Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Health & Human Services Appropriations Committee

HB 3017

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Background:

Various programs in the Department of Social and Health Services' (DSHS) Aging and Adult Services and Developmental Disabilities divisions provide personal care services to elderly or disabled clients who are eligible for publicly funded services. These services may be provided in the client's home by individual providers who contract directly with the DSHS or by agency providers who are employees of a licensed home care agency. This paid provider may be a relative or a household member, although the client's spouse may not be a paid provider under most programs. Personal care services include assistance with various tasks such as toileting, bathing, dressing, ambulating, meal preparation, and household chores.

A plan of care is developed for each client to determine the services allowed. The client may choose whether to obtain services through an individual provider or an agency provider, but the benefits must be the same in amount, duration, and scope under either service option.

Individual providers who contract with the DSHS are compensated at rates established through collective bargaining and funded in the state's operating budget. Agency providers are paid by their employers who are reimbursed by DSHS based on a vender rate that provides parity with the compensation established for individual providers. By statute the DSHS must, in determining the agency vendor rate, use a formula that accounts for:

wages and fringe benefits;
payroll taxes;
mileage;
any contributions that the state pays to the Training Partnership (a program to provide
training for individual providers); and
average increases in workers' compensation costs.

In addition, contributions for health care benefits are paid at the same rate as for individual providers.

The DSHS is prohibited by statute to pay a licensed home care agency for in-home personal care services if the care is provided to a client by the client’s family member. “Family member” is defined as a parent, child, sibling, aunt, uncle, cousin, grandparent, grandchild, grandniece or grandnephew.

Summary of Bill:

The DSHS may pay a home care agency for in-home personal care services provided under the Medicaid In-Home Personal Care Program (Program) if the care is provided by a family member of a client who is unable to supervise his or her paid care provider and has no qualified person willing to accept in writing the responsibilities and obligations of providing such supervision. A "qualified person" is an individual age 21 or older who is selected by the client or his or her legal representative and meets the DSHS' background check requirements and who does not receive payment from the DSHS' for providing services to the client.

A person is considered unable to supervise his or her paid care provider if so determined by the DSHS' comprehensive assessment reporting evaluation or any successor evaluation tool adopted by the DSHS or if the inability to supervise the paid care provider results from the client's level of cognitive performance, clinical complexity or mood or behavior symptoms as certified by the client's treating physician.