SENATE BILL REPORT

                   SB 6544

              As Reported By Senate Committee On:

           Health & Long-Term Care, February 6, 1998

                Ways & Means, February 10, 1998

Title:  An act relating to improving long‑term care.

Brief Description:  Providing for adult family home and boarding home training.

Sponsors:  Senators Deccio, Franklin, Wood, Wojahn and Winsley.

Brief History:

Committee Activity:  Health & Long‑Term Care:  1/23/98, 2/6/98 [DPS-WM].

Ways & Means: 2/10/98 [DP2S].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report:  That Substitute Senate Bill No. 6544 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.

  Signed by Senators Deccio, Chair; Wood, Vice Chair; Benton, Fairley, Franklin, Strannigan and Wojahn.

Staff:  Rhoda Jones (786-7198)

SENATE COMMITTEE ON WAYS & MEANS

Majority Report:  That Second Substitute Senate Bill No. 6544 be substituted therefor, and the second substitute bill do pass.

  Signed by Senators West, Chair; Deccio, Vice Chair; Bauer, Brown, Fraser, Hochstatter, Kohl, Long, Loveland, McDonald, Rossi, B. Sheldon, Snyder, Spanel, Swecker, Thibaudeau and Winsley.

Staff:  Tim Yowell (786-7435)

Background:  There are over 27,000 elderly and disabled residents living in boarding homes and adult family homes in Washington State.  These facilities provide room and board and an array of services ranging from personal care to limited nursing care.  Residents have a range of health care needs, including conditions which leave them frail, confused, and otherwise vulnerable.

Currently, caregivers in adult family homes and some boarding homes are required to have a minimum of 22 hours of training in infection control, first aid, and residents= rights. Caregivers in homes where there are residents with dementia, developmental disabilities or mental illness are not required to have any specific training related to caring for these special populations.

Summary of Second Substitute Bill:  The Department of Health, the Department of Social and Health Services, the Nursing Care Quality Assurance Commission and representatives of other long-term care services  are directed to meet with boarding home and adult family home providers and resident groups to develop recommendations on training standards for caregivers and administrators in adult family homes and boarding homes.  Their report is due to the Legislature by December 1, 1998.

The proposal must include recommended training standards for both administrators and staff serving residents with a diagnosis of dementia, mental illness or developmental disability.  Training recommendations must take into account the following factors:  availability and affordability of training; potential costs to DSHS and private providers; what types of training  could transfer; competency testing; and practical and clinical coursework.

Disclosure language requires all facilities receive a full assessment of the health condition of each resident before admission.  Specific required information is defined.  These assessments are required before admission except in cases of emergency placements.

Facilities must also fully disclose to potential residents what items and activities they are capable of arranging.  Facilities must also inform each resident in advance of changes in services, charges for services, or changes in the facility's rules.   Facilities with six or fewer residents may make changes with a 14-day notice.

Second Substitute Bill Compared to Original Bill:  The original bill directed DSHS, DOH and NQAC to adopt rules implementing training enhancements following the 1999 Legislature.  In the substitute bill, the requirement for recent medical history information to be part of the patient assessment before entering a long-term care facility was removed for persons who object for religious reasons.  In the second substitute bill, DSHS is required to report on the cost of implementing the new training standards, rather than automatically adjusting payment rates to cover them.

Appropriation:  None.

Fiscal Note:  Available.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For (Health & Long-Term Care):  This will ensure there is serious discussion of the amount of new training necessary for caregivers in adult family homes and boarding homes.

Testimony Against (Health & Long-Term Care):  None.

Testified (Health & Long-Term Care):  PRO:  Sue Elliott, ARC of Washington; Sherm Cox, DOH; Lauri St. Ours, Northwest Assisted Living Facilities Association; Louise Ryan, LTC Ombudsman; Kathy Leitch, DSHS-AASA; Jeff Larsen, WSRCC; Bill Day, Adult Family Home Association; Kary Hyre, LTCOP; Jeff Crollard, Columbia Legal Services; Jan Kavadas, Dorothy Meeks, Citizens for Improvement of Nursing Homes; Donna Patrick, Developmental Disabilities Council.

Testimony For (Ways & Means):  We need to work with caregivers to build a quality training system.  Homes cannot afford any additional training costs without being reimbursed for it.  Acuity is increasing in community-based facilities, so increased training is essential.

Testimony Against (Ways & Means):  None.

Testified (Ways & Means):  PRO:  Bill Day, Adult Family Home Association of Washington; Jeff Larson, WA State Residential Care Council; Donna Patrick, Developmental Disabilities Council; Kary Hyre, Long-Term Care Ombudsman.