Paid Family and Medical Leave.
The state Paid Family and Medical Leave (PFML) Program, administered by the Employment Security Department (Department), provides paid family and medical leave for eligible workers who have worked at least 820 hours during a qualifying period. The PFML benefits are generally provided: when an employee is bonding after the birth or placement of a child, because of an employee's or family member's serious health condition, or for a military exigency. Under the PFML Program, a "serious health condition" generally means an illness, injury, impairment, or physical or mental condition that involves: (1) inpatient hospital, hospice, or residential medical care; or (2) continuing treatment by a health care provider for periods of incapacity, pregnancy, or certain chronic conditions causing incapacity.
To receive PFML benefits, among other requirements, the employee must provide a document authorizing the family member's or employee's health care provider, as applicable, to disclose the family member's or employee's health care information in the form of the certification of a serious health condition.
Fees for Providing Health Care Information.
Under the Uniform Health Care Information Act, a patient may authorize a health care provider or health care facility to disclose the patient's health care information. A health care provider or health care facility must generally honor such an authorization and, if requested, provide a copy of the recorded health care information. Subject to certain exceptions, health care providers may charge a reasonable fee for providing copies of health care records.
A health care provider must provide a certification of a serious health condition as required by the PFML Program for qualifying a patient for PFML benefits within seven calendar days of receipt of a request and authorization from the patient. If a health care facility requires administrative review before allowing a provider to provide a certification of a serious health condition, the administrative review process must comply with this timing requirement.
A health care provider or health care facility may not charge a fee for the execution of a certification of a serious health condition, but a health care provider may charge a fee associated with any office visit necessary for evaluating the patient.
The substitute bill:
(In support) The Paid Family and Medical Leave Program (PFML) is a lifeline for a lot of Washington families, particularly lower-income families. It is important for people to be able to access benefits in a timely way if they have a new child or a serious health care condition. Before a worker can access benefits related to a serious health condition, a provider must sign a certification form. Workers often face a process delay due to the frequent difficulty in getting a provider to sign a certification of a serious health condition in a timely manner. Sometimes it can take weeks to have a provider sign the certification form, or the provider charges a fee for signing the form, both of which defeat the purpose of the PFML Program. Requiring providers to fill out the form in five business days will help ensure access to benefits. This bill will help streamline the process for applying for benefits.
(Opposed) None.
(Other) The bill should be amended so that it does not require providers to send the certification forms directly to the Department. The bill should be amended to clarify the circumstances under which a provider would be required to meet the five day deadline, such as when a relationship has already been established between the provider and patient. There are already a lot of constraints on primary care professionals, and this bill could produce the unintended consequence of diverting primary care professionals' attention from other pressing matters.
(In support) Representative Liz Berry, prime sponsor; Carrie Glover, WithinReach; Joe Kendo, Washington State Labor Council, American Federation of Labor and Congress of Industrial Organizations; and Gabriela Quintana, Economic Opportunity Institute.