HB 1471 -
By Committee on Health Care
ADOPTED 04/12/2013
Strike everything after the enacting clause and insert the following:
"Sec. 1 RCW 43.70.056 and 2010 c 113 s 1 are each amended to read
as follows:
(1) The definitions in this subsection apply throughout this
section unless the context clearly requires otherwise.
(a) "Health care-associated infection" means a localized or
systemic condition that results from adverse reaction to the presence
of an infectious agent or its toxins and that was not present or
incubating at the time of admission to the hospital.
(b) "Hospital" means a health care facility licensed under chapter
70.41 RCW.
(2)(a) A hospital shall collect data related to health
care-associated infections as required under this subsection (2) on the
following:
(i) ((Beginning July 1, 2008, central line-associated bloodstream
infection in the intensive care unit;)) Central line-associated
bloodstream infection in all hospital inpatient areas where patients
normally reside at least twenty-four hours;
(ii) Beginning January 1, 2009, ventilator-associated pneumonia;
and
(iii) Beginning January 1, 2010,
(ii) Surgical site infection for the following procedures:
(A) Deep sternal wound for cardiac surgery, including coronary
artery bypass graft;
(B) Total hip and knee replacement surgery; and
(C) ((Hysterectomy, abdominal and vaginal.)) Colon and abdominal hysterectomy procedures.
(b)(i) Except as required under (b)(ii) and (c) of this
subsection,
(b) The department shall, by rule, delete, add, or modify
categories of reporting when the department determines that doing so is
necessary to align state reporting with the reporting categories of the
centers for medicare and medicaid services. The department shall begin
rule making forty-five calendar days, or as soon as practicable, after
the centers for medicare and medicaid services adopts changes to
reporting requirements.
(c) A hospital must routinely collect and submit the data required
to be collected under (a) and (b) of this subsection to the national
healthcare safety network of the United States centers for disease
control and prevention in accordance with national healthcare safety
network definitions, methods, requirements, and procedures.
(((ii) Until the national health care safety network releases a
revised module that successfully interfaces with a majority of computer
systems of Washington hospitals required to report data under (a)(iii)
of this subsection or three years, whichever occurs sooner, a hospital
shall monthly submit the data required to be collected under (a)(iii)
of this subsection to the Washington state hospital association's
quality benchmarking system instead of the national health care safety
network. The department shall not include data reported to the quality
benchmarking system in reports published under subsection (3)(d) of
this section. The data the hospital submits to the quality
benchmarking system under (b)(ii) of this subsection:)) If the centers for medicare
and medicaid services changes reporting from the national healthcare
safety network to another database or through another process, the
department shall review the new reporting database or process and
consider whether it aligns with the purposes of this section.
(A) Must include the number of infections and the total number of
surgeries performed for each type of surgery; and
(B) Must be the basis for a report developed by the Washington
state hospital association and published on its web site that compares
the health care-associated infection rates for surgical site infections
at individual hospitals in the state using the data reported in the
previous calendar year pursuant to this subsection. The report must be
published on December 1, 2010, and every year thereafter until data is
again reported to the national health care safety network.
(c)(i) With respect to any of the health care-associated infection
measures for which reporting is required under (a) of this subsection,
the department must, by rule, require hospitals to collect and submit
the data to the centers for medicare and medicaid services according to
the definitions, methods, requirements, and procedures of the hospital
compare program, or its successor, instead of to the national
healthcare safety network, if the department determines that:
(A) The measure is available for reporting under the hospital
compare program, or its successor, under substantially the same
definition; and
(B) Reporting under this subsection (2)(c) will provide
substantially the same information to the public.
(ii) If the department determines that reporting of a measure must
be conducted under this subsection (2)(c), the department must adopt
rules to implement such reporting. The department's rules must require
reporting to the centers for medicare and medicaid services as soon as
practicable, but not more than one hundred twenty days, after the
centers for medicare and medicaid services allow hospitals to report
the respective measure to the hospital compare program, or its
successor. However, if the centers for medicare and medicaid services
allow infection rates to be reported using the centers for disease
control and prevention's national healthcare safety network, the
department's rules must require reporting that reduces the burden of
data reporting and minimizes changes that hospitals must make to
accommodate requirements for reporting.
(d) Data collection and submission required under this subsection
(2) must be overseen by a qualified individual with the appropriate
level of skill and knowledge to oversee data collection and submission.
(e)(i) A hospital must release to the department, or grant the
department access to, its hospital-specific information contained in
the reports submitted under this subsection (2), as requested by the
department consistent with RCW 70.02.050.
(ii) The hospital reports obtained by the department under this
subsection (2), and any of the information contained in them, are not
subject to discovery by subpoena or admissible as evidence in a civil
proceeding, and are not subject to public disclosure as provided in RCW
42.56.360.
(3) The department shall:
(a) Provide oversight of the health care-associated infection
reporting program established in this section;
(b) By January 1, ((2011)) 2014, and biennially thereafter, submit
a report to the appropriate committees of the legislature ((based on
the recommendations of the advisory committee established in subsection
(5) of this section for additional reporting requirements related to
health care-associated infections, considering the methodologies and
practices of the United States centers for disease control and
prevention, the centers for medicare and medicaid services, the joint
commission, the national quality forum, the institute for healthcare
improvement, and other relevant organizations)) that contains: (i)
Categories of reporting currently required of hospitals under
subsection (2)(a) of this section; (ii) categories of reporting the
department plans to add, delete, or modify by rule; and (iii) a
description of the evaluation process used under (f) of this
subsection;
(c) ((Delete, by rule, the reporting of categories that the
department determines are no longer necessary to protect public health
and safety;)) By December 1, 2016, report to the appropriate committees of
the legislature with an update on the categories of reporting required
under subsection (2)(a) of this section, any plans for federal
reporting requirements on the categories, and recommendations for an
expiration of the reporting requirements;
(d)
(d) By rule, delete, add, or modify categories of reporting when
the department determines that it is necessary to align state reporting
with the reporting categories of the centers for medicare and medicaid
services. The department shall begin rule making forty-five calendar
days, or as soon as practicable, after the centers for medicare and
medicaid services adopts changes to reporting requirements;
(e) By December 1, 2009, and by each December 1st thereafter,
prepare and publish a report on the department's web site that compares
the health care-associated infection rates at individual hospitals in
the state using the data reported in the previous calendar year
pursuant to subsection (2) of this section. The department may update
the reports quarterly. In developing a methodology for the report and
determining its contents, the department shall consider the
recommendations of the advisory committee established in subsection (5)
of this section. The report is subject to the following:
(i) The report must disclose data in a format that does not release
health information about any individual patient; and
(ii) The report must not include data if the department determines
that a data set is too small or possesses other characteristics that
make it otherwise unrepresentative of a hospital's particular ability
to achieve a specific outcome; ((and)) (f) Evaluate, on a regular basis, the quality and accuracy of
health care-associated infection reporting required under subsection
(2) of this section and the data collection, analysis, and reporting
methodologies; and
(e)
(g) Provide assistance to hospitals with the reporting requirements
of this chapter including definitions of required reporting elements.
(4) The department may respond to requests for data and other
information from the data required to be reported under subsection (2)
of this section, at the requestor's expense, for special studies and
analysis consistent with requirements for confidentiality of patient
records.
(5)(a) The department shall establish an advisory committee which
may include members representing infection control professionals and
epidemiologists, licensed health care providers, nursing staff,
organizations that represent health care providers and facilities,
health maintenance organizations, health care payers and consumers, and
the department. The advisory committee shall make recommendations to
assist the department in carrying out its responsibilities under this
section, including making recommendations on allowing a hospital to
review and verify data to be released in the report and on excluding
from the report selected data from certified critical access hospitals.
((Annually, beginning January 1, 2011, the advisory committee shall
also make a recommendation to the department as to whether current
science supports expanding presurgical screening for methicillin-resistant staphylococcus aureus prior to open chest cardiac, total hip,
and total knee elective surgeries.))
(b) In developing its recommendations, the advisory committee shall
consider methodologies and practices related to health care-associated
infections of the United States centers for disease control and
prevention, the centers for medicare and medicaid services, the joint
commission, the national quality forum, the institute for healthcare
improvement, and other relevant organizations.
(6) The department shall adopt rules as necessary to carry out its
responsibilities under this section."
HB 1471 -
By Committee on Health Care
ADOPTED 04/12/2013
On page 1, line 2 of the title, after "reporting;" strike the remainder of the title and insert "and amending RCW 43.70.056."