WSR 15-19-082 PROPOSED RULES DEPARTMENT OF SOCIAL AND HEALTH SERVICES (Children's Administration) [Filed September 15, 2015, 2:26 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 15-15-083.
Title of Rule and Other Identifying Information: WAC 388-148-1320 When will the department grant me a foster family license? and 388-145-1335 What additional steps must I complete prior to licensing?
The department is proposing new language to WAC 388-148-1320(4) and 388-145-1332(4) to provide further instructions on how to proceed with foster care applicants and their household members over the age of eighteen years or agency staff that have a positive tuberculosis (TB) test due to latent TB.
This update will also include changes to WAC 388-148-1320(6) and 388-145-1335(5) to allow for a medical exemption to the requirement for proof of the influenza vaccination if the vaccination would result in a severe medical consequence to the person and there is no other form of influenza vaccine that would not cause severe medical consequences. This will allow these applicants and agencies that otherwise meet all other licensing regulations to be licensed for birth to two years of age with a medical doctor's (MD) statement.
Hearing Location(s): Office Building 2, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at http://www1.dshs.wa.gov/msa/rpau/RPAU-OB-2directions.html), on October 27, 2015, at 10:00 a.m.
Date of Intended Adoption: Not earlier than October 28, 2015.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m., October 27, 2015.
Assistance for Persons with Disabilities: Contact Jeff Kildahl, DSHS rules consultant, by October 13, 2015, phone (360) 664-6092, TTY (360) 664-6178, or e-mail KildaJA@dshs.wa.gov.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The current WAC does not allow for exemptions for the influenza vaccination or for a positive TB result. The requested revisions for WAC 388-148-1320 (4), (6) and 388-145-1335 (4), (5) will allow the department to license these homes or agencies that otherwise meet the minimum licensing requirements with an MD's statement.
Reasons Supporting Proposal: The proposal will allow the department to license these homes and agencies that otherwise meet the minimum licensing requirements with an MD's statement.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of social and health services, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Kristina Wright, Olympia, Washington, OB2, (360) 902-8349.
A small business economic impact statement has been prepared under chapter 19.85 RCW.
Small Business Economic Impact Statement
SUMMARY OF PROPOSED RULES: The department of social and health services' (DSHS) children's administration (CA) is proposing amendments to WAC 388-145-1335 (4), (5) and 388-148-1320 (4), (6), licensing requirement for group care facilities and child foster homes.
The intent of the WAC revisions are to provide foster parents, department staff, and group care facilities additional clarification regarding the required TB test and influenza vaccination.
The proposed language change to WAC 388-148-1320(4) and 388-145-1335(4) provides further instructions on how to proceed with foster care applicants and their household members over the age of eighteen, or agency staff that have a positive TB test due to latent TB. These applicants will be required to obtain a physician's statement noting that they are not contagious, nor do they pose a risk to others. Once the physician's statement is provided to the division of licensed resources (DLR) and they have been determined to meet all other licensing regulations they will be issued a foster care license or approved to work unsupervised at a group care facility.
WAC 388-148-1320(6) and 388-145-1335(5) currently require that the applicant and all household members, or agency staff or volunteers to have proof of the influenza vaccination if being licensed to care for children under the age of two years. This WAC revision will allow for a medical exception to this requirement if the vaccination would result in a severe medical consequence to the person and there is no other form of influenza vaccine that would not cause severe medical consequences. This will allow these applicants and agencies that otherwise meet all other licensing regulations to be licensed for birth to two years of age with an MD's statement.
These changes have been requested by foster parents, DSHS agency staff, group care facilities, and child placing agencies. There will be no other content or language changes to WAC 388-148-1320 or 388-145-1335.
DLR licensing requirements were last amended on January 11, 2015.
SMALL BUSINESS ECONOMIC IMPACT STATEMENT (SBEIS)—DETERMINATION OF NEED: Chapter 19.85 RCW, the Regulatory Fairness Act, requires that the economic impact of proposed regulations be analyzed in relation to small businesses. The statute defines small businesses as those business entities that employ fifty or fewer people and are independently owned and operated.
These proposed rules impact child placing agency foster homes and group care facilities. These businesses fall under the child group foster homes designation by the North American Industry Classification System (NAICS) codes (#623990).
Preparation of an SBEIS is required when a proposed rule has the potential of placing a disproportionate economic impact on small businesses. The statute outlines information that must be included in an SBEIS.
The CA has analyzed the proposed rule amendments and has determined that small businesses will not be disproportionately impacted by these changes. There are no additional costs to group care facilities with the implementation of the WAC revisions noted above.
INDUSTRY ANALYSIS: The DLR, CA, is responsible for the development and regulatory oversight of all licensing requirements for group residential facilities per chapter 74.15 RCW. As part of their monitoring, DLR keeps a current internal database that identifies all affected small businesses.
Most of the facilities with whom CA contracts are considered to be small businesses employing fewer than fifty staff. These proposed rules impact the licensing group care facilities.
INVOLVEMENT OF SMALL BUSINESSES: DLR involved group residential care stakeholders. An e-mail survey was sent out to the one hundred thirty-two group care facilities licensed by the DLR statewide. These small businesses were asked whether or not the implementation of the proposed WAC revision for practice changes related to TB and the influenza vaccination would cause additional costs to your group care facility. All of the agencies that responded indicated that there would not be additional costs.
COST OF COMPLIANCE: Under RCW 19.85.020, CA has considered annual costs to small businesses that are fifty dollars or more per child served annually.
GENERAL COSTS: DLR's analysis revealed that there are no costs imposed by the proposed amendments. An e-mail survey was sent out to the one hundred thirty-two group care facilities that the DLR licenses statewide. Out of one hundred thirty-two e-mails sent, twelve responses were received and one hundred percent reported that the implementation of the proposed WAC revision would not cause any additional cost to the group care facilities.
BENEFITS FOR PROPOSED RULES: The proposed revisions for WAC 388-148-1320 (4), (6) and 388-145-1335 (4), (5) will allow DLR to license these homes that otherwise meet the minimum licensing requirements with a physician's statement for the TB or an MD's statement for the influenza exemption. Therefore, allowing DLR to license additional foster homes that the current WAC does not permit.
JOBS CREATED OR LOST: We do not anticipate that jobs will be lost or created as a result of these rules. However, this will make it easier for foster parents and group care facilities to be licensed to care for children ages birth to two years. This proposed WAC change was asked for by the stakeholders.
CONCLUSION: The DLR, CA has given careful consideration to the impact of proposed rules in chapter 388-145 WAC, Licensing requirements for group care facilities and chapter 388-148 WAC, child foster homes, would have on small businesses. To comply with the Regulatory Fairness Act, chapter 19.85 RCW, DLR has analyzed impacts on small businesses and there is no cost to group care facilities with the proposed WAC amendments.
Please contact Kristina Wright if you have questions.
A copy of the statement may be obtained by contacting Kristina Wright, 1115 Washington Street, Olympia, WA 98504-5710, phone (360) 902-8349, fax (360) 902-7903, e-mail wrighks@dshs.wa.gov.
A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Kristina Wright, 1115 Washington Street, Olympia, WA 98504-5710, phone (360) 902-8349, fax (360) 902-7903, e-mail wrighks@dshs.wa.gov.
September 15, 2015
Katherine I. Vasquez
Rules Coordinator
AMENDATORY SECTION (Amending WSR 15-01-069, filed 12/11/14, effective 1/11/15)
WAC 388-145-1335 What additional steps must I complete prior to licensing?
(1) You must submit to your licensor a detailed written program description for DLR approval. In the description you must outline:
(a) Your mission and goals;
(b) A description of the services you will provide to children and their families;
(c) Your written policies covering qualifications, duties and ongoing training for developing and upgrading staff skills; and
(d) A description of your agency's policies and procedures.
(e) For staffed residential facilities in family homes, you must provide a written plan to the child's DSHS worker for the supervision of children in your care if you work outside of your staffed residential home.
(2) You must have a site inspection by your DLR licensor or someone designated by DLR who can verify that your premises have:
(a) Adequate storage for staff and client files;
(b) A landline working telephone;
(c) Adequate space for privacy when interviewing parents and children;
(d) Room or area used for administrative purposes;
(e) Adequate space for visitation;
(f) Appropriate furnishings for the children in your facility; and
(g) Your license clearly posted (if inspection is for a renewal license).
(3) All facilities described in this chapter, (except for staffed residential homes for five or fewer children), are required to meet the health requirements to receive a certificate of compliance from the Washington state department of health (DOH) and the fire safety requirements from the Washington state patrol fire protection bureau (WSP/FPB).
(4) You, your employees and volunteers are required to submit a negative tuberculosis test or an X ray. If there is a positive TB test, then the individual must submit a physician's statement identifying that there is no active TB or risk of contagion to children in care.
(a) We may grant an exception to the TB test requirement, in consultation with a licensed health care provider.
(b) This exception would require a statement from a licensed health care provider (MD, DO, ND, PA or ARNP) indicating that a valid medical reason exists for not having a TB test.
(5) If you are being licensed to care for children under the age of two, you, your employees and volunteers working in the facility caring for children under the age of two are required to provide documentation verifying you have current pertussis and influenza vaccinations. The department may license you to serve children under the age of two even though you, your employees or volunteers are unable to obtain an influenza vaccination for medical reasons. In this case, a medical doctor's (MD) statement is required noting that the influenza vaccination would result in severe medical consequences to the person and that there is no other form of the influenza vaccine that would not cause severe medical consequences. All other employees or volunteers must still be vaccinated. We recommend (but do not require) these immunizations for you, your employees and volunteers when you serve children age two and older.
(6) You must have proof of current immunizations for any children living on the premises, not in out-of-home care. We may, in consultation with a licensed health care provider, grant exceptions to this requirement if you have a statement from a licensed health care provider (MD, DO, ND, PA or ARNP).
AMENDATORY SECTION (Amending WSR 15-01-069, filed 12/11/14, effective 1/11/15)
WAC 388-148-1320 When will the department grant me a foster family license?
(1) We issue you a license when you and everyone in your household meet the licensing requirements contained in this chapter, and all required documents are in the licensing file.
(2) You and other caregivers over the age of eighteen must:
(a) Complete first aid training and age-appropriate adult and/or infant CPR (cardiopulmonary resuscitation). Training must be department approved and accredited with nationally recognized standards; and
(b) Complete HIV/AIDS and bloodborne pathogens training including infection control standards consistent with educational materials published by the department of health, office on HIV/AIDS.
(3) You, your household members and anyone else having unsupervised contact with your foster child(ren) must pass the following background check requirements per chapter 388-06 WAC (This includes people living on any part of your property):
(a) Anyone over the age of sixteen must pass a criminal history check.
(b) Anyone over the age of eighteen must pass an FBI fingerprint check.
(c) Anyone over the age of eighteen must complete a child abuse and neglect registry check from each state they have lived in over the past five years indicating:
(i) No license denials or revocations from an agency that regulates the care of children or vulnerable adults, unless the department determines that you do not pose a risk to a child's health, safety, well-being and long-term stability; and
(ii) No finding or substantiation of abuse or neglect of a child or a vulnerable adult, unless the department determines that you do not pose a risk to a child's safety, well-being, and long-term stability.
(4) You, and your household members over the age of eighteen must submit a negative tuberculosis test or an X-ray, unless you can demonstrate a medical reason prohibiting the TB test, or have had a negative TB test in the previous twelve months. If there is a positive TB test, then the individual must submit a physician's statement identifying that there is no active TB or risk of contagion to children in care.
(5) You must have proof of current immunizations for any children living on your premises, not in out-of-home care. We may, in consultation with a licensed health care provider, grant exception to this requirement if you have a statement from a licensed health care provider (MD, DO, ND, PA and ARNP).
(6) We recommend that you have pertussis and influenza immunizations. The department will not license you to serve foster children under the age of two, without proof of pertussis and influenza immunizations for all people living in your home. The department may license you to serve children under the age of two even though you or someone in your home is unable to obtain an influenza vaccination for medical reasons. In this case, a medical doctor's (MD) statement is required noting that the influenza vaccination would result in severe medical consequences to the person and that there is no other form of the influenza vaccine that would not cause severe medical consequences. All other persons in the home must still be vaccinated.
(7) Before granting or renewing a license, your licensor will assess your ability to provide a safe home and to provide the quality of care needed by children placed in your home. Your licensor will also determine that you meet training requirements.
(8) Foster children under the care and authority of the department living in your home do not need to obtain a criminal history check, FBI fingerprint check or TB test.
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