AN ACT Relating to the department of social and health services; amending RCW 43.190.020, 43.190.030, 43.190.070, and 43.190.110; adding new sections to chapter 43.190 RCW; and repealing RCW 43.190.060 and 43.190.090.

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

Sec. 1. Section 2, chapter 290, Laws of 1983 and RCW 43.190.020 are each amended to read as follows:

As used in this chapter, the following terms have the meanings indicated unless the context clearly requires otherwise:

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

(2) "Long-term care facility" means any of the following which provide services to persons sixty years of age and older and is:

((~~(1)~~)) (a) A facility which:

((~~(a)~~)) (i) Maintains and operates twenty-four hour skilled nursing services for the care and treatment of chronically ill or convalescent patients, including mental, emotional, or behavioral problems, mental retardation, or alcoholism;

((~~(b)~~)) (ii) Provides supportive, restorative, and preventive health services in conjunction with a socially oriented program to its residents, and which maintains and operates twenty-four hour services including board, room, personal care, and intermittent nursing care. "Long-term health care facility" includes nursing homes, skilled nursing facilities, and intermediate care facilities, but does not include acute care hospital or other licensed facilities except for that distinct part of the hospital or facility which provides nursing home, skilled nursing facility, or intermediate care facility services.

((~~(2)~~)) (b) Any family home, group care facility, or similar facility determined by the secretary, for twenty-four hour nonmedical care of persons in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or for the protection of the individual.

((~~(3)~~)) (c) Any swing bed in an acute care facility.

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

Sec. 2. Section 3, chapter 290, Laws of 1983 and RCW 43.190.030 are each amended to read as follows:

(1) There is created within the ((~~department of social and health services~~)) office of the attorney general the office of the state long-term care ombudsman. The ((~~secretary~~)) attorney general shall place the office in an area within the department which will enable the office to fully carry out the purposes of this chapter. The ((~~secretary~~)) attorney general shall ensure that all program and staff support necessary to enable the ombudsman to effectively protect the interests of residents, patients, and clients of all long-term care facilities is made available to the ombudsman to the extent authorized by RCW 43.190.120.

(2) ((~~The state ombudsman shall have the following powers and duties:~~

~~(a) To provide services for coordinating the activities of long-term care ombudsmen throughout the state;~~

~~(b) Carry out such other activities as the secretary deems appropriate;~~

(c) Establish procedures consistent with RCW 43.190.110 for appropriate access by long-term care ombudsmen to long-term care facilities and patients' records, including procedures to protect the confidentiality of the records and ensure that the identity of any complainant or resident will not be disclosed without the written consent of the complainant or resident, or upon court order;

(d) Establish a state-wide uniform reporting system to collect and analyze data relating to complaints and conditions in long-term care facilities for the purpose of identifying and resolving significant problems, with provision for submission of such data to the department of social and health services and to the federal department of health and human services, or its successor agency, on a regular basis; and

(e) Establish procedures to assure that any files maintained by ombudsman programs shall be disclosed only at the discretion of the ombudsman having authority over the disposition of such files, except that the identity of any complainant or resident of a long-term care facility shall not be disclosed by such ombudsman unless:

~~(i) Such complainant or resident, or the complainant's or resident's legal representative, consents in writing to such disclosure; or~~

~~(ii) Such disclosure is required by court order~~)) Supervision of the ombudsman shall be by the attorney general.

NEW SECTION. Sec. 3. A new section is added to chapter 43.190 RCW to read as follows:

The state long-term care ombudsman shall:

(1) Investigate and resolve complaints made by or on behalf of older individuals who are residents of long-term care facilities relating to administrative action which may adversely affect the health, safety, welfare, and rights of these individuals;

(2) Monitor the development and implementation of federal, state, and local laws, rules, regulations, and policies with respect to long-term care facilities in this state;

(3) Provide information as appropriate to public agencies regarding the problems of individuals residing in long-term care facilities;

(4) Provide for training volunteers and promoting the development of citizen organizations to participate in the ombudsman program;

(5) Provide services for coordinating the activities of long-term care ombudsmen throughout the state;

(6) Establish procedures consistent with RCW 43.190.110 for appropriate access by long-term care ombudsmen to long-term care facilities and patients' records, including procedures to protect the confidentiality of the records and ensure that the identity of any complainant or resident will not be disclosed without the written consent of the complainant or resident, or upon court order;

(7) Establish a state-wide uniform reporting system to collect and analyze data relating to complaints and conditions in long-term care facilities for the purpose of identifying and resolving significant problems, with provision for submission of such data to the department of social and health services and to the federal department of health and human services, or its successor agency, on a regular basis.

The state long-term care ombudsman may contract with local ombudsmen to aid in the performance of the ombudsman's duties.

Sec. 4. Section 7, chapter 290, Laws of 1983 and RCW 43.190.070 are each amended to read as follows:

(1) The office of the state long-term care ombudsman shall develop referral procedures for all long-term care ombudsman programs to refer any complaint to any appropriate state or local government agency. The department ((~~of social and health services shall act as quickly as possible on any complaint referred to them by a long-term care ombudsman~~)) shall serve as the primary investigator of complaints referred to them by the long-term care ombudsman and shall respond to complaints in a timely manner consistent with the gravity of the complaint.

(2) Volunteer ombudsmen may identify and resolve problems regarding the care of residents in long-term care facilities. Volunteers shall not be used for complaint investigation or problem resolution activities authorized in section 3(1) of this 1987 act but may engage in fact-finding activities to determine whether a formal complaint should be submitted to the department.

(3) The department ((~~of social and health services~~)) shall respond to any complaint against a long-term care facility which was referred to it by a long-term care ombudsman and shall forward to that ombudsman a summary of the results of the investigation and action proposed or taken.

(4) The state long-term ombudsman shall monitor and oversee the long-term complaint investigation process of the department to ensure its efficiency and effectiveness. The state ombudsman shall report its recommendations to improve the efficiency and effectiveness of the complaint investigation process of the department as part of its reporting requirements of RCW 43.190.100.

Sec. 5. Section 11, chapter 290, Laws of 1983 and RCW 43.190.110 are each amended to read as follows:

(1) All records and files of state, local, and volunteer long-term care ombudsmen relating to any complaint or investigation made pursuant to carrying out their duties and the identities of complainants, witnesses, patients, or residents shall remain confidential unless disclosure is authorized by the patient or resident or his or her guardian or legal representative. No disclosures may be made outside the office without the consent of any named witnesses, resident, patient, client, or complainant unless the disclosure is made without the identity of any of these individuals being disclosed.

(2) No long-term care ombudsman is liable for good faith performance of responsibilities under this chapter.

(3) No discriminatory, disciplinary, or retaliatory action may be taken against any employee of a facility or agency, any patient, resident, or client of a long-term care facility, or any volunteer, for any communication made, or information given or disclosed, to aid the long-term care ombudsman in carrying out its duties and responsibilities, unless the same was done maliciously or without good faith. This subsection is not intended to infringe on the rights of the employer to supervise, discipline, or terminate an employee for other reasons.

(4) All communications by a long-term care ombudsman, if reasonably related to the requirements of that individual's responsibilities under this chapter and done in good faith, are privileged and that privilege shall serve as a defense to any action in libel or slander.

(5) A representative of the office is exempt from being required to testify in court as to any confidential matters except as the court may deem necessary to enforce this chapter.

NEW SECTION. Sec. 6. A new section is added to chapter 43.190 RCW to read as follows:

There is hereby created the long-term care ombudsman advisory committee consisting of six members to be appointed by the attorney general. The committee shall be comprised of:

(1) A representative from the nursing home industry;

(2) A representative from state area agencies on aging;

(3) A resident/family member of a nursing home resident;

(4) A representative from a senior citizen organization;

(5) A representative from an adult family home; and

(6) A member from the general public.

For the initial committee, two members shall be appointed for one year, two members shall be appointed for two years, and three members shall be appointed for three years. Their successors, upon being appointed, shall serve a three-year term. In the case of a vacancy, it shall be filled by appointment by the attorney general for the unexpired term in which the vacancy occurs. Any member may be removed at any time for cause by the attorney general. No member shall serve more than five total years. Members of the committee shall be reimbursed for travel expenses in accordance with RCW 43.03.050 and 43.03.060.

NEW SECTION. Sec. 7. A new section is added to chapter 43.190 RCW to read as follows:

The long-term care ombudsman advisory committee shall screen and recommend candidates for the position of state long-term ombudsman and advise the ombudsman on the annual reports provided for in RCW 43.190.100. Employment of the state long-term care ombudsman shall be in accordance with chapter 41.06 RCW relating to state civil service.

NEW SECTION. Sec. 8. The following acts or parts of acts are each repealed:

(1) Section 6, chapter 290, Laws of 1983 and RCW 43.190.060; and

(2) Section 9, chapter 290, Laws of 1983 and RCW 43.190.090.