Bills that impact the state budget had another major cutoff last week, when they were supposed to have been voted on by their fiscal committees. By March 11, bills must be voted on and passed by their house of origin.
Although the hearing schedule is significantly lighter when compared to the early weeks of the legislative session, that’s no indication of a lighter policy load. The next two weeks will be devoted largely to caucus meetings and votes on the House and Senate floors.
During this time, we keep an eye on our bills as they move through the legislative process because amendments can quickly fix a bad bill or poison a previously good one. We’re also preparing for bills to cross into the other house, where they will likely encounter a whole new political climate.
Nurse Meal and Rest Breaks and On-Call Staffing: Your Voice is Needed
One of our main concerns right now is the nurse staffing bill that addresses meal and rest breaks and the use of on call time—HB 1732. Nurses are valued and essential parts of high-quality patient care in hospitals. But the bill makes it impossible for nurses or hospitals to schedule in ways that are flexible enough to change to meet the needs of our patients.
Read our issue brief about nurse staffing here.
HB 1732, which regulates meal and rest breaks and on call staffing, has a significant fiscal impact because it would increase personnel costs at public hospitals and the Department of Corrections. It would also raise costs at all other hospitals—costs which are eventually passed on to insurance companies, employers and patients.
Currently, Washington State Department of Labor and Industry rules already mandate that workers be able to get regular meal and rest breaks. Hospital contracts with unions contain additional protections in the form of meal and rest break agreements.
Important, life-saving treatment does not work on a set schedule. Hospitals need the ability to use pre-scheduled on-call to provide patients critical services such as needed surgeries and baby deliveries, which is why hospital staff have scheduled on-call hours. The bill’s provisions could result in delayed procedures and threats to patient safety. Nurses can now choose to take their breaks when patients’ needs are lower, for example, when patients are in surgery or with a doctor. But with fixed break times, hospitals will have to hire additional nurses to be sure to have coverage all the time. This increases the number of nurses and the cost, but does not improve the quality of care.
On Friday, HB 1732 was voted out of House Appropriations and will next go to the House floor for a vote.
We need your voice to be heard! The bill will soon come up for a vote in the House.
Please call or email now and tell your House Representative (or Representatives) that you oppose this bill because it does not allow for changing patient needs, reduces scheduling flexibility, raises costs, and does not improve the quality of care. Find your Representatives on our Contact Your Legislator page. (Chelene Whiteaker, 206/216-2545)
Bills Still Alive
These are the bills that were affected by the fiscal-committee cutoff.
| Bill Number | Short Description | WSHA Position |
| HB 1067 | Removes the sunset provision from a significant portion of the Medicaid False Claims Act, which would mean there would be no study or report on the effectiveness of the FCA. (SB 5287) | Oppose |
| HB 1437 | Modifies the all-payer claims database to improve health care quality and cost transparency. (SB 5084) | Strong Support |
| HB 1684 | Allows state agencies and local government (including public hospital districts) to charge for public records provided electronically. | Support (AWPHD) |
| HB 1732 | Mandates rest breaks and overtime rules; eliminates flexibility for nurses; could result in postponed procedures and threats to patient safety. | Strongly Oppose |
| SB 5593 | Clarifies guarding responsibility and payment for health care services for hospitals for inmates and persons detained by law enforcement. | Strong Support |
| SB 5644 | The first version of this bill authorized psychiatric boarding by giving broad authorization to single bed certifications; WSHA opposed it but worked with the sponsor to create a framework for allowing workable short-term psychiatric care in hospitals and other improvements to the mental health system. | Amended to be Strong Support |
Bills Mostly Dead
These are the bills that were affected by the fiscal-committee cutoff.
| Bill Number | Short Description | WSHA Position |
| HB 1340 | Creates a structured process to allow pilot programs for health care professionals to learn new skills or roles, use existing skills in new circumstances, and accelerate training. | Strong Support |
| HB 1669 | Creates a Continuity of Health Coverage Taskforce that would make recommendations on how to ease financial and eligibility barriers to insurance coverage; also requires state study of affordability and availability of health care coverage. | Support |
| HB 1733 | Mandates nurse staffing ratios, which reduces flexibility, limits the ability of the nurse to provide full care to patients and families, and undermines autonomy of nurse-staffing committees. | Strongly Oppose |
| SB 5590 | Allows Medicaid Managed Care plans to pay the Medicaid rate in the absence of a contract only if they have offered a contract to the provider. | Support |
WSHA Legislative Testimony: March 2-6
At this point, none of our priority bills are scheduled for hearings next week, but that can change with very little notice. Because new bills are being added quickly to the hearing schedules, you may also want to check Appropriations and Ways and Means.
HB 1956: Independent Review Organization (House Rules). Washington was one of the first states to establish the right to have an “Independent Review Organization” (IRO) review health insurance claims denials in 2000, as part of the Patient Bill of Rights. IROs review insurer denials after the consumer has exhausted the insurer’s internal appeal process. It is a dispute resolution mechanism that can also add transparency to the insurance process (see Seattle Times editorial on the bill). (Chelene Whiteaker, 206/216-2545)
Thank you for last week!
We are very thankful for everyone who came down to testify! Your testimony is essential for helping legislators and the public to understand the real impact of proposed legislation.
And even on those long days—and nights—when not all the testimony gets heard, we appreciate that you were willing to come out. Your presence is felt by the legislators.
The following people volunteered to testify last week:
- Darcy Jaffe, Chief Nursing Officer, Senior Associate Administrator, UW Medicine, Harborview Medical Center
- Maylynn Bennett, Assistant Clinical Manager, St. Clare Hospital, CHI Franciscan Health
- Jane Hutcheson, Vice-President Operations, Swedish Ballard
- Laureen Driscoll, Chief Operating Officer, Swedish Cherry Hill Campus
- Karla Green, Community Paramedic Program- Nurse Case Manager, PMH Medical Center (Prosser)
