BILL REQ. #:  S-0786.1 

Read first time 01/28/11.   Referred to Committee on Health & Long-Term Care.

     AN ACT Relating to freestanding emergency rooms; amending RCW 70.41.020 and 43.70.052; adding new sections to chapter 70.41 RCW; creating a new section; providing an expiration date; and declaring an emergency.

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

NEW SECTION.  Sec. 1   (1) The legislature finds that there is a clear public interest in studying and evaluating the impact of freestanding emergency rooms so as to make informed decisions about whether they should be subject to certificate of need or other regulation and, if so, the appropriate scope of that regulation.
     (2) The legislature further finds that certain measures should be implemented at existing freestanding emergency rooms to ensure patient safety and public accountability.

Sec. 2   RCW 70.41.020 and 2010 c 94 s 17 are each amended to read as follows:
     Unless the context clearly indicates otherwise, the following terms, whenever used in this chapter, shall be deemed to have the following meanings:
     (1) "Department" means the Washington state department of health.
     (2) "Emergency care to victims of sexual assault" means medical examinations, procedures, and services provided by a hospital emergency room to a victim of sexual assault following an alleged sexual assault.
     (3) "Emergency contraception" means any health care treatment approved by the food and drug administration that prevents pregnancy, including but not limited to administering two increased doses of certain oral contraceptive pills within seventy-two hours of sexual contact.
     (4) "Freestanding emergency room" means a facility that is advertised or presented to the public as an emergency department, but is not physically connected or adjacent to a hospital licensed under chapter 70.41 RCW.
     (5) "Hospital" means any institution, place, building, or agency which provides accommodations, facilities and services over a continuous period of twenty-four hours or more, for observation, diagnosis, or care, of two or more individuals not related to the operator who are suffering from illness, injury, deformity, or abnormality, or from any other condition for which obstetrical, medical, or surgical services would be appropriate for care or diagnosis. "Hospital" as used in this chapter does not include hotels, or similar places furnishing only food and lodging, or simply domiciliary care; nor does it include clinics, or physician's offices where patients are not regularly kept as bed patients for twenty-four hours or more; nor does it include nursing homes, as defined and which come within the scope of chapter 18.51 RCW; nor does it include birthing centers, which come within the scope of chapter 18.46 RCW; nor does it include psychiatric hospitals, which come within the scope of chapter 71.12 RCW; nor any other hospital, or institution specifically intended for use in the diagnosis and care of those suffering from mental illness, intellectual disability, convulsive disorders, or other abnormal mental condition. Furthermore, nothing in this chapter or the rules adopted pursuant thereto shall be construed as authorizing the supervision, regulation, or control of the remedial care or treatment of residents or patients in any hospital conducted for those who rely primarily upon treatment by prayer or spiritual means in accordance with the creed or tenets of any well recognized church or religious denominations.
     (((5))) (6) "Person" means any individual, firm, partnership, corporation, company, association, or joint stock association, and the legal successor thereof.
     (((6))) (7) "Secretary" means the secretary of health.
     (((7))) (8) "Sexual assault" has the same meaning as in RCW 70.125.030.
     (((8))) (9) "Victim of sexual assault" means a person who alleges or is alleged to have been sexually assaulted and who presents as a patient.

NEW SECTION.  Sec. 3   A new section is added to chapter 70.41 RCW to read as follows:
     (1) The legislature declares a moratorium on the construction of freestanding emergency rooms if a construction review has not been completed and construction documents have not been approved by the department before January 1, 2011, to allow for a study and evaluation of the impact of freestanding emergency rooms to take place.
     (2) This section expires July 1, 2013.

NEW SECTION.  Sec. 4   A new section is added to chapter 70.41 RCW to read as follows:
     Any hospital that operates a freestanding emergency room as defined in RCW 70.41.020 must conform to the following requirements to ensure patient safety and public accountability:
     (1) After emergency services are rendered and to the extent a patient needs transport to an inpatient facility, the freestanding emergency room must arrange to have the patient delivered to the nearest available hospital in road miles traveled that is capable of delivering the level of care required by the patient;
     (2) All transportation from a freestanding emergency room to an inpatient setting must be paid for by the sponsoring hospital, with no requirement on the insurer or patient to share in the costs; and
     (3) In meeting the requirements of RCW 43.70.052, a hospital shall separately report financial information for any freestanding emergency room that it operates.

Sec. 5   RCW 43.70.052 and 1995 c 267 s 1 are each amended to read as follows:
     (1) To promote the public interest consistent with the purposes of chapter 492, Laws of 1993 as amended by chapter 267, Laws of 1995, the department shall continue to require hospitals to submit hospital financial and patient discharge information, which shall be collected, maintained, analyzed, and disseminated by the department. The department shall, if deemed cost-effective and efficient, contract with a private entity for any or all parts of data collection. Data elements shall be reported in conformance with a uniform reporting system established by the department. This includes data elements identifying each hospital's revenues, expenses, contractual allowances, charity care, bad debt, other income, total units of inpatient and outpatient services, and other financial information reasonably necessary to fulfill the purposes of this section. Data elements relating to use of hospital services by patients ((shall be the same as those currently compiled by hospitals through inpatient discharge abstracts)) must include patient discharge information for inpatient, outpatient, and emergency department services. The department shall encourage and permit reporting by electronic transmission or hard copy as is practical and economical to reporters.
     (2) In identifying financial reporting requirements, the department may require both annual reports and condensed quarterly reports from hospitals, so as to achieve both accuracy and timeliness in reporting, but shall craft such requirements with due regard of the data reporting burdens of hospitals.
     (3) The health care data collected, maintained, and studied by the department shall only be available for retrieval in original or processed form to public and private requestors and shall be available within a reasonable period of time after the date of request. The cost of retrieving data for state officials and agencies shall be funded through the state general appropriation. The cost of retrieving data for individuals and organizations engaged in research or private use of data or studies shall be funded by a fee schedule developed by the department that reflects the direct cost of retrieving the data or study in the requested form.
     (4) The department shall, in consultation and collaboration with the federally recognized tribes, urban or other Indian health service organizations, and the federal area Indian health service, design, develop, and maintain an American Indian-specific health data, statistics information system. The department rules regarding confidentiality shall apply to safeguard the information from inappropriate use or release.
     (5) All persons subject to the data collection requirements of this section shall comply with departmental requirements established by rule in the acquisition of data.

NEW SECTION.  Sec. 6   This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect immediately.