A look at the recently wrapped session: Washington legislators discuss new women’s, youth health laws


Shane Ersland


Several bills that aim to improve the health of women and children, and increase access to dental care were passed during this year’s legislative session—which ended on April 12th—in Washington. Leaders of three of the legislature’s health committees discussed how these bills will help Washingtonians with State of Reform.


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Addressing the needs of Washington’s children

Rep. Tana Senn (D-Mercer Island) chairs the House Human Services, Youth, and Early Learning Committee. She worked on several bills that will help Washington youthsincluding those with developmental disabilitiesaccess needed services.

House Bill 1188 will ensure that children with disabilities in foster care have equitable access to the same developmental disability services as their peers. Washington foster youths were previously unable to access developmental disability services. The bill will expand the Children’s Intensive In-Home Behavior Support Services waiver, and require Medicaid waiver services to be provided to eligible individuals who receive certain child welfare services no later than Dec. 1st, 2024.

“Now, foster youth can get added to the waiver,” Senn said. “They shouldn’t have to suffer just because they’re in foster care.”

HB 1407 helps children maintain eligibility for developmental disability services. If a child is diagnosed with a developmental disability at a young age, the diagnosis is usually indefinite, but there were previously barriers to accessing ongoing support. HB 1407 eliminates those barriers by eliminating the redetermination process for a child under 18 based solely on their age.

“Currently in Washington, families have to reapply for developmental disability services when they’re age 10,” Senn said. “If they qualify any time before age 10, they have to reapply even though there is zero medical reason to. We eliminated that; there’s no more redoing it at age 10. It’s a big boon for families to stay covered and not have to reapply.”

HB 1580 requires the governor to maintain a children and youth multisystem care coordinator to serve as a state lead on addressing complex cases of children in crisis. 

“It creates a multi-agency group that will assist hospitals, and help make sure that whatever that kid needs, they find a way to get them into the home with the services they need,” Senn said.

Senate Bill 5599 provides protections for runaway or homeless youths seeking protected healthcare services. The bill garnered some conflicting testimony during committee hearings.

“That ensures youth seeking gender-affirming care can have access to services,” Senn said. “The bill had nothing to do with the actual medical care delivery, it was just saying these children should not be homeless. The Department of Children, Youth, and Families will work with the child now. They can check for safety issues, and provide services as well.”

HB 1394 creates a developmentally appropriate response to youth who commit sexual offenses. It places limits on when a juvenile is required to register in the sex offender registry based on committing a sex offense, reduces the time period a person adjudicated in juvenile court must register as a sex offender to two or three years, and reduces the classification of failing to register as a sex offender to a gross misdemeanor for individuals who are required to register based on the commission of a juvenile sex offense.

“It aims to try and break the cycle of sex abuse,” Senn said. “We are increasing the use of therapy to ensure more of the youth sex offenders get therapy and less sex registration. Sex registration leads to kids being homeless, being sex-trafficked themselves, and it’s not healthy for anybody. They were just being punished and had no therapy. This keeps families whole and breaks the cycle of sex abuse. A significant number of sex abusers were abused themselves.”

Providing needed services for women

Sen. Ann Rivers (R-La Center), ranking member of the Senate Health and Long Term Care Committee, worked on several bills that will be helpful for women seeking healthcare services, including HB 1745.

HB 1745 will increase diversity in clinical trials, something Rivers has been trying to achieve for several years.

“Five sessions after I began introducing legislation to increase diversity in clinical trials of medications and medical devices, the idea is finally becoming law, albeit as a House bill,” Rivers said. “This is huge. It’s no coincidence that members of certain communitiesparticularly women, and especially women of colorare dying of disease at higher rates than other groups, considering how they are underrepresented in such studies.”

HB 1745 will require the Washington State Institutional Review Board to establish a program to increase diversity in clinical trials. It will require the Department of Health (DOH) to provide recommendations to increase participation by underrepresented groups in clinical trials and provide a report to the legislature. It will also authorize the Andy Hill Cancer Research Endowment to provide grant funding to community-based organizations to provide outreach and engagement for specific clinical trials at the request of educational institutions based on community outreach.

“I’m amazed it took so long for a bill with ‘diversity’ in the title to receive majority support, but now we’ll be on a path to seeing better medications,” Rivers said. “I’m delighted that the entities to be involved in this important work will include the Andy Hill Cancer Research Endowment, named for my late friend, who was one of our state’s most distinguished senators.”

SB 5581 will direct The Office of the Insurance Commissioner to develop strategies to reduce or eliminate deductibles for maternal support services and postpartum care. 

“The needs of women who choose to give birth fall into the category of reproductive healthcare, but have been overlooked,” Rivers said. “This is another good new law from Sen. Ron Muzzall (R-Oak Harbor), which I was glad to co-sponsor, because it’s about reducing or eliminating deductibles for maternal support services and postpartum care.”

The passage of SB 5396 means that health carriers for health plans that include coverage of supplemental breast examinations and diagnostic breast examinations cannot impose cost sharing for those examinations beginning on Jan. 1st, 2024.

“Out-of-pocket costs can be high for diagnostic and supplemental breast exams that may be needed after a mammogram,” Rivers said. “This new law will end the cost sharing by plans that cover such exams, which removes a financial barrier to diagnoses and treatment.”

The legislature could have done more to improve women’s health by passing SB 5580, Rivers said. The bill would have increased the federal poverty level (FPL) threshold for pregnant and postpartum individuals eligible for Medicaid from equal to or below 193% to 210% of the FPL. It would have directed the HCA to create a post-delivery and transitional care program for individuals with substance use disorder at the time of delivery, allowing for extended post-delivery hospital care.

“This is another bill to address the needs of women who have substance use issues and choose to give birth,” Rivers said.

The committee also worked on laws that aim to supplement the state’s nurse workforce. SB 5499 will enter Washington into the Nurse Licensure Compact, which expedites licensure for registered nurses (RNs) and licensed practical nurses (LPNs) who are already licensed in another state. It allows RNs, LPNs, or vocational nurses to have one multi-state license in order to practice in their home state and other compact states without obtaining additional licenses.

“I was glad to work across party lines to co-sponsor this new law, which makes Washington the 40th state to join the Nurse Licensure Compact,” Rivers said. “(It) will address the nursing workforce shortage by expediting the licensure for RNs and LPNs across state lines.”

SB 5582 will reduce barriers and expand educational opportunities to increase the supply of nurses in Washington.

“The aim of this new law is to address the demand for nurses in Washington through better access to training and education,” Rivers said. “It includes support for a pilot project that expands training opportunities for rural and underserved students.”

Rivers also would have liked to see the legislature pass SB 5716, which would have directed the Joint Legislative Audit and Review Committee to conduct a performance audit of the on-site monitoring, state licensure, and validation surveys performed on in-home services agencies.

“I see it as a way to ensure accountability by the executive branch agencies that perform those surveys,” Rivers said. “So did every other senator and every member of the (House Health Care and Wellness Committee). Then it mysteriously became another casualty of the House Appropriations Committee.”

Improving access to dental services

Rep. Marcus Riccelli (D-Spokane) chairs the House Health Care & Wellness Committee. This session provided him with an opportunity to work on some bills that will aid the dental sector. He became focused on dental issues after working with a man who informed him he was having problems gaining access to the care he needed, and spent a lot of time going in and out of emergency rooms (ER). 

“I came to the legislature with not a ton of background in oral health issues,” Riccelli said. “I went to meet with some activists for particularly low-income issues, and met a guy who talked about his ER experiences. I got interested in the issue. It’s personal for me because he died at age 37. Dental therapy had been a contentious issue for years. I told folks we’d open the door to look at scope. l said if it’s safe, if it increases access and doesn’t increase cost to the system, then we should take a look. I thought we could work on a path.”

Riccelli coordinated with lawmakers to pass legislation that will provide needed dental therapy services in the state. HB 1678 will allow for dental therapy in limited settings. Dental therapists, under the supervision of a dentist, can now fill cavities and perform emergency emergency services if authorized by the dentist. The bill’s passage required careful coordination with his legislative counterparts, Riccelli said.

“It was going line by line, working with members about their concerns, and I think a more limited setting was key,” he said. “This is only allowable at federally-qualified health clinics, which see a large Medicaid population. If you get online to try and find a dentist, for Medicaid patients, there are some real challenges. In Spokane, we have the NATIVE Project, and in Seattle, there’s the Indian Health Board. So it expands there. Not all places want to do it, but for those who do, this expands access. It’s been a decade-plus trying to work on something like that.”

Riccelli’s HB 1466 also passed. The bill renames the “limited” license as a “temporary” license for dental hygiene license, and extends the license from 18 months to five years to allow hygienists more time to get licensed while working in the field.

His HB 1503 will require health professionals to submit demographic information upon initial licensure and renewal. 

“That looks at the diversity in our providers, and it will help us understand how we can do a better job training people from communities of color,” Riccelli said. “The information will help us have a culturally competent workforce. It’s important for patients to meet with people with similar lived experiences. 

It will require the DOH to collect important information about the demographics of our providers. We need a more diverse workforce, and we can invest in recruitment and incentivizing. The goal is to give people the ability to find providers they are comfortable working with.”

Riccelli felt lawmakers could have focused more on healthcare cost transparency. HB 1508 did not pass, but it would have directed the Health Care Authority’s Health Care Cost Transparency Board to conduct an annual survey of underinsured residents, and study how state tax preferences affect the calculation of healthcare expenditures.

“The insurance industry was concerned about it,” Riccelli said. “There were some fair arguments around it where we were headed toward not taking into account inflation. We have to have accurate data and take into account things like inflation and the drivers of healthcare costs. If you look at what other states are doing, they have data and transparency [tools] to make sure they’re not gouging people on costs. Other states are passing it, and that’s the way to go.”

Riccelli hopes lawmakers will revisit the issue in future sessions.