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    Senate passes bill to better protect public from outbreaks of measles

Senate passes bill to better protect public from outbreaks of measles

April 18th, 2019|

Taking action to safeguard the public against health threats like the ongoing measles outbreak in Clark County, the Senate passed House Bill 1638 on a 25-22 vote late Wednesday.

“We talk a lot about ‘protecting the most vulnerable among us.’ Well, protecting the most vulnerable among us is precisely what this legislation is all about,” said Sen. Annette Cleveland (D-Vancouver), who chairs the Senate Health Care Committee. “The threat of contagion from measles is real and it is growing, especially for infants too young to be vaccinated and for children and adults with depressed immune systems due to disease or cancer treatment.”

State law requires vaccinations for a number of diseases but allows exemptions on the basis of medical necessity, religion, and personal belief. HB 1638 removes the personal belief exemption from vaccinations for measles, mumps and rubella (MMR) while retaining medical and religious exemptions, and leaves intact personal belief exemptions for all other required immunizations. In recent years, the use of exemptions has risen as parents have been swayed by online campaigns to sow doubt as to the safety of vaccinations.

“It’s an unfortunate reality today that many people will sooner embrace conspiracy theories and alternative facts than proven science — a process that made passing this legislation harder than it should have been,” said Cleveland, who sponsored similar legislation in the Senate. “Vaccine deniers are no less a threat to public health than climate deniers are to our environmental health.”

Cleveland said the near party-line vote — no Senate Republicans voted for the bill and only one member of the Senate Democratic Caucus voted against it — demonstrated a commitment to act on the public’s behalf despite extremely vocal, organized efforts of vaccine deniers to intimidate lawmakers and confuse the facts about vaccinations.

“It’s our job to do difficult things, to ignore the noise and to execute our responsibilities as lawmakers to govern in the people’s best interest,” she said. “Putting people first means protecting the health and safety of all Washingtonians even when it’s the most difficult, not just when it’s convenient.”

Cleveland noted that the rate of measles cases in Washington plummeted from nearly 20,000 cases the year before the current measles vaccine was introduced, to fewer than 2,500 cases the following year, and to zero cases in 2000, when the Centers for Disease Control declared measles eradicated across the nation.

“The simple truth is that diseases like measles can be easily and safely avoided through widespread immunization — which is exactly how our country tamed what was once a raging threat to national health,” she said. “You cannot have an outbreak unless you have enough unimmunized people for the disease to flourish.”

Cleveland said she respects parents’ concerns of exposure to potentially harmful substances and agrees on the need to reduce or eliminate such exposures, but said it is important to pursue those efforts responsibly.

“Our world is rife with harmful chemicals, there’s no question of that, but not everything rumored to be harmful is in reality harmful,” Cleveland said. “Let’s work together, using science to focus on the true threats, and help dispel fears of threats that are unfounded.”

Washington state Senate passes vaccine bill

April 18th, 2019|

Washington is the first state in the nation in four years to remove the personal exemption for vaccinations immunizing the public from measles, mumps and rubella, as reported today in The Washington Post.

You can read the story here.


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    Governor signs legislation into law to protect health care benefits

Governor signs legislation into law to protect health care benefits

April 17th, 2019|

Health care policies sold in Washington must honor existing patient protections even if those standards are eliminated by action taken at the federal level, under legislation signed into law today by Gov. Jay Inslee.

House Bill 1870 takes effect immediately, as a result of an emergency clause added by Sen. Annette Cleveland (D-Vancouver). Cleveland added the clause in March, after the U.S. Justice Department asked 5th Circuit Court of Appeals in New Orleans to uphold an earlier Texas court ruling that the Affordable Care Act (ACA) is unconstitutional. That ruling, which is under appeal, would rescind the ACA and a wide range of important consumer protections.

“We wanted to get these protections into law as quickly as possible to guard against any potential actions by the Trump administration or the courts,” said Cleveland, who chairs the Senate Health Care Committee. “Given the president’s repeated efforts to roll back health care standards, we made it a priority this session to protect Washingtonians from any reductions in coverage.”

HB 1870 ensures that individuals and families in Washington state no longer face the threat of losing coverage due to a pre-existing condition, or because they reach a lifetime spending cap, along with other limits prohibited by the ACA. After the ACA was passed, the state’s uninsured rate dropped 61%, and the number of adults gaining coverage grew by 800,000.

Cleveland sponsored identical companion legislation in the Senate, ensuring that Washingtonians’ health care coverage would be protected regardless of which chamber passed its legislation.

House Bill 1870 requires that any health care plan sold in Washington state provide numerous consumer protections, including:

  • Strict annual limits on out-of-pocket costs to consumers, such as copays and deductibles;
  • Coverage cannot be denied based on a consumer’s existing medical condition;
  • Guarantees that patients can’t be dropped from coverage, except in cases of fraud;
  • Prevents patients from being charged more based on their health status;
  • Providers cannot cap the maximum cost of coverage or benefits in a patient’s lifetime; and
  • Provides patients with a standardized summary of benefits so they can more clearly understand what is covered.

The bill also codifies requirements for: outpatient care; emergency services; hospitalization; pregnancy, maternity and newborn care; mental health and substance abuse treatment; prescription drugs; rehabilitative services and equipment; laboratory services; preventive and wellness services and chronic disease management; reproductive care; breastfeeding; and pediatric services.

“This critical legislation means no one in the other Washington can eliminate our right to get the health care we need and deserve, for ourselves and for our families,” Cleveland said. “This will prevent anyone at the federal level from playing politics with our health care.”

House passes Senate’s comprehensive opioid legislation

April 16th, 2019|

Legislation passed today by the House would take multiple steps to address society’s growing opioid crisis.

“The opioid epidemic is taking a toll on communities around our state, at tremendous financial cost,” said Sen. Annette Cleveland (D-Vancouver), the sponsor of Senate Bill 5380. “The even greater toll, however, is to people and families. The opioid crisis claimed more than 700 lives in Washington last year and is now the leading cause of accidental deaths in almost every part of our state.”

Cleveland, who chairs the Senate Health Care Committee, noted that the Centers for Disease Control and Prevention estimates the total economic burden of prescription opioid misuse alone in the United States at $78.5 billion a year, including the cost of healthcare, lost productivity, addiction treatment, and criminal justice involvement. 

“Our communities are reeling from opioid misuse and abuse in too many ways to address with a single solution,” Cleveland said. “This legislation takes action on everything from length of prescriptions and prescription monitoring, to collaboration by multiple state agencies to develop a comprehensive, statewide approach to treating and preventing opioid use disorder.  The bill addresses prevention, education, treatment and swift responses to overdoes.”

Passed unanimously, SB 5380 would modify numerous protocols for using medications to treat opioid use disorder. It would:

  • Permit pharmacists to partially fill certain prescriptions upon patient request.
    • Require prescribers to discuss the risks of opioids with certain patients and provide the patient with the option to refuse an opioid prescription.
    • Establish new requirements for how electronic health records integrate with the state’s prescription monitoring program and how the data can be used.
    • Require the Health Care Authority and the Department of Health to partner and work with other state agencies on initiatives that promote a statewide approach in addressing opioid use disorder.
    • Permit the Secretary of Health to issue a standing order for opioid reversal medication and require pharmacists to provide written instructions for dispensing reversal medication for opioid overdoses.
    • Allow hospital emergency departments to dispense opioid overdose reversal medication when a patient is at risk of opioid overdose.

“The opioid crisis demands action, and it demands comprehensive action,” Cleveland said. “This legislation takes a broad approach, providing and directing our key health agencies to make opioid concerns a statewide priority. I know of no other crisis negatively impacting the health of so many in our state that is as dire, or as devastating as the opioid epidemic.  We must swiftly pass this bill to provide help, support and hope to all of those currently suffering. ”

Having been amended in the House, the bill now must go back to the Senate for reconsideration.

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    Legislature OKs bill expanding options for veterinary care for pets in low-income households

Legislature OKs bill expanding options for veterinary care for pets in low-income households

April 12th, 2019|

Humane societies will be able to offer a wide range of veterinary care for pets in low-income households at reduced fees, as a result of legislation passed today by the House on a 77-18 vote.

Senate Bill 5004, sponsored by Sen. Annette Cleveland (D-Vancouver), would remove severe state restrictions on the types of care that can be offered for reduced fees by animal care-and-control agencies and non-profit humane societies.

“At a time when more households are struggling to make ends meet, this will help people better care for their pets, relieve pain and suffering, and even avoid economic euthanasia,” Cleveland said. “For many people, including and especially our senior citizens, the cost of veterinary care is simply out of the question.”

When pets need care, people often turn to their local Humane Society for help, and yet, under current law, the help they can provide is severely limited.  Washington is one of fewer than 10 states that limit the range of services that humane societies can offer for reduced fees to include only vaccines, spaying or neutering, and microchipping. As a result, according to a recent Humane Society survey:

  • 60% of those seeking care for a pet do not regularly see a veterinarian;
  • 46% would need to borrow money to pay for treatment;
  • 65% would have their pets go untreated because they cannot afford treatment; and
  • 70% had to surrender aging or sick pets to be euthanized because they could not afford care.

“In households throughout our community, the mutual affection we share with our pets provides precious companionship, sometimes even someone’s primary companionship,” Cleveland said. “No one should have to watch a beloved companion suffer or die because of economic hardship.”

Cleveland’s bill would allow Humane societies to provide low-cost or no-cost veterinary services to low-income pet owners. Allowing emergency care and other services to those who meet specific income criteria would enable them to better care for their pets and avoid the stress, fear and delays in care that occur today. Households eligible for care must have an adjusted income less than 80 percent of the median family income, adjusted for household size, for the county where the household is located.

Having already passed the Senate, the legislation now goes to the governor to be signed into law.

Senate passes bill barring use of prior-wage information

April 12th, 2019|

Potential employers would be prohibited from requesting a job applicant’s wage or salary history, or require that their salary history meet certain criteria, under legislation passed today by the Senate.

“This landmark legislation will help eliminate the perpetuation of inequities suffered by women who have been paid significantly less on average than men with comparable experience doing comparable work,” said Sen. Annette Cleveland (D-Vancouver), a longtime champion for equal pay laws. “When someone has been underpaid for years, that inequity continues so long as future pay raises are calculated based on their past rate of pay. They never catch up, and they continue to lose money year after year compared to their male counterparts, on average.”

House Bill 1696 addresses this perpetual inequity three ways:

  • It prohibits an employer from seeking an applicant’s wage or salary history, or requiring that the wage or salary history meet certain criteria, with limited exceptions;
  • It requires employers to provide certain wage scales and salary ranges to employees and applicants, so everyone can know the expected pay range; and
  • It allows an employee to bring a civil action for actual damages; statutory damages equal to the actual damages or $5,000, whichever is greater; and interest, costs, and reasonable attorneys’ fees.

The legislation builds on actions by Cleveland in each on the past two legislative sessions to address inequities in pay based on gender.

In 2017, Cleveland inserted a proviso into the state’s operating budget to extend protections to employees who work for vendors that contract with six Washington state agencies. Those protections prohibit discrimination in compensation and provide remedies, including damages and civil penalties assessed by the state Department of Labor & Industries, and civil action brought by an employee.

In 2018, legislation sponsored by Cleveland extended those protections to employees of all businesses that operate in Washington state. The law also established protections for employees who are offered unequal workplace opportunities based on gender, and prohibited employers from requiring employees not to discuss their wages with each other.

Having been amended by the Senate, HB 1696 now goes back to the House for further consideration.

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    Senate passes legislation to protect patients from ‘surprise billing’

Senate passes legislation to protect patients from ‘surprise billing’

April 11th, 2019|

Legislation passed unanimously late Wednesday by the Senate will protect patients from being billed extra when they receive medical care involving an out-of-network provider.

“Patients should not be surprised by an unexpected medical bill when they receive health care,” said Sen. Annette Cleveland (D-Vancouver), who sponsored Senate legislation similar to House Bill 1065, the version that wound up as the vehicle for passage. “This bill to eliminate ‘surprise billing’ is one more way of ensuring patients are not caught in the middle when an insurer does not contract with a provider a patient receives their treatment from.” 

Surprise billing occurs when someone receives health care services performed by a provider who is outside their carrier’s network, and the provider bills the patient for the difference between what the provider has billed and the insurance plan chooses to pay. This typically occurs when someone needs to seek emergency care at an out-of-network hospital that is bound by federal law to treat the patient, or when someone receives care at an in-network hospital but receives care from an out-of-network provider who works there. Recent studies suggest that roughly 1-in-5 emergency room visits and 1-in-10 elective inpatient procedures result in the potential for a surprise bill.

“The financial consequences of these surprise fees can be devastating to a patient or their household,” Cleveland said. “If it’s more than the patient can afford and the bill is sent to collections, no one wins — the provider has to spend enormous effort to get the money and often never gets it, and the consumer’s credit history can be ruined.”

To protect patients in such cases, HB 1065 establishes an arbitration process in which the hospital and the out-of-network provider must negotiate their differences in fees, instead of passing additional costs on to patients, and ensures an evenhanded process for settling billing disputes between out-of-network providers and facilities and health carriers.

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    Cleveland: Passage of project legislation enhances I-5 bridge efforts

Cleveland: Passage of project legislation enhances I-5 bridge efforts

April 11th, 2019|

Legislation passed late Wednesday by the Senate will lay additional groundwork to replace the outdated I-5 Bridge, Sen. Annette Cleveland (D-Vancouver) said.

“The path to the new bridge demands patience and many steps, and this is one of those steps,” Cleveland said. “Each step moves us forward, and together these small steps will deliver the bridge and the major benefits it will bring our community and our regional economy.”

HB 1994 designates a new I-5 bridge as a project of statewide significance and requires the state Department of Transportation to assign a coordinator and identify a team that will coordinate efforts to facilitate its design and completion.

In related news, the Senate last week passed a transportation budget that includes $8.5 million toward the operation of an I-5 bridge joint office between Washington and Oregon. The office enables the two states to restart the process of designing and building a new bridge.

“I am gratified by this additional progress and will continue to tirelessly push forward toward successful replacement of the antiquated I-5 bridge,” Cleveland said. “This project is not only critical for our community, it is crucial to our state and region.”

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    Senate committee takes action to prevent future measles outbreaks

Senate committee takes action to prevent future measles outbreaks

April 2nd, 2019|

Legislation to address the health threat posed by the ongoing measles outbreak in Clark County awaits a vote of the full Senate after a key committee recommended its adoption. 

“At a time when internet myths and alternate facts make it harder for people to know the truth about the science-based measures that keep our communities safe, we are taking action to protect the public health from highly contagious diseases,” said Sen. Annette Cleveland (D-Vancouver), chair of the Senate Health Committee. “Exposure to measles is a major threat to babies, pregnant mothers and people with compromised immune systems, and can be easily and safely prevented.”

As recently as 1964, more than 20,000 Washingtonians suffered exposure to measles in a single year, but the introduction of the current measles vaccine in 1968 reduced exposures to mere hundreds, Cleveland noted. By the year 2000, the nation was able to declare measles eradicated. Since then, however, an internet-fueled movement against vaccinations has led to a rise in unvaccinated children, with measles exposures reaching a 20-year high in 2014. In 90% of those cases, the measles patients either had not been vaccinated or their vaccination status could not be determined.

“Every credible organization, every science-based policy, and every peer-reviewed study consistently shows that vaccinations easily and safely prevent measles,” Cleveland said. “Most people understand this, but the loud voices of a passionate minority have sowed confusion and controversy about these reliable immunizations that have kept us safe for generations from diseases that once were common.”

House Bill 1638 would eliminate the personal belief exemption from vaccinations for measles, mumps and rubella (MMR) while retaining medical and religious exemptions. A broader Senate bill sponsored by Cleveland would have removed the personal belief exemptions for all required immunizations but failed to pass out of the Senate in time to meet a key legislative deadline.

“It’s essential we take action to keep the public safe from these highly contagious diseases, as the outbreak in Clark County shows right in our back yard,” said Cleveland. “The threat of contagion is real and it is serious, not only to other students but especially to infants too young to be vaccinated, to children and adults with depressed immune systems due to disease or cancer treatment, and to pregnant women.” 

Cleveland’s amendment, adopted Monday in committee, removed language from five Republican amendments that had weakened the bill and retained language from a Democratic amendment that strengthened it. That amendment prohibits employees or volunteers from working at licensed child day care centers unless they present proof of immunization for the MMR vaccine or proof of immunity to measles from a health care provider or laboratory. The amendment provides for two exceptions: employees and volunteers for whom MMR immunization is certified as inadvisable by a health care practitioner; and employees or volunteers who have received the MMR vaccine or are immune from measles but need time to obtain and provide the records.

“We must take swift action now to prevent any additional needless suffering and the potential of death from this latest serious outbreak,” Cleveland said. “We must not forget that in the U.S., vaccine-preventable infections kill more people annually than breast cancer, HIV/AIDS, or traffic accidents. Approximately 50,000 adults die each year from vaccine-preventable diseases in the U.S.”

Diseases not only undermine the health of individuals and their families but also carry a high price tag for society as a whole, exceeding $10 billion per year in direct and indirect costs, Cleveland said. The measles outbreak in Clark County alone has so far cost the public over $1 million dollars.

The measles outbreak in Clark County has been declared a state of emergency by Gov. Jay Inslee and, among other things, has caused many children to miss school either due to illness or preventive measures by school administrators, Cleveland noted.

The number of confirmed measles exposures in Clark County has reached 73, with 53 cases between ages 1-10; 15 in ages 11-18, one case in ages 19-19; and four cases in ages 30-39. Sixty-three of the 73 had not been immunized, and three others had received a single MMR vaccine but not the second; the immunization status of the remaining seven others could not be verified. “Before the current vaccine became available, annual exposures were typically in the thousands, often topping 20,000; vaccinations eventually reduced the number of exposures to the hundreds and then to double digits for several decades now,” Cleveland said. “The central question before us is whether the right of one person to refuse a vaccine outweighs the rights of the larger community to be protected from a disease, and the numbers give a pretty definitive answer.”

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    Legislature sends bill to governor’s desk protecting health care

Legislature sends bill to governor’s desk protecting health care

April 2nd, 2019|

Health care policies sold in Washington must honor existing patient protections even if those standards are eliminated by action taken at the federal level, under legislation passed Monday by the state Legislature.

House Bill 1870 had passed the House on March 1, but the Senate amended it to include an emergency clause last week after the U.S. Justice Department asked 5th Circuit Court of Appeals in New Orleans to uphold an earlier Texas court ruling that the Affordable Care Act (ACA) is unconstitutional. That ruling, which is under appeal, would rescind the ACA and a wide range of important consumer protections. The emergency clause, which required the House pass the bill a second time, means Washington’s law will take effect immediately upon its signing by Gov. Jay Inslee.

“We know the Trump administration has vowed repeatedly to repeal the ACA, and last week’s actions prompted us to get these protections into law as quickly as possible,” said Sen. Annette Cleveland (D-Vancouver), who sponsored the amendment to add the emergency clause. “We’re just a signature away from protecting Washingtonians from losing the health care they need, regardless of what the White House or the courts do.”

As chair of the Senate Health Care Committee, Cleveland has made protecting and maintaining the gains made in health care coverage for citizens in Washington state a priority. 

“Washington State has benefited from the federal Affordable Care Act that put in place health insurance protections families and individuals have come to depend on, including no longer facing the threat of losing coverage due to a pre-existing condition, or due to reaching a lifetime spending cap,” said Cleveland. “As a result, our state’s uninsured rate has dropped 61%, and the number of adults gaining coverage grew by 800,000.”

Cleveland sponsored identical companion legislation in the Senate, ensuring that Washingtonians’ health care coverage would be protected regardless of which chamber passed its legislation.

“In the face of continued efforts at the federal level to roll back this progress, it was crucial for us to take action now to bring key components of these health reforms into state law,” she said. “I am pleased our citizens can now have greater certainty that their health care coverage is not in jeopardy.”

House Bill 1870 requires that any health care plan sold in Washington state provide numerous consumer protections, including:

  • Strict annual limits on out-of-pocket costs to consumers, such as copays and deductibles;
  • Coverage cannot be denied based on a consumer’s existing medical condition;
  • Guarantees that patients can’t be dropped from coverage, except in cases of fraud;
  • Prevents patients from being charged more based on their health status;
  • Providers cannot cap the maximum cost of coverage or benefits in a patient’s lifetime; and
  • Provides patients with a standardized summary of benefits so they can more clearly understand what is covered.

The bill also codifies requirements for: outpatient care; emergency services; hospitalization; pregnancy, maternity and newborn care; mental health and substance abuse treatment; prescription drugs; rehabilitative services and equipment; laboratory services; preventive and wellness services and chronic disease management; reproductive care; breastfeeding; and pediatric services.

“This critical legislation will reassure Washingtonians that no one in the other Washington can eliminate their right to get the health care they need and deserve, for themselves and for their families,” Cleveland said. “We’re not going to let anyone play politics with people’s health care, at least not in Washington state.”