5967-S AMH JOHN 44

SSB 5967 - H AMD 306 ADOPTED 4-25-99

By Representative

On page 2, after line 23, insert the following:

ASec. 3. 1999 c ... (ESSB 5180) s 207 (uncodified) is amended to read as follows:

FOR THE DEPARTMENT OF SOCIAL AND HEALTH SERVICES‑-AGING AND ADULT SERVICES PROGRAM

General Fund‑-State Appropriation (FY 2000).... $ ((~~451,758,000~~))

452,044,000

General Fund‑-State Appropriation (FY 2001).... $ ((~~476,187,000~~))

476,761,000

General Fund‑-Federal Appropriation............. $.................................. ((~~1,000,701,000~~))

1,001,629,000

General Fund‑-Private/Local Appropriation...... $ 4,274,000

Health Services Account‑-State Appropriation... $ 2,104,000

TOTAL APPROPRIATION................. $ ((~~1,935,024,000~~))

1,936,812,000

The appropriations in this section are subject to the following conditions and limitations:

(1) The entire health services account appropriation, $2,118,000 of the general fund‑-federal appropriation, $923,000 of the general fund‑-state appropriation for fiscal year 2000, and $958,000 of the general fund‑-state appropriation for fiscal year 2001 are provided solely for health care benefits for home care workers who are employed through state contracts for at least twenty hours per week. Premium payments for individual provider home care workers shall be made only to the subsidized basic health plan. Home care agencies may obtain coverage either through the basic health plan or through an alternative plan with substantially equivalent benefits.

(2) $1,640,000 of the general fund‑-state appropriation for fiscal year 2000 and $1,640,000 of the general fund‑-state appropriation for fiscal year 2001, plus the associated vendor rate increase for each year, are provided solely for operation of the volunteer chore services program.

(3) For purposes of implementing Engrossed Second Substitute House Bill No. 1484 (nursing home payment rates), the weighted average nursing facility payment rate for fiscal year 2000 shall be no more than $10.36 for the capital portion of the rate and no more than $108.20 for the noncapital portion of the rate. For fiscal year ((~~2000~~)) 2001, the weighted average nursing facility payment rate shall be no more than $10.57 for the capital portion of the rate and no more than $110.91 for the noncapital portion of the rate. These rates include vendor rate increases, but exclude nurse's aide training.

(4) ((If Engrossed Second Substitute House Bill No. 1484 is not enacted by June 30, 1999, for purposes of implementing chapter 322, Laws of 1998 (nursing home payment rates), the weighted average nursing home payment rate shall be no more than $118.39 for fiscal year 2000 and no more than $120.36 for fiscal year 2001, including vendor rate increases but excluding nurse's aide training. The appropriations in this section include $69,173,000 for fiscal year 2000 and $68,123,000 for fiscal year 2001 for the department of social and health services to include a property component, a financing allowance component, and a variable return component in the rate it pays to nursing facilities. By July 1, 1999, the department shall adopt rules on an emergency basis pursuant to RCW 34.05.350 under which each nursing facility contractor shall continue to be paid the property, the financing allowance, and the variable return rate which it was paid on June 30, 1999. Each nursing facility contractor's June 30, 1999, variable return rate shall be increased by 1 percent effective July 1, 1999. Each nursing facility contractor's June 30, 2000 variable return rate shall be increased by 1 percent effective July 1, 2000. With respect to a nursing facility which enters the medicaid program for the first time on or after July 1, 1999, the department shall pay the lesser of (a) the property, the financing allowance, and the variable return rate for which the facility would qualify under chapter 388-96 WAC; or (b) the state-wide average rate for each of those rate components, weighted by medicaid patient days. With respect to a nursing facility which makes a capitalized addition or replacement which requires a certificate of need and which is approved by the department of health on or after July 1, 1999, the department shall pay the lesser of (a) the property, the financing allowance, and the variable return rate for which the facility would qualify under chapter 388-96 WAC; or (b) the state-wide average rate for each of those rate components, weighted by medicaid patient days.))In addition to the rates set forth in subsection (3), $286,000 of the general fund--state appropriation for fiscal year 2000, $574,000 of the general fund--state appropriation for fiscal year 2001, and $928,000 of the general fund--federal appropriation are provided solely for supplemental rate adjustments for certain nursing facilities. In accordance with RCW 74.46.431, the department shall use these funds to apply an additional economic trends and conditions adjustment factor to the rate of any facility whose total rate allocation would otherwise be less than its April 1, 1999, total rate, adjusted for case-mix changes. This supplemental adjustment factor shall be the percentage by which the facility's April 1, 1999, rate would otherwise exceed the rate calculated in accordance with chapter 74.46 RCW and sub-section (3) of this section, except that (a) no adjustment shall be provided for any amounts by which a facility's rate is lower due to a reduction in its facility-average medicaid case-mix score; and (b) the adjustment factor shall be reduced proportionately for all facilities by the percentage by which total supplemental payments would otherwise exceed the funds provided for such payments in this sub-section.

(5) $50,000 of the general fund‑-state appropriation for fiscal year 2000 and $50,000 of the general fund‑-state appropriation for fiscal year 2001 are provided solely for payments to any nursing facility licensed under chapter 18.51 RCW which meets all of the following criteria: (a) The nursing home entered into an arm's length agreement for a facility lease prior to January 1, 1980; (b) the lessee purchased the leased nursing home after January 1, 1980; and (c) the lessor defaulted on its loan or mortgage for the assets of the home after January 1, 1991, and prior to January 1, 1992. Payments provided pursuant to this subsection shall not be subject to the settlement, audit, or rate-setting requirements contained in chapter 74.46 RCW.

(6) $6,264,000 of the general fund‑-state appropriation for fiscal year 2000, $13,860,000 of the general fund‑-state appropriation for fiscal year 2001, and $21,795,000 of the general fund‑-federal appropriation are provided solely to increase compensation for individual and for agency home care providers. Payments to individual home care providers are to be increased from $6.18 per hour to $6.68 per hour on July 1, 1999, and to $7.18 per hour on July 1, 2000. Payments to agency providers are to increase to $11.97 per hour on July 1, 1999, and to $12.62 per hour on July 1, 2000. All but 14 cents per hour of the July 1, 1999, increase to agency providers, and all but 15 cents per hour of the additional July 1, 2000, increase is to be used to increase wages for direct care workers. The appropriations in this subsection also include the funds needed for the employer share of unemployment and social security taxes on the amount of the increase.

(7) $200,000 of the general fund‑-state appropriation for fiscal year 2000, $80,000 of the general fund‑-state appropriation for fiscal year 2001, and $280,000 of the general fund‑-federal appropriation are provided solely for enhancement and integration of existing management information systems to (a) provide data at the local office level on service utilization, costs, and recipient characteristics; and (b) reduce the staff time devoted to data entry.

(8) The department of social and health services shall provide access and choice to consumers of adult day health services for the purposes of nursing services, physical therapy, occupational therapy, and psychosocial therapy. Adult day health services shall not be considered a duplication of services for persons receiving care in long-term care settings licensed under chapter 18.20, 72.36, or 70.128 RCW.

(9) $1,452,000 of the general fund‑-state appropriation for fiscal year 2000, $1,528,000 of the general fund‑-state appropriation for fiscal year 2001, and $2,980,000 of the general fund‑-federal appropriation are provided solely for implementation of Second Substitute House Bill No. 1546 (in-home care services). If Second Substitute House Bill No. 1546 is not enacted by June 30, 1999, the amounts provided in this subsection shall lapse.

NEW SECTION. Sec. 4. This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect July 1, 1999.@