AN ACT Relating to adult family homes; adding a new chapter to Title 18 RCW; and prescribing penalties.

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

NEW SECTION. Sec. 1. The purpose of this chapter is to provide for the development, establishment, and enforcement of standards for the maintenance and operation of adult family homes, which, considering advancing knowledge, will promote safe and adequate care of the individuals therein. It is further the intent of the legislature that adult family homes only be available to those individuals who need some degree of assistance in personal care but do not require medical or nursing care.

NEW SECTION. Sec. 2. Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Adult family home" means the regular family abode of a person or persons licensed to provide therein full-time family care and supervision for from one to no more than four adults who are not related to the person or persons providing care.

(2) "Adult in need of personal care" means a person age eighteen or more who, because of developmental disability, age, or mental or physical infirmity requires some degree of supervision and assistance in activities of daily living, but does not require regular or continuous medical or nursing care.

(3) "Ambulatory resident" means a resident physically and mentally capable of walking unaided or capable of independent mobility with the use of a cane, crutches, a walkerette, a walker, a wheelchair, or artificial limb. It includes an individual able to walk or traverse a normal path to safety unaided by another individual. This definition shall not be construed to include an individual needing the assistance of another individual in order to get into and out of bed, to transfer to a chair or toilet, or to move from place to place.

(4) "Capacity" means the maximum number of persons permitted to be under care at a given time.

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

(6) "Developmentally disabled adult" means a person age eighteen or more who has been determined to be developmentally disabled as defined in RCW 71.20.016 by the department.

(7) "Person" means any individual, firm, partnership, corporation, company, association, or joint stock association, and the legal successor thereof.

(8) "Secretary" means the secretary of the department.

NEW SECTION. Sec. 3. After July 1, 1988, no person may operate or maintain an adult family home as defined in this chapter within the state without a license under this chapter.

NEW SECTION. Sec. 4. (1) An application for a license shall be made to the department upon forms provided by the department and shall contain such information as the department reasonably requires, which shall include affirmative evidence of ability to comply with such rules as are adopted by the department.

(2) Department staff or any member of a staff member's household involved directly or in an administrative or supervisory capacity in the adult family home licensing process, or in placement of persons in a licensed adult family home, or in authorizing payment for such persons is prohibited from obtaining an adult family home license.

(3) Licenses shall not be issued to an applicant for both children and adults in the same adult family home. Exceptions may be made only if it is clearly evident that the care of one category of persons does not interfere with the quality of care to be provided to the other category of persons. In such circumstances, the total number of persons in care in both categories shall not exceed the number permitted by the most stringent capacity limitation of an adult family home.

NEW SECTION. Sec. 5. Upon receipt of an application for license, if the applicant and the adult family home meet the requirements established under this chapter, the department shall issue a license. If there is a failure to comply with the provisions of this chapter or the standards and rules adopted under it, the department may in its discretion issue to an applicant for a license or for the renewal of a license, a provisional license which will permit the operation of the adult family home for a period to be determined by the department, but not to exceed twelve months, which provisional licenses shall not be subject to renewal. At the time of the application for or renewal of a license or provisional license, the licensee shall pay a license fee as established by the department under RCW 43.20B.110. All licenses issued under this chapter shall expire on a date to be set by the department, but no license issued under this chapter may exceed twelve months in duration. If the annual license renewal date of a previously licensed adult family home is set by the department on a date fewer than twelve months before the expiration date of a license in effect at the time of reissuance, the license fee shall be prorated on a monthly basis and a credit shall be allowed at the first renewal of a license for any period of one month or more covered by the previous license. All applications for renewal of license shall be made not later than thirty days before the date of expiration of the license. Each license shall be issued only for the premises and persons named in the application, and licenses shall not be transferable or assignable. Licenses shall be posted in a conspicuous place on the licensed premises.

NEW SECTION. Sec. 6. The department, after notice and opportunity for hearing to the applicant or license holder, may deny, suspend, or revoke a license in any case in which it finds there has been a failure or refusal to comply with the requirements established under this chapter or the rules adopted under it.

Notice of denial, suspension, or revocation shall be given by registered mail or by personal service in the manner of service of summons in a civil action; which notice shall set forth the particular reasons for the proposed denial, suspension, or revocation and shall fix a date not fewer than twenty days from the date of mailing or service, during which time the applicant or licensee may in writing request a hearing on the denial, suspension, or revocation. If the applicant or licensee fails to request a hearing within that time, the department may deny, suspend, or revoke the license without further notice or action. The order of denial, suspension, or revocation shall be mailed to the applicant or licensee by registered mail or personally served on him or her in the manner of service of summons in a civil action.

If the applicant or licensee requests a hearing within such time, the department shall fix a time for the hearing and shall give the applicant or licensee or such person's attorney written notice thereof.

The procedure governing hearings shall be in accordance with rules adopted by the department and any such hearing shall be informal and summary, except that a record shall be kept of the testimony taken on behalf of the applicant or licensee and the department, which need not be transcribed unless an appeal from the hearing is taken. The department shall render its decision within a reasonable time after the hearing and issue its order, which shall be served on the applicant or licensee or such person's attorney, and the order shall become final unless an appeal from the order is taken.

NEW SECTION. Sec. 7. Within twenty days after the date of mailing of the decision of the department, the interested applicant or licensee may appeal to the superior court of the county in which the adult family home is located or is to be located, and such appeal shall be heard de novo as a case in equity, but upon such appeal only such issues of law may be raised as were properly included in the hearing before the department. Full opportunity to be heard upon the issues of law and fact shall be had before judgment is pronounced. An appeal shall be perfected by serving a notice of appeal with the department and by filing the notice of appeal, together with proof of service thereof, with the clerk of the court. The service and the filing, together with proof of service on the notice of appeal, all within twenty days of the date of mailing the decision of the department, is jurisdictional. The department shall, within twenty days after receipt of the notice of appeal, serve and file a notice of appearance upon the appellant or the appellant's attorney of record, and the appeal shall thereupon be deemed at issue. The department shall serve upon the appellant and file with the clerk of the court before the hearing, a certified copy of the completed record of the administrative proceedings which shall, upon being so filed, become the record in the case. The cost of transcribing the record shall be borne by the appellant if the order of the department is affirmed by the court. In the event of modification or reversal, the cost shall be borne as directed by the court.

NEW SECTION. Sec. 8. (1) The department shall adopt and amend such rules and standards with respect to all adult family homes and adult family home operators to be licensed under this chapter as may be designed to further the accomplishment of the purposes of this chapter in promoting safe and adequate care of individuals in adult family homes and the sanitary, hygienic, and safe conditions of the adult family home in the interest of public health, safety, and welfare.

(2) The rules and standards adopted under this chapter shall include the following:

(a) Provisions for and documentation showing well- balanced, palatable, and properly prepared meals that meet the dietary allowances of the food and nutrition board of the national research council;

(b) A resident record maintained on a monthly basis documenting compliance with this chapter and the rules adopted under it; and

(c) Provisions for socialization and activities designed to encourage each resident to maintain normal activity and optimal level of independence with adequate physical space provided for recreational activities.

NEW SECTION. Sec. 9. The department shall make at least a yearly inspection and investigation of all adult family homes. Every inspection may include an inspection of every part of the premises and an examination of all records other than financial records, methods of administration, the general and special dietary needs of patients, and the stores and methods of supplying those needs. Following such inspection or inspections, written notice of any violation of this chapter or the rules adopted under it shall be given to the applicant or licensee and the department. The department may prescribe by rule that any applicant or licensee desiring to make specified types of alterations or additions to its facilities or to construct new facilities shall, before commencing such alteration, addition, or new construction, submit plans and specifications therefor to the department or to the authorized department for preliminary inspection and approval or recommendations with respect to compliance with the rules and standards adopted under this chapter.

NEW SECTION. Sec. 10. The department shall establish a procedure for making on-site investigations of complaints against adult family homes. Chapter 70.124 RCW, the patient abuse and reporting act, applies to adult family homes licensed under this chapter.

NEW SECTION. Sec. 11. Standards for fire protection and the enforcement thereof, with respect to all adult family homes to be licensed under this chapter, shall be the responsibility of the state fire marshal, who shall adopt such recognized standards as may be applicable to adult family homes for the protection of life against the cause and spread of fire and fire hazards but in no event may these standards be lower than those in existence for other similar residential programs in existence as of the effective date of this section. The department, upon receipt of an application for a license, shall submit to the state fire marshal in writing, a request for an inspection, giving the applicant's name and the location of the premises to be licensed. Upon receipt of such a request, the state fire marshal or the state fire marshal's deputy shall make an inspection of the adult family home to be licensed. If it is found that the premises do not comply with the required safety standards and fire regulations as adopted by the state fire marshal, the state fire marshal or the fire marshal's deputy shall promptly make a written report to the adult family home and to the department as to the manner and time allowed for the premises to qualify for a license and shall set forth the conditions to be remedied with respect to fire regulations. The applicant or licensee shall notify the state fire marshal upon completion of any requirements made by him or her, and the state fire marshal or his or her deputy shall make a reinspection of the premises. Whenever the adult family home to be licensed meets with the approval of the state fire marshal, the state fire marshal shall submit to the department a written report approving the facility with respect to fire protection before a full license can be issued. The state fire marshal shall make or cause to be made inspections of such homes at least annually.

In cities that have a comprehensive building code the provisions of which are determined by the state fire marshal to be equal to the minimum standards of the state fire marshal's code for adult family homes, the chief of the fire department, provided the latter is a paid chief of a paid fire department, shall make the inspection with the state fire marshal or the state fire marshal's deputy and they shall jointly approve the premises before a full license can be issued.

NEW SECTION. Sec. 12. Any person operating or maintaining any adult family home without a license under this chapter shall be guilty of a misdemeanor and each day of a continuing violation shall be considered a separate offense.

NEW SECTION. Sec. 13. Notwithstanding the existence or use of any other remedy, the department may, in the manner provided by law, upon the advice of the attorney general who shall represent the department in the proceedings, maintain an action in the name of the state for an injunction or other process against any person to restrain or prevent the operation or maintenance of an adult family home without a license under this chapter.

NEW SECTION. Sec. 14. (1) Insofar as a general or specific nuisance or a danger to the individuals or others is not created, each resident shall have, in addition to any rights not specifically withheld by law, the following rights:

(a) To be informed or to have an agent, designated by the resident, informed of his or her rights and the policies of the adult family home at the time of admission. A written copy of rights and policies shall be provided to each resident or designated agent;

(b) To be treated in a manner that respects his or her individual identity and human dignity and fosters constructive self-esteem;

(c) To be notified thirty days in advance if he or she requires transfer for medical or nursing care or for his or her welfare or that of other residents, except as prohibited by Title XVIII, XIX, or XX of the social security act, unless an emergency condition requires immediate transfer or there is a failure to comply with the written policy of the adult family home or to ensure orderly transfer or discharge. The notice of transfer or discharge and discharge planning shall be documented in the resident's record;

(d) To associate and communicate privately with persons of his or her choice; to send or receive uncensored correspondence through the mail; and to have reasonable access to a telephone both to make and to receive personal phone calls;

(e) To manage personal financial affairs unless the person has been adjudicated to be incompetent in a court proceeding directed to that particular issue or pursuant to law;

(f) To retain and use personal clothing and possessions unless to do so would infringe upon the rights of other residents;

(g) To refuse to perform services for the facility unless the services are included in the plan of care;

(h) To be assured privacy for visits with relatives or guests;

(i) To voice grievances and recommend changes in policies and services to the sponsor and to outside representatives of his or her choice free from restraint, interference, coercion, discrimination, or reprisal;

(j) To be informed of phone numbers and addresses of the licensing agency of appropriate advocacy group or groups;

(k) To meet with and participate in activities of social, religious, and community groups at his or her discretion;

(l) To be free from physical, chemical, and psychological restraints unless authorized by law;

(m) To be free from exploitation, assault, abuse, and neglect;

(n) To have information contained in resident health records kept confidential with access only to authorized personnel and the department; and

(o) To be given timely notice of changes in admission or retention policy and procedure.

(2) Each resident shall have at least one comfortable pillow and adequate, clean bedding. Clean sheets, a pillow case, towels, and washcloths shall be provided as needed and at least each week.

(3) A resident shall be regularly observed for changes in physical, mental, and emotional functioning. When observations reveal the resident has need for services unavailable in the adult family home, the sponsor or designee shall arrange for the transfer of the resident.

(4) Care services shall be conducted so as to attain or maintain each resident's highest degree of functioning possible and compatible with individual safety and welfare.

NEW SECTION. Sec. 15. The sponsor shall comply with federal and state statutory and regulatory requirements regarding nondiscrimination, including RCW 74.42.055 regarding medicaid discrimination.

NEW SECTION. Sec. 16. No person operating an adult family home licensed under this chapter may admit or retain in the adult family home any person requiring nursing or medical care of a type provided by institutions licensed under chapter 18.51, 70.41, or 71.12 RCW, except that when registered nurses are available, and upon a doctor's order that a supervised medication service is needed, it may be provided. Supervised medication services, as defined by the department, may include an approved program of self- medication or self-directed medication. Such medication service shall be provided only to residents who otherwise meet all requirements for residency in an adult family home.

NEW SECTION. Sec. 17. Nothing in this chapter or the rules adopted under it may be construed as authorizing the supervision, regulation, or control of the remedial care or treatment of residents in any adult family home conducted for those who rely upon treatment by prayer or spiritual means in accordance with the creed or tenets of any well-recognized church or religious denomination.

NEW SECTION. Sec. 18. Sections 1 through 17 of this act shall constitute a new chapter in Title 18 RCW.

NEW SECTION. Sec. 19. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.