AN ACT Relating to the establishment of a demonstration project at Northern State for the neurologically impaired; creating new sections; making an appropriation; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. The legislature recognizes that:

(1) Persons over the age of eighteen who suffer neurological impairment have a variety of program and service needs for which there is no clearly defined, ultimate responsibility vested in any single state agency and for which there are few programs currently attempting to meet their needs.

(2) The lack of clearly defined, ultimate responsibility has resulted in severe financial liability and physical and mental strain on neurologically impaired persons, their families, and caregivers.

(3) Terminology and nomenclature used to describe neurological impairments are varied and confusing, in part because of different medical diagnoses and professional opinions, as well as differences in terminology used by the various funding sources for programs and services.

(4) Neurological damage frequently results in functional impairments that adversely affect personality, behavior, and ability to perform daily activities. These impairments result in dependency on others for care and decision making. The manifestations of neurological damage include impairments of memory, cognitive ability, orientation, judgment, emotional response, and social inhibition.

NEW SECTION. Sec. 2. A neurologically impaired service center pilot project shall be established on the grounds of Northern State Hospital by July 1, 1986.

The department of social and health services shall contract with a nonprofit community agency to establish the pilot project.

The purpose of the center is to coordinate and provide a wide range of services tailored to the needs of neurologically impaired persons. The responsibilities of the center shall include the following:

(1) To assist neurologically impaired persons' access to services provided by state agencies and other public and private programs;

(2) To work closely with and coordinate agencies and organizations serving neurologically impaired adults, their families, and caregivers in order to ensure, consistent with requirements for quality of services as may be established by the center director, that the greatest number of individuals are served and that the optimal number of organizations participate;

(3) To provide other services, to the extent funding is available including but not limited to a centralized diagnostic unit, day care and day health care, legal counseling, financial consultation services, respite care, and family consultation to help plan for hospital, in-home, or institutional care needs;

(4) To cooperate with the appropriate divisions and bureaus of the department on those activities necessary for the proper implementation of this chapter;

(5) To work with the department in order to establish standards for eligibility for services and devise a method for determining levels of copayment;

(6) To assist in the identification and documentation of service needs and the development of necessary programs and services to meet the needs of neurologically impaired adults in the pilot project's geographic area; and

(7) To provide a state-wide clearing house for information on programs and services for neuroligical patients.

NEW SECTION. Sec. 3. Unless the context clearly indicates otherwise, the definitions in this section apply throughout sections 1 through 5 of this act.

(1) "Neurological damage," "degenerative brain diseases," and "brain impairment" mean significant destruction of brain tissue with resultant loss of brain function. Examples of causes of the impairments include, but are not limited to, all of the following:

(a) Progressive, degenerative, and dementing illnesses, including but not limited to, presenile and senile dementias, Alzheimer's disease, multiinfaret disease, Pick's disease, and Kreutzfeldt-Jakob's disease.

(b) Degenerative diseases of the central nervous system that can lead to dementia or severe brain impairment, including but not limited to, epilepsy, multiple sclerosis, Parkinson's disease, amyotrophic lateral sclerosis, and hereditary diseases such as Huntington's disease.

(c) Permanent damage caused by cerebrovascular accidents more commonly referred to as "strokes," including but not limited to, cerebral hemorrhage, aneurysm, and embolism.

(d) Posttraumatic, postanoxic, and postinfection damage caused by incidents, including but not limited to, coma, accidental skull and closed-head injuries, loss of oxygen (anoxia), and infections such as encephalitis, herpes simplex, and tuberculosis.

(e) Permanent brain damage or temporary or progressive dementia as a result of tumors (neoplasm), hydrocephalus, abscesses, seizures, substance toxicity, and other disorders.

(2) "Neurologically impaired adult" means a person whose impairment has occurred after the age of eighteen.

(3) "Department" means the department of social and health services.

(4) "Secretary" means the secretary of the department of social and health services.

NEW SECTION. Sec. 4. The department, in conjunction with the neurologically impaired service center shall report to the legislature by December 1, 1987, on the implementation of the pilot project at Northern State Hospital and its impact on services to the neurologically impaired.

The report shall also include, but not be limited to, all of the following:

(1) A comparative assessment of the costs and effectiveness of each type of service or combinations of services provided;

(2) An assessment of the nature and extent of the demand for services and an evaluation of their success in meeting this demand;

(3) An analysis of the effectiveness and cost savings of the pilot project in deterring the institutionalization of neurologically impaired adults, allowing caregivers to maintain a normal routine, and promoting the continuance of quality care for neurologically impaired adults; and

(4) Recommendations for ensuring that unmet needs of neurologically impaired persons and their families are identified and addressed with appropriate programs and services.

NEW SECTION. Sec. 5. (1) An advisory committee shall be appointed jointly by the secretary of the department and the agency director of the nonprofit agency selected to establish the center.

(2) Responsibilities of the advisory committee shall include but not be limited to:

(a) Providing advice to the director of the center on major policies, which affect the quality and quantity of services to neurologically impaired adults, budgetary issues, eligibility criteria, and the promulgation of rules concerning services to neurologically impaired adults.

(b) Reviewing with the centers' director and making recommendations to the directors of the appropriate divisions and bureaus of the department concerning the needs of neurologically impaired adults, the effectiveness of the services and the priorities of the center in meeting these needs, and the measures that could be taken to improve the centers services.

(3) The advisory committee shall be made up of at least four individuals who are, or have family members who are, or who represent neurologically impaired persons, two other individuals with expertise in services for the neurologically impaired, and one representative each from the divisions of mental health, developmental disabilities, vocational rehabilitation, and the bureau of aging and adult services.

NEW SECTION. Sec. 6. There is appropriated to the department of social and health services the sum of thirty thousand dollars from the general fund for the biennium ending June 30, 1987, for the purposes of this act. These funds shall not be used to supplant any funds currently being provided through other appropriations or to fund any services for which neurologically impaired individuals are entitled under state and federal statutes.

NEW SECTION. Sec. 7. This act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect immediately.