INITIATIVE 1163
To the People
Chapter 1, Laws of 2012
LONG-TERM CARE SERVICES--TRAINING--BACKGROUND CHECKS
EFFECTIVE DATE: 01/07/12
Approved by the
People of the State of Washington
in the General Election on
November 8, 2011
ORIGINALLY FILED
April 21, 2011
Secretary of State
1AN ACT Relating to restoring long-term care services for eligible
2elderly and persons with disabilities; adding new sections to chapter
374.39A RCW; adding new sections to chapter 18.88B RCW; creating new
4sections; repealing RCW 18.88B.020, 18.88B.030, 18.88B.040, 74.39A.009,
574.39A.050, 74.39A.055, 74.39A.073, 74.39A.075, 74.39A.085, 74.39A.260,
674.39A.310, 74.39A.330, 74.39A.340, and 74.39A.350; providing an
7effective date; and providing contingent effective dates.
8BE IT ENACTED BY THE PEOPLE OF THE STATE OF WASHINGTON:
9NEW SECTION. Sec. 1. It is the intent of the people through this
10initiative to protect vulnerable elderly and people with disabilities
11by reinstating the requirement that all long-term care workers obtain
12criminal background checks and adequate training. The people of the
13state of Washington find as follows:
14(1) The state legislature proposes to eliminate the requirement
15that long-term care workers obtain criminal background checks and
16adequate training, which would jeopardize the safety and quality care
17of vulnerable elderly and persons with disabilities. Should the
18legislature take this action, this initiative will reinstate these
1critical protections for vulnerable elderly and persons with
2disabilities; and
3(2) Taxpayers' investment will be protected by requiring regular
4program audits, including fraud investigations, and capping
5administrative expenses.
6PART I
7PROTECTING VULNERABLE ELDERLY AND PERSONS WITH DISABILITIES BY
8REINSTATING CRIMINAL BACKGROUND CHECK AND TRAINING REQUIREMENTS
9FOR LONG-TERM CARE WORKERS
10NEW SECTION. Sec. 101. A new section is added to chapter 74.39A
11RCW to read as follows:
12(1) All long-term care workers for the elderly or persons with
13disabilities hired after January 1, 2012, shall be screened through
14state and federal background checks in a uniform and timely manner to
15ensure that they do not have a criminal history that would disqualify
16them from working with vulnerable persons. These background checks
17shall include checking against the federal bureau of investigation
18fingerprint identification records system and against the national sex
19offenders registry or their successor programs. The department shall
20require these long-term care workers to submit fingerprints for the
21purpose of investigating conviction records through both the Washington
22state patrol and the federal bureau of investigation.
23(2) To allow the department of health to satisfy its certification
24responsibilities under chapter 18.88B RCW, the department shall share
25state and federal background check results with the department of
26health. Neither department may share the federal background check
27results with any other state agency or person.
28(3) The department shall not pass on the cost of these criminal
29background checks to the workers or their employers.
30(4) The department shall adopt rules to implement the provisions of
31this section by August 1, 2010.
32NEW SECTION. Sec. 102. A new section is added to chapter 74.39A
33RCW to read as follows:
34The department must perform criminal background checks for
35individual providers and prospective individual providers and ensure
1that the authority has ready access to any long-term care abuse and
2neglect registry used by the department. Individual providers who are
3hired after January 1, 2012, are subject to background checks under RCW
474.39A.055.
5NEW SECTION. Sec. 103. A new section is added to chapter 18.88B
6RCW to read as follows:
7(1) Effective January 1, 2011, except as provided in RCW
818.88B.040, the department of health shall require that any person
9hired as a long-term care worker for the elderly or persons with
10disabilities must be certified as a home care aide within one hundred
11fifty days from the date of being hired.
12(2) Except as provided in RCW 18.88B.040, certification as a home
13care aide requires both completion of seventy-five hours of training
14and successful completion of a certification examination pursuant to
15RCW 74.39A.073 and 18.88B.030.
16(3) No person may practice or, by use of any title or description,
17represent himself or herself as a certified home care aide without
18being certified pursuant to this chapter.
19(4) The department of health shall adopt rules by August 1, 2010,
20to implement this section.
21NEW SECTION. Sec. 104. A new section is added to chapter 18.88B
22RCW to read as follows:
23(1) Effective January 1, 2011, except as provided in RCW
2418.88B.040, the department of health shall require that all long-term
25care workers successfully complete a certification examination. Any
26long-term care worker failing to make the required grade for the
27examination will not be certified as a home care aide.
28(2) The department of health, in consultation with consumer and
29worker representatives, shall develop a home care aide certification
30examination to evaluate whether an applicant possesses the skills and
31knowledge necessary to practice competently. Unless excluded by RCW
3218.88B.040 (1) and (2), only those who have completed the training
33requirements in RCW 74.39A.073 shall be eligible to sit for this
34examination.
35(3) The examination shall include both a skills demonstration and
36a written or oral knowledge test. The examination papers, all grading
1of the papers, and records related to the grading of skills
2demonstration shall be preserved for a period of not less than one
3year. The department of health shall establish rules governing the
4number of times and under what circumstances individuals who have
5failed the examination may sit for the examination, including whether
6any intermediate remedial steps should be required.
7(4) All examinations shall be conducted by fair and wholly
8impartial methods. The certification examination shall be administered
9and evaluated by the department of health or by a contractor to the
10department of health that is neither an employer of long-term care
11workers or private contractors providing training services under this
12chapter.
13(5) The department of health has the authority to:
14(a) Establish forms, procedures, and examinations necessary to
15certify home care aides pursuant to this chapter;
16(b) Hire clerical, administrative, and investigative staff as
17needed to implement this section;
18(c) Issue certification as a home care aide to any applicant who
19has successfully completed the home care aide examination;
20(d) Maintain the official record of all applicants and persons with
21certificates;
22(e) Exercise disciplinary authority as authorized in chapter 18.130
23RCW; and
24(f) Deny certification to applicants who do not meet training,
25competency examination, and conduct requirements for certification.
26(6) The department of health shall adopt rules by August 1, 2010,
27that establish the procedures, including criteria for reviewing an
28applicant's state and federal background checks, and examinations
29necessary to carry this section into effect.
30NEW SECTION. Sec. 105. A new section is added to chapter 18.88B
31RCW to read as follows:
32The following long-term care workers are not required to become a
33certified home care aide pursuant to this chapter.
34(1) Registered nurses, licensed practical nurses, certified nursing
35assistants or persons who are in an approved training program for
36certified nursing assistants under chapter 18.88A RCW, medicare-
37certified home health aides, or other persons who hold a similar health
1credential, as determined by the secretary of health, or persons with
2special education training and an endorsement granted by the
3superintendent of public instruction, as described in RCW 28A.300.010,
4if the secretary of health determines that the circumstances do not
5require certification. Individuals exempted by this subsection may
6obtain certification as a home care aide from the department of health
7without fulfilling the training requirements in RCW 74.39A.073 but must
8successfully complete a certification examination pursuant to RCW
918.88B.030.
10(2) A person already employed as a long-term care worker prior to
11January 1, 2011, who completes all of his or her training requirements
12in effect as of the date he or she was hired, is not required to obtain
13certification. Individuals exempted by this subsection may obtain
14certification as a home care aide from the department of health without
15fulfilling the training requirements in RCW 74.39A.073 but must
16successfully complete a certification examination pursuant to RCW
1718.88B.030.
18(3) All long-term care workers employed by supported living
19providers are not required to obtain certification under this chapter.
20(4) An individual provider caring only for his or her biological,
21step, or adoptive child or parent is not required to obtain
22certification under this chapter.
23(5) Prior to June 30, 2014, a person hired as an individual
24provider who provides twenty hours or less of care for one person in
25any calendar month is not required to obtain certification under this
26chapter.
27(6) A long-term care worker exempted by this section from the
28training requirements contained in RCW 74.39A.073 may not be prohibited
29from enrolling in training pursuant to that section.
30(7) The department of health shall adopt rules by August 1, 2010,
31to implement this section.
32NEW SECTION. Sec. 106. A new section is added to chapter 74.39A
33RCW to read as follows:
34The department's system of quality improvement for long-term care
35services shall use the following principles, consistent with applicable
36federal laws and regulations:
1(1) The system shall be client-centered and promote privacy,
2independence, dignity, choice, and a home or home-like environment for
3consumers consistent with chapter 392, Laws of 1997.
4(2) The goal of the system is continuous quality improvement with
5the focus on consumer satisfaction and outcomes for consumers. This
6includes that when conducting licensing or contract inspections, the
7department shall interview an appropriate percentage of residents,
8family members, resident case managers, and advocates in addition to
9interviewing providers and staff.
10(3) Providers should be supported in their efforts to improve
11quality and address identified problems initially through training,
12consultation, technical assistance, and case management.
13(4) The emphasis should be on problem prevention both in monitoring
14and in screening potential providers of service.
15(5) Monitoring should be outcome based and responsive to consumer
16complaints and based on a clear set of health, quality of care, and
17safety standards that are easily understandable and have been made
18available to providers, residents, and other interested parties.
19(6) Prompt and specific enforcement remedies shall also be
20implemented without delay, pursuant to RCW 74.39A.080, RCW 70.128.160,
21chapter 18.51 RCW, or chapter 74.42 RCW, for providers found to have
22delivered care or failed to deliver care resulting in problems that are
23serious, recurring, or uncorrected, or that create a hazard that is
24causing or likely to cause death or serious harm to one or more
25residents. These enforcement remedies may also include, when
26appropriate, reasonable conditions on a contract or license. In the
27selection of remedies, the safety, health, and well-being of residents
28shall be of paramount importance.
29(7) All long-term care workers shall be screened through background
30checks in a uniform and timely manner to ensure that they do not have
31a criminal history that would disqualify them from working with
32vulnerable persons. Long-term care workers who are hired after January
331, 2012, are subject to background checks under RCW 74.39A.055. This
34information will be shared with the department of health in accordance
35with RCW 74.39A.055 to advance the purposes of chapter 2, Laws of 2009.
36(8) No provider, or its staff, or long-term care worker, or
37prospective provider or long-term care worker, with a stipulated
38finding of fact, conclusion of law, an agreed order, or finding of
1fact, conclusion of law, or final order issued by a disciplining
2authority, a court of law, or entered into a state registry finding him
3or her guilty of abuse, neglect, exploitation, or abandonment of a
4minor or a vulnerable adult as defined in chapter 74.34 RCW shall be
5employed in the care of and have unsupervised access to vulnerable
6adults.
7(9) The department shall establish, by rule, a state registry which
8contains identifying information about long-term care workers
9identified under this chapter who have substantiated findings of abuse,
10neglect, financial exploitation, or abandonment of a vulnerable adult
11as defined in RCW 74.34.020. The rule must include disclosure,
12disposition of findings, notification, findings of fact, appeal rights,
13and fair hearing requirements. The department shall disclose, upon
14request, substantiated findings of abuse, neglect, financial
15exploitation, or abandonment to any person so requesting this
16information. This information will also be shared with the department
17of health to advance the purposes of chapter 2, Laws of 2009.
18(10) Until December 31, 2010, individual providers and home care
19agency providers must satisfactorily complete department-approved
20orientation, basic training, and continuing education within the time
21period specified by the department in rule. The department shall adopt
22rules by March 1, 2002, for the implementation of this section. The
23department shall deny payment to an individual provider or a home care
24provider who does not complete the training requirements within the
25time limit specified by the department by rule.
26(11) Until December 31, 2010, in an effort to improve access to
27training and education and reduce costs, especially for rural
28communities, the coordinated system of long-term care training and
29education must include the use of innovative types of learning
30strategies such as internet resources, videotapes, and distance
31learning using satellite technology coordinated through community
32colleges or other entities, as defined by the department.
33(12) The department shall create an approval system by March 1,
342002, for those seeking to conduct department-approved training.
35(13) The department shall establish, by rule, background checks and
36other quality assurance requirements for long-term care workers who
37provide in-home services funded by medicaid personal care as described
38in RCW 74.09.520, community options program entry system waiver
1services as described in RCW 74.39A.030, or chore services as described
2in RCW 74.39A.110 that are equivalent to requirements for individual
3providers. Long-term care workers who are hired after January 1, 2012,
4are subject to background checks under RCW 74.39A.055.
5(14) Under existing funds the department shall establish internally
6a quality improvement standards committee to monitor the development of
7standards and to suggest modifications.
8(15) Within existing funds, the department shall design, develop,
9and implement a long-term care training program that is flexible,
10relevant, and qualifies towards the requirements for a nursing
11assistant certificate as established under chapter 18.88A RCW. This
12subsection does not require completion of the nursing assistant
13certificate training program by providers or their staff. The long-
14term care teaching curriculum must consist of a fundamental module, or
15modules, and a range of other available relevant training modules that
16provide the caregiver with appropriate options that assist in meeting
17the resident's care needs. Some of the training modules may include,
18but are not limited to, specific training on the special care needs of
19persons with developmental disabilities, dementia, mental illness, and
20the care needs of the elderly. No less than one training module must
21be dedicated to workplace violence prevention. The nursing care
22quality assurance commission shall work together with the department to
23develop the curriculum modules. The nursing care quality assurance
24commission shall direct the nursing assistant training programs to
25accept some or all of the skills and competencies from the curriculum
26modules towards meeting the requirements for a nursing assistant
27certificate as defined in chapter 18.88A RCW. A process may be
28developed to test persons completing modules from a caregiver's class
29to verify that they have the transferable skills and competencies for
30entry into a nursing assistant training program. The department may
31review whether facilities can develop their own related long-term care
32training programs. The department may develop a review process for
33determining what previous experience and training may be used to waive
34some or all of the mandatory training. The department of social and
35health services and the nursing care quality assurance commission shall
36work together to develop an implementation plan by December 12, 1998.
1NEW SECTION. Sec. 107. A new section is added to chapter 74.39A
2RCW to read as follows:
3(1) Effective January 1, 2011, except as provided in RCW
418.88B.040, all persons employed as long-term care workers for the
5elderly or persons with disabilities must meet the minimum training
6requirements in this section within one hundred twenty calendar days of
7employment.
8(2) All persons employed as long-term care workers must obtain
9seventy-five hours of entry-level training approved by the department.
10A long-term care worker must accomplish five of these seventy-five
11hours before becoming eligible to provide care.
12(3) Training required by subsection (4)(c) of this section will be
13applied towards training required under RCW 18.20.270 or 70.128.230 as
14well as any statutory or regulatory training requirements for long-term
15care workers employed by supportive living providers.
16(4) Only training curriculum approved by the department may be used
17to fulfill the training requirements specified in this section. The
18seventy-five hours of entry-level training required shall be as
19follows:
20(a) Before a long-term care worker is eligible to provide care, he
21or she must complete two hours of orientation training regarding his or
22her role as caregiver and the applicable terms of employment;
23(b) Before a long-term care worker is eligible to provide care, he
24or she must complete three hours of safety training, including basic
25safety precautions, emergency procedures, and infection control; and
26(c) All long-term care workers must complete seventy hours of
27long-term care basic training, including training related to core
28competencies and population specific competencies.
29(5) The department shall only approve training curriculum that:
30(a) Has been developed with input from consumer and worker
31representatives; and
32(b) Requires comprehensive instruction by qualified instructors on
33the competencies and training topics in this section.
34(6) Individual providers under RCW 74.39A.270 shall be compensated
35for training time required by this section.
36(7) The department of health shall adopt rules by August 1, 2010,
37to implement subsections (1), (2), and (3) of this section.
1(8) The department shall adopt rules by August 1, 2010, to
2implement subsections (4) and (5) of this section.
3NEW SECTION. Sec. 108. A new section is added to chapter 74.39A
4RCW to read as follows:
5(1) Effective January 1, 2011, a biological, step, or adoptive
6parent who is the individual provider only for his or her
7developmentally disabled son or daughter must receive twelve hours of
8training relevant to the needs of adults with developmental
9disabilities within the first one hundred twenty days of becoming an
10individual provider.
11(2) Effective January 1, 2011, individual providers identified in
12(a) and (b) of this subsection must complete thirty-five hours of
13training within the first one hundred twenty days of becoming an
14individual provider. Five of the thirty-five hours must be completed
15before becoming eligible to provide care. Two of these five hours
16shall be devoted to an orientation training regarding an individual
17provider's role as caregiver and the applicable terms of employment,
18and three hours shall be devoted to safety training, including basic
19safety precautions, emergency procedures, and infection control.
20Individual providers subject to this requirement include:
21(a) An individual provider caring only for his or her biological,
22step, or adoptive child or parent unless covered by subsection (1) of
23this section; and
24(b) Before January 1, 2014, a person hired as an individual
25provider who provides twenty hours or less of care for one person in
26any calendar month.
27(3) Only training curriculum approved by the department may be used
28to fulfill the training requirements specified in this section. The
29department shall only approve training curriculum that:
30(a) Has been developed with input from consumer and worker
31representatives; and
32(b) Requires comprehensive instruction by qualified instructors.
33(4) The department shall adopt rules by August 1, 2010, to
34implement this section.
35NEW SECTION. Sec. 109. A new section is added to chapter 74.39A
36RCW to read as follows:
1(1) The department shall deny payment to any individual provider of
2home care services who has not been certified by the department of
3health as a home care aide as required under chapter 2, Laws of 2009
4or, if exempted from certification by RCW 18.88B.040, has not completed
5his or her required training pursuant to chapter 2, Laws of 2009.
6(2) The department may terminate the contract of any individual
7provider of home care services, or take any other enforcement measure
8deemed appropriate by the department if the individual provider's
9certification is revoked under chapter 2, Laws of 2009 or, if exempted
10from certification by RCW 18.88B.040, has not completed his or her
11required training pursuant to chapter 2, Laws of 2009.
12(3) The department shall take appropriate enforcement action
13related to the contract of a private agency or facility licensed by the
14state, to provide personal care services, other than an individual
15provider, who knowingly employs a long-term care worker who is not a
16certified home care aide as required under chapter 2, Laws of 2009 or,
17if exempted from certification by RCW 18.88B.040, has not completed his
18or her required training pursuant to chapter 2, Laws of 2009.
19(4) Chapter 34.05 RCW shall govern actions by the department under
20this section.
21(5) The department shall adopt rules by August 1, 2010, to
22implement this section.
23NEW SECTION. Sec. 110. A new section is added to chapter 74.39A
24RCW to read as follows:
25(1) The department shall create a formula that converts the cost of
26the increase in wages and benefits negotiated and funded in the
27contract for individual providers of home care services pursuant to RCW
2874.39A.270 and 74.39A.300, into a per-hour amount, excluding those
29benefits defined in subsection (2) of this section. That per-hour
30amount shall be added to the statewide home care agency vendor rate and
31shall be used exclusively for improving the wages and benefits of home
32care agency workers who provide direct care. The formula shall account
33for:
34(a) All types of wages, benefits, and compensation negotiated and
35funded each biennium, including but not limited to:
36(i) Regular wages;
37(ii) Benefit pay, such as vacation, sick, and holiday pay;
1(iii) Taxes on wages/benefit pay;
2(iv) Mileage; and
3(v) Contributions to a training partnership; and
4(b) The increase in the average cost of worker's compensation for
5home care agencies and application of the increases identified in (a)
6of this subsection to all hours required to be paid, including travel
7time, of direct service workers under the wage and hour laws and
8associated employer taxes.
9(2) The contribution rate for health care benefits, including but
10not limited to medical, dental, and vision benefits, for eligible
11agency home care workers shall be paid by the department to home care
12agencies at the same rate as negotiated and funded in the collective
13bargaining agreement for individual providers of home care services.
14NEW SECTION. Sec. 111. A new section is added to chapter 74.39A
15RCW to read as follows:
16Long-term care workers shall be offered on-the-job training or peer
17mentorship for at least one hour per week in the first ninety days of
18work from a long-term care worker who has completed at least twelve
19hours of mentor training and is mentoring no more than ten other
20workers at any given time. This requirement applies to long-term care
21workers who begin work on or after July 1, 2011.
22NEW SECTION. Sec. 112. A new section is added to chapter 74.39A
23RCW to read as follows:
24(1) The department of health shall ensure that all long-term care
25workers shall complete twelve hours of continuing education training in
26advanced training topics each year. This requirement applies beginning
27on July 1, 2011.
28(2) Completion of continuing education as required in this section
29is a prerequisite to maintaining home care aide certification under
30chapter 2, Laws of 2009.
31(3) Unless voluntarily certified as a home care aide under chapter
322, Laws of 2009, subsection (1) of this section does not apply to:
33(a) An individual provider caring only for his or her biological,
34step, or adoptive child; and
35(b) Before June 30, 2014, a person hired as an individual provider
1who provides twenty hours or less of care for one person in any
2calendar month.
3(4) Only training curriculum approved by the department may be used
4to fulfill the training requirements specified in this section. The
5department shall only approve training curriculum that:
6(a) Has been developed with input from consumer and worker
7representatives; and
8(b) Requires comprehensive instruction by qualified instructors.
9(5) Individual providers under RCW 74.39A.270 shall be compensated
10for training time required by this section.
11(6) The department of health shall adopt rules by August 1, 2010,
12to implement subsections (1), (2), and (3) of this section.
13(7) The department shall adopt rules by August 1, 2010, to
14implement subsection (4) of this section.
15NEW SECTION. Sec. 113. A new section is added to chapter 74.39A
16RCW to read as follows:
17The department shall offer, directly or through contract, training
18opportunities sufficient for a long-term care worker to accumulate
19seventy hours of training within a reasonable time period. For
20individual providers represented by an exclusive bargaining
21representative under RCW 74.39A.270, the training opportunities shall
22be offered through the training partnership established under RCW
2374.39A.360. Training topics shall include, but are not limited to:
24Client rights; personal care; mental illness; dementia; developmental
25disabilities; depression; medication assistance; advanced communication
26skills; positive client behavior support; developing or improving
27client-centered activities; dealing with wandering or aggressive client
28behaviors; medical conditions; nurse delegation core training; peer
29mentor training; and advocacy for quality care training. The
30department may not require long-term care workers to obtain the
31training described in this section. This requirement to offer advanced
32training applies beginning January 1, 2012.
33NEW SECTION. Sec. 114. A new section is added to chapter 74.39A
34RCW to read as follows:
35Unless the context clearly requires otherwise, the definitions in
36this section apply throughout this chapter.
1(1) "Adult family home" means a home licensed under chapter 70.128
2RCW.
3(2) "Adult residential care" means services provided by a boarding
4home that is licensed under chapter 18.20 RCW and that has a contract
5with the department under RCW 74.39A.020 to provide personal care
6services.
7(3) "Assisted living services" means services provided by a
8boarding home that has a contract with the department under RCW
974.39A.010 to provide personal care services, intermittent nursing
10services, and medication administration services, and the resident is
11housed in a private apartment-like unit.
12(4) "Boarding home" means a facility licensed under chapter 18.20
13RCW.
14(5) "Core competencies" means basic training topics, including but
15not limited to, communication skills, worker self-care, problem
16solving, maintaining dignity, consumer directed care, cultural
17sensitivity, body mechanics, fall prevention, skin and body care, long-
18term care worker roles and boundaries, supporting activities of daily
19living, and food preparation and handling.
20(6) "Cost-effective care" means care provided in a setting of an
21individual's choice that is necessary to promote the most appropriate
22level of physical, mental, and psychosocial well-being consistent with
23client choice, in an environment that is appropriate to the care and
24safety needs of the individual, and such care cannot be provided at a
25lower cost in any other setting. But this in no way precludes an
26individual from choosing a different residential setting to achieve his
27or her desired quality of life.
28(7) "Department" means the department of social and health
29services.
30(8) "Developmental disability" has the same meaning as defined in
31RCW 71A.10.020.
32(9) "Direct care worker" means a paid caregiver who provides
33direct, hands-on personal care services to persons with disabilities or
34the elderly requiring long-term care.
35(10) "Enhanced adult residential care" means services provided by
36a boarding home that is licensed under chapter 18.20 RCW and that has
37a contract with the department under RCW 74.39A.010 to provide personal
1care services, intermittent nursing services, and medication
2administration services.
3(11) "Functionally disabled person" or "person who is functionally
4disabled" is synonymous with chronic functionally disabled and means a
5person who because of a recognized chronic physical or mental condition
6or disease, or developmental disability, including chemical dependency,
7is impaired to the extent of being dependent upon others for direct
8care, support, supervision, or monitoring to perform activities of
9daily living. "Activities of daily living", in this context, means
10self-care abilities related to personal care such as bathing, eating,
11using the toilet, dressing, and transfer. Instrumental activities of
12daily living may also be used to assess a person's functional abilities
13as they are related to the mental capacity to perform activities in the
14home and the community such as cooking, shopping, house cleaning, doing
15laundry, working, and managing personal finances.
16(12) "Home and community services" means adult family homes, in-
17home services, and other services administered or provided by contract
18by the department directly or through contract with area agencies on
19aging or similar services provided by facilities and agencies licensed
20by the department.
21(13) "Home care aide" means a long-term care worker who has
22obtained certification as a home care aide by the department of health.
23(14) "Individual provider" is defined according to RCW 74.39A.240.
24(15) "Long-term care" is synonymous with chronic care and means
25care and supports delivered indefinitely, intermittently, or over a
26sustained time to persons of any age disabled by chronic mental or
27physical illness, disease, chemical dependency, or a medical condition
28that is permanent, not reversible or curable, or is long-lasting and
29severely limits their mental or physical capacity for self-care. The
30use of this definition is not intended to expand the scope of services,
31care, or assistance by any individuals, groups, residential care
32settings, or professions unless otherwise expressed by law.
33(16)(a) "Long-term care workers for the elderly or persons with
34disabilities" or "long-term care workers" includes all persons who are
35long-term care workers for the elderly or persons with disabilities,
36including but not limited to individual providers of home care
37services, direct care employees of home care agencies, providers of
38home care services to persons with developmental disabilities under
1Title 71 RCW, all direct care workers in state-licensed boarding homes,
2assisted living facilities, and adult family homes, respite care
3providers, community residential service providers, and any other
4direct care worker providing home or community-based services to the
5elderly or persons with functional disabilities or developmental
6disabilities.
7(b) "Long-term care workers" do not include: (i) Persons employed
8by the following facilities or agencies: Nursing homes subject to
9chapter 18.51 RCW, hospitals or other acute care settings, residential
10habilitation centers under chapter 71A.20 RCW, facilities certified
11under 42 C.F.R., Part 483, hospice agencies subject to chapter 70.127
12RCW, adult day care centers, and adult day health care centers; or (ii)
13persons who are not paid by the state or by a private agency or
14facility licensed by the state to provide personal care services.
15(17) "Nursing home" means a facility licensed under chapter 18.51
16RCW.
17(18) "Personal care services" means physical or verbal assistance
18with activities of daily living and instrumental activities of daily
19living provided because of a person's functional disability.
20(19) "Population specific competencies" means basic training topics
21unique to the care needs of the population the long-term care worker is
22serving, including but not limited to, mental health, dementia,
23developmental disabilities, young adults with physical disabilities,
24and older adults.
25(20) "Qualified instructor" means a registered nurse or other
26person with specific knowledge, training, and work experience in the
27provision of direct, hands-on personal care and other assistance
28services to the elderly or persons with disabilities requiring
29long-term care.
30(21) "Secretary" means the secretary of social and health services.
31(22) "Secretary of health" means the secretary of health or the
32secretary's designee.
33(23) "Training partnership" means a joint partnership or trust that
34includes the office of the governor and the exclusive bargaining
35representative of individual providers under RCW 74.39A.270 with the
36capacity to provide training, peer mentoring, and workforce
37development, or other services to individual providers.
1(24) "Tribally licensed boarding home" means a boarding home
2licensed by a federally recognized Indian tribe which home provides
3services similar to boarding homes licensed under chapter 18.20 RCW.
4NEW SECTION. Sec. 115. The following acts or parts of acts are
5each repealed:
6(1) RCW 18.88B.020 (Certification requirements) and 2011 c ... s
7..., 2009 c 580 s 18, & 2009 c 2 s 4;
8(2) RCW 18.88B.030 (Certification examinations) and 2011 c ... s
9..., 2009 c 580 s 4, & 2009 c 2 s 6;
10(3) RCW 18.88B.040 (Exemptions from training requirements) and 2011
11c ... s ..., 2010 c 169 s 11, 2009 c 580 s 15, & 2009 c 2 s 7;
12(4) RCW 74.39A.009 (Definitions) and 2011 c ... s ..., 2009 c 580
13s 1, 2009 c 2 s 2, 2007 c 361 s 2, 2004 c 142 s 14, & 1997 c 392 s 103;
14(5) RCW 74.39A.050 (Quality improvement principles) and 2011 c ...
15s ..., 2009 c 580 s 7, 2009 c 2 s 14, 2004 c 140 s 6, 2000 c 121 s 10,
161999 c 336 s 5, 1998 c 85 s 1, 1997 c 392 s 209, & 1995 1st sp.s. c 18
17s 12;
18(6) RCW 74.39A.055 (Criminal history checks on long-term care
19workers) and 2011 c ... s ..., 2009 c 580 s 2, & 2009 c 2 s 3;
20(7) RCW 74.39A.073 (Training requirements for long-term care
21workers) and 2011 c ... s ..., 2009 c 580 s 10, & 2009 c 2 s 5;
22(8) RCW 74.39A.075 (Training requirements for individual providers
23caring for family members) and 2011 c ... s ..., 2009 c 580 s 11, &
242009 c 2 s 8;
25(9) RCW 74.39A.085 (Enforcement actions against persons not
26certified as home care aides and their employers) and 2011 c ... s ...,
272009 c 580 s 14, & 2009 c 2 s 12;
28(10) RCW 74.39A.260 (Department duties--Criminal background checks
29on individual providers) and 2011 c ... s ..., 2009 c 580 s 9, & 2002
30c 3 s 5;
31(11) RCW 74.39A.310 (Contract for individual home care services
32providers--Cost of increase in wages and benefits funded--Formula) and
332011 c ... s ..., 2007 c 361 s 8, & 2006 c 9 s 1;
34(12) RCW 74.39A.330 (Peer mentoring) and 2011 c ... s ..., 2009 c
35478 s 1, & 2007 c 361 s 3;
36(13) RCW 74.39A.340 (Continuing education requirements for long-
1term care workers) and 2011 c ... s ..., 2009 c 580 s 12, 2009 c 2 s 9,
2& 2007 c 361 s 4; and
3(14) RCW 74.39A.350 (Advanced training) and 2011 c ... s ..., 2009
4c 580 s 13, 2009 c 2 s 10, & 2007 c 361 s 5.
5PART II
6PROTECTING TAXPAYERS BY REQUIRING ANNUAL INDEPENDENT AUDITS,
7INCREASING FRAUD INVESTIGATION, AND CAPPING ADMINISTRATIVE
8EXPENSES
9NEW SECTION. Sec. 201. The state auditor shall conduct
10performance audits of the long-term in-home care program. The first
11audit must be completed within twelve months after the effective date
12of this section, and must be completed on a biannual basis thereafter.
13As part of this auditing process, the state shall hire five additional
14fraud investigators to ensure that clients receiving services at
15taxpayers' expense are medically and financially qualified to receive
16the services and are actually receiving the services.
17NEW SECTION. Sec. 202. The people hereby establish limits on the
18percentage of tax revenues that can be used for administrative expenses
19in the long-term in-home care program. Within one hundred eighty days
20of the effective date of this section, the state shall prepare a plan
21to cap administrative expenses so that at least ninety percent of
22taxpayer spending must be devoted to direct care. This limitation must
23be achieved within two years from the effective date of this section.
24PART III
25MISCELLANEOUS
26NEW SECTION. Sec. 301. (1) Sections 101 and 115(6) of this act
27only take effect if RCW 74.39A.055 is amended or repealed by the
28legislature in 2011.
29(2) Sections 102 and 115(10) of this act only take effect if RCW
3074.39A.260 is amended or repealed by the legislature in 2011.
31(3) Sections 103 and 115(1) of this act only take effect if RCW
3218.88B.020 is amended or repealed by the legislature in 2011.
1(4) Sections 104 and 115(2) of this act only take effect if RCW
218.88B.030 is amended or repealed by the legislature in 2011.
3(5) Sections 105 and 115(3) of this act only take effect if RCW
418.88B.040 is amended or repealed by the legislature in 2011.
5(6) Sections 106 and 115(5) of this act only take effect if RCW
674.39A.050 is amended or repealed by the legislature in 2011.
7(7) Sections 107 and 115(7) of this act only take effect if RCW
874.39A.073 is amended or repealed by the legislature in 2011.
9(8) Sections 108 and 115(8) of this act only take effect if RCW
1074.39A.075 is amended or repealed by the legislature in 2011.
11(9) Sections 109 and 115(9) of this act only take effect if RCW
1274.39A.085 is amended or repealed by the legislature in 2011.
13(10) Sections 110 and 115(11) of this act only take effect if RCW
1474.39A.310 is amended or repealed by the legislature in 2011.
15(11) Sections 111 and 115(12) of this act only take effect if RCW
1674.39A.330 is amended or repealed by the legislature in 2011.
17(12) Sections 112 and 115(13) of this act only take effect if RCW
1874.39A.340 is amended or repealed by the legislature in 2011.
19(13) Sections 113 and 115(14) of this act only take effect if RCW
2074.39A.350 is amended or repealed by the legislature in 2011.
21(14) Sections 114 and 115(4) of this act only take effect if RCW
2274.39A.009 is amended or repealed by the legislature in 2011.
23(15) Section 303 of this act takes effect only if one or more other
24sections of this act take effect pursuant to paragraphs (1) through
25(14) of this section.
26NEW SECTION. Sec. 302. The code reviser is directed to note in
27the Revised Code of Washington that sections 101 through 114 of this
28act are versions of statutes existing prior to the 2011 regular
29legislative session as follows:
30(1) Section 101 of this act is the same language as RCW 74.39A.055
31and 2009 c 580 s 2;
32(2) Section 102 of this act is the same language as RCW 74.39A.260
33and 2009 c 580 s 9;
34(3) Section 103 of this act is the same language as RCW 18.88B.020
35and 2009 c 580 s 18;
36(4) Section 104 of this act is the same language as RCW 18.88B.030
37and 2009 c 580 s 4;
1(5) Section 105 of this act is the same language as RCW 18.88B.040
2and 2010 c 169 s 11;
3(6) Section 106 of this act is the same language as RCW 74.39A.050
4and 2009 c 580 s 7;
5(7) Section 107 of this act is the same language as RCW 74.39A.073
6and 2009 c 580 s 10;
7(8) Section 108 of this act is the same language as RCW 74.39A.075
8and 2009 c 580 s 11;
9(9) Section 109 of this act is the same language as RCW 74.39A.085
10and 2009 c 580 s 14;
11(10) Section 110 of this act is the same language as RCW 74.39A.310
12and 2007 c 361 s 8;
13(11) Section 111 of this act is the same language as RCW 74.39A.330
14and 2009 c 478 s 1;
15(12) Section 112 of this act is the same language as RCW 74.39A.340
16and 2009 c 580 s 12;
17(13) Section 113 of this act is the same language as RCW 74.39A.350
18and 2009 c 580 s 13; and
19(14) Section 114 of this act is the same language as RCW 74.39A.009
20and 2009 c 580 s 1.
21If any of sections 101 through 114 of this act take effect, the
22code reviser is directed to codify such sections in the revised code of
23washington under the same statute number as previously used for such
24statute, as set forth in this section.
25NEW SECTION. Sec. 303. Notwithstanding any action of the
26legislature during 2011, all long-term care workers as defined under
27RCW 74.39A.009(16), as it existed on April 1, 2011, are covered by
28sections 101 through 113 of this act or by the corresponding original
29versions of the statutes, as referenced in section 302 (1) through (13)
30on the schedules set forth in those sections, except that long-term
31care workers employed as community residential service providers are
32covered by sections 101 through 113 of this act beginning January 1,
332016.
34NEW SECTION. Sec. 304. A new section is added to chapter 74.39A
35RCW to read as follows:
1(1) If any provision of this act triggers changes to an agreement
2reached under RCW 74.39A.300, the changes must go into effect
3immediately without need for legislative approval.
4(2) The requirements contained in RCW 74.39A.300 and this act
5constitute ministerial, mandatory, and nondiscretionary duties.
6Failure to fully perform such duties constitutes a violation of this
7act. Any person may bring an action to require the governor or other
8responsible persons to perform such duties. Such action may be brought
9in the superior court, at the petitioner's option, for (a) Thurston
10county, or (b) the county of the petitioner's residence or principal
11place of business, or such action may be filed directly with the
12supreme court, which is hereby given original jurisdiction over such
13action.
14NEW SECTION. Sec. 305. The provisions of this act are to be
15liberally construed to effectuate the intent, policies, and purposes of
16this act.
17NEW SECTION. Sec. 306. If any provision of this act or its
18application to any person or circumstance is held invalid, the
19remainder of the act or the application of the provision to other
20persons or circumstances is not affected.
21NEW SECTION. Sec. 307. This act takes effect sixty days from its
22enactment by the people.
23NEW SECTION. Sec. 308. This act may be known and cited as the
24restoring quality home care initiative.Originally filed in Office of Secretary of State April 21, 2011.
Approved by the People of the State of Washington in the General Election on November 8, 2011.