title: RCW 70.38.220

text:
(1) The legislature recognizes that in this state ethnic minorities currently use nursing home care at a lower rate than the general population. The legislature also recognizes and supports the federal mandate that nursing homes receiving federal funds provide residents with a homelike environment. The legislature finds that certain ethnic minorities have special cultural, language, dietary, and other needs not generally met by existing nursing homes which are intended to serve the general population. Accordingly, the legislature further finds that there is a need to foster the development of nursing homes designed to serve the special cultural, language, dietary, and other needs of ethnic minorities.
(2) The department shall establish a separate pool of no more than two hundred fifty beds for nursing homes designed to serve the special needs of ethnic minorities. The pool shall be made up of nursing home beds that become available on or after March 15, 1991, due to:
(a) Loss of license or reduction in licensed bed capacity if the beds are not otherwise obligated for replacement; or
(b) Expiration of a certificate of need.
(3) The department shall develop procedures for the fair and efficient award of beds from the special pool. In making its decisions regarding the award of beds from the pool, the department shall consider at least the following:
(a) The relative degree to which the long-term care needs of an ethnic minority are not otherwise being met;
(b) The percentage of low-income persons who would be served by the proposed nursing home;
(c) The financial feasibility of the proposed nursing home; and
(d) The impact of the proposal on the area's total need for nursing home beds.
(4) To be eligible to apply for or receive an award of beds from the special pool, an application must be to build a new nursing home, or add beds to a nursing home, that:
(a) Will be owned and operated by a nonprofit corporation, and at least fifty percent of the board of directors of the corporation are members of the ethnic minority the nursing home is intended to serve;
(b) Will be designed, managed, and administered to serve the special cultural, language, dietary, and other needs of an ethnic minority; and
(c) Will not discriminate in admissions against persons who are not members of the ethnic minority whose special needs the nursing home is designed to serve.
(5) If a nursing home or portion of a nursing home that is built as a result of an award from the special pool is sold or leased within ten years to a party not eligible under subsection (4) of this section:
(a) The purchaser or lessee may not operate those beds as nursing home beds without first obtaining a certificate of need for new beds under this chapter; and
(b) The beds that had been awarded from the special pool shall be returned to the special pool.
(6) The department shall initially award up to one hundred beds before that number of beds are actually in the special pool, provided that the number of beds so awarded are subtracted from the total of two hundred fifty beds that can be awarded from the special pool.
[ 1991 c 271 s 1.]

catchline: Ethnic minorities—Nursing home beds that reflect cultural differences.


doc_type: statute

jurisdiction: wa

title: RCW 70.38.230

text:
(1) A change in bed capacity at a residential hospice care center shall not be subject to certificate of need review under this chapter if the department determined prior to June 1994 that the construction, development, or other establishment of the residential hospice care center was not subject to certificate of need review under this chapter.
(2) For purposes of this section, a "residential hospice care center" means any building, facility, place, or equivalent that opened in December 1996 and is organized, maintained, and operated specifically to provide beds, accommodations, facilities, and services over a continuous period of twenty-four hours or more for palliative care of two or more individuals, not related to the operator, who are diagnosed as being in the latter stages of an advanced disease that is expected to lead to death.
[ 1998 c 322 s 50.]

license: public-domain-government-work

rule_set: Revised Code of Washington

catchline: Residential hospice care centers—Defined—Change in bed capacity—Applicability of chapter.

code: rcw

unit: section

court: Washington State Legislature


title: RCW 70.38.250

text:
(1) The need for projects identified in *RCW 70.38.240 shall be determined using the individual planning area's estimated nursing home bed need ratio and includes but is not limited to the following criteria:
(a) The current capacity of nursing homes and other long-term care services;
(b) The occupancy rates of nursing homes and other long-term care services over the previous two-year period; and
(c) The ability of the other long-term care services to serve all people regardless of payor source.
(2) For the purposes of this section, nursing home beds include long-term care units or distinct part long-term care units located in a hospital that is licensed under chapter 70.41 RCW.
[ 1999 c 376 s 2.]
Notes:
*Reviser's note: RCW 70.38.240 expired June 30, 2004.
Effective date—1999 c 376: "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 takes effect July 1, 1999." [ 1999 c 376 s 4.]

catchline: Redistribution and addition of beds—Determination.


title: RCW 70.38.260

text:
(1) For a grant awarded during fiscal years 2018 and 2019 by the department of commerce under this section, hospitals licensed under chapter 70.41 RCW and behavioral health hospitals licensed as establishments under chapter 71.12 RCW are not subject to certificate of need requirements for the addition of the number of new psychiatric beds indicated in the grant. The department of commerce may not make a prior approval of a certificate of need application a condition for a grant application under this section. The period during which an approved hospital or behavioral health hospital project qualifies for a certificate of need exemption under this section is two years from the date of the grant award.
(2)(a) Until June 30, 2028, a hospital licensed under chapter 70.41 RCW is exempt from certificate of need requirements for the addition of new psychiatric beds.
(b) A hospital that adds new psychiatric beds under this subsection (2) must:
(i) Notify the department of the addition of new psychiatric beds. The department shall provide the hospital with a notice of exemption within 30 days; and
(ii) Commence the project within two years of the date of receipt of the notice of exemption.
(c) Beds granted an exemption under RCW 70.38.111(11)(b) must remain psychiatric beds unless a certificate of need is granted to change their use or the hospital voluntarily reduces its licensed capacity.
(3)(a) Until June 30, 2028, a behavioral health hospital licensed as an establishment under chapter 71.12 RCW is exempt from certificate of need requirements for the one-time addition of up to 30 new psychiatric beds devoted solely for 90-day and 180-day civil commitment services and for the one-time addition of up to 30 new voluntary psychiatric beds or involuntary psychiatric beds for patients on a 120 hour detention or 14-day civil commitment order, if the hospital makes a commitment to maintain a payer mix of at least 50 percent medicare and medicaid based on a calculation using patient days for a period of five consecutive years after the beds are made available for use by patients, if it demonstrates to the satisfaction of the department:
(i) That its most recent two years of publicly available fiscal year-end report data as required under RCW 43.70.050 reported to the department by the behavioral health hospital, show a payer mix of a minimum of 50 percent medicare and medicaid based on a calculation using patient days; and
(ii) A commitment to maintaining the payer mix in (a) of this subsection for a period of five consecutive years after the beds are made available for use by patients.
(b) A behavioral health hospital that adds new psychiatric beds under this subsection (3) must:
(i) Notify the department of the addition of new psychiatric beds. The department shall provide the behavioral health hospital with a notice of exemption within 30 days; and
(ii) Commence the project within two years of the date of receipt of the notice of exemption.
(c) Beds granted an exemption under RCW 70.38.111(11)(b) must remain the types of psychiatric beds indicated to the department in the original exemption application unless a certificate of need is granted to change their use or the behavioral health hospital voluntarily reduces its licensed capacity.
(4)(a) Until June 30, 2028, an entity seeking to construct, develop, or establish a behavioral health hospital licensed as an establishment under chapter 71.12 RCW is exempt from certificate of need requirements if the proposed behavioral health hospital will have no more than 16 beds and dedicate a portion of the beds to providing treatment to adults on 90 or 180-day involuntary commitment orders. The behavioral health hospital may also provide treatment to adults on a 120 hour detention or 14-day involuntary commitment order.
(b) An entity that seeks to construct, develop, or establish a behavioral health hospital under this subsection (4) must:
(i) Notify the department of the addition of construction, development, or establishment. The department shall provide the entity with a notice of exemption within 30 days; and
(ii) Commence the project within two years of the date of receipt of the notice of exemption.
(c) Entities granted an exemption under RCW 70.38.111(11)(b)(ii) may not exceed 16 beds unless a certificate of need is granted to increase the behavioral health hospital's capacity.
(5) This section expires June 30, 2029.
[ 2024 c 165 s 2; 2024 c 121 s 24; 2021 c 277 s 2; 2019 c 324 s 9; 2017 c 199 s 2; 2015 3rd sp.s. c 22 s 2.]
Notes:
Reviser's note: This section was amended by 2024 c 121 s 24 and by 2024 c 165 s 2, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025(2). For rule of construction, see RCW 1.12.025(1).
Effective date—2021 c 277: See note following RCW 70.38.111.
Findings—Intent—2019 c 324: See note following RCW 71.24.648.
Mental health drop-in center services pilot program—2019 c 324: See note following RCW 71.24.649.
Report—2019 c 324: See note following RCW 70.38.111.
Recommendations—Residential intensive behavioral health and developmental disability services—2019 c 324: See note following RCW 74.39A.030.
Effective date—2017 c 199: See note following RCW 70.38.111.
Intent—2015 3rd sp.s. c 22: "To accommodate the urgent need for inpatient psychiatric services and to facilitate state compliance with the Washington state supreme court decision, In re the Detention of D.W., No. 90110–4, August 7, 2014, which prohibits the practice of psychiatric boarding, the legislature intends to exempt certain hospital mental health projects provided grant funding by the department of commerce from certificate of need requirements." [ 2015 3rd sp.s. c 22 s 1.]
Effective date—2015 3rd sp.s. c 22: "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 takes effect immediately [July 6, 2015]." [ 2015 3rd sp.s. c 22 s 4.]

catchline: Certain hospitals not subject to certificate of need requirements for the addition of the number of new psychiatric beds. (Expires June 30, 2029.)


title: RCW 70.38.270

text:
(1) New psychiatric beds added under RCW 70.38.260 must remain psychiatric beds unless a certificate of need is granted to change their use or the hospital or psychiatric hospital voluntarily reduces its licensed capacity.
(2) This section expires June 30, 2029.
[ 2024 c 165 s 3; 2015 3rd sp.s. c 22 s 3.]
Notes:
Intent—Effective date—2015 3rd sp.s. c 22: See notes following RCW 70.38.260.

catchline: Psychiatric beds added under RCW 70.38.260. (Expires June 30, 2029.)


title: RCW 70.38.280

text:
(1) Notwithstanding RCW 70.38.105(4)(h), a kidney disease center may be granted an exemption to exceed its authorized number of dialysis stations during a temporary emergency situation upon approval of the department.
(2) A temporary emergency situation is defined to include:
(a) Natural disasters, such as earthquakes, floods, fires, or snowstorms that limit or restrict access to one or more kidney disease centers thereby creating a need for additional capacity at other centers;
(b) Power outages or water system shutdowns;
(c) Mold remediations or other physical plant issues that would put patient safety at risk;
(d) Staffing shortages that require kidney disease center reconfiguration to facilitate delivery of dialysis services as long as the facility does not exceed the number of patients served at the time of the exemption request. If granted, an exemption under this subsection (2)(d) is valid for 90 days, and may be extended at 90-day increments at the discretion of the department; and
(e) Any additional temporary emergency situations as included by the department in rule.
(3) In order to be granted an exemption, a kidney dialysis center must make a written request to the department that may be sent by email, and include the following information:
(a) A brief description of the circumstances requiring the exemption;
(b) The number of additional dialysis stations required to meet patient needs, and except as noted in subsection (2)(d) of this section, the expected duration that the additional stations will be required to address patient needs; and
(c) An acknowledgment that:
(i) Patient safety, health, or well-being are not being threatened;
(ii) Fire and life safety regulations, infection control standards, or other applicable codes or regulations will not be reduced; and
(iii) Structural integrity of the building will not be impaired.
(4) Approval of an exemption does not authorize a kidney disease center to permanently increase the number of dialysis stations. If a kidney disease center seeks a permanent increase in approved stations, a certificate of need review and approval is required.
(5) The department may adopt any rules necessary to implement this section.
[ 2023 c 48 s 1.]

catchline: Kidney disease centers—Emergency certificate of need exemptions.


title: RCW 70.38.905

text:
In any case where the provisions of this chapter may directly conflict with federal law, or regulations promulgated thereunder, the federal law shall supersede and be paramount as necessary to the receipt of federal funds by the state.
[ 1983 c 235 s 12; 1979 ex.s. c 161 s 16.]

catchline: Conflict with federal law—Construction.


title: RCW 70.38.914

text:
A certificate of need application which was submitted and declared complete, but upon which final action had not been taken prior to *the effective date of this act, shall be reviewed and action taken based on chapter 70.38 RCW, as in effect prior to *the effective date of this act, and the rules adopted thereunder.
[ 1983 c 235 s 14.]
Notes:
*Reviser's note: For "the effective date of this act," see note following RCW 70.38.157.

catchline: Pending certificates of need—1983 c 235.


title: RCW 70.38.915

text:
(1) *Sections 10, 11, 12, and 21 shall take effect on January 1, 1980.
(2) Any certificate of need application which was submitted and declared complete, but upon which final action had not been taken prior to January 1, 1980, shall be reviewed and action taken based on chapter 70.38 RCW, as in effect prior to **the effective date of this 1979 act, and the regulations adopted thereunder.
[ 1979 ex.s. c 161 s 19.]
Notes:
Reviser's note: *(1) Sections 10, 11, and 12 are codified as RCW 70.38.105, 70.38.115, and 70.38.125. Section 21 was a repealer which repealed RCW 70.38.020, 70.38.110 through 70.38.190, and 70.38.210.
**(2) The effective date of those remaining sections of 1979 ex.s. c 161 which do not have a specific effective date indicated in this section is September 1, 1979.

catchline: Effective dates—Pending certificates of need—1979 ex.s. c 161.


title: RCW 70.38.916

text:
*Sections 7, 8, and 10 of this 1980 act shall take effect January 1, 1981.
[ 1980 c 139 s 14.]
Notes:
Reviser's note: *(1) "Sections 7, 8, and 10 of this 1980 act" consist of amendments to RCW 70.38.105, 70.38.115, and 70.38.125.
(2) The effective date of those remaining sections of 1980 c 139 is June 12, 1980.

catchline: Effective date—1980 c 139.


title: RCW 70.38.918

text:
Any certificate of need application which was submitted and declared complete, but upon which final action had not been taken prior to July 1, 1989, shall be reviewed and action taken based on chapter 70.38 RCW, as in effect prior to July 1, 1989, and the rules adopted thereunder.
[ 1989 1st ex.s. c 9 s 609.]

catchline: Effective dates—Pending certificates of need—1989 1st ex.s. c 9.


title: RCW 70.38.920

text:
This act may be cited as the "State Health Planning and Resources Development Act".
[ 1979 ex.s. c 161 s 22.]

catchline: Short title.


title: RCW 70.385.010

text:
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Authority" means the Washington state health care authority.
(2) "Peer support services" means services authorized under RCW 71.24.385 which are delivered by individuals who have common life experiences with the people they are serving.
[ 2019 c 446 s 48.]

catchline: Definitions.


title: RCW 70.385.020

text:
(1) The authority shall administer a peer counselor certification program to support the delivery of peer support services in Washington state.
(2) By July 1, 2019, the authority shall incorporate education and training for substance use disorder peers in its peer counselor certification program.
(3) By July 1, 2019, the authority must include reimbursement for peer support services by substance use disorder peers in its behavioral health capitation rates and allow for federal matching funds, consistent with the directive enacted in section 213(5)(ss), chapter 299, Laws of 2018 (ESSB 6032).
[ 2019 c 446 s 49.]

catchline: Peer counselor certification program—Education and training for substance use disorder peers—Reimbursement for services.


title: RCW 70.385.030

text:
To ensure an adequate workforce of peer counselors, the authority must approve entities to perform specialized peer training for peer counselor certification using the state curriculum upon request if the entity meets qualifications to perform the training as determined by the authority.
[ 2019 c 446 s 50.]

catchline: Specialized peer training for peer counselor certification.


title: RCW 70.385.900

text:
Sections 48 through 53 of this act are necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and take effect July 1, 2019.
[ 2019 c 446 s 54.]

catchline: Effective date—2019 c 446 ss 48-53.


title: RCW 70.390.010

text:
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Authority" means the health care authority.
(2) "Board" means the health care cost transparency board.
(3) "Health care" means items, services, and supplies intended to improve or maintain human function or treat or ameliorate pain, disease, condition, or injury including, but not limited to, the following types of services:
(a) Medical;
(b) Behavioral;
(c) Substance use disorder;
(d) Mental health;
(e) Surgical;
(f) Optometric;
(g) Dental;
(h) Podiatric;
(i) Chiropractic;
(j) Psychiatric;
(k) Pharmaceutical;
(l) Therapeutic;
(m) Preventive;
(n) Rehabilitative;
(o) Supportive;
(p) Geriatric; or
(q) Long-term care.
(4) "Health care cost growth" means the annual percentage change in total health care expenditures in the state.
(5) "Health care cost growth benchmark" means the target percentage for health care cost growth.
(6) "Health care coverage" means policies, contracts, certificates, and agreements issued or offered by a payer.
(7) "Health care provider" means a person or entity that is licensed, certified, registered, or otherwise authorized by the law of this state to provide health care in the ordinary course of business or practice of a profession.
(8) "Net cost of private health care coverage" means the difference in premiums received by a payer and the claims for the cost of health care paid by the payer under a policy or certificate of health care coverage.
(9) "Payer" means:
(a) A health carrier as defined in RCW 48.43.005;
(b) A publicly funded health care program, including medicaid, medicare, the state children's health insurance program, and public and school employee benefit programs administered under chapter 41.05 RCW;
(c) A third-party administrator; and
(d) Any other public or private entity, other than an individual, that pays or reimburses the cost for the provision of health care.
(10) "Total health care expenditures" means all health care expenditures in this state by public and private sources, including:
(a) All payments on health care providers' claims for reimbursement for the cost of health care provided;
(b) All payments to health care providers other than payments described in (a) of this subsection;
(c) All cost-sharing paid by residents of this state, including copayments, deductibles, and coinsurance; and
(d) The net cost of private health care coverage.
[ 2020 c 340 s 1.]


title: RCW 70.390.020

text:
The authority shall establish a board to be known as the health care cost transparency board. The board is responsible for the analysis of total health care expenditures in Washington, identifying trends in health care cost growth, and establishing a health care cost growth benchmark. The board shall provide analysis of the factors impacting these trends in health care cost growth and, after review and consultation with identified entities, shall identify those health care providers and payers that are exceeding the health care cost growth benchmark. The authority may create rules needed to implement this chapter.
[ 2023 c 51 s 30; 2020 c 340 s 2.]

catchline: Health care cost transparency board—Duties.


title: RCW 70.390.030

text:
(1) The board shall consist of fourteen members who shall be appointed as follows:
(a) The insurance commissioner, or the commissioner's designee;
(b) The administrator [director] of the health care authority, or the administrator's [director's] designee;
(c) The director of labor and industries, or the director's designee;
(d) The chief executive officer of the health benefit exchange, or the chief executive officer's designee;
(e) One member representing local governments that purchase health care for their employees;
(f) Two members representing consumers;
(g) One member representing Taft-Hartley health benefit plans;
(h) Two members representing large employers, at least one of which is a self-funded group health plan;
(i) One member representing small businesses;
(j) One member who is an actuary or an expert in health care economics;
(k) One member who is an expert in health care financing; and
(l) One nonvoting member who is a member of the advisory committee of health care providers and carriers and has operational experience in health care delivery.
(2) The governor:
(a) Shall appoint the members of the board. Each of the two largest caucuses in both the house of representatives and the senate shall submit to the governor a list of five nominees. The nominees must be for members of the board identified in subsection (1)(f) through (k) of this section, may not be legislators, and, except for the members of the board identified in subsection (1)(j) and (k) of this section, the nominees may not be employees of the state or its political subdivisions. No caucus may submit the same nominee. The caucus nominations must reflect diversity in geography, gender, and ethnicity;
(b) May reject a nominee and request a new submission from a caucus if a nominee does not meet the requirements of this section; and
(c) Must choose at least one nominee from each caucus.
(3) The governor shall appoint the chair of the board.
(4)(a) Initial members of the board shall serve staggered terms not to exceed four years. Members appointed thereafter shall serve two-year terms.
(b) A member of the board whose term has expired or who otherwise leaves the board shall be replaced by gubernatorial appointment. Upon the expiration of a member's term, the member shall continue to serve until a successor has been appointed and has assumed office. When the person leaving was nominated by one of the caucuses of the house of representatives or the senate, his or her replacement shall be appointed from a list of five nominees submitted by that caucus within thirty days after the person leaves. If the member to be replaced is the chair, the governor shall appoint a new chair within thirty days after the vacancy occurs. A person appointed to replace a member who leaves the board prior to the expiration of his or her term shall serve only the duration of the unexpired term. Members of the board may be reappointed to multiple terms.
(5) No member of the board may be appointed if the member's participation in the decisions of the board could benefit the member's own financial interests or the financial interests of an entity the member represents. A board member who develops such a conflict of interest shall resign or be removed from the board.
(6) Members of the board must be reimbursed for their travel expenses while on official business in accordance with RCW 43.03.050 and 43.03.060. The board shall prescribe rules for the conduct of its business. Meetings of the board are subject to the call of the chair.
(7) The board and its subcommittees are subject to the provisions of chapter 42.30 RCW, the open public meetings act, and chapter 42.56 RCW, the public records act. The board and its subcommittees may not disclose any health care information that identifies or could reasonably identify the patient or consumer who is the subject of the health care information.
(8) Members of the board are not civilly or criminally liable and may not have any penalty or cause of action of any nature arise against them for any action taken or not taken, including any discretionary decision or failure to make a discretionary decision, when the action or inaction is done in good faith and in the performance of the powers and duties under this chapter.
[ 2020 c 340 s 3.]

catchline: Health care cost transparency board—Appointment—Terms—Conflicts—Reimbursement—Liability.


title: RCW 70.390.040

text:
(1) The board shall establish an advisory committee on data issues and a health care stakeholder advisory committee. The board may establish other advisory committees as it finds necessary. Any other standing advisory committee established by the board shall include members representing the interests of consumer, labor, and employer purchasers, at a minimum, and may include other stakeholders with expertise in the subject of the advisory committee, such as health care providers, payers, and health care cost researchers.
(2) Appointments to the advisory committee on data issues shall be made by the board. Members of the committee must have expertise in health data collection and reporting, health care claims data analysis, health care economic analysis, actuarial analysis, or other relevant expertise related to health data.
(3) Appointments to the health care stakeholder advisory committee shall be made by the board and must include the following membership:
(a) One member representing hospitals and hospital systems, selected from a list of three nominees submitted by the Washington state hospital association;
(b) One member representing federally qualified health centers, selected from a list of three nominees submitted by the Washington association for community health;
(c) One physician, selected from a list of three nominees submitted by the Washington state medical association;
(d) One primary care physician, selected from a list of three nominees submitted by the Washington academy of family physicians;
(e) One member representing behavioral health providers, selected from a list of three nominees submitted by the Washington council for behavioral health;
(f) One member representing pharmacists and pharmacies, selected from a list of three nominees submitted by the Washington state pharmacy association;
(g) One member representing *advanced registered nurse practitioners, selected from a list of three nominees submitted by ARNPs united of Washington state;
(h) One member representing tribal health providers, selected from a list of three nominees submitted by the American Indian health commission;
(i) One member representing a health maintenance organization, selected from a list of three nominees submitted by the association of Washington health care plans;
(j) One member representing a managed care organization that contracts with the authority to serve medical assistance enrollees, selected from a list of three nominees submitted by the association of Washington health care plans;
(k) One member representing a health care service contractor, selected from a list of three nominees submitted by the association of Washington health care plans;
(l) One member representing an ambulatory surgery center selected from a list of three nominees submitted by the ambulatory surgery center association;
(m) Three members, at least one of whom represents a disability insurer, selected from a list of six nominees submitted by America's health insurance plans;
(n) At least two members representing the interests of consumers, selected from a list of nominees submitted by consumer organizations;
(o) At least two members representing the interests of labor purchasers, selected from a list of nominees submitted by the Washington state labor council; and
(p) At least two members representing the interests of employer purchasers, including at least one small business representative, selected from a list of nominees submitted by business organizations. The members appointed under this subsection (3)(p) may not be directly or indirectly affiliated with an employer which has income from health care services, health care products, health insurance, or other health care sector-related activities as its primary source of revenue.
[ 2024 c 80 s 1; 2020 c 340 s 4.]
Notes:
*Reviser's note: The term "advanced registered nurse practitioner" was changed to "advanced practice registered nurse" by 2024 c 239 s 1, effective June 30, 2027.

catchline: Advisory committees—Appointment.


title: RCW 70.390.050

text:
(1) The board has the authority to establish and appoint advisory committees, in accordance with the requirements of RCW 70.390.040, and shall seek input and recommendations from relevant advisory committees.
(2) The board shall:
(a) Determine the types and sources of data necessary to annually calculate total health care expenditures and health care cost growth, establish the health care cost growth benchmark, and analyze the impact of cost drivers on health care spending, including execution of any necessary access and data security agreements with the custodians of the data. The board shall first identify existing data sources, such as the statewide health care claims database established in chapter 43.371 RCW and prescription drug data collected under chapter 43.71C RCW, and primarily rely on these sources when possible in order to minimize the creation of new reporting requirements. The board may use data received from existing data sources including, but not limited to, publicly available information filed by carriers under Title 48 RCW and data collected under chapters 43.70, 43.71, 43.71C, 43.371, and 70.405 RCW, in its analyses and discussions to the same extent that the custodians of the data are permitted to use the data. As appropriate to promote administrative efficiencies, the board may share its data with the prescription drug affordability board under chapter 70.405 RCW and other health care cost analysis efforts conducted by the state;
(b) Determine the means and methods for gathering data to annually calculate total health care expenditures and health care cost growth, and to establish the health care cost growth benchmark. The board must select an appropriate economic indicator to use when establishing the health care cost growth benchmark. The activities may include selecting methodologies and determining sources of data. The board shall solicit and consider recommendations from the advisory committee on data issues and the health care stakeholder advisory committee regarding the value and feasibility of reporting various categories of information under (c) of this subsection, such as urban and rural, public sector and private sector, and major categories of health services, including prescription drugs, inpatient treatment, and outpatient treatment;
(c) Annually calculate total health care expenditures and health care cost growth:
(i) Statewide and by geographic rating area;
(ii) For each health care provider or provider system and each payer, taking into account the health status of the patients of the health care provider or the enrollees of the payer, utilization by the patients of the health care provider or the enrollees of the payer, intensity of services provided to the patients of the health care provider or the enrollees of the payer, and regional differences in input prices. The board must develop an implementation plan for reporting information about health care providers, provider systems, and payers;
(iii) By market segment;
(iv) Per capita; and
(v) For other categories, as recommended by the advisory committees in (b) of this subsection, and approved by the board;
(d) Annually establish the health care cost growth benchmark for increases in total health expenditures. The board, in determining the health care cost growth benchmark, shall begin with an initial implementation that applies to the highest cost drivers in the health care system and develop a phased plan to include other components of the health system for subsequent years;
(e) Beginning in 2023, analyze the impacts of cost drivers to health care and incorporate this analysis into determining the annual total health care expenditures and establishing the annual health care cost growth benchmark. The cost drivers may include, to the extent such data is available:
(i) Labor, including but not limited to, wages, benefits, and salaries;
(ii) Capital costs, including but not limited to new technology;
(iii) Supply costs, including but not limited to prescription drug costs;
(iv) Uncompensated care;
(v) Administrative and compliance costs;
(vi) Federal, state, and local taxes;
(vii) Capacity, funding, and access to postacute care, long-term services and supports, and housing;
(viii) Regional differences in input prices;
(ix) Financial earnings of health care providers and payers, including information regarding profits, assets, accumulated surpluses, reserves, and investment income, and similar information;
(x) Utilization trends and adjustments for demographic changes and severity of illness;
(xi) New state health insurance benefit mandates enacted by the legislature that require carriers to reimburse the cost of specified procedures or prescriptions; and
(xii) Other cost drivers determined by the board to be informative to determining annual total health care expenditures and establishing the annual health care cost growth benchmark; and
(f) Release reports in accordance with RCW 70.390.070.
[ 2024 c 80 s 2; 2020 c 340 s 5.]

catchline: Authority to establish advisory committees—Duties.


title: RCW 70.390.060

text:
(1) The authority may contract with a private nonprofit entity to administer the board and provide support to the board to carry out its responsibilities under this chapter. The authority may not contract with a private nonprofit entity that has a financial interest that may create a potential conflict of interest or introduce bias into the board's deliberations.
(2) The authority or the contracted entity shall actively solicit federal and private funding and in-kind contributions necessary to complete its work in a timely fashion. The contracted entity shall not accept private funds if receipt of such funding could present a potential conflict of interest or introduce bias into the board's deliberations.
[ 2020 c 340 s 6.]

catchline: Contracting for administration—Funding.


title: RCW 70.390.070

text:
By December 1st of each year, the board shall submit annual reports to the governor and each chamber of the legislature. The annual reports may include policy recommendations applicable to the board's activities and analysis of its work, including any recommendations related to lowering health care costs, focusing on private sector purchasers, and the establishment of a rating system of health care providers and payers.
[ 2024 c 80 s 3; 2020 c 340 s 7.]

catchline: Reporting.


title: RCW 70.390.080

text:
(1) The board shall measure and report on primary care expenditures in Washington and the progress towards increasing it to 12 percent of total health care expenditures.
(2) By December 1, 2022, the board shall submit a preliminary report to the governor and relevant committees of the legislature addressing primary care expenditures in Washington. The report must include:
(a) How to define "primary care" for purposes of calculating primary care expenditures as a proportion of total health care expenditures, and how the definition aligns with existing definitions already implemented in Washington, including the previous report from the office of financial management and the Bree collaborative's recommendations;
(b) Barriers to the access and use of the data needed to calculate primary care expenditures, and how to overcome them;
(c) The annual progress needed for primary care expenditures to reach 12 percent of total health care expenditures in a reasonable amount of time;
(d) How and by whom it should annually be determined whether desired levels of primary care expenditures are being achieved;
(e) Methods to incentivize the achievement of desired levels of primary care expenditures;
(f)(i) Specific practices and methods of reimbursement to achieve and sustain desired levels of primary care expenditures while achieving improvements in health outcomes, experience of health care, and value from the health care system, including but not limited to: Supporting advanced, integrated primary care involving a multidisciplinary team of health and social service professionals; addressing social determinants of health within the primary care setting; leveraging innovative uses of efficient, interoperable health information technology; increasing the primary care and behavioral health workforce; and reinforcing to patients the value of primary care, and eliminating any barriers to access.
(ii) As much as possible, the practices and methods specified must hold primary care providers accountable for improved health outcomes, not increase the administrative burden on primary care providers or overall health care expenditures in the state, strive for alignment across payers, and take into account differences in urban and rural delivery settings; and
(g) The ongoing role of the board in guiding and overseeing the development and application of primary care expenditure targets, and the implementation and evaluation of strategies to achieve them.
(3) Beginning August 1, 2023, the board shall annually submit reports to the governor and relevant committees of the legislature. To the extent possible, the reports must:
(a) Include annual primary care expenditures for the most recent year for which data is available by insurance carrier, by market or payer, in total and as a percentage of total health care expenditure;
(b) Break down annual primary care expenditures by relevant characteristics such as whether expenditures were for physical or behavioral health, by type of provider and by payment mechanism; and
(c) If necessary, identify any barriers to the reporting requirements and propose recommendations for how to overcome them.
(4) In developing the measures and reporting, the board shall consult with primary care providers and organizations representing primary care providers and review existing work in this and other states regarding primary care, including but not limited to the December 2019 report by the office of financial management, the work of the Bree collaborative, the work of the advancing integrated mental health center and the center for health workforce studies at the University of Washington, the work of the Milbank memorial fund, the work of the national academy of sciences, engineering, and medicine, and the work of the authority to strengthen primary care within state purchased health care.
[ 2022 c 155 s 1.]


title: RCW 70.390.090

text:
(1) At least biennially, the board shall conduct a survey of underinsurance among Washington residents.
(a) The survey shall be conducted among a representative sample of Washington residents. Analysis of the survey results shall be disaggregated to the greatest extent feasible by demographic factors such as race, ethnicity, gender and gender identity, age, disability status, household income level, type of insurance coverage, geography, and preferred language. In addition, the survey shall be designed to allow for the analyses of the aggregate impact of out-of-pocket costs and premiums according to the standards in (b) of this subsection as well as the share of Washington residents who delay or forego care due to cost.
(b) The board shall measure underinsurance as the share of Washington residents whose out-of-pocket costs over the prior 12 months, excluding premiums, are equal to:
(i) For persons whose household income is over 200 percent of the federal poverty level, 10 percent or more of household income;
(ii) For persons whose household income is less than 200 percent of the federal poverty level, five percent or more of household income; or
(iii) For any income level, deductibles constituting five percent or more of household income.
(c) Beginning in 2026, the board may implement improvements to the measure of underinsurance defined in (b) of this subsection, such as a broader health care affordability index that considers health care expenses in the context of other household expenses.
(2) At least biennially, the board shall conduct a survey of insurance trends among employers and employees. The survey must be conducted among a representative sample of Washington employers and employees.
(3) The board may conduct the surveys through the authority, by contract with a private entity, or by arrangement with another state agency conducting a related survey.
(4) Beginning in 2025, analysis of the survey results shall be included in the annual report required by RCW 70.390.070.
[ 2024 c 80 s 4.]

catchline: Underinsurance survey—Reporting.


title: RCW 70.390.100

text:
(1) No later than December 1, 2024, and annually thereafter, the board shall hold a public hearing related to discussing the growth in total health care expenditures in relation to the health care cost growth benchmark in the previous performance period, in accordance with the open public meetings act, chapter 42.30 RCW. The agenda and any materials for this hearing must be made available to the public at least 14 days prior to the hearing.
(2)(a) Except as provided in (b) of this subsection, to the extent data permits, the hearing must include the public identification of any payers or health care providers for which health care cost growth in the previous performance period exceeded the health care cost growth benchmark.
(b) Provider groups with fewer than 10,000 unique attributed lives shall be exempt from identification under (a) of this subsection.
(3) At the hearing, the board:
(a) May require testimony by payers or health care providers that have substantially exceeded the health care cost growth benchmark in the previous calendar year to better understand the reasons for the excess health care cost growth and measures that are being undertaken to restore health care cost growth within the limits of the benchmark;
(b) Shall invite testimony from health care stakeholders, other than payers and health care providers, including health care consumers, business interests, and labor representatives; and
(c) Shall provide an opportunity for public comment.
[ 2024 c 80 s 5.]

catchline: Health care expenditure hearing.


title: RCW 70.395.010

text:
(1) The legislature finds that all people confined in prisons and detention facilities in Washington deserve basic health care, nutrition, and safety. As held in United States v. California, 921 F.3d 865, 886 (9th Cir. 2019), states possess "the general authority to ensure the health and welfare of inmates and detainees in facilities within its borders." States have broad authority to enforce generally applicable health and safety laws against contractors operating private detention facilities within the state. The ninth circuit reinforced this authority in Geo Group, Inc. v. Newsom, 50 F.4th 745, 750 (9th Cir. 2022), stating "[p]rivate contractors do not stand on the same footing as the federal government, so states can impose many laws on federal contractors that they could not apply to the federal government itself."
(2) The legislature finds that profit motives lead private prisons and detention facilities to cut operational costs, including the provision of food, health care, and rehabilitative services, because their primary fiduciary duty is to maximize shareholder profits. This is in stark contrast to the interests of the state to ensure the health, safety, and welfare of Washingtonians, including all inmates and detainees within Washington's borders.
(3) The legislature finds that people confined in for-profit prisons and detention facilities have experienced abuses and have been confined in dangerous and unsanitary conditions. Safety risks and abuses in private prisons and detention facilities at the local, state, and federal level have been consistently and repeatedly documented. The United States department of justice office of the inspector general found in 2016 that privately operated prisons "incurred more safety and security incidents per capita than comparable BOP [federal bureau of prisons] institutions." The office of inspector general additionally found that privately operated prisons had higher rates of staff uses of force and that people detained in private prisons submitted more safety and security related grievances, including those regarding the quality of food.
(4) The legislature finds that private prison operators have cut costs by reducing essential security and health care staffing. The sentencing project, a national research and advocacy organization, found in 2012 that private prison staff earn an average of five thousand dollars less than staff at publicly run facilities and receive almost 60 hours less training. The office of inspector general also found that people confined in private facilities often failed to receive necessary medical care and that one private prison went without a full-time physician for eight months. People confined within private detention facilities are subjected to prolonged periods of confinement, inadequate nutrition, medical and mental health access issues, and arbitrary and improper visitation and communication restrictions. In 2018, the sentencing project, a national research and advocacy organization, found that private prisons offer lower quality services and have higher staff turnover rates compared to publicly operated facilities. The office of inspector general also found that people confined in private facilities often failed to receive necessary medical care.
(5) The legislature finds that private prisons and detention centers are less accountable for what happens inside those facilities than state-run facilities, as they are not subject to the freedom of information act under 5 U.S.C. Sec. 552 or the Washington public records act under chapter 42.56 RCW.
(6) The legislature finds that at least 22 other states have stopped confining people in private for-profit facilities.
(7) Therefore, it is the intent of the legislature to prohibit the use of private, for-profit prisons and detention facilities in the state, and to set minimum standards for the conditions of confinement within private detention facilities in the state and to require the inspection and review of those facilities by appropriate state or local agencies to ensure public health and safety.
[ 2023 c 419 s 8; 2021 c 30 s 1.]
Notes:
Effective date—Construction—2023 c 419: See notes following RCW 42.56.475.

catchline: Findings—Intent.


title: RCW 70.395.020

text:
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Abuse" means an act by any individual which injures, exploits, or in any way jeopardizes a detained person's health, welfare, or safety, including, but not limited to:
(a) Physically damaging or potentially damaging nonaccidental acts;
(b) Emotionally damaging verbal behavior and harassment or other actions which may result in emotional or behavioral problems; and
(c) Sexual abuse, exploitation, and mistreatment through inappropriate touching, inappropriate remarks, or encouraging participation in pornography or prostitution.
(2) "Detained person" means a person confined in a private detention facility.
(3) "Detention facility" means any facility in which persons are incarcerated or otherwise involuntarily confined for purposes including prior to trial or sentencing, fulfilling the terms of a sentence imposed by a court, or for other judicial or administrative processes or proceedings.
(4) "Dietitian" means an individual certified under chapter 18.138 RCW.
(5) "Neglect" means conduct which results in deprivation of care necessary to maintain a detained person's minimum physical and mental health including, but not limited to:
(a) Physical and material deprivation;
(b) Lack of medical care;
(c) Inadequate food, clothing or cleanliness;
(d) Refusal to acknowledge, hear, or consider a detained person's concerns;
(e) Lack of social interaction and physical activity;
(f) Lack of personal care; and
(g) Lack of supervision appropriate for the detained person's level of functioning.
(6) "Private detention facility" means a detention facility that is operated by a private, nongovernmental entity and operating pursuant to a contract or agreement with a federal, state, or local governmental entity.
[ 2025 c 235 s 1; 2023 c 419 s 9; 2021 c 30 s 2.]
Notes:
Effective date—2025 c 235: "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 takes effect immediately [May 12, 2025]." [ 2025 c 235 s 8.]
Construction—2025 c 235: "This act shall be construed liberally to effectuate its purposes." [ 2025 c 235 s 10.]
Effective date—Construction—2023 c 419: See notes following RCW 42.56.475.


title: RCW 70.395.030

text:
(1) Except as provided in subsections (2) and (3) of this section, no person, business, or state or local governmental entity shall operate a private detention facility within the state or utilize a contract with a private detention facility within the state. No state or local governmental entity shall utilize a contract with a private detention facility outside of Washington state, except as provided in RCW 72.68.010(2).
(2) A private detention facility that is operating pursuant to a valid contract with a governmental entity that was in effect prior to January 1, 2021, may remain in operation for the duration of that contract, not to include any extensions or modifications made to, or authorized by, that contract.
(3) In accordance with the legislative findings in RCW 70.395.010, this section does not apply if the involuntary confinement is at:
(a) A facility providing rehabilitative, counseling, treatment, mental health, educational, or medical services to juveniles who are subject to Title 13 RCW, or similarly applicable federal law;
(b) A facility providing evaluation and treatment or forensic services to a person who has been civilly detained or is subject to an order of commitment by a court pursuant to chapter 10.77, 71.05, 71.09, or 71.34 RCW, or similarly applicable federal law;
(c) A facility used for the quarantine or isolation of persons for public health reasons pursuant to RCW 43.20.050, or similarly applicable federal law;
(d) A facility used for work release under chapter 72.65 RCW, or similarly applicable federal law;
(e) A facility used for extraordinary medical placement;
(f) A facility used for residential substance use disorder treatment;
(g) A facility used to house persons pursuant to 18 U.S.C. Sec. 4013; or
(h) A facility owned and operated by federally recognized tribes and contracting with a government.
[ 2021 c 30 s 3.]

catchline: Prohibition on private incarceration.


title: RCW 70.395.040

text:
(1) The department of health shall adopt rules as may be necessary to effectuate the intent and purposes of this section in order to ensure private detention facilities comply with measurable standards providing sanitary, hygienic, and safe conditions for detained persons. The department of health rules shall include that:
(a) A detained person should have a safe, clean, and comfortable environment that allows a detained person to use the person's personal belongings to the extent possible;
(b) Living areas, including areas used for sleeping, recreation, dining, telecommunications, visitation, and bathrooms, must be cleaned and sanitized regularly;
(c) A private detention facility must provide laundry facilities, equipment, handling, and processes for linen and laundered items that are clean and in good repair, adequate to meet the needs of detained persons, and maintained according to the manufacturer's instructions. Laundry and linen must be handled, cleaned, and stored according to acceptable methods of infection control including preventing contamination from other sources. Separate areas for handling clean laundry and soiled laundry must be provided and laundry rooms and areas must be ventilated to the exterior;
(d) Basic personal hygiene items must be provided to a detained person regularly at no cost;
(e) A private detention facility shall provide a nutritious and balanced diet, including fresh fruits and vegetables, and shall recognize a detained person's need for a special diet. A private detention facility must follow proper food handling and hygiene practices. A private detention facility must provide at least three meals per day, at no cost, and at reasonable hours;
(f) Safe indoor air quality must be maintained;
(g) The private detention facility must have both heating and air conditioning equipment that can be adjusted by room or area. Rooms used by a detained person must be able to maintain interior temperatures between 65 degrees Fahrenheit and 78 degrees Fahrenheit year-round. Excessive odors and moisture must be prevented in the building;
(h) A private detention facility must implement and maintain an infection control program that prevents the transmission of infections and communicable disease among detained persons, staff, and visitors; and
(i) A private detention facility must provide:
(i) Ready access and equipment to accommodate detained persons with physical and mental disabilities;
(ii) Adequate lighting in all areas;
(iii) An adequate supply of hot and cold running water under pressure meeting the standards in chapters 246-290 and 246-291 WAC, with devices to prevent backflow into the potable water supply system, and water temperature not exceeding 120 degrees Fahrenheit automatically regulated at all plumbing fixtures used by detained persons;
(iv) Written policies, procedures, and schedules for maintenance and housekeeping functions;
(v) Housekeeping and service facilities on each floor, including:
(A) One or more service sinks, designed for filling and emptying mop buckets;
(B) Housekeeping closets that are equipped with shelving, ventilated to the out-of-doors, and kept locked; and
(C) A utility service area designed and equipped for washing, disinfecting, storing, and housing medical and nursing supplies and equipment; and
(vi) Equipment and facilities to collect and dispose of all sewage, garbage, refuse, and liquid waste in a safe and sanitary manner.
(2) The office of the attorney general may enforce violations of this section on its own initiative or in response to complaints or violations.
[ 2025 c 235 s 2; 2023 c 419 s 2.]
Notes:
Effective date—Construction—2025 c 235: See notes following RCW 70.395.020.
Effective date—Construction—2023 c 419: See notes following RCW 42.56.475.

catchline: Standards for sanitation, hygiene, and safety—Enforcement.


title: RCW 70.395.050

text:
(1) The department of health may at any time inspect a private detention facility to determine whether it 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 such facilities.
(2) The department of health shall:
(a) Conduct routine, unannounced inspections of private detention facilities including, but not limited to, inspection of food service and food handling, sanitation and hygiene, and nutrition as provided in (c) of this subsection;
(b) Conduct investigations of complaints received relating to any private detention facility located within the state;
(c) Regularly review the list of food items provided to detained persons to ensure the specific nutrition and calorie needs of each detained person are met, including any needs related to medical requirements, food allergies, or religious dietary restrictions;
(d) Test water used for drinking and bathing and air quality every six months at private detention facilities both inside and outside of the facility; and
(e) Post inspection results on its website and in a conspicuous place viewable by detained persons and visitors to private detention facilities. Results should be posted in English and in languages spoken by detainees, to the extent practicable.
(3) The department of health may delegate food safety inspections to the local health jurisdiction, where the local health jurisdiction is in the county where the private detention facility is located, to conduct inspections pursuant to regulations.
(4) The department of health shall adopt rules as may be necessary to effectuate the intent and purposes of this section in order to ensure private detention facilities allow regular inspections and comply with measurable standards providing sanitary, hygienic, and safe conditions for detained persons.
(5) The department of labor and industries shall conduct routine, unannounced inspections of workplace conditions at private detention facilities, including work undertaken by detained persons.
(6) The office of the attorney general may enforce violations of this section on its own initiative or in response to complaints or violations.
[ 2025 c 235 s 3; 2023 c 419 s 3.]
Notes:
Effective date—Construction—2025 c 235: See notes following RCW 70.395.020.
Effective date—Construction—2023 c 419: See notes following RCW 42.56.475.


title: RCW 70.395.055

text:
In any case in which the department of health conducts an inspection of a private detention facility and finds that the private detention facility has failed or refused to comply with applicable state statutes or regulations, the department of health may take one or more of the following actions:
(1) When the department of health determines the private detention facility 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 has failed to correct noncompliance with a statute or rule by a date established or agreed to by the department of health, the department of health may impose reasonable conditions on the private detention facility, which may include correction within a specified amount of time, training, or hiring a consultant approved by the department of health if the private detention facility cannot demonstrate that it has access to sufficient internal expertise.
(2)(a) In accordance with the authority under RCW 43.70.095, the department of health may assess a civil fine of up to $10,000 per violation, not to exceed a total fine of $1,000,000, on a private detention facility if the private detention facility 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 has failed to correct noncompliance with a statute or rule by a date established or agreed to by the department of health.
(b) Proceeds from these fines may only be used by the department of health to provide training or technical assistance to private detention facilities.
(c) The department of health shall adopt in rules specific fine amounts in relation to the severity of the noncompliance.
(d) If a private detention facility is aggrieved by the department of health's action of assessing civil fines, the private detention facility has the right to appeal under RCW 43.70.095.
[ 2025 c 235 s 4.]
Notes:
Effective date—Construction—2025 c 235: See notes following RCW 70.395.020.


title: RCW 70.395.058

text:
As resources allow, the department of health shall make private detention facility inspection statements of deficiencies, plans of correction, notice of acceptance of plans of correction, enforcement actions, and notices of resolution available to the public on the internet.
[ 2025 c 235 s 5.]
Notes:
Effective date—Construction—2025 c 235: See notes following RCW 70.395.020.

catchline: Inspections—Publishing results.


title: RCW 70.395.060

text:
(1) This section does not apply to private detention facilities operating pursuant to a valid contract that was in effect prior to January 1, 2023, for the duration of that contract, not to include any extensions or modifications made to, or authorized by, that contract.
(2) A private detention facility operating pursuant to a contract or agreement with a federal, state, or local government shall comply with the following:
(a) The private detention facility shall:
(i) Comply with food service rules under chapters 246-215 and 246-217 WAC;
(ii) Designate an individual responsible for managing and supervising food services 24 hours per day, including:
(A) Incorporating ongoing recommendations of a dietitian;
(B) Serving at least three meals a day at regular intervals with 15 or fewer hours between the evening meal and breakfast, unless the facility provides a nutritious snack between the evening meal and breakfast;
(C) Providing well-balanced meals and nourishments that meet the current recommendations published in recommended dietary allowances by the national research council, 10th edition, 1989, adjusted for the detained person's age, sex, and activities unless contraindicated;
(D) Making nourishing snacks available as needed for detained persons, and posted as part of the menu;
(E) Preparing and serving therapeutic diets according to written medical orders;
(F) Preparing and serving meals under the supervision of food service staff;
(G) Maintaining a current diet manual, approved in writing by the dietitian and medical staff, for use in planning and preparing therapeutic diets; and
(H) Ensuring all menus: Are written at least one week in advance; indicate the date, day of week, month, and year; include all foods and snacks served that contribute to nutritional requirements; provide a variety of foods; are approved in writing by the dietitian; are posted in a location easily accessible to detained persons at the facility; and are retained for one year;
(iii) Substitute foods, when necessary, of comparable nutrient value and record changes on the menu;
(iv) Allow sufficient time for detained persons to consume meals;
(v) Ensure staff from dietary and food services are present in the facility during all meal times; and
(vi) Keep policies and procedures pertaining to food storage, preparation, and cleaning food service equipment and work areas in the food service area for easy reference by dietary staff at all times;
(b) The private detention facility shall provide a readily available telephone for detained persons to make and receive confidential calls, and make a nonpay telephone or equivalent communication device readily accessible on each floor occupied by a detained person for emergency use;
(c) The private detention facility shall provide a visiting area allowing privacy for detained persons and visitors;
(d) The private detention facility shall develop and implement the written policies and procedures consistent with assuring the rights of detained persons, protecting against abuse and neglect, and reporting suspected incidents, and post those policies and procedures in a prominent place for detained persons at the facility to read;
(e) The private detention facility shall employ sufficient, qualified staff to:
(i) Provide adequate services to detained persons;
(ii) Maintain the facility free of safety hazards; and
(iii) Implement fire and disaster plans;
(f) The private detention facility shall provide and document orientation and appropriate training for all staff, including:
(i) Organization of the facility;
(ii) Physical layout of facility, including buildings, departments, exits, and services;
(iii) Fire and disaster plans, including monthly drills;
(iv) Infection control;
(v) Specific duties and responsibilities;
(vi) Policies, procedures, and equipment necessary to perform duties;
(vii) Policies related to the rights of detained persons and protecting against abuse and neglect;
(viii) Managing the behavior of detained persons; and
(ix) Appropriate training for expected duties; and
(g) The private detention facility shall establish and implement an effective facility-wide infection control program including, at a minimum, the following:
(i) Written policies and procedures describing:
(A) Types of surveillance used to monitor rates of infections originating at the facility;
(B) Systems to collect and analyze data; and
(C) Activities to prevent and control infections;
(ii) A review process to determine if staff and detained person infections originated at the facility;
(iii) A procedure for reviewing and approving infection control aspects of policies and procedures used in each area of the facility;
(iv) A procedure to monitor the physical environment of the facility for situations which may contribute to the spread of infectious diseases; and
(v) Provisions for:
(A) Providing consultation regarding care practices, equipment, and supplies which may influence the risk of infection;
(B) Providing consultation regarding appropriate procedures and products for cleaning, disinfecting, and sterilizing;
(C) Providing infection control information for orientation and in-service education for staff providing direct care;
(D) Making recommendations, consistent with federal, state, and local laws and rules, for methods of safe and sanitary disposal of sewage, solid and liquid wastes, and infectious wastes, including safe management of sharps;
(E) Identifying specific precautions to prevent transmission of infections; and
(F) Coordinating employee activities to control exposure and transmission of infections to or from employees and others performing services.
(3) The office of the attorney general may enforce violations of this section on its own initiative or in response to complaints or violations.
[ 2025 c 235 s 6; 2023 c 419 s 4.]
Notes:
Effective date—Construction—2025 c 235: See notes following RCW 70.395.020.
Effective date—Construction—2023 c 419: See notes following RCW 42.56.475.

catchline: Requirements.


title: RCW 70.395.070

text:
(1) A detained person aggrieved by a violation of this chapter has a right of action in superior court and may recover for each violation as follows:
(a) Against any person who negligently violates a provision of this chapter, $1,000, or actual damages, whichever is greater, for each violation;
(b) Against any person who intentionally or recklessly violates a provision of this chapter, $10,000, or actual damages, whichever is greater, for each violation;
(c) Reasonable attorneys' fees and costs if the detained person is the prevailing party; and
(d) Other relief, including an injunction, as the court may deem appropriate. Injunctive relief may be issued without bond in the discretion of the court, notwithstanding any other requirement imposed by statute.
(2) Any action under this chapter is barred unless the action is commenced within three years after the cause of action accrues.
(3) For the purposes of this section, "person" means an owner, operator, contractor, subcontractor, or employee of a private detention facility.
(4) The state and its agencies are not liable for a violation of this chapter.
[ 2023 c 419 s 5.]
Notes:
Effective date—Construction—2023 c 419: See notes following RCW 42.56.475.

catchline: Violations—Rights of action.


title: RCW 70.395.080

text:
(1) Any person who fails to comply with this chapter may be subject to a civil penalty in an amount of not more than $1,000 per violation per day.
(2) Subject to the availability of amounts appropriated for this specific purpose, the secretary of the department of health may adopt by rule a penalty matrix that establishes procedures for civil penalties assessed under this chapter.
(3) Each violation is a separate and distinct offense. The department of health shall impose the civil penalty in accordance with chapter 34.05 RCW. Moneys collected under this section must be deposited into the state general fund.
(4) If the civil penalty is not paid to the department of health within 15 days after receipt of notice, the office of the attorney general may bring an action to recover the penalty in the name of the state of Washington in the superior court of Thurston county or in the county where the private detention facility is located. In all such actions, the procedure and rules of evidence are the same as in ordinary civil actions. All penalties recovered by the attorney general under this chapter must be paid into the Washington state attorney general humane detention account created in RCW 70.395.090.
(5) For the purposes of this section, "person" means an owner, operator, contractor, subcontractor, or employee of a private detention facility.
(6) The state and its agencies are not liable for a violation of this chapter.
[ 2023 c 419 s 6.]
Notes:
Effective date—Construction—2023 c 419: See notes following RCW 42.56.475.

catchline: Violations—Civil penalties.


title: RCW 70.395.090

text:
The Washington state attorney general humane detention account is created in the custody of the state treasurer. All receipts from civil penalties under RCW 70.395.080 must be deposited in the account. Only the attorney general or the attorney general's designee may authorize expenditures from the account. Moneys in the account must be used exclusively for the costs associated with the attorney general's enforcement of the provisions of this chapter governing the recovery of civil penalties. The account is subject to allotment procedures under chapter 43.88 RCW, but an appropriation is not required for expenditures.
[ 2023 c 419 s 7.]
Notes:
Effective date—Construction—2023 c 419: See notes following RCW 42.56.475.

catchline: Attorney general humane detention account.


title: RCW 70.395.100

text:
RCW 70.395.040 through 70.395.080 do not apply to a private detention facility that is:
(1) Providing counseling, treatment, mental health, educational, or medical services to juveniles under chapter 74.15 RCW;
(2) Providing evaluation and treatment or forensic services to a person who has been civilly detained or is subject to an order of commitment by a court pursuant to chapter 10.77, 71.05, 71.09, or 71.34 RCW, or similarly applicable federal law, including facilities regulated under chapters 70.41, 71.12, and 71.24 RCW;
(3) Used for the quarantine or isolation of persons for public health reasons pursuant to RCW 43.20.050, or similarly applicable federal law;
(4) Used for work release under chapter 72.65 RCW, or similarly applicable federal law;
(5) Used for extraordinary medical placement;
(6) Used for residential substance use disorder treatment; or
(7) Owned and operated by federally recognized tribes and contracting with a government.
[ 2025 c 235 s 7; 2023 c 419 s 10.]
Notes:
Effective date—Construction—2025 c 235: See notes following RCW 70.395.020.
Effective date—Construction—2023 c 419: See notes following RCW 42.56.475.

catchline: Facilities excluded.


title: RCW 70.395.900

text:
Chapter 30, Laws of 2021 shall be construed liberally for the accomplishment of the purposes thereof.
[ 2021 c 30 s 4.]

catchline: Construction—2021 c 30.


title: RCW 70.395.901

text:
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 takes effect immediately [April 14, 2021].
[ 2021 c 30 s 5.]

catchline: Effective date—2021 c 30.


title: RCW 70.40.005

text:
The powers and duties of the department of social and health services and the secretary of social and health services under this chapter shall be performed by the department of health and the secretary of health.
[ 1989 1st ex.s. c 9 s 248.]
Notes:
Effective date—Severability—1989 1st ex.s. c 9: See RCW 43.70.910 and 43.70.920.

catchline: Transfer of duties to the department of health.


title: RCW 70.40.010

text:
This chapter may be cited as the "Washington Hospital and Medical Facilities Survey and Construction Act."
[ 1959 c 252 s 1; 1949 c 197 s 1; Rem. Supp. 1949 s 6090-60.]

catchline: Short title.


title: RCW 70.40.020

text:
As used in this chapter:
(1) "Secretary" means the secretary of the state department of health;
(2) "The federal act" means Title VI of the public health service act, as amended, or as hereafter amended by congress;
(3) "The surgeon general" means the surgeon general of the public health service of the United States;
(4) "Hospital" includes public health centers and general, tuberculosis, mental, chronic disease, and other types of hospitals, and related facilities, such as laboratories, outpatient departments, nurses' home and training facilities, and central service facilities operated in connection with hospitals;
(5) "Public health center" means a publicly owned facility for the provision of public health services, including related facilities such as laboratories, clinics, and administrative offices operated in connection with public health centers;
(6) "Nonprofit hospital" and "nonprofit medical facility" means any hospital or medical facility owned and operated by a corporation or association, no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private shareholder or individual;
(7) "Medical facilities" means diagnostic or diagnostic and treatment centers, rehabilitation facilities and nursing homes as those terms are defined in the federal act.
[ 1991 c 3 s 331; 1979 c 141 s 96; 1959 c 252 s 2; 1949 c 197 s 2; Rem. Supp. 1949 s 6090-61.]

catchline: Definitions.


title: RCW 70.40.030

text:
There is hereby established in the state department of health a "section of hospital and medical facility survey and construction" which shall be administered by a full time salaried head under the supervision and direction of the secretary. The state department of health, through such section, shall constitute the sole agency of the state for the purpose of:
(1) Making an inventory of existing hospitals and medical facilities, surveying the need for construction of hospitals and medical facilities, and developing a program of hospital and medical facility construction; and
(2) Developing and administering a state plan for the construction of public and other nonprofit hospitals and medical facilities as provided in this chapter.
[ 1991 c 3 s 332; 1979 c 141 s 97; 1959 c 252 s 3; 1949 c 197 s 3; Rem. Supp. 1949 s 6090-62.]

catchline: Section of hospital and medical facility survey and construction established—Duties.


title: RCW 70.40.040

text:
In carrying out the purposes of the chapter the secretary is authorized and directed:
(1) To require such reports, make such inspections and investigations, and prescribe such regulations as he or she deems necessary;
(2) To provide such methods of administration, appoint a head and other personnel of the section, and take such other action as may be necessary to comply with the requirements of the federal act and the regulations thereunder;
(3) To procure in his or her discretion the temporary or intermittent services of experts or consultants or organizations thereof, by contract, when such services are to be performed on a part time or fee-for-service basis and do not involve the performance of administrative duties;
(4) To the extent that he or she considers desirable to effectuate the purposes of this chapter, to enter into agreements for the utilization of the facilities and services of other departments, agencies, and institutions public or private;
(5) To accept on behalf of the state and to deposit with the state treasurer, any grant, gift, or contribution made to assist in meeting the cost of carrying out the purposes of this chapter, and to expend the same for such purpose; and
(6) To make an annual report to the governor on activities pursuant to this chapter, including recommendations for such additional legislation as the secretary considers appropriate to furnish adequate hospital and medical facilities to the people of this state.
[ 2012 c 117 s 375; 1979 c 141 s 98; 1977 c 75 s 83; 1959 c 252 s 4; 1949 c 197 s 4; Rem. Supp. 1949 s 6090-63.]

catchline: General duties of the secretary.


title: RCW 70.40.060

text:
The secretary is authorized and directed to make an inventory of existing hospitals and medical facilities, including public nonprofit and proprietary hospitals and medical facilities, to survey the need for construction of hospitals and medical facilities, and, on the basis of such inventory and survey, to develop a program for the construction of such public and other nonprofit hospitals and medical facilities as will, in conjunction with existing facilities, afford the necessary physical facilities for furnishing adequate hospital and medical facility services to all the people of the state.
[ 1979 c 141 s 99; 1959 c 252 s 6; 1949 c 197 s 6; Rem. Supp. 1949 s 6090-65.]

catchline: Development of program for construction of facilities needed.


title: RCW 70.40.070

text:
The construction program shall provide, in accordance with regulations prescribed under the federal act, for adequate hospital and medical facilities for the people residing in this state and insofar as possible shall provide for their distribution throughout the state in such manner as to make all types of hospital and medical facility service reasonably accessible to all persons in the state.
[ 1959 c 252 s 7; 1949 c 197 s 7; Rem. Supp. 1949 s 6090-66.]

catchline: Distribution of facilities.


title: RCW 70.40.080

text:
The secretary is authorized to make application to the surgeon general for federal funds to assist in carrying out the survey and planning activities herein provided. Such funds shall be deposited with the state treasurer and shall be available to the secretary for expenditure in carrying out the purposes of this part. Any such funds received and not expended for such purposes shall be repaid to the treasurer of the United States.
[ 1979 c 141 s 100; 1949 c 197 s 8; Rem. Supp. 1949 s 6090-67.]

catchline: Federal funds—Application for—Deposit, use.


title: RCW 70.40.090

text:
The secretary shall prepare and submit to the surgeon general a state plan which shall include the hospital and medical facility construction program developed under this chapter and which shall provide for the establishment, administration, and operation of hospital and medical facility construction activities in accordance with the requirements of the federal act and the regulations thereunder. The secretary shall, prior to the submission of such plan to the surgeon general, give adequate publicity to a general description of all the provisions proposed to be included therein, and hold a public hearing at which all persons or organizations with a legitimate interest in such plan may be given an opportunity to express their views. After approval of the plan by the surgeon general, the secretary shall publish a general description of the provisions thereof in at least one newspaper having general circulation in the state, and shall make the plan, or a copy thereof, available upon request to all interested persons or organizations. The secretary shall from time to time review the hospital and medical facility construction program and submit to the surgeon general any modifications thereof which he or she may find necessary and may submit to the surgeon general such modifications of the state plan, not inconsistent with the requirements of the federal act, as he or she may deem advisable.
[ 2012 c 117 s 376; 1979 c 141 s 101; 1959 c 252 s 8; 1949 c 197 s 9; Rem. Supp. 1949 s 6090-68.]

catchline: State plan—Publication—Hearing—Approval by surgeon general—Modifications.


title: RCW 70.40.100

text:
The state plan shall set forth the relative need for the several projects included in the construction program determined in accordance with regulations prescribed pursuant to the federal act, and provide for the construction, insofar as financial resources available therefor and for maintenance and operations make possible, in the order of such relative need.
[ 1949 c 197 s 11; Rem. Supp. 1949 s 6090-70.]

catchline: Plan shall provide for construction in order of relative needs.


title: RCW 70.40.110

text:
The secretary shall by regulation prescribe minimum standards for the maintenance and operation of hospitals and medical facilities which receive federal aid for construction under the state plan.
[ 1979 c 141 s 102; 1959 c 252 s 9; 1949 c 197 s 10; Rem. Supp. 1949 s 6090-69.]

catchline: Minimum standards for maintenance and operation.


title: RCW 70.40.120

text:
Applications for hospital and medical facility construction projects for which federal funds are requested shall be submitted to the secretary and may be submitted by the state or any political subdivision thereof or by any public or nonprofit agency authorized to construct and operate a hospital or medical facility: PROVIDED, That except as may be permitted by federal law no application for a diagnostic or treatment center shall be approved unless the applicant is (1) a state, political subdivision, or public agency, or (2) a corporation or association which owns and operates a nonprofit hospital. Each application for a construction project shall conform to federal and state requirements.
[ 1979 c 141 s 103; 1959 c 252 s 10; 1949 c 197 s 12; Rem. Supp. 1949 s 6090-71.]

catchline: Applications for construction projects—Diagnostic, treatment centers.


title: RCW 70.40.130

text:
The secretary shall afford to every applicant for a construction project an opportunity for a fair hearing. If the secretary, after affording reasonable opportunity for development and presentation of applications in the order of relative need, finds that a project application complies with the requirements of RCW 70.40.120 and is otherwise in conformity with the state plan, he or she shall approve such application and shall recommend and forward it to the surgeon general.
[ 2012 c 117 s 377; 1979 c 141 s 104; 1949 c 197 s 13; Rem. Supp. 1949 s 6090-72.]

catchline: Hearing—Approval.


title: RCW 70.40.140

text:
From time to time the secretary shall inspect each construction project approved by the surgeon general, and, if the inspection so warrants, the secretary shall certify to the surgeon general that work has been performed upon the project, or purchases have been made, in accordance with the approved plans and specifications, and that payment of an installment of federal funds is due to the applicant.
[ 1979 c 141 s 105; 1949 c 197 s 14; Rem. Supp. 1949 s 6090-73.]

catchline: Inspection of project under construction—Certification as to federal funds due.


title: RCW 70.40.150

text:
The secretary is hereby authorized to receive federal funds in behalf of, and transmit them to, such applicants or to approve applicants for federal funds and authorize the payment of such funds directly to such applicants as may be allowed by federal law. To achieve that end there is hereby established, separate and apart from all public moneys and funds of this state, a trust fund to be known as the "hospital and medical facility construction fund", of which the state treasurer shall ex officio be custodian. Moneys received from the federal government for construction projects approved by the surgeon general shall be deposited to the credit of this fund, shall be used solely for payments due applicants for work performed, or purchases made, in carrying out approved projects. Vouchers covering all payments from the hospital and medical facility construction fund shall be prepared by the department of health and shall bear the signature of the secretary or his or her duly authorized agent for such purpose, and warrants therefor shall be signed by the state treasurer.
[ 1991 c 3 s 333; 1973 c 106 s 31; 1959 c 252 s 11; 1949 c 197 s 15; Rem. Supp. 1949 s 6090-74.]

catchline: Hospital and medical facility construction fund—Deposits, use.


title: RCW 70.400.010

text:
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Department" means the department of health.
(2) "Health care entity" means an entity that supervises, controls, grants privileges to, directs the practice of, or directly or indirectly restricts the practice of, a health care provider.
(3) "Health care provider" has the same meaning as in RCW 70.02.010.
[ 2021 c 235 s 1.]


title: RCW 70.400.020

text:
(1) Except as provided in subsection (2) of this section, if a health care provider is acting in good faith, within the provider's scope of practice, education, training, and experience and within the accepted standard of care, a health care entity may not prohibit the health care provider from providing health care services related to complications of pregnancy, including but not limited to health services related to miscarriage management and treatment for ectopic pregnancies, in cases in which failure to provide the service would violate the accepted standard of care or when the patient presents a medical condition manifesting itself by acute symptoms of sufficient severity such that the absence of medical attention could reasonably be expected to pose a risk:
(a) To the patient's life; or
(b) Of irreversible complications or impairment to the patient's bodily functions or any bodily organ or part.
(2) Nothing in this section prohibits a health care entity from limiting a health care provider's practice for purposes of:
(a) Complying with the network or utilization review requirements of any program or entity authorized by state or federal law to provide insurance coverage for health care services to enrollees; or
(b) Quality control and patient safety, including when quality control or patient safety issues are identified pursuant to peer review.
(3) A health care entity may not discharge, demote, suspend, discipline, or otherwise discriminate against a health care provider for providing services in compliance with this section.
[ 2021 c 235 s 2.]

catchline: Provision of care for complications of pregnancy—Retaliatory action prohibited.


title: RCW 70.400.030

text:
A patient, a health care provider, or an individual, who is aggrieved by a violation of RCW 70.400.020, may bring a civil action against a health care entity to enjoin further violations, to recover damages, or both. The prevailing party in such action may in the discretion of the court recover costs of litigation and reasonable attorneys' fees.
[ 2021 c 235 s 3.]

catchline: Retaliatory action—Civil action.


title: RCW 70.400.040

text:
Beginning March 1, 2022, a health care entity shall provide the information prepared by the department under RCW 43.70.619 at the time of hiring, contracting with, or privileging health care providers and staff, and on a yearly basis thereafter.
[ 2021 c 235 s 4.]

catchline: Distribution of informational resources.


title: RCW 70.400.900

text:
If any part of this act is found to be in conflict with federal requirements that are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this act is inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and this finding does not affect the operation of the remainder of this act in its application to the agencies concerned. Rules adopted under this act must meet federal requirements that are a necessary condition to the receipt of federal funds by the state.
[ 2021 c 235 s 6.]

catchline: Conflict with federal requirements—2021 c 235.


title: RCW 70.405.010

text:
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Authority" means the health care authority.
(2) "Biological product" has the same meaning as in 42 U.S.C. Sec. 262(i)(1).
(3) "Biosimilar" has the same meaning as in 42 U.S.C. Sec. 262(i)(2).
(4) "Board" means the prescription drug affordability board.
(5) "Excess costs" means:
(a) Costs of appropriate utilization of a prescription drug that exceed the therapeutic benefit relative to other alternative treatments; or
(b) Costs of appropriate utilization of a prescription drug that are not sustainable to public and private health care systems over a 10-year time frame.
(6) "Generic drug" has the same meaning as in RCW 69.48.020.
(7) "Health carrier" or "carrier" has the same meaning as in RCW 48.43.005.
(8) "Manufacturer" means a person, corporation, or other entity engaged in the manufacture of prescription drugs sold in or into Washington state. "Manufacturer" does not include a private label distributor or retail pharmacy that sells a drug under the retail pharmacy's store, or a prescription drug repackager.
(9) "Prescription drug" means a drug regulated under chapter 69.41 or 69.50 RCW, including generic, brand name, specialty drugs, and biological products.
[ 2022 c 153 s 1.]

catchline: Definitions.


title: RCW 70.405.020

text:
(1) The prescription drug affordability board is established, to include five members who have expertise in health care economics or clinical medicine appointed by the governor.
(2) Board members shall serve for a term of five years and members may be reappointed by the governor for additional terms.
(3) No board member or advisory group member may be an employee of, a board member of, or consultant to a prescription drug manufacturer, pharmacy benefit manager, health carrier, prescription drug wholesale distributor, or related trade association, except that a representative from the prescription drug industry serving on an advisory group may be an employee, consultant, or board member of a prescription drug manufacturer or related trade association and shall not be deemed to have a conflict of interest pursuant to subsection (4) of this section.
(4)(a) Board members, advisory group members, staff members, and contractors providing services on behalf of the board shall recuse themselves from any board activity in any case in which they have a conflict of interest.
(b) For the purposes of this section, a conflict of interest means an association, including a financial or personal association, that has the potential to bias or appear to bias an individual's decisions in matters related to the board or the activities of the board.
(5) The board shall establish advisory groups consisting of relevant stakeholders, including but not limited to patients and patient advocates for the condition treated by the drug and one member who is a representative of the prescription drug industry, for each drug affordability review conducted by the board pursuant to RCW 70.405.040. Advisory group members are immune from civil liability for any official act performed in good faith as a member of the group.
(6) The authority shall provide administrative support to the board and any advisory group of the board and shall adopt rules governing their operation that shall include how and when the board will use and discuss confidential information that is exempt from public disclosure. The rules adopted under this subsection may not go into effect until at least 90 days after the next regular legislative session.
(7) Board members shall be compensated for participation in the work of the board in accordance with a personal services contract to be executed after appointment and before commencement of activities related to the work of the board.
(8) A simple majority of the board's membership constitutes a quorum for the purpose of conducting business.
(9) All meetings of the board must be open and public, except that the board may hold executive sessions to the extent permitted by chapter 42.30 RCW.
(10) The board may not hold its first meeting until at least one year after the authority publishes its first report on the impact that drug costs, rebates, and other discounts have on health care premiums pursuant to RCW 43.71C.100.
(11) The board must coordinate and collaborate with the authority, other boards, work groups, and commissions related to prescription drug costs and emerging therapies, including but not limited to the health care cost transparency board established in chapter 70.390 RCW, and the universal health care commission established in RCW 41.05.840. All coordination and collaboration by the board pursuant to this subsection must comply with chapter 42.30 RCW, the open public meetings act.
(12) The board may collaborate with prescription drug affordability boards established in other states.
[ 2022 c 153 s 2.]

catchline: Prescription drug affordability board.


title: RCW 70.405.030

text:
By June 30, 2023, and annually thereafter, utilizing data collected pursuant to chapters 43.71C, 43.371, and 70.390 RCW, or other data deemed relevant by the board, the board must identify prescription drugs that have been on the market for at least seven years, are dispensed at a retail, specialty, or mail-order pharmacy, are not designated by the United States food and drug administration under 21 U.S.C. Sec. 360bb as a drug solely for the treatment of a rare disease or condition, and meet the following thresholds:
(1) Brand name prescription drugs and biologic products that:
(a) Have a wholesale acquisition cost of $60,000 or more per year or course of treatment lasting less than one year; or
(b) Have a price increase of 15 percent or more in any 12-month period or for a course of treatment lasting less than 12 months, or a 50 percent cumulative increase over three years;
(2) A biosimilar product with an initial wholesale acquisition cost that is not at least 15 percent lower than the reference biological product; and
(3) Generic drugs with a wholesale acquisition cost of $100 or more for a 30-day supply or less that has increased in price by 200 percent or more in the preceding 12 months.
[ 2024 c 80 s 7; 2022 c 153 s 3.]

catchline: Authority to review drug prices.


title: RCW 70.405.040

text:
(1) The board may choose to conduct an affordability review of up to 24 prescription drugs per year identified pursuant to RCW 70.405.030. When deciding whether to conduct a review, the board shall consider:
(a) The class of the prescription drug and whether any therapeutically equivalent prescription drugs are available for sale;
(b) Input from relevant advisory groups established pursuant to RCW 70.405.020; and
(c) The average patient's out-of-pocket cost for the drug.
(2) For prescription drugs chosen for an affordability review, the board must determine whether the prescription drug has led or will lead to excess costs to patients. The board may examine publicly available information as well as collect confidential and proprietary information from the prescription drug manufacturer and other relevant sources.
(3) A manufacturer must submit all requested information to the board within 30 days of the request.
(4) The authority may assess a fine of up to $100,000 against a manufacturer for each failure to comply with an information request from the board. The process for the assessment of a fine under this subsection shall be established by the authority in rule and is subject to review under the administrative procedure act, chapter 34.05 RCW. The rules adopted under this subsection may not go into effect until at least 90 days after the next regular legislative session.
(5) When conducting a review, the board shall consider:
(a) The relevant factors contributing to the price paid for the prescription drug, including the wholesale acquisition cost, discounts, rebates, or other price concessions;
(b) The average patient copay or other cost sharing for the drug;
(c) The effect of the price on consumers' access to the drug in the state;
(d) Orphan drug status;
(e) The dollar value and accessibility of patient assistance programs offered by the manufacturer for the drug;
(f) The price and availability of therapeutic alternatives;
(g) Input from:
(i) Patients affected by the condition or disease treated by the drug; and
(ii) Individuals with medical or scientific expertise related to the condition or disease treated by the drug;
(h) Any other information the drug manufacturer or other relevant entity chooses to provide;
(i) The impact of pharmacy benefit manager policies on the price consumers pay for the drug; and
(j) Any other relevant factors as determined by the board.
(6) In performing an affordability review of a drug the board may consider the following factors:
(a) Life-cycle management;
(b) The average cost of the drug in the state;
(c) Market competition and context;
(d) Projected revenue;
(e) Off-label usage of the drug; and
(f) Any additional factors identified by the board.
(7) All information collected by the board pursuant to this section is confidential and not subject to public disclosure under chapter 42.56 RCW.
(8) The board shall publicize which prescription drugs are subject to an affordability review before the review begins.
[ 2022 c 153 s 4.]

catchline: Affordability reviews.