Bill Summary – FastDemocracy

CERTIFICATION OF ENROLLMENT
                ENGROSSED SUBSTITUTE SENATE BILL 5271
                       Chapter 121, Laws of 2024
                               68th Legislature
                             2024 Regular Session
           HEALTH CARE FACILITIES—REGULATION ENFORCEMENT
                      EFFECTIVE DATE: June 6, 2024
Passed by the Senate January 24, 2024                CERTIFICATE
  Yeas 29 Nays 20
                                        I, Sarah Bannister, Secretary of
                                        the   Senate   of  the   State   of
              DENNY HECK                Washington, do hereby certify that
President of the Senate                 the     attached   is     ENGROSSED
                                        SUBSTITUTE SENATE BILL 5271      as
                                        passed by the Senate and the House
                                        of Representatives on the dates
Passed by the House February 29, 2024   hereon set forth.
  Yeas 61 Nays 35
                                                  SARAH BANNISTER
            LAURIE JINKINS
                                                                     Secretary
Speaker of the House of
Representatives
Approved March 15, 2024 9:52 AM                         FILED
                                                    March 15, 2024
                                                Secretary of State
              JAY INSLEE                        State of Washington
Governor of the State of Washington
                     ENGROSSED SUBSTITUTE SENATE BILL 5271
                   Passed Legislature - 2024 Regular Session
     State of Washington         68th Legislature     2023 Regular Session
     By Senate Health & Long Term Care (originally sponsored by Senators
     Cleveland, Robinson, Kuderer, Nobles, Wellman, and C. Wilson; by
     request of Department of Health)
     READ FIRST TIME 02/08/23.
     AN ACT Relating to protecting patients in facilities regulated by
 the department of health by establishing uniform enforcement tools;
 amending RCW 18.46.010, 18.46.050, 18.46.130, 70.42.010, 70.42.130,
 70.42.180,    70.127.010,    70.127.170,   70.127.213,    70.230.010,
 70.230.070, 71.12.710, 71.12.500, 70.38.025, 70.38.111, 70.38.260,
 71.24.037, 70.170.020, 18.64.005, 18.64.011, 18.64.047, 18.64.165,
 18.64A.020, 18.64A.060, 69.45.080, 69.43.100, 69.43.140, 69.50.302,
 69.50.303, 69.50.304, 69.50.310, 69.50.320, and 69.41.080; reenacting
 and amending RCW 71.12.455 and 71.24.025; adding a new section to
 chapter 18.46 RCW; adding new sections to chapter 70.42 RCW; adding
 new sections to chapter 70.127 RCW; adding a new section to chapter
 70.230 RCW; adding a new section to chapter 71.12 RCW; adding a new
 section to chapter 71.24 RCW; adding new sections to chapter 18.64
 RCW; adding a new section to chapter 69.38 RCW; adding a new section
 to chapter 69.45 RCW; repealing RCW 18.64.200, 18.64.390, and
 69.50.305; and prescribing penalties.
 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
     Sec. 1.   RCW 18.46.010 and 2000 c 93 s 30 are each amended to
 read as follows:
     (1) "Birthing center" or "childbirth center" means any health
 facility, not part of a hospital or in a hospital, that provides
                                       p. 1                    ESSB 5271.SL
 facilities and staff to support a birth service to low-risk maternity
 clients: PROVIDED, HOWEVER, That this chapter shall not apply to any
 hospital approved by the American College of Surgeons, American
 Osteopathic Association, or its successor.
     (2) "Department" means the state department of health.
     (3) "Immediate jeopardy" means a situation in which the birthing
 center's noncompliance with one or more statutory or regulatory
 requirements has placed the health and safety of patients in its care
 at risk for serious injury, serious harm, serious impairment, or
 death.
     (4) "Low-risk" means normal, uncomplicated prenatal course as
 determined by adequate prenatal care and prospects for a normal
 uncomplicated birth as defined by reasonable and generally accepted
 criteria of maternal and fetal health.
     (((4))) (5) "Person" means any individual, firm, partnership,
 corporation, company, association, or joint stock association, and
 the legal successor thereof.
     Sec. 2.   RCW 18.46.050 and 1997 c 58 s 823 are each amended to
 read as follows:
     (1) ((The department may deny, suspend, or revoke a license in
 any case in which it finds that there has been failure or refusal to
 comply with the requirements established under this chapter or the
 rules adopted under it.
     (2) The department shall immediately suspend the license of a
 person who has been certified pursuant to RCW 74.20A.320 by the
 department of social and health services as a person who is not in
 compliance with a support order or a residential or visitation order.
 If the person has continued to meet all other requirements for
 reinstatement during the suspension, reissuance of the license shall
 be automatic upon the department's receipt of a release issued by the
 department of social and health services stating that the person is
 in compliance with the order.
     RCW 43.70.115 governs notice of a license denial, revocation,
 suspension, or modification and provides the right to an adjudicative
 proceeding but shall not apply to actions taken under subsection (2)
 of this section)) In any case in which the department finds that a
 birthing center has failed or refused to comply with the requirements
 of this chapter, the standards or rules adopted under this chapter,
 or other applicable state or federal statutes or rules regulating
                                     p. 2                     ESSB 5271.SL
 birthing centers, the department may take one or more of the actions
 identified in this section, except as otherwise limited in this
 section.
     (a) When the department determines the birthing center has
 previously been subject to an enforcement action for the same or
 similar type of violation of the same statute or rule, or has been
 given any previous statement of deficiency that included the same or
 similar type of violation of the same or similar statute or rule, or
 when the birthing center failed to correct noncompliance with a
 statute or rule by a date established or agreed to by the department,
 the department may impose reasonable conditions on a license.
 Conditions may include correction within a specified amount of time,
 training, or hiring a department-approved consultant if the birthing
 center cannot demonstrate to the department that it has access to
 sufficient internal expertise. If the department determines that the
 violations constitute immediate jeopardy, the conditions may be
 imposed immediately in accordance with subsection (2) of this
 section.
     (b) In accordance with the authority the department has under RCW
 43.70.095, the department may assess a civil fine of up to $3,000 per
 violation on a birthing center licensed under this chapter when the
 department determines the birthing center has previously been subject
 to an enforcement action for the same or similar type of violation of
 the same statute or rule, or has been given any previous statement of
 deficiency that included the same or similar type of violation of the
 same or similar statute or rule, or when the birthing center failed
 to correct noncompliance with a statute or rule by a date established
 or agreed to by the department.
     (i) Proceeds from these fines may only be used by the department
 to offset costs associated with licensing and enforcement of birthing
 centers.
     (ii) The department shall adopt in rules under this chapter
 specific   fine  amounts   in   relation to   the  severity   of  the
 noncompliance and at an adequate level to be a deterrent to future
 noncompliance.
     (iii) If a birthing center is aggrieved by the department's
 action of assessing civil fines, the licensee has the right to appeal
 under RCW 43.70.095.
     (c) The department may suspend a specific category or categories
 of services or care or birthing rooms within the birthing center as
                                     p. 3                     ESSB 5271.SL
 related to the violation by imposing a limited stop service. This may
 only be done if the department finds that noncompliance results in
 immediate jeopardy.
     (i) Prior to imposing a limited stop service, the department
 shall provide a birthing center written notification upon identifying
 deficient practices or conditions that constitute an immediate
 jeopardy. The birthing center shall have 24 hours from notification
 to develop and implement a department-approved plan to correct the
 deficient practices or conditions that constitute an immediate
 jeopardy. If the deficient practices or conditions that constitute
 immediate jeopardy are not verified by the department as having been
 corrected within the same 24-hour period, the department may issue
 the limited stop service.
     (ii) When the department imposes a limited stop service, the
 birthing center may not provide the services in the category or
 categories subject to the limited stop service to any new or existing
 patients, unless otherwise allowed by the department, until the
 limited stop service is terminated.
     (iii) The department shall conduct a follow-up inspection within
 five business days or within the time period requested by the
 birthing center if more than five business days is needed to verify
 the violation necessitating the limited stop service has been
 corrected.
     (iv) The limited stop service shall be terminated when:
     (A) The department verifies the violation necessitating the
 limited stop service has been corrected or the department determines
 that the birthing center has taken intermediate action to address the
 immediate jeopardy; and
     (B) The birthing center establishes the ability to maintain
 correction of the violation previously found deficient.
     (d) The department may suspend new admissions to the birthing
 center by imposing a stop placement. This may only be done if the
 department finds that noncompliance results in immediate jeopardy and
 is not confined to a specific category or categories of patients or a
 specific area of the birthing center.
     (i) Prior to imposing a stop placement, the department shall
 provide a birthing center written notification upon identifying
 deficient practices or conditions that constitute an immediate
 jeopardy. The birthing center shall have 24 hours from notification
 to develop and implement a department-approved plan to correct the
                                     p. 4                     ESSB 5271.SL
 deficient practices or conditions that constitute an immediate
 jeopardy. If the deficient practices or conditions that constitute
 immediate jeopardy are not verified by the department as having been
 corrected within the same 24-hour period, the department may issue
 the stop placement.
     (ii) When the department imposes a stop placement, the birthing
 center may not admit any new patients until the stop placement is
 terminated.
     (iii) The department shall conduct a follow-up inspection within
 five business days or within the time period requested by the
 birthing center if more than five business days is needed to verify
 the violation necessitating the stop placement has been corrected.
     (iv) The stop placement shall be terminated when:
     (A) The department verifies the violation necessitating the stop
 placement has been corrected or the department determines that the
 birthing center has taken intermediate action to address the
 immediate jeopardy; and
     (B) The birthing center establishes the ability to maintain
 correction of the violation previously found deficient.
     (e) The department may deny an application for a license or
 suspend, revoke, or refuse to renew a license.
     (2) Except as otherwise provided, RCW 43.70.115 governs notice of
 actions taken by the department under subsection (1) of this section
 and provides the right to an adjudicative proceeding. Adjudicative
 proceedings and hearings under this section are governed by the
 administrative procedure act, chapter 34.05 RCW. The application for
 an adjudicative proceeding must be in writing, state the basis for
 contesting the adverse action, include a copy of the department's
 notice, be served on and received by the department within 28 days of
 the birthing center's receipt of the adverse notice, and be served in
 a manner that shows proof of receipt.
     (3) When the department determines a licensee's noncompliance
 results in immediate jeopardy, the department may make the imposition
 of conditions on a licensee, a limited stop service, stop placement,
 or the suspension of a license effective immediately upon receipt of
 the notice by the licensee, pending any adjudicative proceeding.
     (a) When the department makes the suspension of a license or
 imposition of conditions on a license effective immediately, a
 licensee is entitled to a show cause hearing before a presiding
 officer within 14 days of making the request. The licensee must
                                     p. 5                     ESSB 5271.SL
 request the show cause hearing within 28 days of receipt of the
 notice of immediate suspension or immediate imposition of conditions.
 At the show cause hearing the department has the burden of
 demonstrating that more probably than not there is an immediate
 jeopardy.
     (b) At the show cause hearing, the presiding officer may consider
 the notice and documents supporting the immediate suspension or
 immediate imposition of conditions and the licensee's response and
 shall provide the parties with an opportunity to provide documentary
 evidence and written testimony, and to be represented by counsel.
 Prior to the show cause hearing, the department shall provide the
 licensee with all documentation that supports the department's
 immediate suspension or imposition of conditions.
     (c) If the presiding officer determines there is no immediate
 jeopardy, the presiding officer may overturn the immediate suspension
 or immediate imposition of conditions.
     (d) If the presiding officer determines there is immediate
 jeopardy, the immediate suspension or immediate imposition of
 conditions shall remain in effect pending a full hearing.
     (e) If the presiding officer sustains the immediate suspension or
 immediate imposition of conditions, the licensee may request an
 expedited full hearing on the merits of the department's action. A
 full hearing must be provided within 90 days of the licensee's
 request.
     (4) When the department determines an alleged violation, if true,
 would constitute an immediate jeopardy, and the licensee fails to
 cooperate with the department's investigation of such an alleged
 violation, the department may impose an immediate stop placement,
 immediate limited stop service, immediate imposition of conditions,
 or immediate suspension.
     (a) When the department imposes an immediate stop placement,
 immediate limited stop service, immediate imposition of conditions,
 or immediate suspension for failure to cooperate, a licensee is
 entitled to a show cause hearing before a presiding officer within 14
 days of making the request. The licensee must request the show cause
 hearing within 28 days of receipt of the notice of an immediate stop
 placement, immediate limited stop service, immediate imposition of
 conditions, or immediate suspension for failure to cooperate. At the
 show cause hearing the department has the burden of demonstrating
 that more probably than not the alleged violation, if true, would
                                     p. 6                     ESSB 5271.SL
 constitute an immediate jeopardy and the licensee failed to cooperate
 with the department's investigation.
     (b) At the show cause hearing, the presiding officer may consider
 the notice and documents supporting the immediate stop placement,
 immediate limited stop service, immediate imposition of conditions,
 or immediate suspension for failure to cooperate, and the licensee's
 response and shall provide the parties with an opportunity to provide
 documentary evidence and written testimony, and to be represented by
 counsel. Prior to the show cause hearing, the department shall
 provide the licensee with all documentation that supports the
 department's immediate action for failure to cooperate.
     (c) If the presiding officer determines the alleged violation, if
 true, does not constitute an immediate jeopardy or determines that
 the licensee cooperated with the department's investigation, the
 presiding officer may overturn the immediate action for failure to
 cooperate.
     (d) If the presiding officer determines the allegation, if true,
 would constitute an immediate jeopardy and the licensee failed to
 cooperate with the department's investigation, the immediate action
 for failure to cooperate shall remain in effect pending a full
 hearing.
     (e) If the presiding officer sustains the immediate action for
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