HOUSE BILL REPORT

                 2SSB 6544

                 As Passed House - Amended:

                        March 5, 1998

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

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

Sponsors:  Senate Committee on Ways & Means (originally sponsored by Senators Deccio, Franklin, Wood, Wojahn and Winsley).

Brief History:

  Committee Activity:

Health Care:  2/24/98, 2/27/98 [DPA];

Appropriations:  2/28/98 [DPA(HC/APP)s].

Floor Activity:

Passed House - Amended:  3/5/98, 98-0.

HOUSE COMMITTEE ON HEALTH CARE

Majority Report:  Do pass as amended.  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).

HOUSE COMMITTEE ON APPROPRIATIONS

Majority Report:  Do pass as amended by Committee on Health Care as such amendment is amended by Committee on Appropriations.  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).

Background:  Washington State has four principal types of long-term care facilities for its disabled or frail elderly citizens.  These include nursing homes, state developmentally disabled (DD) institutions, adult family homes, and boarding homes.   Boarding homes are care facilities usually ranging in size from 10 to 60 residents.   Smaller boarding homes are often called group homes and larger ones might be marketed to the public as assisted living facilities.  Adult family homes are regular neighborhood residences providing care for two-six residents.  The owner of the adult family home, or staff hired by the owner, provide the care.  They provide room, board, laundry, necessary supervision, assistance with activities of daily living, personal care and social services.  Nursing services can be provided in the home.  Adult family homes are licensed, regulated and inspected by the Department of Social and Health Services (DSHS).  The state has approximately 2,300 adult family homes providing services to almost 8,000 clients.  Of the total adult family home caseload, approximately 3,000 are state clients.

Direct care staff in adult family homes and boarding homes are required to receive 22 hours of training and must have 10 hours of continuing education related to caregiving every calendar year.

In 1997, the Legislature required the Nursing Care Quality Assurance Commission (NCQAC) and the DSHS to create a 22-hour long-term care training program within existing funds that consists of modules, some of which qualify hour for hour toward the requirements for nursing assistant education.  The two agencies created a five-person steering committee and a 29-person work group to determine the best approach to implement this new education framework for home care workers.  The agency and the commission submitted their recommendations to the Legislature in December of 1997.  The committee recommended a number of technical changes including modification in the original statute to allow the transfer of classroom hours from hour for hour to be changed to a transfer of skills and competencies.

The State Long-term Care Ombudsman also worked with a caregivers training group consisting of long-term care provider associations and consumers advocacy groups.  Their objective was to develop a set of training requirements consistent with their 1995 and 1996 study findings that increase the quality of care in in-home care settings. Their reports indicated that numerous safety and care problems in adult family homes and boarding homes were caused by insufficiently qualified caregivers.  The ombudsman study group recommended reviewing the training standards.

Summary of Bill: The Secretary of the Department of Health is required to appoint an advisory committee, in consultation with DSHS, on matters relating to the regulation of administrative rules, enforcement process, staffing, and training requirements of adult family homes.  The advisory committee is composed of six members.  Three of the members must be consumers and three are facility providers who provide services to the developmentally disabled, the mentally ill, or persons with dementia.  The chair of the committee must represent the public.  Terms for the selection of members and duration of membership on the board are specified.  The advisory committee is established in addition to already existing advisory committees in both the Department of Social and Health Services and the Department of Health.  The advisory committee is given the authority to establish meetings.  Each member of the advisory committee must serve without compensation, but may be reimbursed for travel expenses.

The requirement for adult family homes to submit an application for renewal of a license is eliminate however, the license will remain valid if the yearly licence fee is paid and the license has not be voluntarily surrendered, suspended, or revoked.

Appropriation:  None.

Fiscal Note:  Not requested.

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

Testimony For:  (Health Care)  A further review of training should increase the quality of care.  Coordination of the state's training for caregivers is vital to developing a long-term care system that is responsive, especially for those who need specialized care.

(Appropriations)   None.

Testimony Against:  (Health Care)  None.

(Appropriations)   None.

Testified:  (Health Care)  Gene Forrester, American Association of Retired Persons; Donna Patrick, Developmental Disabilities Council; Kathy Leitch and Tim Brown, Department of Social & Health Services; Kary Hyre, Long-term Care Ombudsman Program; Nick Federici, Washington Association of Homes for the Aging; Bill Day, Adult Family Homes Association; Lauri St. Ours, NOR-ALFA; Jeff Larsen, Washington State Residential Care Council; Scott Sigmon, Washington Health Care Association; Margaret Casey, Washington State Catholic Conference and WSAHCS; Jeff Crollard, Long-term Care Ombudsman Program; and Bruce Miyahara, Department of Health.

(Appropriations)   None.