BILL REQ. #:  S-4473.1 

READ FIRST TIME 02/06/04.   

     AN ACT Relating to mandated reporters in boarding homes and nursing homes; amending RCW 74.34.020, 74.34.035, and 9A.42.010; and declaring an emergency.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1   RCW 74.34.020 and 2003 c 230 s 1 are each amended to read as follows:
     Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
     (1) "Abandonment" means action or inaction by a person or entity with a duty of care for a vulnerable adult that leaves the vulnerable person without the means or ability to obtain necessary food, clothing, shelter, or health care.
     (2) "Abuse" means the willful action or inaction that inflicts injury, unreasonable confinement, intimidation, or punishment on a vulnerable adult. In instances of abuse of a vulnerable adult who is unable to express or demonstrate physical harm, pain, or mental anguish, the abuse is presumed to cause physical harm, pain, or mental anguish. Abuse includes sexual abuse, mental abuse, physical abuse, and exploitation of a vulnerable adult, which have the following meanings:
     (a) "Sexual abuse" means any form of nonconsensual sexual contact, including but not limited to unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually explicit photographing, and sexual harassment. Sexual abuse includes any sexual contact between a staff person, who is not also a resident or client, of a facility or a staff person of a program authorized under chapter 71A.12 RCW, and a vulnerable adult living in that facility or receiving service from a program authorized under chapter 71A.12 RCW, whether or not it is consensual.
     (b) "Physical abuse" means the willful action of inflicting bodily injury or physical mistreatment. Physical abuse includes, but is not limited to, striking with or without an object, slapping, pinching, choking, kicking, shoving, prodding, or the use of chemical restraints or physical restraints unless the restraints are consistent with licensing requirements, and includes restraints that are otherwise being used inappropriately.
     (c) "Mental abuse" means any willful action or inaction of mental or verbal abuse. Mental abuse includes, but is not limited to, coercion, harassment, inappropriately isolating a vulnerable adult from family, friends, or regular activity, and verbal assault that includes ridiculing, intimidating, yelling, or swearing.
     (d) "Exploitation" means an act of forcing, compelling, or exerting undue influence over a vulnerable adult causing the vulnerable adult to act in a way that is inconsistent with relevant past behavior, or causing the vulnerable adult to perform services for the benefit of another.
     (3) "Consent" means express written consent granted after the vulnerable adult or his or her legal representative has been fully informed of the nature of the services to be offered and that the receipt of services is voluntary.
     (4) "Department" means the department of social and health services.
     (5) "Facility" means a residence licensed or required to be licensed under chapter 18.20 RCW, boarding homes; chapter 18.51 RCW, nursing homes; chapter 70.128 RCW, adult family homes; chapter 72.36 RCW, soldiers' homes; or chapter 71A.20 RCW, residential habilitation centers; or any other facility licensed by the department.
     (6) "Facility designated reporter" means an employee of a facility, as defined in subsection (5) of this section, designated by the facility to report to the department incidents as defined in subsection (8) of this section.
     (7) "Financial exploitation" means the illegal or improper use of the property, income, resources, or trust funds of the vulnerable adult by any person for any person's profit or advantage.
     (((7))) (8) "Incident" means an occurrence of abuse; neglect; abandonment; misappropriation of resident property; financial exploitation; or a substantial injury of unknown source, or cause, or circumstance, involving a resident in a facility.
     (9) "Individual provider" means a person under contract with the department to provide services in the home under chapter 74.09 or 74.39A RCW.
     (((8))) (10) "Mandated reporter" is an employee of the department; law enforcement officer; social worker; professional school personnel; individual provider; an employee of a facility; an operator of a facility; an employee of a social service, welfare, mental health, adult day health, adult day care, home health, home care, or hospice agency; county coroner or medical examiner; Christian Science practitioner; or health care provider subject to chapter 18.130 RCW.
     (((9))) (11) "Neglect" means (a) a pattern of conduct or inaction by a person or entity with a duty of care that fails to provide the goods and services that maintain physical or mental health of a vulnerable adult, or that fails to avoid or prevent physical or mental harm or pain to a vulnerable adult; or (b) an act or omission that demonstrates a serious disregard of consequences of such a magnitude as to constitute a clear and present danger to the vulnerable adult's health, welfare, or safety.
     (((10))) (12) "Permissive reporter" means any person, employee of a financial institution, attorney, or volunteer in a facility or program providing services for vulnerable adults.
     (((11))) (13) "Protective services" means any services provided by the department to a vulnerable adult with the consent of the vulnerable adult, or the legal representative of the vulnerable adult, who has been abandoned, abused, financially exploited, neglected, or in a state of self-neglect. These services may include, but are not limited to case management, social casework, home care, placement, arranging for medical evaluations, psychological evaluations, day care, or referral for legal assistance.
     (((12))) (14) "Self-neglect" means the failure of a vulnerable adult, not living in a facility, to provide for himself or herself the goods and services necessary for the vulnerable adult's physical or mental health, and the absence of which impairs or threatens the vulnerable adult's well-being. This definition may include a vulnerable adult who is receiving services through home health, hospice, or a home care agency, or an individual provider when the neglect is not a result of inaction by that agency or individual provider.
     (((13))) (15) "Substantial injury of unknown source" means injuries greater than superficial that would require more than first aid and may require close monitoring by nursing or medical staff; or those injuries occurring in areas not generally vulnerable to trauma, such as injuries to the back, face, head, neck, chest, breasts, groin, inner thigh, buttock, genital, or anal area.
     (16) "Vulnerable adult" includes a person:
     (a) Sixty years of age or older who has the functional, mental, or physical inability to care for himself or herself; or
     (b) Found incapacitated under chapter 11.88 RCW; or
     (c) Who has a developmental disability as defined under RCW 71A.10.020; or
     (d) Admitted to any facility; or
     (e) Receiving services from home health, hospice, or home care agencies licensed or required to be licensed under chapter 70.127 RCW; or
     (f) Receiving services from an individual provider.

Sec. 2   RCW 74.34.035 and 2003 c 230 s 2 are each amended to read as follows:
     (1) When there is reasonable cause to believe that abandonment, abuse, financial exploitation, or neglect of a vulnerable adult has occurred, mandated reporters shall immediately report to the department. However, a mandated reporter who works in a facility shall report consistent with subsections (2) through (5) of this section.
     (2) When there is reason to suspect that sexual assault has occurred, mandated reporters shall immediately report to the appropriate law enforcement agency and to the department.
     (3) When there is reason to suspect that physical assault has occurred or there is reasonable cause to believe that an act has caused fear of imminent harm:
     (a) Mandated reporters shall immediately report to the department; and
     (b) Mandated reporters shall immediately report to the appropriate law enforcement agency, except as provided in subsection (((4))) (8) of this section.
     (4) A mandated reporter who works in a facility shall make a report to the department when the reporter:
     (a) Observes an incident;
     (b) Hears the vulnerable adult state that the incident happened;
     (c) Hears about an incident from a permissive reporter who has direct knowledge of the incident; or
     (d) hears about an incident from a mandated reporter who has direct knowledge of the incident but who has not reported as required.
     (5) The facility shall designate staff, known as facility designated reporters, to immediately report to the department any incident, as defined in this chapter. The facility shall have a facility designated reporter available twenty-four hours per day. The facility designated reporter shall make reports on behalf of the facility, however, if the facility designated reporter also has a separate obligation under this chapter to make an individual mandated report, one report satisfies both obligations.
     (6) The reporting criteria, described in subsection (1) of this section, shall apply when determining whether a report under subsections (4)(b) and (5) of this section must be made to the department.
     (7) Nursing facilities shall also report consistent with federal requirements.
     (8) A mandated reporter is not required to report to a law enforcement agency, unless requested by the injured vulnerable adult or his or her legal representative or family member, an incident of physical assault between vulnerable adults that causes minor bodily injury and does not require more than basic first aid, unless:
     (a) The injury appears on the back, face, head, neck, chest, breasts, groin, inner thigh, buttock, genital, or anal area;
     (b) There is a fracture;
     (c) There is a pattern of physical assault between the same vulnerable adults or involving the same vulnerable adults; or
     (d) There is an attempt to choke a vulnerable adult.
     (((5))) (9) Permissive reporters may report to the department or a law enforcement agency when there is reasonable cause to believe that a vulnerable adult is being or has been abandoned, abused, financially exploited, or neglected.
     (((6))) (10) No facility, as defined by this chapter, agency licensed or required to be licensed under chapter 70.127 RCW, or facility or agency under contract with the department to provide care for vulnerable adults may develop policies or procedures that interfere with the reporting requirements of this chapter.
     (((7))) (11) Each report, oral or written, must contain as much as possible of the following information:
     (a) The name and address of the person making the report;
     (b) The name and address of the vulnerable adult and the name of the facility or agency providing care for the vulnerable adult;
     (c) The name and address of the legal guardian or alternate decision maker;
     (d) The nature and extent of the abandonment, abuse, financial exploitation, neglect, or self-neglect;
     (e) Any history of previous abandonment, abuse, financial exploitation, neglect, or self-neglect;
     (f) The identity of the alleged perpetrator, if known; and
     (g) Other information that may be helpful in establishing the extent of abandonment, abuse, financial exploitation, neglect, or the cause of death of the deceased vulnerable adult.
     (((8))) (12) Unless there is a judicial proceeding or the person consents, the identity of the person making the report under this section is confidential.

Sec. 3   RCW 9A.42.010 and 1997 c 392 s 508 are each amended to read as follows:
     As used in this chapter:
     (1) "Basic necessities of life" means food, water, shelter, clothing, and medically necessary health care, including but not limited to health-related treatment or activities, hygiene, oxygen, and medication.
     (2)(a) "Bodily injury" means physical pain or injury, illness, or an impairment of physical condition;
     (b) "Substantial bodily harm" means bodily injury which involves a temporary but substantial disfigurement, or which causes a temporary but substantial loss or impairment of the function of any bodily part or organ, or which causes a fracture of any bodily part;
     (c) "Great bodily harm" means bodily injury which creates a high probability of death, or which causes serious permanent disfigurement, or which causes a permanent or protracted loss or impairment of the function of any bodily part or organ.
     (3) "Child" means a person under eighteen years of age.
     (4) "Dependent person" means a person who, because of physical or mental disability, or because of extreme advanced age, is dependent upon another person to provide the basic necessities of life. A resident of a nursing home, as defined in RCW 18.51.010, a resident of an adult family home, as defined in RCW 70.128.010, and a frail elder or vulnerable adult, as defined in RCW 74.34.020(((8))) (16), is presumed to be a dependent person for purposes of this chapter.
     (5) "Employed" means hired by a dependent person, another person acting on behalf of a dependent person, or by an organization or governmental entity, to provide to a dependent person any of the basic necessities of life. A person may be "employed" regardless of whether the person is paid for the services or, if paid, regardless of who pays for the person's services.
     (6) "Parent" has its ordinary meaning and also includes a guardian and the authorized agent of a parent or guardian.
     (7) "Abandons" means leaving a child or other dependent person without the means or ability to obtain one or more of the basic necessities of life.

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 immediately.