H-3797.1 _______________________________________________
HOUSE BILL 2181
_______________________________________________
State of Washington 54th Legislature 1996 Regular Session
By Representatives Dyer, Horn, L. Thomas, Carlson and Benton
Read first time 01/08/96. Referred to Committee on Health Care.
AN ACT Relating to enhancing long-term care services; and amending RCW 74.39.040.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1. RCW 74.39.040 and 1989 c 427 s 13 are each amended to read as follows:
(((1)
A long-term care commission is created. It shall consist of:
(a)
Four legislators who shall serve on the executive committee, one from each of
the two largest caucuses in the house of representatives and the senate who
shall be selected by the president of the senate and the speaker of the house
of representatives;
(b)
Six members, to be selected by the executive committee, who shall be
authorities in gerontology, developmental disabilities, neurological
impairments, physical disabilities, mental illness, nursing, long-term care
service delivery, long-term care service financing, systems development, or
systems analysis;
(c)
Three members, to be selected by the executive committee, who represent
long-term care consumers, services providers, or advocates;
(d)
Two members, to be selected by the executive committee, who represent county
government;
(e)
One member, to be selected by the secretary of social and health services, to
represent the department of social and health services long-term care programs,
including at least developmental disabilities, mental health, aging and adult
services, AIDS, children's services, alcohol and substance abuse, and
vocational rehabilitation; and
(f)
Two members, to represent the governor, who shall serve on the executive
committee.
The
legislative members shall select a chair from the membership of the commission.
The
commission shall be staffed, to the extent possible, by staff from the
appropriate senate and house of representatives committees.
The
commission may form technical advisory committees to assist it with any particular
matters deemed necessary by the commission.
The
commission and technical advisory committee members shall receive no
compensation, but except for publicly funded agency staff, shall, to the extent
funds are available, be reimbursed for their expenses while attending any
meetings in the same manner as legislators engaged in interim committee
business as specified in RCW 44.04.120.
The
commission may receive appropriations, grants, gifts, and other payments from
any governmental or other public or private entity or person which it may use
to defray the cost of its operations or to contract for technical assistance,
with the approval of the senate committee on facilities and operations and the
house of representatives executive rules committee.
(2)
The long-term care commission shall develop legislation and recommend
administrative actions necessary to achieve the following long-term care
reforms:
(a)
The systematic coordination, planning, budgeting, and administration of
long-term care services currently administered by the department of social and
health services, division of developmental disabilities, aging and adult
services administration, division of vocational rehabilitation, office on AIDS,
division of health, and the bureau of alcohol and substance abuse;
(b))) The
legislature finds the intent of the 1989 legislature to reform statutory
provisions of long-term care for persons of all ages with chronic functional
disability, although not enacted, continues to be applicable. The need to
streamline the current bureaucratic fragmentation of chronic health services
for the person with functional disabilities and facilitate the development of
client centered, accessible, high quality, cost-effective, and appropriate
long-term care services options for persons with functional disabilities is
even more pressing today. The legislature further finds that if we are going
to meet the significant and growing chronic care needs in the next two decades,
rapid fundamental changes will need to take place in the way we finance,
organize, and provide long-term care services to the functionally disabled.
The public demands, and it is the intent of the legislature to reduce the cost
and size of government and provide efficient and effective public service to
the persons most impaired by chronic functional disability.
To realize the need for a cost-effective, uniform, and fully integrated long-term care system while simultaneously reducing the size and cost of government, the legislative budget committee, in coordination with the Washington health care policy board, shall develop a working plan for long-term care reform, including recommendations and statutory changes, by December 12, 1996, to accomplish the following:
(1) Reorganize and consolidate, on a noncategorical basis, all disease or age-specific (categorical) organizational entities of state administration and their regional elements pertaining to chronic care services to persons with functional mental and physical disabilities, including but not limited to: In the department of social and health services: Health and rehabilitative services and aging and adult services; in the department of health: Aids chronic care and boarding homes; the department of services to the blind; in the department of veterans affairs: Nursing facilities; and in all other state agencies that provide chronic long-term health care services;
(2) Implement a streamlined client centered administrative and delivery system for long-term care services state-wide that incorporates all long-term care services for the person with functional disabilities to include the functionally disabled, developmentally disabled, mentally ill, traumatically brain injured, and others with chronic functional disabilities. The system shall be a single point entry system administered at the local level that allows the person with functional disabilities to obtain needs determination, eligibility screening, priority setting, and services information and assistance. The system shall be designed so that acute health care services are effectively coordinated with long-term care services. The system shall recognize and respect the individuality and dignity of all functionally disabled individuals and promote self-reliance and the preference for the assistance and comfort provided by families, friends, and community volunteers. It shall also recognize the importance of community organizations and the public and private infrastructure in the delivery of care and support. All major points of access into the long-term care system shall be identified and integrated into the system to insure that clients are fully informed of the most appropriate least expensive care options;
(3) Provision of long-term care services to persons based on their functional disabilities noncategorically and in the most independent living situation consistent with the person's needs and preferences;
(((c)))
(4) A consistent definition of appropriate roles and responsibilities
for state and local government, regional organizations, and private
organizations in the planning, administration, financing, and delivery of
long-term care services;
(((d)))
(5) Technical assistance to enable local communities to have greater
participation and control in the planning, administration, and provision of
long-term care services;
(((e)))
(6) A case management system that coordinates an appropriate and
cost-effective plan of care and services for eligible functionally disabled
persons based on their individual needs and preferences;
(((f)))
(7) A sufficient supply of quality institutional and
noninstitutional residential alternatives for functionally disabled persons,
and supports for the providers of such services;
(((g)))
(8) Public and private alternative funding for long-term care services,
((such as federal Title XIX funding of personal care services through the
limited casualty program for the medically needy and other optional services))
that includes the promotion of affordable stand alone long-term care
insurance options or as part of overall health care insurance benefits, a
uniform fee copayment scale for client participation in state-funded,
long-term care programs, and private, long-term care insurance;
(((h)))
(9) A systematic and balanced long-term care services payment and reimbursement
system, including a case mix nursing home reimbursement, that will
provide access to needed services while controlling the rate of cost increases
for such services;
(((i)))
(10) Active involvement of volunteers and advocacy groups;
(((j)))
(11) An integrated data base that provides long-term care client
tracking;
(((k)))
(12) A coordinated education system for long-term care to insure
client safety and quality of services; ((and
(l))) (13)
Administratively separate the nonmeans tested economic and social welfare and
advocacy programs of the older Americans act, 42 U.S.C. Chap 35 and 45 C.F.R.
1321 et seq. from the need and means tested programs for persons with
functional disabilities;
(14) Review all activities mandated and expenditures authorized by the senior citizens services act, chapter 74.38 RCW; and identify which funds are being used for functionally disabled seniors and identify how these senior citizens services act funds can be directed to programs serving the most disabled elderly; and
(15)
Other issues deemed appropriate by the ((implementation team)) joint
committee on health systems oversight.
The
((commission)) legislative budget committee shall report to the
legislature with its findings, recommendations, and proposed legislation by
December ((1, 1990)) 12, 1996.
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