2007 Legislative Session Wrap-up

Every year, WHF works to advance a select set of health policy priorities to move Washington closer to becoming the healthiest state in the nation. Here's a run-down of WHF's efforts during the Washington State Legislature's 2007 session.

Improve Public Health System Performance and Capacity

In the United Health Foundation's 2006 state health rankings, Washington again ranked 44th nationally in public health spending, at $81 per capita. This is one of Washington's greatest measurable weaknesses in terms of state health. It translates to deficiencies in Washington's public mental health and substance abuse treatment programs, emergency preparedness, infectious disease control, environmental health, public health assessment, prevention and treatment of chronic diseases, and medical care safety net programs.

The bipartisan Joint Select Committee on Public Health Financing, appointed in 2005 to study this problem, found that local public health systems are in a state of deterioration as a result of chronic under-funding and expanding populations. The committee recommended a down payment of $100 million to start bridging the most urgent gaps in Washington's public health system.

In agreement with the committee's recommendations, WHF actively supported companion bills HB 1825 and SB 5729 which sought to provide dedicated funding for public health services, and equally important to WHF, to improve accountability for use of these funds. As of this writing, it appears that the legislature is responding to WHF and the joint select committee's recommendations with its own version of a "down payment" — $20 million. Although this figure is only a fraction of what Washington needs to bridge its public health gaps, it is a twenty-million-dollar step in the right direction for which WHF is grateful.

Provide Health Homes for All; Children First

WHF's concept of a "Health Home" is the product of a number of factors: a family's trusted relationship with a knowledgeable health provider, timely receipt of proven preventive care, the development of a personal wellness plan, and the compilation of all health records in a single location. As a first step toward our ambitious goal, WHF actively supported legislation establishing Health Homes for all children in Washington by 2010. WHF sought in 2007 for targeted education and outreach, expansions in public and private insurance programs, and improvements in proven school health and public health services.

Because of the broad nature of Health Homes, a number of bills considered by the legislature this year fell within the purview of this policy priority. But one bill provided perhaps the best demonstration of the health home concept — SB 5093, Concerning access to health care services for children, which goes into effect in July of this year. Consistent with WHF's policy priority, this bill sets out to accomplish several goals: 1) Provide affordable health coverage for all children with family incomes at or below 250 to 300 percent of the Federal Poverty Level; 2) Support proactive and targeted outreach efforts to connect eligible children with the appropriate coverage; and 3) Set several key goals for school health that include creating school health advisory committees, moving toward healthier food and beverages, and providing 150 minutes per week of physical exercise for students in grades 1 through 8.

WHF counts as an accomplishment the fact that the objectives of SB 5093 are nearly perfectly aligned with WHF’s designated "first steps" toward providing Health Homes for all.

SB 5930, Providing high quality, affordable health care to Washingtonians based on the recommendations of the blue ribbon commission on health care costs and access, was passed by the Senate and House and delivered to the governor for her review. The Blue Ribbon Commission was established by the 2006 Legislature to develop a five-year plan for improving health care affordability and access for all Washingtonians. SB 5930 was developed in response to the commission's recommendations. The proposed projects delineated in SB 5930 are too varied to list here, but bill expands insurance coverage to more Washingtonians, enrolls more chronically ill persons in "health homes", improves health information systems and the use of evidence in health care decision making, emphasizes wellness and preventive care and otherwise advances WHF's Campaign objectives. WHF supports the primary thrust of this legislation and optimistically awaits the governor's decision on the bill.

Next Steps Toward Closing the Health Disparities Gap

Health disparities are differences in the incidence or prevalence of illnesses, injuries, deaths or receipt of health services between sub-groups within the population. In Washington, as in other states, these disparities are prominent between racially, ethnically, economically, and educationally disadvantaged individuals and others. WHF focused health disparities reduction efforts this year on educational attainment (perhaps the strongest single health determinant) and other disparities in the state's treatment of racial and ethnic groups. This included support for the following measures:

SB 5841, Enhancing student learning opportunities and achievement, passed the Senate and House and has been forwarded to the governor for her review. The bill makes many improvements to Washington's schools, based on the recommendations of the governor's Washington Learns study in what promises to be a thoughtful beginning in addressing health disparities — namely the disparities that result from the education achievement gap. The bill begins by amending the state's goals in basic education in ways that emphasize academic success for all students toward becoming "responsible and respectful global citizens". Specific goals include understanding cultural diversity. The bill goes on to phase in full day kindergarten, beginning in our state's poorest school districts, with links to early learning programs. It establishes several intensive demonstration programs in grades K-3 for English Learners, and seeks to use the experience to train future teachers. It creates tutoring programs, fixes holes in the special education safety net and much more. Combined with a state biennial budget that funds class size reductions, teacher salary increases, incentive scholarship programs and more, the legislature made this session a good one for education generally, and took some important first steps to improve education for racial and ethnic minority kids suffering the education achievement gap.

HB 1573, Authorizing a statewide program for comprehensive dropout prevention, intervention, and retrieval, as of this writing, passed both houses and is awaiting signature by the Governor. This bill creates local partnerships of schools, families, and communities who can provide dropouts or students at risk of dropping out of school with assistance and support to facilitate the continuation of their education. This is an important step toward closing the achievement gap between the Caucasian majority and the racial, ethnic and economic minorities.

SB 5268, Requiring reviews and revisions of the essential academic learning requirements, did not make it out of its house of origin this legislative session, but it will be eligible for reconsideration during the 2008 session. This bill sought to establish routine reviews of Washington's mandated learning requirements to ensure that they are culturally relevant.

HB 1472, Analyzing and remedying racial disproportionality and racial disparity in child welfare, as of this writing, passed the Senate and House, and is awaiting signature by the Governor. This bill establishes an advisory committee to analyze and make recommendations on the disproportionate representation of children of color in Washington’s child welfare and juvenile justice systems.

While WHF applauds the legislature for the passage of HB 5841, HB 1472 and HB 1573, we look forward to increased public awareness that the health disparities problem should continue to be addressed in the doctor's office, communities, schools, public welfare programs, and other non-medical settings.

Healthy Eating and Active Living

WHF supports policies that make meaningful changes to promote healthy eating and active living — especially in the environments where people spend the majority of their day, including schools, workplaces, and communities. To this end, we actively supported numerous bills in the legislature this session, many of which revolved around the schools as a crucial setting for promoting healthy eating and active living. Here's a brief run-down of these bills:

While HB 1188, Requiring physical activity opportunities every school day, did not make it out of its house of origin, its primary purpose was incorporated in SB 5093's state goal for schools of providing 150 minutes of physical activity per week. If necessary, HB 1188 remains eligible for reconsideration during the 2008 session..

Companion bills HB 1550 and SB 5438, Creating the Washington community learning center program, both died in their houses of origin. As with all bills that did not make it out of their house of origin, they will be up for reconsideration during next year's session.

HB 1588, Providing mobility education to students in driver training programs, did not pass the Senate. This bill proposes to expand driver training programs to encompass broader transportation issues such as the use of mass transit and the awareness of bicyclists and pedestrians. WHF believes that alternative forms of transportation are key to healthy communities and active living, therefore transportation training programs should not be limited to automobile driver training alone.

HB 1677, Creating the outdoor education and recreation grant program for schools and others, passed the House and Senate, and was signed by the governor on April 21. This grant program targets the schools and students with the greatest academic needs, using outdoor classrooms as a means of re-connecting children with nature while reinforcing the science curriculum.

SB 5665, Establishing the state employee health program and a state employee health demonstration project, was incorporated into SB 5930 which is awaiting the governor's decision.

SB 5415, Creating health advisory councils, died in the Senate Committee on Ways and Means, after the Senate Health Committee enthusiastically endorsed a WHF package of amendments to the bill that would have required some $5 million in new funds for coordinated school health demonstration programs in a limited number of schools with lower than median WASL scores and higher than median proportions of free and reduced breakfast and lunch students. As with all of the bills that did not pass the legislature this year, it will be eligible for reconsideration during the 2008 session.

Although these bills collectively represent some forward progress, particularly within Washington's schools, WHF believes that this progress should be expanded to include even greater numbers of workplaces, communities, and public health realms. For example, we encourage the use of workplace wellness programs in both government and private settings. We support action by restaurants to offer healthier choices and transparency of nutritional information. We hope to see city planning that incorporates pedestrian- and bike-friendly routes and effective mass transit. In the meantime, WHF will use its Healthiest State in the Nation Campaign to continue promoting healthy eating and active living for all Washingtonians.

Note:

As of this writing, Governor Christine Gregoire has not yet acted on all of the bills that were passed by the Washington State Legislature's 2007 session. Therefore, some of the statements put forth here are reasonable predictions — rather than confirmed outcomes.

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