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Senate Budget Proposal on Hospital Safety Net Assessment Program
WSHA is still working to clarify the Senate proposal for the hospital safety net program, but it’s becoming clear that some of our information was incorrect, and that the proposal is significantly worse for hospitals than it initially appeared.
In order to maintain their “no new tax†commitment and still raise additional revenue to fund the state services, the Senate budget increased the assessment rate, took a disproportionate share of funds for state services, and is requiring hospitals to divert some of their benefits to other state health programs.
Remember that the hospital safety net assessment is a carefully structured tax that is used to leverage federal dollars to help cover the cost of hospital services provided to Medicaid patients (Medicaid only pays about 70 percent of the cost of care). The program was designed to allow both the state and hospitals to benefit when revenues increase from the assessment pool.
Compared to the House proposal for the safety net assessment which delivers an additional $143 million to the state general fund in the upcoming biennium, the Senate program takes a full $47 million more for the state general fund. It gives significantly less revenues to hospitals. In addition, the Senate proposal diverts an additional $20 million from the hospital benefits over the biennium to fund family medicine and integrated psychiatry residencies.
The House funds family practice residencies at only $4.9 million and does not fund the integrated psychiatry program. The $4.9 million for residencies comes from the general fund. Since the safety net assessment already contributes to the general fund, it should not also be used as direct funding for other health programs.
In 2010, the state raided the assessment revenue and used both the state and the hospital funds to fill gaps in the state budget. Given this background, the WSHA Board created a set of guidelines under which it could endorse an expanded safety net assessment program, including certain protections for hospitals.
The WSHA Board is hosting a special meeting on Wednesday April 8 to discuss the Senate proposal. WSHA has testified in strong opposition to the Senate proposal.
Read the issue brief for more information about the Safety Net Assessment.
A Better Path Forward for Pharmacy Practice
As the 2015 legislative session progresses, there are two of the key pharmacy bills that WSHA has been working on remaining. WSHA’s primary focus is on SB 5460, which allows hospitals to distribute emergency medication to patients being discharged from an emergency department when twenty-four hour pharmacy services are not available. The bill also clarifies how medications are transferred and handled between a hospital pharmacy and a clinic, and allows hospital clinic pharmacies to be licensed under the main hospital pharmacy license.
WSHA worked closely with the Washington State Department of Health over several weeks to achieve consensus on this bill and it has moved quickly through both the Senate and the House. We would like to thank DOH staff for their help and continued commitment to ensuring patients have access to the medications they need, when they need them.
Read the Issue Brief on emergency medications here.
The other pharmacy bill, HB 1625 allows hospitals to provide drugs to emergency medical services, thereby ensuring access while providing more cost-effective options for local emergency medical service providers. WSHA worked hard to amend this bill, removing language that limited the volume of drugs a hospital could provide. Again, we appreciate the Department’s support and the passage of this bill will provide a needed service to local communities.
Pharmacy issues had not traditionally been part of WSHA’s policy agenda, but we heard members’ concerns around some of these issues. We are now devoting substantial resources and time to addressing pharmacy policy, both on the legislative end as well as through regulatory work with the state’s Pharmacy Commission. Our initial efforts are paying off and we are excited to be making improvements on behalf of our members and out communities. There are also other pharmacy bills working their way through the legislature that we hope to see pass.
We would also like to thank Senator Linda Parlette and Representatives Joe Schmick and Eileen Cody for their help and support in improving the practice of pharmacy in Washington State. (Ian Corbridge, 206-216-2514)
What’s next?
The majority of the legislative work next week will take place on the floor as bills get voted out of their second house and on their way to conference committees. Bills are still being heard in the appropriations committees, but the schedule for these is fast-moving.
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