Hospitals treating inmates could be safer, cheaper under new Washington state rule

Legislation passed this week could make hospitals safer for nurses and doctors treating people suspected of violent or sexual crimes, and could save taxpayers some money on medical costs.

Washington state lawmakers unanimously agreed to codify what is currently standard practice for most Whatcom County law enforcement agencies: requiring a guard or officer stay with someone while they are treated at a hospital if they are in custody for certain crimes.

The legislation, which was passed Tuesday, April 21, and has yet to be signed into law by the governor, aims to prevent assaults on nurses, doctors and even other hospital patients, which has happened when agencies dropped off a violent person at a hospital for treatment.

“We had a past history of law enforcement dropping off folks and asking to be called when they were released, and we didn’t know why they were there,” said Cassie Sauer, spokeswoman for the Washington State Hospital Association, which represents all 99 hospitals in the state. “There were some patient and staff assaults that happened. We were really concerned about that. ... As you can imagine, hospital patients are quite vulnerable.”

Until this year’s bill, SSB 5593, there was no requirement that a guard or officer stay with someone brought in on a violent crime while they were treated at a hospital. The new rule will require guards, unless a doctor or the officer decides the patient is no longer a safety risk. The rule also allows the guard or officer to leave to respond to another emergency, if necessary.

Also new, officers will be allowed to remain in the hospital room with patients, which was previously barred by privacy laws.

“They do not get full access to the patient’s medical record, bu they don’t have to leave the room,” Sauer said.

For the most part, the requirement for a guard shouldn’t make things more expensive for Whatcom County agencies. Local police said they already post guards outside the rooms of people who might be a security threat.

“Typically, if we take somebody on a felony crime, really any crime, and they have to be taken to the hospital, we sit on ‘em,” said Sgt. Kevin Davis of the Ferndale Police Department. “It doesn’t happen all that often.”

Davis said Ferndale posted an officer with someone only once or twice in 2014.

Bellingham Police Department has had cases where an officer had to guard someone for two weeks, said Lt. Bob Vander Yacht.

“We’ve had to have an overtime detail that was very specific to watch that person 24/7,” he said. “If we are pretty sure we’re going to end up making an arrest, or continuing an investigation, and they’re not free to leave, we do have an obligation to provide a guard service for them.”

For people who have already been booked into jail, corrections staff and the prosecutor will discuss a risk assessment for that person to see if they need to be supervised, said Whatcom County Jail Chief Wendy Jones.

“Every once in a while we take somebody up, they need care in the hospital for a few days, and they’re here on a nonviolent offense, say a property offense, where they’re not a risk to the public,” Jones said. “We get written permission from a judge to leave them there and the hospital lets us know when they can come back.”

Many people who are booked into jail don’t have private insurance, and oftentimes Medicaid won’t cover the costs of health care for inmates who have it. That means the jail, and thus local taxpayers, are on the hook for those medical costs.

Whatcom County Jail works closely with PeaceHealth St. Joseph Medical Center to contract for services at a better deal for taxpayers, but not every jurisdiction in the state has such arrangements. The new legislation changes that.

In 2014, Whatcom County Jail took 84 inmates to the Emergency Department, and 15 inmates were admitted to the hospital. The total cost for inmate health care that year was $1,516,596, Jones said. Of that, $158,997 was paid to St. Joseph hospital.

With discounted rates negotiated with the health-care providers, the jail saved about 50 percent on its bill for the hospital and for treatment from specialists, Jones said.

The new legislation enables jurisdictions that don’t have their own contracts negotiated with hospitals to use a standard schedule of costs that the state Department of Labor and Industries maintains.

“Law enforcement agencies were being charged all over the map, and didn’t have any sense of what it would cost,” Sauer said. “They had no clue because they didn’t have signed contracts; usually an insurer would negotiate that. What they wanted was a reasonable cost that was predictable and known, a transparent price structure.”

In negotiating with the Washington Association of Sheriffs and Police Chiefs and the Association of Washington Cities to help craft the legislation, hospitals made it clear they didn’t want to agree to a Medicaid fee structure, because it pays well below the cost for care, Sauer said. They compromised and agreed the fee structure set by Labor and Industries would work.

“It should give them some cost savings, but more than anything it should give them predictability,” Sauer said.