HOUSE BILL REPORT

                  HB 2239

             As Reported By House Committee On:

                         Health Care

                       Appropriations

Title:  An act relating to enhanced adult residential care services.

Brief Description:  Providing for conversion of nursing home bed capacity to enhanced residential care services.

Sponsors:  Representative Sherstad.

Brief History:

Committee Activity:

Health Care:  3/4/97 [DPS];

Appropriations:  3/8/97 [DP2S(w/o sub HC)].

HOUSE COMMITTEE ON HEALTH CARE

Majority Report:  The substitute bill be substituted therefor and the substitute bill do pass.  Signed by 11 members:  Representatives Dyer, Chairman; Backlund, Vice Chairman; Skinner, Vice Chairman; Cody, Ranking Minority Member; Murray, Assistant Ranking Minority Member; Anderson; Conway; Parlette; Sherstad; Wood and Zellinsky.

Staff:  Antonio Sanchez (786-7383).

Background:  In the 1995 legislative session when ESSHB 1908 was enacted into law, it was the intent of the Legislature that both assisted living and enhanced adult residential care services be developed.  These services are designed to offer persons who are otherwise eligible for nursing home services a choice of receiving limited nursing services in a licensed boarding home in either a private apartment-like unit or in a semi-private room without the full functional/structural amenities of an apartment-like unit.  The two services, assisted living and enhanced adult residential care, not only offer persons a choice in their setting but also were designed to encourage licensed nursing homes and boarding homes to provide such services.  In ESSHB 1908, section 2, the Legislature prohibits the Department of Social and Health Services from requiring licensed nursing homes to make structural modifications for the purpose of providing enhanced adult residential care.

Since the passage of ESSHB 1908, only one licensed nursing home has reportedly converted its beds to provide enhanced adult residential care.  It has been suggested by nursing home administrators that the reasons for the lack of enhanced adult residential care beds involve, in part, the failure of ESSHB 1908 to also clearly direct the Department of Health to not require licensed nursing homes to comply with boarding home construction and life safety requirements.  Additionally, by Department of Health regulation, outside health care services cannot be provided to residents in semi-private room which limits the nursing services that are otherwise made available to assisted living residents residing in private rooms.

Summary of Substitute Bill:  Certain restrictions are removed that discourage nursing homes from providing enhanced adult residential care.  Licensed nursing homes that choose to be licensed as boarding homes for the purpose of providing enhanced residential care can be deemed to be in compliance with the boarding home building code and life safety requirements.  The Department of Health is directed to allow outside health care services to be provide in semi-private rooms.

Substitute Bill Compared to Original Bill:  Specific licensing requirements are added for boarding homes architectural modifications, unless the modifications are determined to be functionally equivalent based on a prelicensure survey inspection.

Appropriation:  None.

Fiscal Note:  Not requested.

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

Testimony For:  This measure will correct some oversight in previous legislation and allow the state to comply with the intent of more community long-term care options.

Testimony Against:  None.

Testified:  Jerry Reilly, Washington Health Care Association (pro); and Kathy Stout, Department of Health (pro).

HOUSE COMMITTEE ON APPROPRIATIONS

Majority Report:  The second substitute bill be substituted therefor and the second substitute bill do pass and do not pass the substitute bill by Committee on Health Care.  Signed by 31 members:  Representatives Huff, Chairman; Alexander, Vice Chairman; Clements, Vice Chairman; Wensman, Vice Chairman; H. Sommers, Ranking Minority Member; Doumit, Assistant Ranking Minority Member; Gombosky, Assistant Ranking Minority Member; Benson; Carlson; Chopp; Cody; Cooke; Crouse; Dyer; Grant; Keiser; Kenney; Kessler; Lambert; Linville; Lisk; Mastin; McMorris; Parlette; Poulsen; Regala; D. Schmidt; Sehlin; Sheahan; Talcott and Tokuda.

Staff:  Jason Hall (786-7145).

Summary of Recommendation of Committee on Appropriations Compared to Recommendation of Committee on Health Care:  The second substitute bill removes the requirement that enhanced adult residential care services provided at nursing homes be in parity with assisted living services.

Appropriation:  None.

Fiscal Note:  Not requested.

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

Testimony For:  This bill is amended as agreed to by the department.  The requested fiscal note will verify that there is no cost to the state and this provides needed options for nursing facilities to provide community care.

Testimony Against:  None.

Testified:  Representative Philip Dyer.