Purpose: To make the adult family home regulations clearer, more easily understood, and more reflective of practices and expectations that are currently in place.

Citation of Existing Rules Affected by this Order: Amending WAC 388-76-540, 388-76-550, 388-76-560, 388-76-570, 388-76-595, 388-76-605, 388-76-620, 388-76-635, 388-76-655, 388-76-660, 388-76-665, 388-76-670, 388-76-675, 388-76-680, 388-76-685, 388-76-690, 388-76-695, and 388-76-705.

Statutory Authority for Adoption: RCW 70.128.040.

Other Authority: Chapters 70.128 and 70.129 RCW.

Adopted under notice filed as WSR 98-02-077 on January 7, 1998.

Changes Other than Editing from Proposed to Adopted Version:

reasons for adopting the rules

Due to laws passed in the 1995 legislative session, rules governing adult family homes were completely revised and became effective in July 1996. Since that time, internal and external stakeholders have provided input and feedback concerning their experience implementing these rules. This feedback made it evident that changes to the regulations were needed to: Eliminate faulty and/or confusing language; make the regulations clearer and more easily understood; and make the regulations more reflective of current practices and laws. In addition, some changes are necessary to ensure department expectations are clearly defined and easily understood.

VARIANCE BETWEEN PROPOSED AND FINAL RULES ADULT FAMILY HOME MINIMUM LICENSING REQUIREMENTS WAC 388-76-540 THROUGH 388-76-705

The following is a description of differences between the proposed rules and the adopted version, and the principal reasons.

WAC 388-76-540 Definitions.

Caregiver - within this definition "entity responsible individual" was changed to "entity representative." This change was made throughout the rules.

Entity representative - we changed the name from "entity responsible individual" to "entity representative" as was suggested to us; we found the latter term less awkward. Other minor editorial changes were made to make this definition clearer. Throughout the rules, "entity responsible individual" has been replaced with "entity representative."

Individual provider - clarifying changes were made to make this definition clearer.

WAC 388-76-550 License application.

Section title revised to reflect recent statutory changes (eliminating renewal applications and implementing a nonexpiring license).

(1) Deleted "renewal" to reflect recent statutory changes (eliminating renewal applications and implementing a nonexpiring license).

(3) Minor editorial changes made to make this subsection easier to read.

(4) This subsection was revised to reflect recent statutory changes (eliminating renewal applications and implementing a nonexpiring license).

(6) Deleted "or renew" from this subsection to reflect recent statutory changes (eliminating renewal applications and implementing a nonexpiring license).

(8) Added "provider" after applicant for clarity, and deleted "or renewal" from this subsection to reflect recent statutory changes (eliminating renewal applications and implementing a nonexpiring license).

(9) Made numerous editorial and clarifying changes to make this subsection easier to read and understand.

(10-11) Deleted "or renewal" from these subsections to reflect recent statutory changes (eliminating renewal applications and implementing a nonexpiring license).

(12) This subsection deleted as it is no longer relevant due to the recent statutory change (eliminating renewal applications and implementing a nonexpiring license).

WAC 388-76-560 License eligibility. Section title revised to reflect recent statutory changes (eliminating renewal applications and implementing a nonexpiring license).

(5) Added a clarifying sentence to remind adult family homes that their Department of Health (DOH) registration must be renewed annually.

(6) Added a clarifying sentence to remind adult family homes that resident manager's DOH registration must be renewed annually. Deleted "within sixty days of being designated as an adult family home resident manager" because our assistant attorney general advised the department that we do not have statutory authority to make this change.

(9) Reorganized this section and made minor editorial changes to try and make it clearer and easier to read. Deleted reference to renewal of licenses to reflect recent statutory changes. Due to comments received, clarified in (c) and (d) that the action must be taken by an agency.

(10-13) Reorganized these subsections and made minor editorial changes to try and make it clearer and easier to read. Deleted reference to renewal of licenses to reflect recent statutory changes.

(14) Deleted reference to renewal of licenses to reflect recent statutory changes.

(15) This subsection deleted as it is no longer relevant (due to the recent statutory change eliminating renewal applications and implementing a nonexpiring license).

WAC 388-76-570 Additional license requirements --Multiple-facility providers.

(5) Inserted "prior to" in new subsection (5) in order to eliminate old subsections (5-6).

WAC 388-76-595 Inspections and ombudsman visits.

(2) Added examples of willful interference and failure to cooperate in this subsection in response to comments received. (4-5) Changed "shall" to "will" for clarity.

(6-10) Reorganized this section and made minor editorial changes to try and make it clearer and easier to read. Revised some of the requirements of this section because they conflicted with public disclosure laws and confidentiality requirements. (11) Added in "state regulations for the long-term care ombudsman program" for clarity.

WAC 388-76-605 Restraints.

(4)(b) Deleted "who has assessed the resident" for accuracy, as health care professionals with prescriptive authority follow standards of practice under their respective licenses.

(4)(c) Revised language to be clearer. Prior language was not entirely accurate.

WAC 388-76-620 Provision of services and care.

(3) Changed "service" to "care." This change has been made throughout the rules, and this "service" was accidentally missed. (4)(b) Changed "ensures" to "promotes" in response to comments received about the use of the word ensure.

WAC 388-76-635 Nurse delegation--Penalties.

The department has changed "shall" to "may" to reflect recent statutory changes.

WAC 388-76-655 General management and administration. (2)(d) "For example" was replaced with "including but not limited to" in order to be clear that the being on vacation was only one example, not the only example.

(3)(a) This entire subsection had been incorrectly deleted; what was needed was additional language to specify that damage or loss of the resident's property is covered if due to negligence of the insured. The correct language has been added.

(7)(a) The specific WAC citation has changed, so this subsection was revised.

(7)(b) Language was added to clarify that the maximum time a resident can be left alone must be documented in a resident's negotiated care plan.

WAC 388-76-660 Training.

(2)(a) Some minor language was revised to make this subsection clearer.

(4) Language was added to clarify that AFHs who take a special Division of Developmental Disabilities training are exempt from the fundamentals of caregiving training.

WAC 388-76-670 Disaster and emergency preparedness.

(4) Minor editorial changes were made to this subsection to make it clearer and more easily understood.

WAC 388-76-675 Reporting requirements.

(2) No changes will be made in this subsection. It was decided to leave this section as it currently is, and not make any changes.

WAC 388-76-680 Infection control and communicable disease. (2-4) Revisions were made in these subsections to make them clearer and more reflective of current standards in regard to tuberculosis (TB).

WAC 388-76-685 Criminal history disclosure and background inquiries.

(3) "Against persons" was deleted based on our assistant attorney general's advice. The statute this subsection refers to lists more than just crimes against persons, and so the prior language was not accurate.

WAC 388-76-690 Advance directives, guardianship, and decision making.

(4-5) The language in these subsections was completely revised to be simpler, clearer, and to comply with the appropriate statutes.

WAC 388-76-705 Remedies.

(3)(a)(iii)(A-B) In order to clarify that there are two circumstances when civil fines can exceed one hundred dollars per day, new language was added in (A) and (B) to specifically identify those two circumstances. The two circumstances are defined in statute, and those statutes are referenced in (A) and (B) of this subsection.

(3)(a)(iv) "Or refusal to renew" was deleted to reflect recent statutory changes (eliminating renewal applications and implementing a nonexpiring license).

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, amended 0, repealed 0; Federal Rules or Standards: New 0, amended 0, repealed 0; or Recently Enacted State Statutes: New 0, amended 0, repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, amended 0, repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, amended 18, repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, amended 0, repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, amended 0, repealed 0; Pilot Rule Making: New 0, amended 0, repealed 0; or Other Alternative Rule Making: New 0, amended 18, repealed 0.

Effective Date of Rule: July 1, 1998.

May 20, 1998

Marie Myerchin-Redifer, Manager

Rules and Policies Assistance Unit

© Washington State Code Reviser's Office