Supporting emergency medical services in rural hospitals

Providing health care in rural regions presents unique challenges. Providers and patients deal with remote geographic locations, small or outdated facilities, limited workforce and physician shortages, and often limited financial resources. Without a bill prime-sponsored by Rep. Matt Manweller last year, many small public hospitals would have likely lost their emergency medical services. Can you imagine living in a town of about 2,000 people and being two hours from the nearest health care facility?

It is common practice for the Washington State Legislature to adopt changes to retirement plans to ensure our pension systems are continually financially stable and secure, and our pension system strong.

However, in the years leading up to 2005, the Legislature passed a number of laws related to the Law Enforcement Officers’ and Fire Fighters’ (LEOFF) retirement system and the regulation of Emergency Medical Technicians (EMTs). The result was a series of contradictory or unclear laws. The interpretation of the laws was not shared with public hospital districts until 2011. At that time, the Department of Retirement Systems (DRS) sent letters to all hospital districts that employed EMTs giving notice that, under their interpretation of the law:

  1. Any person with an EMT license working for a hospital district was required to join the LEOFF program.
  2. That provision was retroactive to 2005.

This would have required the hospital districts to pay into LEOFF both the employer share and the employee share and then attempt to recover the employee share from employees (who in many cases had retired or died).

Without a change to the law or the interpretation by the DRS small public hospital districts such as Lincoln Hospital in Davenport, Odessa Memorial Healthcare or East Adams Rural Healthcare in Ritzville could be facing bankruptcy.

Rep. Matt Manweller, one of the legislators on and now chair of the Select Committee on Pension Policy, began working with stakeholders to solve the issue. He was the prime-sponsor of House Bill 2202.

The Legislature passed House Bill 2202 in the 2017 session and the governor signed the bill into law on May 16. Now, many small hospital districts are able to continue to provide access to emergency medical services. The Association of Washington of Public Health Districts (AWPHD) says there is no question the services would have gone away.

For hospital districts with larger programs and full time EMTs, the legislation also made a significant difference. Hospital districts like Chelan Public Hospital District #1, Cascade Hospital in Leavenworth, and Whidbey Island Hospital District in Coupeville, the cost savings was in the millions of dollars.

It also enabled larger public hospital districts that employ full time EMTs to move forward in a way that enabled the EMTs to participate fairly without unreasonable and unnecessary costs. The existing law would have also kept the window open indefinitely meaning the hospital districts would never be able to close their books on the issue. The AWPHD conservatively estimate that the savings to all our hospital districts that have EMS programs was at least $10 million. For those who live in rural areas who need emergency care, they may view the legislation as much more valuable than that.