health care service because of indigence.
     (e) At no time shall the withdrawal of funds for the payment of a medical service copayment result in reducing an offender's institution account to an amount less than the level of indigency as defined in chapter 72.09 RCW.
     (3)(((a))) The department shall report annually to the legislature the following information for the fiscal year preceding the report: (((i))) (a) The total number of health care visits made by offenders; (((ii))) (b) the total number of copayments assessed; (((iii))) (c) the total dollar amount of copayments collected; (((iv))) (d) the total number of copayments not collected due to an offender's indigency; and (((v))) (e) the total number of copayments not assessed due to the serious or emergent nature of the health care treatment or because the health care visit was not offender initiated.
     (((b) The first report required under this section shall be submitted not later than October 1, 1996, and shall include, at a minimum, all available information collected through the second half of fiscal year 1996. This subsection (3)(b) shall expire December 1, 1996.))
     (4)(a) The secretary shall adopt, by rule, a uniform policy relating to the distribution and replenishment of personal hygiene items for inmates incarcerated in all department institutions. The policy shall provide for the initial distribution of adequate personal hygiene items to inmates upon their arrival at an institution.
     (b) The acquisition of replenishment personal hygiene items is the responsibility of inmates, except that indigent inmates shall not be denied adequate personal hygiene items based on their inability to pay for them.
     (c) The policy shall provide that the replenishment personal hygiene items be distributed to inmates only in authorized quantities and at intervals that reflect prudent use and customary wear and consumption of the items.
     (5) To the extent that federal law allows and federal financial participation is available, for the limited purpose of implementing this section, the department, or the department's designee, is authorized to act on behalf of an inmate for purposes of applying for medicaid eligibility.
     (6) The following become a debt and are subject to RCW 72.09.450:
     (a) All copayments under subsection (2) of this section that are not collected when the visit occurs; and
     (b) All charges for replenishment personal hygiene items that are not collected when the item is distributed.

Sec. 2   RCW 72.10.030 and 1989 c 157 s 4 are each amended to read as follows:
     (1) Notwithstanding any other provisions of law, the secretary may enter into contracts with health care practitioners, health care facilities, and other entities or agents as may be necessary to provide ((basic)) medical, behavioral health, and chemical dependency treatment care to inmates. The contracts shall not cause the termination of classified employees of the department rendering the services at the time the contract is executed.
     (2) In contracting for services, the secretary is authorized to provide for indemnification of health care practitioners who cannot obtain professional liability insurance through reasonable effort, from liability on any action, claim, or proceeding instituted against them arising out of the good faith performance or failure of performance of services on behalf of the department. The contracts may provide that for the purposes of chapter 4.92 RCW only, those health care practitioners with whom the department has contracted shall be considered state employees.
     (3) Providers of hospital services that are hospitals licensed under chapter 70.41 RCW shall contract with the department for inpatient, outpatient, and ancillary services if deemed appropriate by the department. Payments to hospitals shall conform to the following requirements:
     (a) The department shall pay hospitals through the provider one system operated by the Washington state health care authority;
     (b) The department shall reimburse the hospitals using the reimbursement methodology in use by the state medicaid program; and
     (c) The department shall only reimburse a provider of hospital services to a hospital patient at a rate no more than the amount payable under the medicaid reimbursement structure, regardless of whether the hospital is located within or outside of Washington.

NEW SECTION.  Sec. 3   A new section is added to chapter 70.41 RCW to read as follows:
     As a condition of licensure, a hospital must contract with the department of corrections pursuant to RCW 72.10.030.