BILL REQ. #:  S-0341.3 

Read first time 01/21/11.   Referred to Committee on Health & Long-Term Care.

     AN ACT Relating to the adverse health events and incident reporting system; amending RCW 70.56.020 and 18.130.080; reenacting and amending RCW 70.56.030; and adding a new section to chapter 70.56 RCW.

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

Sec. 1   RCW 70.56.020 and 2009 c 495 s 12 are each amended to read as follows:
     (1) The legislature intends to establish an adverse health events and incident notification and reporting system that is designed to facilitate quality improvement in the health care system, improve patient safety, assist the public in making informed health care choices, and decrease medical errors in a nonpunitive manner. The notification and reporting system shall not be designed to punish errors by health care practitioners or health care facility employees.
     (2) When a medical facility confirms that an adverse event has occurred, it shall submit to:
     (a) The department of health, using the internet-based system established under RCW 70.56.040(2), if operational, and any payor, as that term is defined in RCW 41.05.036, for service relating to the adverse event:
     (((a))) (i) Notification of the event, with the date, type of adverse event, and any additional contextual information the facility chooses to provide, within forty-eight hours; and
     (((b))) (ii) A report regarding the event within forty-five days that may be amended by the medical facility within sixty days of the submission; and
     (b) The patient or family affected by the adverse event:
     (i) A notice that an adverse event relating to the patient has been reported to the department of health. The notice must include the information provided to the department under (a) of this subsection; and
     (ii) Information on how the patient or family may access adverse event reports via the department of health's web site.
     ((The notification and report shall be submitted to the department using the internet-based system established under RCW 70.56.040(2) if the system is operational.
     (c) A medical facility may amend the notification or report within sixty days of the submission.))
     (3) The notification and report shall be filed in a format specified by the department after consultation with medical facilities and the independent entity if an independent entity has been contracted for under RCW 70.56.040(1). The format shall identify the facility, but shall not include any identifying information for any of the health care professionals, facility employees, or patients involved. This provision does not modify the duty of a hospital to make a report to the department of health or a disciplinary authority if a licensed practitioner has committed unprofessional conduct as defined in RCW 18.130.180.
     (4) As part of the report filed under subsection (2)(((b))) (a)(ii) of this section, the medical facility must conduct a root cause analysis of the event, describe the corrective action plan that will be implemented consistent with the findings of the analysis, or provide an explanation of any reasons for not taking corrective action. The department shall adopt rules, in consultation with medical facilities and the independent entity if an independent entity has been contracted for under RCW 70.56.040(1), related to the form and content of the root cause analysis and corrective action plan. In developing the rules, consideration shall be given to existing standards for root cause analysis or corrective action plans adopted by the joint commission on accreditation of health facilities and other national or governmental entities.
     (5) If, in the course of investigating a complaint received from an employee of a medical facility, the department determines that the facility has not provided notification of an adverse event or undertaken efforts to investigate the occurrence of an adverse event, the department shall direct the facility to provide notification or to undertake an investigation of the event.
     (6) The protections of RCW 43.70.075 apply to notifications of adverse events that are submitted in good faith by employees of medical facilities.

Sec. 2   RCW 18.130.080 and 2008 c 134 s 8 are each amended to read as follows:
     (1)(a) An individual, an impaired practitioner program, or a voluntary substance abuse monitoring program approved by a disciplining authority, may submit a written complaint to the disciplining authority charging a license holder or applicant with unprofessional conduct and specifying the grounds therefor or to report information to the disciplining authority, or voluntary substance abuse monitoring program, or an impaired practitioner program approved by the disciplining authority, which indicates that the license holder may not be able to practice his or her profession with reasonable skill and safety to consumers as a result of a mental or physical condition.
     (b)(i) Every license holder, corporation, organization, health care facility, and state and local governmental agency that employs a license holder shall report to the disciplining authority when the employed license holder's services have been terminated or restricted based upon a final determination that the license holder has either committed an act or acts that may constitute unprofessional conduct or that the license holder may not be able to practice his or her profession with reasonable skill and safety to consumers as a result of a mental or physical condition.
     (ii) All reports required by (b)(i) of this subsection must be submitted to the disciplining authority as soon as possible, but no later than twenty days after a determination has been made. A report should contain the following information, if known:
     (A) The name, address, and telephone number of the person making the report;
     (B) The name, address, and telephone number of the license holder being reported;
     (C) The case number of any patient whose treatment is the subject of the report;
     (D) A brief description or summary of the facts that gave rise to the issuance of the report, including dates of occurrences;
     (E) If court action is involved, the name of the court in which the action is filed, the date of filing, and the docket number; and
     (F) Any further information that would aid in the evaluation of the report.
     (iii) Mandatory reports required by (b)(i) of this subsection are exempt from public inspection and copying to the extent permitted under chapter 42.56 RCW or to the extent that public inspection or copying of the report would invade or violate a person's right to privacy as set forth in RCW 42.56.050.
     (2) After receiving a written complaint under subsection (1) of this section, the disciplining authority must submit a copy of the complaint to the department of health's adverse health events and incident notification and reporting system, which information shall be used as necessary by the department in conducting investigations under RCW 70.56.030.
     (3) If the disciplining authority determines that a complaint submitted under subsection (1) of this section merits investigation, or if the disciplining authority has reason to believe, without a formal complaint, that a license holder or applicant may have engaged in unprofessional conduct, the disciplining authority shall investigate to determine whether there has been unprofessional conduct. In determining whether or not to investigate, the disciplining authority shall consider any prior complaints received by the disciplining authority, any prior findings of fact under RCW 18.130.110, any stipulations to informal disposition under RCW 18.130.172, and any comparable action taken by other state disciplining authorities.
     (((3))) (4) Notwithstanding subsection (((2))) (3) of this section, the disciplining authority shall initiate an investigation in every instance where:
     (a) The disciplining authority receives information that a health care provider has been disqualified from participating in the federal medicare program, under Title XVIII of the federal social security act, or the federal medicaid program, under Title XIX of the federal social security act; or
     (b) There is a pattern of complaints, arrests, or other actions that may not have resulted in a formal adjudication of wrongdoing, but when considered together demonstrate a pattern of similar conduct that, without investigation, likely poses a risk to the safety of the license holder's patients.
     (((4))) (5) Failure of a license holder to submit a mandatory report to the disciplining authority under subsection (1)(b) of this section is punishable by a civil penalty not to exceed five hundred dollars and constitutes unprofessional conduct.
     (((5))) (6) If a report has been made by a hospital to the department under RCW 70.41.210 or an ambulatory surgical facility under RCW 70.230.120, a report to the disciplining authority under subsection (1)(b) of this section is not required.
     (((6))) (7) A person is immune from civil liability, whether direct or derivative, for providing information in good faith to the disciplining authority under this section.
     (((7))) (8)(a) The secretary is authorized to receive criminal history record information that includes nonconviction data for any purpose associated with the investigation or licensing of persons under this chapter.
     (b) Dissemination or use of nonconviction data for purposes other than that authorized in this section is prohibited.

Sec. 3   RCW 70.56.030 and 2009 c 495 s 13 and 2009 c 488 s 1 are each reenacted and amended to read as follows:
     (1) The department shall:
     (a) Receive and investigate, where necessary, notifications and reports of adverse events, including root cause analyses and corrective action plans submitted as part of reports and relevant complaint information submitted under RCW 18.130.080, and communicate to individual facilities the department's conclusions, if any, regarding an adverse event reported by a facility; and
     (b) Adopt rules as necessary to implement this chapter.
     (2) The department may enforce the reporting requirements of RCW 70.56.020 using its existing enforcement authority provided in chapter 18.46 RCW for childbirth centers, chapter 70.41 RCW for hospitals, and chapter 71.12 RCW for psychiatric hospitals.

NEW SECTION.  Sec. 4   A new section is added to chapter 70.56 RCW to read as follows:
     (1) Beginning July 1, 2012, medical facilities must submit an annual fee of one thousand dollars to the department in order to fund the adverse health events and incident notification system. This fee must be used by the department for oversight and enforcement activities as well as investigations conducted under this chapter.
     (2) Fees collected under this section must be deposited into the health professions account in RCW 43.70.320.
     (3) The department may adopt rules to implement this section and may adjust the fee under subsection (1) of this section annually for inflation if deemed necessary by the department.