Engrossed Second Substitute House Bill 1272 CHARS Implementation

The Washington Legislature passed Engrossed Second Substitute House Bill 1272 (Health Systems Transparency) in 2021 that requires hospitals to report patient discharge information related to race, ethnicity, gender identity, sexual orientation, preferred language, any disability, and zip code of primary residence beginning January 1, 2023.

The Department of Health must complete rulemaking by July 1, 2022. For more information on the rulemaking process, visit our rulemaking page.

Project Implementation Timeline

2023

  • January 1, 2023 – HB 1272 new patient demographic reporting goes into effect for most hospitals, those not eligible for, or not requesting a grant or waiver
  • January 6, 2023 – First 60-day report deliverable due for both grant and waiver recipients
  • February 10, 2023 – Second 60-day report deliverable due for both grant and waiver recipients
  • April 10, 2023 – Third 60-day report deliverable due for both grant and waive recipients
  • June 10, 2023 – Fourth 60-day report deliverable due for both grants and waiver recipients
  • July 1, 2023 – HB 1272 new patient demographic reporting goes into effect for hospitals who received a grant
  • August 10, 2023 – Fifth 60-day report deliverable due for waiver recipients
  • October 10, 2023 – Sixth 60-day report deliverable due for waiver recipients
  • November 1, 2023 – Deadline for requesting waiver extension
  • December 1, 2023 – HB 1272 new patient demographic reporting goes into effect for hospitals who received a waiver

2022

  • July 1, 2022 – Rulemaking completed (new data elements finalized)
  • August 10, 2022  – IT requirements defined and sent to data collection contractor
  • August 31, 2022 – First information session for hospitals
  • September 1, 2022 – Second information session for hospitals
  • September 7, 2022 – Two information sessions for eligible hospitals on waiver and grant application
  • October 1, 2022 – Applications available for grants/waivers
  • October 15, 2022 – Application available for grant/waivers
  • November 1, 2022 – Award notifications sent out for waivers and grants
  • November 1, 2022 – Updated CHARS Manuals

Patient handouts - Collecting New Patient Data (PDF)

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Grants and Waivers

HB 1272 also requires the Department to develop a waiver and grant process to assist hospitals that are certified by the Centers for Medicare and Medicaid Services as a critical access hospital or a sole community hospital, or qualify as a Medicare dependent hospital to comply with the requirements.

Implementation dates vary depending upon hospital status and use of grant or waiver. See information below.

Accepting waiver and grant applications: Closed

Hospitals not eligible for grant or waiver

  • Go-live date: January 1, 2023
  • Criteria:
    • Not critical access hospital
    • Not sole community hospital
    • Not Medicaid dependent hospital

Hospitals eligible for a grant

  • Go-live date: July 1, 2023
  • Criteria:
    • Must be critical access hospital, sole community hospital, or Medicaid-dependent hospital
    • Must not be owned/operated by a system with two or more hospitals

Hospitals eligible for a waiver

  • Go-live date: TBD – set by the waiver
  • Criteria:
    • Must be critical access hospital, sole community hospital, or Medicaid-dependent hospital
    • Can be owned/operated by a system with two or more hospitals

Frequently Asked Questions

How can I request to be added to, or removed from, the communication list?

Submit your request to: CHARSGeneral@doh.wa.gov

How do I submit questions?

Submit your questions to: CHARSGeneral@doh.wa.gov

When will the rule making process be completed?

July 1, 2022

What are the criteria for eligibility for a grant or a waiver?

Hospitals eligible for a grant

Go-live date: July 1, 2023 Criteria:
  • Must be critical access hospital, sole community hospital, or Medicaid dependent hospital
  • Must not be owned/operated by a system with two or more hospitals
    • Must be critical access hospital, sole community hospital, or Medicaid dependent hospital
    • Can be owned/operated by a system with two or more hospitals

Hospitals eligible for a waiver

Go-live date: TBD – set by the waiver Criteria:
What is Engrossed Second Substitute House Bill 1272 and what does it require?

Engrossed Second Substitute House Bill 1272 (E2SHB 1272) passed the Legislature in 2021 and has many components. It requires hospitals to collect patient discharge information related to race, ethnicity, gender identity, sexual orientation, preferred language, any disability, and zip code of primary residence. The bill increases transparency in hospital financial data by requiring additional reporting of revenue and expenses and community health improvement activities and requires quarterly reporting of charity care data. The bill also requires a study on the impact of acute care hospital staffing on patient outcomes.

Will the format for inpatient quarterly data files change to accommodate the new patient demographics?

We won’t know the details until data begins to come in to DOH in April 2023.

What are the code sets that will be used for the new patient demographic data?

The code sets have been established. DOH and WSHA are preparing support and guidance documents. We will make the code sets and additional guidance available as soon as it is ready. Most of the communication and guidance will come from WSHA, as the data collector designee working most closely with hospitals. 

What is the waiver and grant application timeline?

The finalized application will be available to eligible hospital contacts on October 1, 2022, and must be returned to DOH by October 15,2022.

When will hospitals be notified if they are awarded a grant or a waiver?

Notifications will go out electronically after November 1, 2022.

Will DOH update hospitals as information becomes available?

Yes. We will update the CHARS/HB 1272 website as additional information and materials are available. We’ll also send emails to share materials and draw attention to the web site.  DOH and WSHA will host virtual information sessions  over the next few months to walk hospital staff through the draft application, answer questions, provide technical assistance, etc.

  • August 31, 9 - 10 am  Open discussions and general questions for all hospitals about new requirements for patient demographic data
  • September  1, 1 - 2 pm Open discussions and general questions for all hospitals about new requirements for patient demographic data
  • September 7, 9-10 am  Eligible hospitals Q&A, and application assistance
  • September 7, 1 - 2 pm  Eligible hospitals Q&A, and application assistance
  • November 1- Nov 3, 2022  Award notifications sent out for waivers and grants

Others will be scheduled as needed.

How do hospitals know how much funding will be available to them from the grant?  

There are $2,000,000 available to disperse between the 37 eligible hospitals. If divided equally, this would be approximate $54,000 for each facility. DOH has asked that hospitals tell us if they are applying and how much they are requesting. DOH will use this information to establish a more precise distribution plan.

What supporting documents do hospitals need to apply for a grant?

The CHARS team has partnered with the Rural Health and the Community Health Systems programs to identify documents that DOH has on file from hospitals that would serve as proof of need. We have identified two options (adjusted patient revenue and operating margin) and will work with hospitals to make sure we have updated information. We hope this will reduce the burden on hospitals by eliminating submission redundancies.

What are the steps to apply for a waiver?

Waiver applications will be available October 1, 2022. DOH will be holding virtual information sessions to walk hospitals through the process and requirements.

  • August 31, 9 - 10 am  Open discussions and general questions for all hospitals about new requirements for patient demographic data
  • September 1, 1 - 2 pm Open discussions and general questions for all hospitals about new requirements for patient demographic data
  • September 7, 9-10 am  Eligible hospitals Q&A, and application assistance
  • September 7, 1 - 2 pm  Eligible hospitals Q&A, and application assistance
How can we prove economic hardship for a grant?
Proof of economic hardship is for the waiver only, not the grant. In considering a hospital application for a grant, the department may consider information about the hospital's need for financial support to alter the hospital's electronic health records system, including, but not limited to, demonstrated costs necessary to update the hospital's current electronic health record system to comply with the requirements in this section and evidence of need for financial assistance. We will use your Adjusted Patient Revenue and Operating Margin reports for this determination and require an itemized cost for updating your system with the application.
Can you combine primary and secondary Medicaid paying patients to get your 30 percent to prove economic hardship for a waiver (not for grant)?
Yes. primary/secondary payer is not broken out. To identify percentage of Medicaid, divide Medicaid revenue by total patient services revenue them multiply by 100.

Example:
($3,341,454/$18,804,319) x 100 = 17.769%

Can the grant be used for training staff and education for patients?
The grant can only be used to update the EHR system to comply with new patient demographic requirements. The rule does not provide for education or staff training.
If a hospital is associated with a rural health clinic, are we also required to gather these additional data from the clinic? If so, where or who would we report these data to? Are clinics even required to report any other type of data that you might be aware of?
No. Clinics do not report to CHARS. Clarification: CHARS only collects hospital discharge data.
Do clinics need to collect all the Health Equity data?
No. The statute does not cover clinics, as clinics do not report to CHARS.
If our EMR /EHR system vendor is implementing the new changes, what else can we use those funds for (when applying for a grant)?
The grant can only be used to update the EHR system to comply with the new patient demographic requirements. The rule does not allow the funds to go toward other expenses.
You have received your award notification, what are the next steps?

For Grant and Waiver Awards: 

  • Review Draft Statement of Work (SOW).
  • Update contacts if necessary.
  • Review your deliverables.

The official contract could take up to two months to process. If you have questions, contact Shelly Cook at Shelly.Cook@DOH.WA.gov .

Questions?

If you have questions about HB 1272 CHARS implementation, you can email CHARSgeneral@doh.wa.gov.