AN ACT Relating to health care; adding a new chapter to Title 70 RCW; prescribing penalties; providing an effective date; and declaring an emergency.

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

NEW SECTION. Sec. 1. The legislature declares that access to adequate health care is of paramount importance to the citizens of Washington state. As such, health care access is a major public policy concern and unless addressed through specific statutory direction, adequate health care through the expenditure of public funds will not be attainable for a vast majority of the state's population.

The legislature finds that the increase in health costs threatens to make health care unaffordable to many citizens. Furthermore, the legislature finds that unreimbursed health care services provided to persons who are unable to pay for such services causes the cost of services to paying patients to increase in a manner unrelated to the actual cost of services delivered. Consequently, the legislature finds that inequities between hospitals in the provision of unreimbursed services prevent hospitals which provide the bulk of such services from competing on an equitable economic basis with hospitals which provide relatively little care to indigent people. Therefore, it is the intent of the legislature to provide a mechanism for the funding of health care services to indigent persons, the cost of which shall be borne by the state and by hospitals which are granted the privilege of operating in this state.

NEW SECTION. Sec. 2. Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Adjusted net patient services revenue" means the revenue from patient services, with the exception of revenues from the following sources:

(a) Reimbursement received through the state medical assistance program;

(b) Reimbursement received through the federal medicare program; and

(2) "Department" means the department of social and health services.

(3) "Hospital" means any health care institution which is required to qualify for a license under RCW 70.41.020(2); or as a psychiatric hospital under chapter 71.12 RCW, but shall not include beds utilized by a comprehensive cancer center for cancer research, or any health care institution conducted for those who rely primarily upon treatment by prayer or spiritual means in accordance with the creed or tenets of any church or denomination.

(4) "Rural hospital" means a hospital outside the boundaries of a standard metropolitan statistical area, as defined by the federal bureau of the census.

NEW SECTION. Sec. 3. The health access fund is created in the custody of the state treasurer. All receipts from assessment fees and penalties collected under sections 4, 5, and 6 of this act or any other funds appropriated for the purposes of this chapter, shall be deposited into the fund. Expenditures from the fund may be used only for: (1) Disbursements to hospitals under the medically indigent program created by RCW 74.09.700; and (2) reimbursement of administrative expenditures as specified in section 5 of this act to the department of social and health services and the department of revenue. Only the secretary of social and health services or the secretary's designee may authorize expenditures from the fund. The fund is subject to allotment procedures under chapter 43.88 RCW.

NEW SECTION. Sec. 4. (1) In addition to any other tax, there is hereby levied and there shall be collected by the department of revenue from each hospital an assessment on the hospital's adjusted net patient services revenue, as defined in section 2 of this act, for the provision of hospital services for the preceding monthly or quarterly payment period. A hospital that does not charge any fees for services rendered to patients may apply to the department for a waiver of the assessment.

(2)(a) The assessment for rural hospitals shall be equal to one and seven one-hundredths percent of the hospital's adjusted net patient services revenue.

(b) The assessment for hospitals which are not rural hospitals shall be equal to two and fourteen one-hundredths percent of the hospital's adjusted net patient services revenue.

(3) The department may adopt such rules, in accordance with chapter 34.05 RCW, as are necessary to administer its duties under this chapter. The department of revenue may adopt such rules, in accordance with chapter 34.05 RCW and pursuant to chapter 82.32 RCW, as are necessary to administer this chapter. The provisions of chapter 82.32 RCW shall be applicable with respect to the assessment imposed under this chapter.

NEW SECTION. Sec. 5. The department shall contract with the department of revenue for the administration and collection of the assessment, and the department of revenue shall deduct a percentage amount, as provided by contract, related to the actual cost of collecting funds not to exceed one percent of the revenues collected for administration and collection expenses incurred by the department of revenue. The contract between the department and the department of revenue shall be approved by the office of financial management. The remainder of any portion of any assessment authorized by this chapter collected by the department of revenue shall be deposited by the department of revenue in the health access fund.

NEW SECTION. Sec. 6. Any hospital that fails to pay its assessment by the due date established by the department of revenue under section 4 of this act shall be subject to penalties and interest charges for unpaid assessment liabilities. Penalties imposed on any hospital shall not exceed five hundred dollars per day.

NEW SECTION. Sec. 7. Sections 1 through 6 of this act shall constitute a new chapter in Title 70 RCW.

NEW SECTION. Sec. 8. 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 shall take effect July 1, 1989.