LEGISLATIVE STEERING COMMITTEE AGENDA - Wacounties.org

LEGISLATIVE STEERING COMMITTEE
AGENDA
OCTOBER 5, 2012 – 11:00AM TO 2:00PM
HAL HOLMES CENTER – ELLENSBURG, WA
11:00am – Welcome & Introductions
Pages
11:05am – Co-Chair Remarks & Approval of Agenda & Minutes (Action Item) 2
Hon. Kathy Lambert & Hon. Dave Sauter
11:10am – Framework for the 2013-2015 Legislative Agenda (Action Item) 3-7
Eric Johnson
12:00pm – Break to Bring Lunch to Table
12:30pm – LSC Operating Procedures (Action Item) 8-13
Josh Weiss
1:10pm – Public Outreach Campaign Plan (Action Item) 14
Michelle Nelson
1:40pm – WSALPHO 2013 Legislative Requests (Action Item) 15-18
Brad Banks
2:00 – Adjourn
1

LEGISLATIVE STEERING COMMITTEE
MINUTES
March1st, 2012 – 8:00 AM TO 10:00 AM
WASHINGTON PUD ASSOCIATION BUILDING – OLYMPIA, WA
Members Participating:
T. Mielke, H. Welch, B. Koch, L. Pratt, P. Johnson, C. Swartz, D. Snyder, R. Walter,
L. Merrill, B. Brady (Wahkiakum), J. Koster, L. Ring-Erickson, D. Wear, P. Pearce, D.
Sauter, K. Lambert, G. Tompkins, K. Bouchey, D. Dashiell, M. Boldt, G. Raiter, L.
Grose, D. Bly, M. Doherty, R. Plager, A. Homola, O. O’Brien, L. Ayers, T. Farrell, R.
Gelder
Others:
B. Banks, B. Brady (Pierce), J. Weiss, M. Brown, S. Merriman, R. Gupta, G. Rowe,
B. Taylor, G. Adkins, B. Enslow, T. McBride, N. Aaland, J. McMahan, M. Shaw
The LSC Co-Chairs provided remarks and welcomed the LSC
members
Approval of Minutes
Commissioner D. Snyder moved approval of the February 16 th meeting minutes.
Commissioner K. Bouchey seconded the motion. Motion carried.
House Revenue/Reform/Reduction Bill
WSAC staff recommends opposing the proposed revenue sweeps and seeking
diversity in the revenue options.
Commissioner P. Pearce moved approval of the House R/R/R Bill. Commissioner L.
Grose seconded the motion. Motion carried.
Meeting Adjourned
2

October 5, 2012
TO:
FROM:
PREPARED BY:
SUBJECT:
WSAC Legislative Steering Committee
Eric Johnson, Executive Director
Policy Staff
Framework for the 2013-2015 Legislative Agenda
Setting a New Course
At the conclusion of the 2012 Legislative Session, WSAC took the opportunity to evaluate our organization and
review our legislative accomplishments. It was clear from this analysis that we needed to chart a new course
to achieve the type of success we desired and our members expected from our legislative program. Following
that realization, WSAC embarked on several endeavors to solicit input from our membership on how to refocus
our legislative strategy with the aim of achieving significant fiscal and legislative outcomes.
Member Survey
In the spring of this year we conducted a survey of WSAC members and key affiliates. We received 140
responses. Specifically we asked what are the most pressing issues facing your county. Roughly half of all
responders indicated that revenue was the greatest concern moving forward. This included concerns about
the stability of existing revenue, potential loss of either state or federal revenue, and the lack of diversity of
current county revenues. A significant number of responders were also concerned about their ability to
continue to provide services in light of the rising costs of providing those services, particularly labor costs and
costs related to criminal justice and the courts.
We also asked if there were specific legislative changes that would help address these issues. New revenue
and revenue flexibility were commonly requested, as were changes to the Public Records Act and tort reform.
LSC Retreat
WSAC held its first ever Legislative Steering Committee retreat in May. Over the course of this multiday
workshop, LSC members identified that our legislative efforts need to be better organized, more strategic in
their direction, and tied to a broader communication and education effort.
Four workgroups were created that delved into greater detail on these identified concerns. These groups
were: Communications & Education, LSC Operations, Finance, and Reform.
Two workgroups, Communications & Education, and LSC Operations made enough progress at the retreat that
they did not meet again. Based on the members’ guidance, staff developed LSC Operating Procedures and a
3

Public Outreach Campaign Plan for consideration and approval. Those recommendations are included in
separate documents.
Finance and Reform Workgroups
The Finance and Reform Workgroups continued to work through the summer. The Reform Workgroup
reached consensus of several key issues concerning the structure of the reform agenda. They concluded that
the agenda should have a narrow focus and have a clear set of limited priorities. The workgroup also
developed a set of criteria to consider when determining whether or not a reform idea should be a WSAC
priority:
1. Likelihood to achieve a meaningful policy change. Factors include, political opportunity, potential
savings/efficiency for counties and state, and timeliness of issue
2. Yields greatest result for greatest number of counties
3. Number of counties that would utilize proposed reform
4. Alignment with WASC's mission and policy statement
Public records, liability, and personnel reform all ranked very high on the workgroup members' list of reform
ideas. The results of this exercise confirmed the input from the WSAC survey as well as the preliminary work
done during the May LSC retreat.
The Finance Workgroup met twice by phone after the retreat. Staff provided a list of budget and finance ideas
that WSAC has considered over the last several years. The workgroup recommended that the LSC place
ideas into tiers in order to focus our efforts.
Similar to the Reform Workgroup, the Finance Workgroup went through an exercise to rank ideas, using the
same criteria. We did not receive a particularly large number of responses to this request, and several
members utilized inconsistent ranking approaches. This made it difficult to draw strong conclusions from the
ranking process. However, based on this exercise, the following ideas rose to the top:
1. Flexibility to use permit fees for long-term planning
2. Flexibility to use Public Works Trust Fund for a broader range of capital projects
3. New transportation/transit funding
4. Increasing the 101% property tax limit by tying it to inflation
A Framework for WSAC’s Legislative Agenda
Over the course of our work this interim a consistent message has emerged: our legislative approach should
more clearly delineate which proposals have a high likelihood of being achieved in the short term, and which
items required greater stakeholder and legislative work. There is a strong desire that we integrate a
communications and education strategy into our legislative approach, so that we are building support for our
priorities over time.
Our recommendation for this approach is described in more detail in the attached Framework document. The
document separates issues identified by the Finance and Reform Workgroups into those that are ready for
immediate action in the 2013 legislative session, and those that require concerted effort over time. It also
identifies the types of strategies and tactics we intend to employ to build stakeholder and legislative support for
the issues that are not ready for immediate success.
4

We are deeply committed to achieving measureable outcomes from this approach. It is difficult to quantify
discrete goals and objectives at the outset of this process, but WSAC staff will endeavor to integrate such
goals as we continue to refine our approach.
The Framework document is not intended to be used outside of WSAC. Staff will develop other
communication pieces, including a Legislative Agenda, for external use.
Recommendation
WSAC staff recommend that the proposed Public Outreach Campaign Plan and LSC Operating Procedures be
adopted.
WSAC staff also recommend adoption of the Framework document, and should implement a legislative
program consistent with this Framework. This will include not only the identified legislative requests for the
2013 legislative session, but also the implementation of actions intended to advance finance and reform ideas
that cannot expect immediate success. At the November LSC meeting, staff will propose a Legislative Agenda
document that is consistent with the Framework, and that can be used for external audiences.
5

Framework for the 2013-2015
Legislative Agenda
Our goal is to accomplish significant legislative successes in the next two years. Doing so requires a
dramatically different approach than what WSAC has attempted before. We propose a multi-year
campaign involving an integrated outreach, media, and legislative strategy.
The WSAC legislative approach is divided into two components. For more difficult issues, we will
focus on creating a foundation for future success. When success appears to be likely on an issue,
and the groundwork for success has been prepared, WSAC will pursue direct legislative action.
Creating a Foundation for Success
Many of WSAC’s current legislative priorities lack the legislative and stakeholder support necessary
to expect that a solution will be achieved in the near future. For example, it is well established that
counties have a structural problem in the way they are financed; yet WSAC has been unable to
advance legislative proposals that address this problem, either on new revenue or needed reforms.
Attaining a solution on these difficult issues requires a step-wise approach and employing a variety of
tactics, such as:
• Working internally with the county family to identify potential solutions
• Educating legislators about the scope of county responsibilities and the issues we face
• Conducting outreach to key stakeholder groups to assess what they might support and what
they might need from us in order to support our solutions
• Developing messaging
• Preparing and initiating a media strategy
• Identifying potential partners and opponents
• Mobilizing affiliates and partners
• Refining solutions based on member and stakeholder feedback
• Converting solutions into legislative language
• Identifying key legislative and stakeholder leaders
• Developing our lobbying strategy
For issues that are placed into this category, we do not expect to introduce legislative requests until
there is a reasonable chance of passage. WSAC will always take advantage of legislative
opportunities that arise serendipitously. However, staff will spend their effort on activities intended to
build a foundation for success over time.
6

Pursue Meaningful Change Now
During the development and implementation of the multi-year campaign, WSAC will focus its
proactive legislative efforts on ideas that have a reasonable likelihood of adoption. Based on work
that has been done, we recommend pursuing legislation in the 2013 legislative session in the Reform
and Finance categories on the following topics:
Public records: Provide the opportunity to legally enjoin harassing requestors, expand the definition
of copying to include digital transfer.
Binding interest arbitration: Require the arbitrator to consider ability to pay and create a definition
of comparables.
Liability: Seek a limitation on joint and several liability. Allow the admissibility of seatbelt usage in
tort cases.
Exempt wells: The WSAC Exempt Well Work Group has been working over the summer to develop
a legislative proposal that would provide greater clarity for the use of permit exempt wells. The Work
Group has included legislators, and should have a legislative proposal developed before legislative
session.
GMA Penalties for Counties Considered in Noncompliance: Allow for jurisdictions to apply for
funding when they are considered by the state to be out of compliance with the GMA.
Protecting state shared revenue: The state budget is currently projected to have a $1.5 billion
shortfall in the next biennium. WSAC will need to work to maintain state shared revenues.
Indigent Defense Court Rules: Provide a filing fee to pay for increased costs associated with
implementation of the Indigent Defense Court Rule.
Support new transportation/transit funding: WSAC should engage in the conversation to create a
new revenue source for transportation and transit for county transportation priorities.
Network of care funding for veterans services: Support funding to establish a state-wide portal for
veterans’ services.
Capital budget funding for timber lands in southwest Washington that are encumbered by
Endangered Species Act restrictions: Support capital budget funding to transfer state-owned trust
lands managed on behalf of county beneficiaries in order to ensure a viable timber economy in
Pacific, Wahkiakum, and Skamania counties. This program has been a 3-year partnership between
DNR and WSAC.
In addition to these items, WSAC will support the legislative proposals from individual counties that
are consistent with WSAC policies and past positions.
7

2012 Legislative Steering Committee
Operating Procedures
Background
The Washington State Association of Counties Legislative Steering Committee (LSC) is
authorized in the by-laws of the organization, and is
“[R]esponsible to prepare and recommended a proposed
legislative program for consideration of the membership at the
Annual Meeting. The Legislative Steering Committee shall monitor
events of each legislative session and shall be empowered to
adopt policy relating to legislation, executive branch policies and
operation, and the activities of other organizations and
associations.” 1
As such, the LSC demands a significant commitment from its members. LSC members have
frequent interaction, particularly during the state’s legislative session with legislators, agency
staff, and representatives of other lobbying organizations.
The body is composed of one member from each of WSAC’s member counties as well as each
of the four County Executives. The LSC has two co-chairs that are appointed biennially by the
WSAC President. Co-chairs may not also serve as members of the WSAC Executive
Committee.
In addition to setting the policy direction for the association through the Legislative Agenda (see
below for more detail), LSC members are expected to attend regular meetings during legislative
session and to communicate with legislators regarding WSAC’s legislative priorities.
Successful LSC Interactions – LSC Member Expectations
The LSC is representative of the entire WSAC membership, and its members hold diverse and
often disparate views. While the association tries to focus on solutions that are effective for all
counties, LSC discussions can become contentious. Sometimes these discussions are rooted
in political differences. In order to be an effective body, members are asked to work toward the
middle to find compromise. Above all, it is crucial that LSC members conduct themselves in a
civil and amicable manner.
1 Section 3.18, WSAC By-­‐Laws.
8

Staff Support
The LSC is primarily supported by WSAC policy and communications staff. Each policy staff
member manages a distinct “policy portfolio”. A current list of WSAC staff, policy portfolios, and
contact information are attached.
LSC members are encouraged to contact WSAC staff directly if they have questions about
legislation, or state agency regulatory, or implementation issues. WSAC staff represent
members from all 39 counties, and must balance the needs of the entire WSAC membership.
During legislative session, WSAC staff is extremely busy, typically tracking dozens of bills, and
often testifying several times a week. They may need to come in and out of LSC meetings in
order to accommodate the legislative schedule.
Legislative Agenda
The Legislative Agenda (Agenda) is adopted every biennium by the LSC and represents the
legislative priorities of the organization. WSAC spends a considerable amount of time each
legislative session reacting to issues that are brought forward by interest groups and legislators.
The Agenda is composed of issues the organization wants to proactively bring forward for
resolution by the legislature.
The LSC develops and approves the Agenda. The Agenda is then considered and approved by
the entire membership at the WSAC Annual Conference in November. While the Agenda is
valid for a biennial period, annual changes and updates are considered and approved.
Policy Statement
The WSAC Policy Statement is a living document that reflects the broad policy position of the
organization on specific policy issues and areas. The Policy Statement is used to guide the
actions and decisions of the LSC and WSAC staff in legislative and policy matters. WSAC staff
use the Policy Statement to determine the positions they will take on pending legislation, and do
not need to consult the LSC when a position is supported by the Policy Statement.
WSAC staff are responsible on an ongoing basis for reviewing and determining whether
revisions to the Policy Statement are needed. The LSC will consider adopting changes to the
Policy Statement when recommended by staff.
LSC Meetings
During legislative session, the LSC meets every other week on Wednesdays and Thursdays
(see below for details). These meeting times are used to hear updates from WSAC staff,
conduct LSC business (such as providing guidance to WSAC staff on legislation that is not
otherwise guided by the Policy Statement), communicate with the legislature, interact with state
agency directors, legislative leaders, or key stakeholders, and interact with WSAC members in a
roundtable format. LSC meetings are frequently attended by WSAC affiliate representatives as
well as government relations staff and contract lobbyists representing WSAC members. LSC
members are expected to attend these meetings and to spend time meeting with legislators.
LSC days are typically formatted as follows:
9

Wednesday
6:00 PM
Thursday
8:00 AM –
10:00 AM
Thursday
10:00 AM –
12:00 PM
Thursday
12:00 PM –
1:00 PM
Thursday
1:00 PM –
3:00 PM
Roundtable discussion
Update from WSAC staff on time sensitive
issues and receive lobbying assignments
LSC members accompany WSAC staff to
advocate for WSAC priorities
Lunch at WSAC. This will be an opportunity
to interact with state agency directors,
legislative leaders, or key stakeholders
Other business items
The specific meeting agenda for LSC meetings will be established by the LSC Co-Chairs and
WSAC staff. LSC members may request specific agenda topics by contacting Josh Weiss.
Requests for agenda items must be submitted by 12:00 PM on the Friday preceding the
upcoming LSC meeting. 2 WSAC staff will discuss agenda requests with the LSC Co-Chairs
who will approve the final agenda.
WSAC staff will electronically distribute meeting agendas and background materials for LSC
meetings by 5:00 PM on the Monday immediately preceding the upcoming LSC meeting
Legislative Training for LSC Members
WSAC staff will develop a comprehensive training approach regarding the Washington
Legislature, LSC operations, and how to lobby.
WSAC staff will provide training to LSC members in two phases. The first phase will occur
following the WSAC Annual Conference. Topics will include LSC structure, operating
procedures, schedule for LSC meetings and legislative session, LSC member interactions,
overview of the WSAC Policy Statement, how to work with WSAC staff and who to contact,
legislative process, capitol campus orientation, and how to work with legislators.
The second phase will occur immediately before the beginning of the legislative session. This
will include up-to-the-date information on legislative committee structure, legislative members
and committee assignments, legislative staff assignments, office locations, and other pertinent
information.
LSC Member Lobbying
LSC members are expected to advocate in support of WSAC priorities with the legislature. This
will frequently occur as a part of each LSC meeting day. WSAC staff will provide organizational
support for these efforts including setting up meetings with legislators, agency directors, or key
2 See Table of Deadlines for Legislative Session
10

stakeholders, providing talking points and key messages, and strategic guidance on how to best
be successful in lobbying.
WSAC Member Testifying
Many times throughout the legislative session, WSAC staff will seek LSC and other WSAC
members, WSAC affiliates, and county staff to testify at legislative hearings. It is important, at
times, to have our county elected and appointed officials interact directly with legislators during
legislative hearings.
LSC Workgroups
The LSC forms workgroups based on specific issue areas or policy issues. These provide an
opportunity for LSC members, other WSAC members, and WSAC affiliates (county staff) to
share information and keep abreast of current issues. Workgroups are formed at the discretion
of the LSC Co-Chairs.
Legislative Alerts
Legislative Alerts are used by WSAC staff to let WSAC members know that their action is
needed with the legislature in an expedient manner. Alerts are typically requests for WSAC
members to call, write, or e-mail their local legislators and urge a particular action.
Legislative Bulletins
Legislative Bulletins are sent every Monday morning during legislative session and provide
updates on the status of specific legislative proposals as well as general information about the
legislative session.
Weekly Schedules
The legislature releases hearing schedules for the upcoming week on Wednesday evenings.
The WSAC lobby team meets on Thursday evenings to review upcoming hearings and discuss
legislative tactics. WSAC staff will prepare a summary of upcoming hearings, which bills staff
will testify on, and the anticipated position. This will be sent to LSC members on Friday
mornings.
Table of Deadlines for Legislative Session
Monday Wednesday Thursday Friday
By 10:00 AM
Legislative
Bulletin
distributed
6:00 PM
Roundtable
discussion
LSC meeting
By 12:00 PM
Weekly hearing
schedule
distributed
By 5:00 PM LSC
meeting
materials
distributed
By 12:00 PM
Agenda requests
due to WSAC
staff
11

Biennial Retreat
The LSC will hold a planning meeting in the spring of even numbered years in order to begin the
process of developing the Legislative Agenda.
12

WSAC Policy Staff - Issue Areas & Contact Information
Eric Johnson - Executive Director
Direct: 360.489.3013 Cell: 360.481.2241
Email: ejohnson@wacounties.org
Josh Weiss - Director, Policy and Legislative Relations and General Counsel
Finance & General Government
Direct: 360.489.3015 Cell: 360.561.3560
Email: jweiss@wacounties.org
Brian Enslow - Senior Policy Director
Criminal Justice & Public Safety
Direct: 360.489.3012 Cell: 360.481.8121
Email: benslow@wacounties.org
Abby Murphy - Policy Director
Human Services & Housing
Direct: 360.489.3021 Cell: 360.561.6547
Email: amurphy@wacounties.org
VACANT - Policy Director
Land Use & Natural Resources
Timber Program Manager
Brad Banks - Managing Director, Washington State Association of Local Public Health Officials
Public Health
Direct: 360.489.3011 Cell: 360.918.6508
Email: bbanks@wacounties.org
Gary Rowe - Managing Director, Washington State Association of County Engineers
Transportation & Public Works
Direct: 360.489.3014 Cell: 360.770.7766
Email: growe@wacounties.org
13

DRAFT - 2013 / 2014 LSC Public Outreach Campaign Plan - DRAFT
Goals
• Engage Legislators and staff in county issues year-round to increase the number of advocates for WSAC legislative priorities
• Increase public awareness of the role of counties and the services provided to residents in order to build understanding and
support
• Develop and produce LSC communications tools to assist members with advocacy efforts
• Inform coalition of labor, environmental, business, tribal and other interests in understanding and supporting counties and
WSAC legislative priorities
Potential Barriers/Challenges
• Complexity and vast number of county issues
• Differentiation of county role from cities and from other levels of
government
• Lack of understanding of relevance or importance to individuals and daily
life
• Lack of budgeted resources to accomplish all strategic activities; some
may require non-dues revenue to complete
Key Messages
• Counties provide critical services on a daily basis for all of Washington's residents, including public health and safety, local transportation systems, trial courts system, elections, jails, 911, and solid waste.
• Counties deliver direct services to residents in unincorporated areas for law enforcement, parks, roads, environmental health, and planning.
• Counties are the closest government to the people and therefore require local control and decision making abilities to meet community needs.
• Counties are the only local government to act as agents for the state and as a result serve a unique function for its residents.
• In addition to critical services, counties have a growing portfolio of state and federal requirements to implement in local communities.
• Every resident in Washington is a county customer.
• Counties continually look for and do business more economically and efficiently on behalf of their residents. use examples
Audiences and Strategies
Audience: Legislators and Legislative Staff Audience: County Residents in Washington Audience: Students in Washington, grades 6-12
• Host interim "County Fam(iliarization) Tours" for Committee
members, legislative staff and others
• Provide an interactive county orientation/forum webinar for
legislators and staff prior to session
• Use TVW programming to reach this audience
• Conduct editorial board meetings with LSC members, legislative
advocates and coalition partners
• Establish social media presence (Facebook, Twitter, blog) to
engage with county residents and present useful, relevant
information
• Use media outlets to feature county issues and local impacts
• Promote NACo National County Government Month (April)
statewide with local features
Tools & Resources
• Develop a compelling tagline and graphic for all public education campaign materials and uses; extend brand recognition through social media
• Integration of information into WSAC website and expanded online resources for audiences
• Talking points and fact sheets for overall legislative package and individual issues
• Customized and specific Legislative Alerts distributed through email and Twitter (opt-in)
• Information sharing opportunities for members beyond LSC meetings; use of technology to improve communications year-round
• Coordination and co-opting opportunities with partners including WACO, WAPA, judicial branch and other peer groups
• Promote NACo/ iCivics "County Works" educational game to
school districts, educators and students through educational
channels and social media
• Utilize existing TVW student programming to feature county
issues and student achievements at the local level
WSAC Legislative Steering Committee ‐ Communication & Education Workgroup
DRAFT 1.2 September 27, 2012
14

LEGISLATIVE STEERING COMMITTEE
ISSUE PAPER
Date October 5, 2012
Category
Policy Area
Subject
Staff Contact
Issue:
Action
Public Health
WSALPHO Legislative Priorities
Brad Banks - WSALPHO Managing Director
The Washington State Association of Local Public Health Officials (WSALPHO) as an affiliate
organization of WSAC and pursuant to our Memorandum of Understanding submit the following
legislative priorities for support and approval by the WSAC Legislative Steering Committee.
The proposed WSALPHO 2013 Agenda includes the following:
• WSALPHO, with its partners, will exercise a funding strategy focused on the maintenance
of current flexible funding for 2013.
• WSALPHO, with the support of its partners, including, but not limited to, WSAC, DOH,
State Board of Health (SBOH), Washington State Nurses Association (WSNA),
Washington State Medical Association (WSMA) and others, will pursue legislation that
clarifies and provides consistency with regards to the prescribing and dispensing of
pharmaceuticals by local health agencies. See included WSALPHO Policy Fact Sheet.
• WSALPHO, with the support of WSAC, will pursue legislation that will allow, but not
mandate, health districts to operate as their own fiscal agent with the consent of the their
local board of health and county government(s). See included WSALPHO Policy Fact
Sheet.
Staff Recommendation:
Support WSALPHO's 2013 Legislative Priorities with the understanding that WSALPHO will keep the
WSAC Legislative Steering Committee updated as to the status of core flexible funding and the two
policy issues noted above (as well as other funding or policy issues that may arise during the course
of Session).
LSC Action/Decision:
15

POLICY FACT SHEET
Policy Issue: Health District Banking Issues Created By RCW 70.46.080
Overview:
Under RCW 70.46.080, a local public health district in Washington State does not have express authority to maintain its own
bank account, although some other special purpose districts are allowed to do this under State law. For example, Fire Districts
(RCW 52.16.050) and Library Districts (RCW 27.12.240) can maintain their own bank accounts separate from county
government. By granting that authority to some special-purpose districts, but not to health districts, the Legislature has implicitly
denied the authority to health districts.
Resulting Inefficiencies
For health districts, this results in duplication of effort and time constraints that reduce financial efficiency and effectiveness.
These inefficiencies include:
• Posting transactions in two separate accounting systems (County and the health district) causing duplicate reconciling.
• Time constraints on issuing health district payroll and accounts payable warrants.
• Inability to efficiently invest excess health district funds due to the unavoidable lag time in the County posting cash
receipt transactions.
• Delays in collecting non-sufficient fund checks due to the lag time in notification.
• In some cases, the inability to implement a “job costing” system to track and bill contracts and grants because payroll
and accounts payable details are recorded in the County’s accounting system --- not the district’s --- necessitating
manual data entry.
Health districts receive significant funding through contracts and grants and need sophisticated tracking, billing and reporting
capabilities without duplicating entries into two accounting systems. Districts may already own the necessary technology to do
this work, but are significantly hampered in using it to its full capacity without the ability to maintain a checking account.
Solution:
Under current law, a health district lacks authority to act as its own fiscal agent. By granting authority to some special-purpose
districts, but not to health districts, the Legislature has impliedly denied the authority to health districts. The Legislature needs to
amend RCW 70.46.080 to authorize, but not mandate, health districts to act as their own fiscal agent and thereby increase
efficiency in a time of scarce resources. The RCW amendment could also require that this authority be granted only with the
approval of the district’s Public Health Board and County government.
206 Tenth Avenue SE Olympia, WA 98501 | Tel: 360.753.1886 Fax: 360.753.2842 | www.wsalpho.org
16

POLICY FACT SHEET
Policy Issue: Statutory Clarity for Pharmaceutical Prescribing & Dispensing by Public Health
Overview:
Role of the Governmental Public Health System in Washington State
Individual persons have a responsibility to manage their individual health and that of their families by exercising individual choice
and accessing the healthcare system and other community resources that promote health and treat illness. The governmental
public health has the responsibility to protect the public as a whole by providing information and implementing systems, policies
and programs to address things that are beyond the control of individuals – such as assuring clear drinking water, requiring
vaccinations in congregate settings like schools, prohibiting smoking in public places to prevent exposure to second-hand
smoke. These types of population-based strategies aim to reduce or prevent situations in which individuals are inadvertently
exposed to risk factors and disease. A major focus of public health is preventing disease from occurring and reducing its spread
among populations while the healthcare system specializes in identifying, diagnosing and treating disease in individuals.
Governmental public health has a unique and statutorily mandated role to prevent and control the spread of disease. [RCW
70.05.070] In Washington State, governmental public health has specific statutory authorities and responsibilities to enforce
public health statues, rules, regulations and ordinances; control and prevent the spread of disease; take such action as is
necessary to maintain health; interview, examine, counsel or treat persons infected or believed to be exposed to sexually
transmitted diseases.
Purpose:
Achieve clarity and consistency on medication prescribing and dispensing practices in the public health context to:
1. Assure patient safety
2. Protect the public by assuring timely access to pharmaceuticals for conditions where a delay in treatment may
negatively impact the health and safety of the public.
3. Ensuring public health prevention activities can take place efficiently to prevent the spread of disease and unintended
pregnancy in order to protect the health and safety of the public.
4. Increase use of best practices
5. Increase consistency of practice in the public health context
6. Increase clarity for health care professionals
This requires balancing the assurance of safe and quality care for individual patients with the safety and health of the public.
Problem 1 – Prescribing in the public health context
The public health context by nature is about populations; assuring the health and safety of groups of people. It is administered
via a network of agencies and professionals, in a variety of settings that includes local health jurisdictions (LHJs). In some
situations like a disease outbreak, these services may be provided to groups of people in setting that are not usually used for
healthcare delivery, like a high school gymnasium, county fairground, and workplace cafeteria.
In the public health context, it is not always feasible for a prescriber to establish a one-to-one patient-prescriber relationship. Nor
is it feasible for a prescriber to see each patient to conduct the assessment, diagnosis and prescribing in person. In many cases
206 Tenth Avenue SE Olympia, WA 98501 | Tel: 360.753.1886 Fax: 360.753.2842 | www.wsalpho.org
17

POLICY FACT SHEET
current practice is that an RN fulfills this role by assessing the patient and any relevant laboratory results; may or may not consult
with the physician Health Officer while the patient is there or after the fact; determines if the patient meets criteria establish by
the physician Health Officer; if so, implements treatment protocols developed by the physician Health Officer; and provides the
patient with a prescription signed by the physician Health Officers for the patient to take to a pharmacy or calls in a prescription
to a local pharmacy on behalf of the physician Health Officer or pursuant to a valid prescription signed by the physician Health
Officer, selects medications from the clinic stock, adds the patient name, and gives them to the patient with instructions for use.
Currently in some cases, some or all of these steps may also be executed by a Disease Investigation Specialist (DIS) or other
public health professionals.
This problem is not unique to public health. It is prevalent through the healthcare system
Problem 2 – Dispensing in the public health context
In RCW 18.64.011, the definitions for “dispense” and “distribute” are less than clear. Well intended health professionals in
different fields may construe them differently and as a result they are not applied uniformly.
Timely access to pharmaceuticals is an important component in achieving the public health goals of prevention, early detection
and swift response to communicable and infectious disease and other health threats. In the public health context, assuring that
patients receive medications at the time of their visit (encounter with the public health system) is essential to minimizing
treatment failure and thus providing the most protection to the patient and the public. This will prevent more disease and more
unintended pregnancies than approaches that delay access to pharmaceuticals and risk treatment failure due to lack of patient
follow-through and patients never beginning treatment.
This dispensing problem is unique to public health because of the “immediacy” – the need to give patients medications at the
time they are seen in order to protect the health of the public; because if a patient is sent away to a pharmacy and they don’t go
or for some other reason don’t get or complete the treatment, this endangers the health of the public.
Solution:
Clear statutory authority that provides consistency for pharmaceutical prescribing and dispensing in public health agencies.
206 Tenth Avenue SE Olympia, WA 98501 | Tel: 360.753.1886 Fax: 360.753.2842 | www.wsalpho.org
18