INITIATIVE 1029


To the People





Chapter 2, Laws of 2009









LONG-TERM CARE SERVICES--ELDERLY--PERSONS WITH DISABILITIES ACT


EFFECTIVE DATE: 03/04/09 - Except section 11, which becomes effective 09/01/09; Contingent - sections 15 and 16 may take effect 04/06/09.



















Approved by the


People of the State of Washington


in the General Election on


November 4, 2008


ORIGINALLY FILED




March 28, 2008



Secretary of State






 1AN ACT Relating to long-term care services for the elderly and

 2persons with disabilities; amending RCW 74.39A.009, 74.39A.340,

 374.39A.350, 74.39A.050, and 18.130.040; reenacting and amending RCW

 418.130.040; adding new sections to chapter 74.39A RCW; adding a new

 5section to chapter 18.88A RCW; adding a new chapter to Title 18 RCW;

 6creating new sections; providing an effective date; and providing a

 7contingent effective date.

 

 8BE IT ENACTED BY THE PEOPLE OF THE STATE OF WASHINGTON:

 

 9NEW SECTION. Sec. 1. It is the intent of the people through this

10initiative to protect the safety of and improve the quality of care to

11the vulnerable elderly and persons with disabilities.

12The people find and declare that current procedures to train and

13educate long-term care workers and to protect the elderly or persons

14with disabilities from caregivers with a criminal background are

15insufficient. The people find and declare that long-term care workers

16for the elderly or persons with disabilities should have a federal

17criminal background check and a formal system of education and

18experiential qualifications leading to a certification test.


 1The people find that the quality of long-term care services for the

 2elderly and persons with disabilities is dependent upon the competency

 3of the workers who provide those services. To assure and enhance the

 4quality of long-term care services for the elderly and persons with

 5disabilities, the people recognize the need for federal criminal

 6background checks and increased training requirements. Their

 7establishment should protect the vulnerable elderly and persons with

 8disabilities, bring about a more stabilized workforce, improve the

 9quality of long-term care services, and provide a valuable resource for

10recruitment into long-term care services for the elderly and persons

11with disabilities.

 

12Sec. 2. RCW 74.39A.009 and 2007 c 361 s 2 are each amended to read

13as follows:

14Unless the context clearly requires otherwise, the definitions in

15this section apply throughout this chapter.

16(1) "Adult family home" means a home licensed under chapter 70.128

17RCW.

18(2) "Adult residential care" means services provided by a boarding

19home that is licensed under chapter 18.20 RCW and that has a contract

20with the department under RCW 74.39A.020 to provide personal care

21services.

22(3) "Assisted living services" means services provided by a

23boarding home that has a contract with the department under RCW

2474.39A.010 to provide personal care services, intermittent nursing

25services, and medication administration services, and the resident is

26housed in a private apartment-like unit.

27(4) "Boarding home" means a facility licensed under chapter 18.20

28RCW.

29(5) "Core competencies" means basic training topics, including but

30not limited to, communication skills, worker self-care, problem

31solving, maintaining dignity, consumer directed care, cultural

32sensitivity, body mechanics, fall prevention, skin and body care, long-

33term care worker roles and boundaries, supporting activities of daily

34living, and food preparation and handling.

35(6) "Cost-effective care" means care provided in a setting of an

36individual's choice that is necessary to promote the most appropriate

37level of physical, mental, and psychosocial well-being consistent with


 1client choice, in an environment that is appropriate to the care and

 2safety needs of the individual, and such care cannot be provided at a

 3lower cost in any other setting. But this in no way precludes an

 4individual from choosing a different residential setting to achieve his

 5or her desired quality of life.

 6(((6))) (7) "Department" means the department of social and health

 7services.

 8(((7))) (8) "Developmental disability" has the same meaning as

 9defined in RCW 71A.10.020.

10(9) "Direct care worker" means a paid caregiver who provides

11direct, hands-on personal care services to persons with disabilities or

12the elderly requiring long-term care.

13(10) "Enhanced adult residential care" means services provided by

14a boarding home that is licensed under chapter 18.20 RCW and that has

15a contract with the department under RCW 74.39A.010 to provide personal

16care services, intermittent nursing services, and medication

17administration services.

18(((8))) (11) "Functionally disabled person" or "person who is

19functionally disabled" is synonymous with chronic functionally disabled

20and means a person who because of a recognized chronic physical or

21mental condition or disease, or developmental disability, including

22chemical dependency, is impaired to the extent of being dependent upon

23others for direct care, support, supervision, or monitoring to perform

24activities of daily living. "Activities of daily living", in this

25context, means self-care abilities related to personal care such as

26bathing, eating, using the toilet, dressing, and transfer.

27Instrumental activities of daily living may also be used to assess a

28person's functional abilities as they are related to the mental

29capacity to perform activities in the home and the community such as

30cooking, shopping, house cleaning, doing laundry, working, and managing

31personal finances.

32(((9))) (12) "Home and community services" means adult family

33homes, in-home services, and other services administered or provided by

34contract by the department directly or through contract with area

35agencies on aging or similar services provided by facilities and

36agencies licensed by the department.

37(((10))) (13) "Home care aide" means a long-term care worker who


 1has obtained certification as a home care aide by the department of

 2health.

 3(14) "Individual provider" is defined according to RCW 74.39A.240.

 4(15) "Long-term care" is synonymous with chronic care and means

 5care and supports delivered indefinitely, intermittently, or over a

 6sustained time to persons of any age disabled by chronic mental or

 7physical illness, disease, chemical dependency, or a medical condition

 8that is permanent, not reversible or curable, or is long-lasting and

 9severely limits their mental or physical capacity for self-care. The

10use of this definition is not intended to expand the scope of services,

11care, or assistance by any individuals, groups, residential care

12settings, or professions unless otherwise expressed by law.

13(((11))) (16)(a) "Long-term care workers for the elderly or persons

14with disabilities" or "long-term care workers" includes all persons who

15are long-term care workers for the elderly or persons with

16disabilities, including but not limited to individual providers of home

17care services, direct care employees of home care agencies, providers

18of home care services to persons with developmental disabilities under

19Title 71 RCW, all direct care workers in state-licensed boarding homes,

20assisted living facilities, and adult family homes, respite care

21providers, community residential service providers, and any other

22direct care worker providing home or community-based services to the

23elderly or persons with functional disabilities or developmental

24disabilities.

25(b) "Long-term care workers" do not include: (i) Persons employed

26in nursing homes subject to chapter 18.51 RCW, hospitals or other acute

27care settings, hospice agencies subject to chapter 70.127 RCW, adult

28day care centers, and adult day health care centers; or (ii) persons

29who are not paid by the state or by a private agency or facility

30licensed by the state to provide personal care services.

31(((12))) (17) "Nursing home" means a facility licensed under

32chapter 18.51 RCW.

33(((13))) (18) "Personal care services" means physical or verbal

34assistance with activities of daily living and instrumental activities

35of daily living provided because of a person's functional disability.

36(19) "Population specific competencies" means basic training topics

37unique to the care needs of the population the long-term care worker is


 1serving, including but not limited to, mental health, dementia,

 2developmental disabilities, young adults with physical disabilities,

 3and older adults.

 4(20) "Qualified instructor" means a registered nurse or other

 5person with specific knowledge, training, and work experience in the

 6provision of direct, hands-on personal care and other assistance

 7services to the elderly or persons with disabilities requiring

 8long-term care.

 9(21) "Secretary" means the secretary of social and health services.

10(((14))) (22) "Secretary of health" means the secretary of health

11or the secretary's designee.

12(23) "Training partnership" means a joint partnership or trust

13((established and maintained jointly by)) that includes the office of

14the governor and the exclusive bargaining representative of individual

15providers under RCW 74.39A.270 with the capacity to provide training,

16peer mentoring, and ((examinations required under this chapter, and

17educational, career)) workforce development, or other services to

18individual providers.

19(((15))) (24) "Tribally licensed boarding home" means a boarding

20home licensed by a federally recognized Indian tribe which home

21provides services similar to boarding homes licensed under chapter

2218.20 RCW.

 

23NEW SECTION. Sec. 3. A new section is added to chapter 74.39A RCW

24to read as follows:

25All long-term care workers for the elderly or persons with

26disabilities hired after January 1, 2010, shall be screened through

27state and federal background checks in a uniform and timely manner to

28ensure that they do not have a criminal history that would disqualify

29them from working with vulnerable persons. These background checks

30shall include checking against the federal bureau of investigation

31fingerprint identification records system and against the national sex

32offenders registry or their successor programs. The department shall

33share this information with the department of health. The department

34shall not pass on the cost of these criminal background checks to the

35workers or their employers. The department shall adopt rules to

36implement the provisions of this section by August 1, 2009.


 1NEW SECTION. Sec. 4. (1) Effective January 1, 2010, except as

 2provided in section 7 of this act, the department of health shall

 3require that any person hired as a long-term care worker for the

 4elderly or persons with disabilities must be certified as a home care

 5aide within one hundred fifty days from the date of being hired.

 6(2) Except as provided in section 7 of this act, certification as

 7a home care aide requires both completion of seventy-five hours of

 8training and successful completion of a certification examination

 9pursuant to sections 5 and 6 of this act.

10(3) No person may practice or, by use of any title or description,

11represent himself or herself as a certified home care aide without

12being certified pursuant to this chapter.

13(4) The department of health shall adopt rules by August 1, 2009,

14to implement this section.

 

15NEW SECTION. Sec. 5. A new section is added to chapter 74.39A RCW

16to read as follows:

17(1) Effective January 1, 2010, except as provided in section 7 of

18this act, all persons employed as long-term care workers for the

19elderly or persons with disabilities must meet the minimum training

20requirements in this section within one hundred twenty calendar days of

21employment.

22(2) All persons employed as long-term care workers must obtain

23seventy-five hours of entry-level training approved by the department.

24A long-term care worker must accomplish five of these seventy-five

25hours before becoming eligible to provide care.

26(3) Training required by subsection (4)(c) of this section will be

27applied towards training required under RCW 18.20.270 or 70.128.230 as

28well as any statutory or regulatory training requirements for long-term

29care workers employed by supportive living providers.

30(4) Only training curriculum approved by the department may be used

31to fulfill the training requirements specified in this section. The

32seventy-five hours of entry-level training required shall be as

33follows:

34(a) Before a long-term care worker is eligible to provide care, he

35or she must complete two hours of orientation training regarding his or

36her role as caregiver and the applicable terms of employment;


 1(b) Before a long-term care worker is eligible to provide care, he

 2or she must complete three hours of safety training, including basic

 3safety precautions, emergency procedures, and infection control; and

 4(c) All long-term care workers must complete seventy hours of

 5long-term care basic training, including training related to core

 6competencies and population specific competencies.

 7(5) The department shall only approve training curriculum that:

 8(a) Has been developed with input from consumer and worker

 9representatives; and

10(b) Requires comprehensive instruction by qualified instructors on

11the competencies and training topics in this section.

12(6) Individual providers under RCW 74.39A.270 shall be compensated

13for training time required by this section.

14(7) The department of health shall adopt rules by August 1, 2009,

15to implement subsections (1), (2), and (3) of this section.

16(8) The department shall adopt rules by August 1, 2009, to

17implement subsections (4) and (5) of this section.

 

18NEW SECTION. Sec. 6. (1) Effective January 1, 2010, except as

19provided in section 7 of this act, the department of health shall

20require that all long-term care workers successfully complete a

21certification examination. Any long-term care worker failing to make

22the required grade for the examination will not be certified as a home

23care aide.

24(2) The department of health, in consultation with consumer and

25worker representatives, shall develop a home care aide certification

26examination to evaluate whether an applicant possesses the skills and

27knowledge necessary to practice competently. Unless excluded by

28section 7 (1) and (2) of this act, only those who have completed the

29training requirements in section 5 of this act shall be eligible to sit

30for this examination.

31(3) The examination shall include both a skills demonstration and

32a written or oral knowledge test. The examination papers, all grading

33of the papers, and records related to the grading of skills

34demonstration shall be preserved for a period of not less than one

35year. The department of health shall establish rules governing the

36number of times and under what circumstances individuals who have


 1failed the examination may sit for the examination, including whether

 2any intermediate remedial steps should be required.

 3(4) All examinations shall be conducted by fair and wholly

 4impartial methods. The certification examination shall be administered

 5and evaluated by the department of health or by a contractor to the

 6department of health that is neither an employer of long-term care

 7workers or private contractors providing training services under this

 8chapter.

 9(5) The department of health has the authority to:

10(a) Establish forms, procedures, and examinations necessary to

11certify home care aides pursuant to this chapter;

12(b) Hire clerical, administrative, and investigative staff as

13needed to implement this section;

14(c) Issue certification as a home care aide to any applicant who

15has successfully completed the home care aide examination;

16(d) Maintain the official record of all applicants and persons with

17certificates;

18(e) Exercise disciplinary authority as authorized in chapter 18.130

19RCW; and

20(f) Deny certification to applicants who do not meet training,

21competency examination, and conduct requirements for certification.

22(6) The department of health shall adopt rules by August 1, 2009,

23that establish the procedures and examinations necessary to carry this

24section into effect.

 

25NEW SECTION. Sec. 7. The following long-term care workers are not

26required to become a certified home care aide pursuant to this chapter.

27(1) Registered nurses, licensed practical nurses, certified nursing

28assistants, medicare-certified home health aides, or other persons who

29hold a similar health credential, as determined by the secretary of

30health, or persons with special education training and an endorsement

31granted by the superintendent of public instruction, as described in

32RCW 28A.300.010, if the secretary of health determines that the

33circumstances do not require certification. Individuals exempted by

34this subsection may obtain certification as a home care aide from the

35department of health without fulfilling the training requirements in

36section 5 of this act but must successfully complete a certification

37examination pursuant to section 6 of this act.


 1(2) A person already employed as a long-term care worker prior to

 2January 1, 2010, who completes all of his or her training requirements

 3in effect as of the date he or she was hired, is not required to obtain

 4certification. Individuals exempted by this subsection may obtain

 5certification as a home care aide from the department of health without

 6fulfilling the training requirements in section 5 of this act but must

 7successfully complete a certification examination pursuant to section

 86 of this act.

 9(3) All long-term care workers employed by supported living

10providers are not required to obtain certification under this chapter.

11(4) An individual provider caring only for his or her biological,

12step, or adoptive child or parent is not required to obtain

13certification under this chapter.

14(5) Prior to June 30, 2014, a person hired as an individual

15provider who provides twenty hours or less of care for one person in

16any calendar month is not required to obtain certification under this

17chapter.

18(6) A long-term care worker exempted by this section from the

19training requirements contained in section 5 of this act may not be

20prohibited from enrolling in training pursuant to that section.

21(7) The department of health shall adopt rules by August 1, 2009,

22to implement this section.

 

23NEW SECTION. Sec. 8. A new section is added to chapter 74.39A RCW

24to read as follows:

25(1) Effective January 1, 2010, a biological, step, or adoptive

26parent who is the individual provider only for his or her

27developmentally disabled son or daughter must receive twelve hours of

28training relevant to the needs of adults with developmental

29disabilities within the first one hundred twenty days of becoming an

30individual provider.

31(2) Effective January 1, 2010, individual providers identified in

32(a) and (b) of this subsection must complete thirty-five hours of

33training within the first one hundred twenty days of becoming an

34individual provider. Five of the thirty-five hours must be completed

35before becoming eligible to provide care. Two of these five hours

36shall be devoted to an orientation training regarding an individual

37provider's role as caregiver and the applicable terms of employment,


 1and three hours shall be devoted to safety training, including basic

 2safety precautions, emergency procedures, and infection control.

 3Individual providers subject to this requirement include:

 4(a) An individual provider caring only for his or her biological,

 5step, or adoptive child or parent unless covered by subsection (1) of

 6this section; and

 7(b) Before January 1, 2014, a person hired as an individual

 8provider who provides twenty hours or less of care for one person in

 9any calendar month.

10(3) Only training curriculum approved by the department may be used

11to fulfill the training requirements specified in this section. The

12department shall only approve training curriculum that:

13(a) Has been developed with input from consumer and worker

14representatives; and

15(b) Requires comprehensive instruction by qualified instructors.

16(4) The department shall adopt rules by August 1, 2009, to

17implement this section.

 

18Sec. 9. RCW 74.39A.340 and 2007 c 361 s 4 are each amended to read

19as follows:

20(1) The department of health shall ensure that all long-term care

21workers shall complete twelve hours of continuing education training in

22advanced training topics each year. This requirement applies beginning

23on January 1, 2010.

24(2) Completion of continuing education as required in this section

25is a prerequisite to maintaining home care aide certification under

26this act.

27(3) Unless voluntarily certified as a home care aide under this

28act, subsection (1) of this section does not apply to:

29(a) An individual provider caring only for his or her biological,

30step, or adoptive child; and

31(b) Before June 30, 2014, a person hired as an individual provider

32who provides twenty hours or less of care for one person in any

33calendar month.

34(4) Only training curriculum approved by the department may be used

35to fulfill the training requirements specified in this section. The

36department shall only approve training curriculum that:


 1(a) Has been developed with input from consumer and worker

 2representatives; and

 3(b) Requires comprehensive instruction by qualified instructors.

 4(5) Individual providers under RCW 74.39A.270 shall be compensated

 5for training time required by this section.

 6(6) The department of health shall adopt rules by August 1, 2009,

 7to implement subsections (1), (2), and (3) of this section.

 8(7) The department shall adopt rules by August 1, 2009, to

 9implement subsection (4) of this section.

 

10Sec. 10. RCW 74.39A.350 and 2007 c 361 s 5 are each amended to

11read as follows:

12The department shall offer, directly or through contract, training

13opportunities sufficient for a long-term care worker to accumulate

14((sixty-five)) seventy hours of training within a reasonable time

15period. For individual providers represented by an exclusive

16bargaining representative under RCW 74.39A.270, the training

17opportunities shall be offered through ((a contract with)) the training

18partnership established under RCW 74.39A.360. Training topics shall

19include, but are not limited to: Client rights; personal care; mental

20illness; dementia; developmental disabilities; depression; medication

21assistance; advanced communication skills; positive client behavior

22support; developing or improving client-centered activities; dealing

23with wandering or aggressive client behaviors; medical conditions;

24nurse delegation core training; peer mentor training; and advocacy for

25quality care training. The department may not require long-term care

26workers to obtain the training described in this section. This

27requirement to offer advanced training applies beginning January 1,

28((2010)) 2011.

 

29NEW SECTION. Sec. 11. A new section is added to chapter 18.88A

30RCW to read as follows:

31By August 1, 2009, the department of health shall develop, in

32consultation with the nursing care quality assurance commission and

33consumer and worker representatives, rules permitting reciprocity to

34the maximum extent possible under federal law between home care aide

35certification and nursing assistant certification.


 1NEW SECTION. Sec. 12. A new section is added to chapter 74.39A

 2RCW to read as follows:

 3(1) The department shall deny payment to any individual provider of

 4home care services who has not been certified by the department of

 5health as a home care aide as required under this act or, if exempted

 6from certification by section 7 of this act, has not completed his or

 7her required training pursuant to this act.

 8(2) The department may terminate the contract of any individual

 9provider of home care services, or take any other enforcement measure

10deemed appropriate by the department if the individual provider's

11certification is revoked under this act or, if exempted from

12certification by section 7 of this act, has not completed his or her

13required training pursuant to this act.

14(3) The department shall take appropriate enforcement action

15related to the contract of a private agency or facility licensed by the

16state, to provide personal care services, other than an individual

17provider, who knowingly employs a long-term care worker who is not a

18certified home care aide as required under this act or, if exempted

19from certification by section 7 of this act, has not completed his or

20her required training pursuant to this act.

21(4) Chapter 34.05 RCW shall govern actions by the department under

22this section.

23(5) The department shall adopt rules by August 1, 2009, to

24implement this section.

 

25NEW SECTION. Sec. 13. (1) The uniform disciplinary act, chapter

2618.130 RCW, governs uncertified practice, issuance of certificates, and

27the discipline of persons with certificates under this chapter. The

28secretary of health shall be the disciplinary authority under this

29chapter.

30(2) The secretary of health may take action to immediately suspend

31the certification of a long-term care worker upon finding that conduct

32of the long-term care worker has caused or presents an imminent threat

33of harm to a functionally disabled person in his or her care.

34(3) If the secretary of health imposes suspension or conditions for

35continuation of certification, the suspension or conditions for

36continuation are effective immediately upon notice and shall continue

37in effect pending the outcome of any hearing.


 1(4) The department of health shall take appropriate enforcement

 2action related to the licensure of a private agency or facility

 3licensed by the state, to provide personal care services, other than an

 4individual provider, who knowingly employs a long-term care worker who

 5is not a certified home care aide as required under this chapter or, if

 6exempted from certification by section 7 of this act, has not completed

 7his or her required training pursuant to this chapter.

 8(5) Chapter 34.05 RCW shall govern actions by the department of

 9health under this section.

10(6) The department of health shall adopt rules by August 1, 2009,

11to implement this section.

 

12Sec. 14. RCW 74.39A.050 and 2004 c 140 s 6 are each amended to

13read as follows:

14The department's system of quality improvement for long-term care

15services shall use the following principles, consistent with applicable

16federal laws and regulations:

17(1) The system shall be client-centered and promote privacy,

18independence, dignity, choice, and a home or home-like environment for

19consumers consistent with chapter 392, Laws of 1997.

20(2) The goal of the system is continuous quality improvement with

21the focus on consumer satisfaction and outcomes for consumers. This

22includes that when conducting licensing or contract inspections, the

23department shall interview an appropriate percentage of residents,

24family members, resident case managers, and advocates in addition to

25interviewing providers and staff.

26(3) Providers should be supported in their efforts to improve

27quality and address identified problems initially through training,

28consultation, technical assistance, and case management.

29(4) The emphasis should be on problem prevention both in monitoring

30and in screening potential providers of service.

31(5) Monitoring should be outcome based and responsive to consumer

32complaints and based on a clear set of health, quality of care, and

33safety standards that are easily understandable and have been made

34available to providers, residents, and other interested parties.

35(6) Prompt and specific enforcement remedies shall also be

36implemented without delay, pursuant to RCW 74.39A.080, RCW 70.128.160,

37chapter 18.51 RCW, or chapter 74.42 RCW, for providers found to have


 1delivered care or failed to deliver care resulting in problems that are

 2serious, recurring, or uncorrected, or that create a hazard that is

 3causing or likely to cause death or serious harm to one or more

 4residents. These enforcement remedies may also include, when

 5appropriate, reasonable conditions on a contract or license. In the

 6selection of remedies, the safety, health, and well-being of residents

 7shall be of paramount importance.

 8(7) ((To the extent funding is available, all long-term care staff

 9directly responsible for the care, supervision, or treatment of

10vulnerable persons should be screened through background checks in a

11uniform and timely manner to ensure that they do not have a criminal

12history that would disqualify them from working with vulnerable

13persons. Whenever a state conviction record check is required by state

14law, persons may be employed or engaged as volunteers or independent

15contractors on a conditional basis according to law and rules adopted

16by the department.)) All long-term care workers shall be screened

17through background checks in a uniform and timely manner to ensure that

18they do not have a criminal history that would disqualify them from

19working with vulnerable persons. This information will be shared with

20the department of health to advance the purposes of this act.

21(8) No provider or ((staff)) long-term care worker, or prospective

22provider or ((staff)) long-term care worker, with a stipulated finding

23of fact, conclusion of law, an agreed order, or finding of fact,

24conclusion of law, or final order issued by a disciplining authority,

25a court of law, or entered into a state registry finding him or her

26guilty of abuse, neglect, exploitation, or abandonment of a minor or a

27vulnerable adult as defined in chapter 74.34 RCW shall be employed in

28the care of and have unsupervised access to vulnerable adults.

29(9) The department shall establish, by rule, a state registry which

30contains identifying information about ((personal care aides))

31long-term care workers identified under this chapter who have

32substantiated findings of abuse, neglect, financial exploitation, or

33abandonment of a vulnerable adult as defined in RCW 74.34.020. The

34rule must include disclosure, disposition of findings, notification,

35findings of fact, appeal rights, and fair hearing requirements. The

36department shall disclose, upon request, substantiated findings of

37abuse, neglect, financial exploitation, or abandonment to any person so


 1requesting this information. This information will also be shared with

 2the department of health to advance the purposes of this act.

 3(10) ((The department shall by rule develop training requirements

 4for individual providers and home care agency providers. Effective

 5March 1, 2002,)) Until December 31, 2009, individual providers and home

 6care agency providers must satisfactorily complete department-approved

 7orientation, basic training, and continuing education within the time

 8period specified by the department in rule. The department shall adopt

 9rules by March 1, 2002, for the implementation of this section ((based

10on the recommendations of the community long-term care training and

11education steering committee established in RCW 74.39A.190)). The

12department shall deny payment to an individual provider or a home care

13provider who does not complete the training requirements within the

14time limit specified by the department by rule.

15(11) Until December 31, 2009, in an effort to improve access to

16training and education and reduce costs, especially for rural

17communities, the coordinated system of long-term care training and

18education must include the use of innovative types of learning

19strategies such as internet resources, videotapes, and distance

20learning using satellite technology coordinated through community

21colleges or other entities, as defined by the department.

22(12) The department shall create an approval system by March 1,

232002, for those seeking to conduct department-approved training. ((In

24the rule-making process, the department shall adopt rules based on the

25recommendations of the community long-term care training and education

26steering committee established in RCW 74.39A.190.))

27(13) The department shall establish, by rule, ((training,))

28background checks((,)) and other quality assurance requirements for

29((personal aides)) long-term care workers who provide in-home services

30funded by medicaid personal care as described in RCW 74.09.520,

31community options program entry system waiver services as described in

32RCW 74.39A.030, or chore services as described in RCW 74.39A.110 that

33are equivalent to requirements for individual providers.

34(14) Under existing funds the department shall establish internally

35a quality improvement standards committee to monitor the development of

36standards and to suggest modifications.

37(15) Within existing funds, the department shall design, develop,

38and implement a long-term care training program that is flexible,


 1relevant, and qualifies towards the requirements for a nursing

 2assistant certificate as established under chapter 18.88A RCW. This

 3subsection does not require completion of the nursing assistant

 4certificate training program by providers or their staff. The long-

 5term care teaching curriculum must consist of a fundamental module, or

 6modules, and a range of other available relevant training modules that

 7provide the caregiver with appropriate options that assist in meeting

 8the resident's care needs. Some of the training modules may include,

 9but are not limited to, specific training on the special care needs of

10persons with developmental disabilities, dementia, mental illness, and

11the care needs of the elderly. No less than one training module must

12be dedicated to workplace violence prevention. The nursing care

13quality assurance commission shall work together with the department to

14develop the curriculum modules. The nursing care quality assurance

15commission shall direct the nursing assistant training programs to

16accept some or all of the skills and competencies from the curriculum

17modules towards meeting the requirements for a nursing assistant

18certificate as defined in chapter 18.88A RCW. A process may be

19developed to test persons completing modules from a caregiver's class

20to verify that they have the transferable skills and competencies for

21entry into a nursing assistant training program. The department may

22review whether facilities can develop their own related long-term care

23training programs. The department may develop a review process for

24determining what previous experience and training may be used to waive

25some or all of the mandatory training. The department of social and

26health services and the nursing care quality assurance commission shall

27work together to develop an implementation plan by December 12, 1998.

 

28Sec. 15. RCW 18.130.040 and 2007 c 269 s 17, 2007 c 253 s 13, and

292007 c 70 s 11 are each reenacted and amended to read as follows:

30(1) This chapter applies only to the secretary and the boards and

31commissions having jurisdiction in relation to the professions licensed

32under the chapters specified in this section. This chapter does not

33apply to any business or profession not licensed under the chapters

34specified in this section.

35(2)(a) The secretary has authority under this chapter in relation

36to the following professions:


 1(i) Dispensing opticians licensed and designated apprentices under

 2chapter 18.34 RCW;

 3(ii) Naturopaths licensed under chapter 18.36A RCW;

 4(iii) Midwives licensed under chapter 18.50 RCW;

 5(iv) Ocularists licensed under chapter 18.55 RCW;

 6(v) Massage operators and businesses licensed under chapter 18.108

 7RCW;

 8(vi) Dental hygienists licensed under chapter 18.29 RCW;

 9(vii) Acupuncturists licensed under chapter 18.06 RCW;

10(viii) Radiologic technologists certified and X-ray technicians

11registered under chapter 18.84 RCW;

12(ix) Respiratory care practitioners licensed under chapter 18.89

13RCW;

14(x) Persons registered under chapter 18.19 RCW;

15(xi) Persons licensed as mental health counselors, marriage and

16family therapists, and social workers under chapter 18.225 RCW;

17(xii) Persons registered as nursing pool operators under chapter

1818.52C RCW;

19(xiii) Nursing assistants registered or certified under chapter

2018.88A RCW;

21(xiv) Health care assistants certified under chapter 18.135 RCW;

22(xv) Dietitians and nutritionists certified under chapter 18.138

23RCW;

24(xvi) Chemical dependency professionals certified under chapter

2518.205 RCW;

26(xvii) Sex offender treatment providers and certified affiliate sex

27offender treatment providers certified under chapter 18.155 RCW;

28(xviii) Persons licensed and certified under chapter 18.73 RCW or

29RCW 18.71.205;

30(xix) Denturists licensed under chapter 18.30 RCW;

31(xx) Orthotists and prosthetists licensed under chapter 18.200 RCW;

32(xxi) Surgical technologists registered under chapter 18.215 RCW;

33(xxii) Recreational therapists;

34(xxiii) Animal massage practitioners certified under chapter 18.240

35RCW; ((and))

36(xxiv) Athletic trainers licensed under chapter 18.250 RCW; and

37(xxv) Home care aides certified under chapter 18.-- RCW (the new

38chapter created in section 18 of this act).


 1(b) The boards and commissions having authority under this chapter

 2are as follows:

 3(i) The podiatric medical board as established in chapter 18.22

 4RCW;

 5(ii) The chiropractic quality assurance commission as established

 6in chapter 18.25 RCW;

 7(iii) The dental quality assurance commission as established in

 8chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW and

 9licenses and registrations issued under chapter 18.260 RCW;

10(iv) The board of hearing and speech as established in chapter

1118.35 RCW;

12(v) The board of examiners for nursing home administrators as

13established in chapter 18.52 RCW;

14(vi) The optometry board as established in chapter 18.54 RCW

15governing licenses issued under chapter 18.53 RCW;

16(vii) The board of osteopathic medicine and surgery as established

17in chapter 18.57 RCW governing licenses issued under chapters 18.57 and

1818.57A RCW;

19(viii) The board of pharmacy as established in chapter 18.64 RCW

20governing licenses issued under chapters 18.64 and 18.64A RCW;

21(ix) The medical quality assurance commission as established in

22chapter 18.71 RCW governing licenses and registrations issued under

23chapters 18.71 and 18.71A RCW;

24(x) The board of physical therapy as established in chapter 18.74

25RCW;

26(xi) The board of occupational therapy practice as established in

27chapter 18.59 RCW;

28(xii) The nursing care quality assurance commission as established

29in chapter 18.79 RCW governing licenses and registrations issued under

30that chapter;

31(xiii) The examining board of psychology and its disciplinary

32committee as established in chapter 18.83 RCW; and

33(xiv) The veterinary board of governors as established in chapter

3418.92 RCW.

35(3) In addition to the authority to discipline license holders, the

36disciplining authority has the authority to grant or deny licenses

37based on the conditions and criteria established in this chapter and

38the chapters specified in subsection (2) of this section. This chapter


 1also governs any investigation, hearing, or proceeding relating to

 2denial of licensure or issuance of a license conditioned on the

 3applicant's compliance with an order entered pursuant to RCW 18.130.160

 4by the disciplining authority.

 5(4) All disciplining authorities shall adopt procedures to ensure

 6substantially consistent application of this chapter, the Uniform

 7Disciplinary Act, among the disciplining authorities listed in

 8subsection (2) of this section.

 

 9Sec. 16. RCW 18.130.040 and 2008 c ... (Fourth Substitute House

10Bill No. 1103) s 18 are each amended to read as follows:

11(1) This chapter applies only to the secretary and the boards and

12commissions having jurisdiction in relation to the professions licensed

13under the chapters specified in this section. This chapter does not

14apply to any business or profession not licensed under the chapters

15specified in this section.

16(2)(a) The secretary has authority under this chapter in relation

17to the following professions:

18(i) Dispensing opticians licensed and designated apprentices under

19chapter 18.34 RCW;

20(ii) Naturopaths licensed under chapter 18.36A RCW;

21(iii) Midwives licensed under chapter 18.50 RCW;

22(iv) Ocularists licensed under chapter 18.55 RCW;

23(v) Massage operators and businesses licensed under chapter 18.108

24RCW;

25(vi) Dental hygienists licensed under chapter 18.29 RCW;

26(vii) Acupuncturists licensed under chapter 18.06 RCW;

27(viii) Radiologic technologists certified and X-ray technicians

28registered under chapter 18.84 RCW;

29(ix) Respiratory care practitioners licensed under chapter 18.89

30RCW;

31(x) Persons registered under chapter 18.19 RCW;

32(xi) Persons licensed as mental health counselors, marriage and

33family therapists, and social workers under chapter 18.225 RCW;

34(xii) Persons registered as nursing pool operators under chapter

3518.52C RCW;

36(xiii) Nursing assistants registered or certified under chapter

3718.88A RCW;


 1(xiv) Health care assistants certified under chapter 18.135 RCW;

 2(xv) Dietitians and nutritionists certified under chapter 18.138

 3RCW;

 4(xvi) Chemical dependency professionals certified under chapter

 518.205 RCW;

 6(xvii) Sex offender treatment providers and certified affiliate sex

 7offender treatment providers certified under chapter 18.155 RCW;

 8(xviii) Persons licensed and certified under chapter 18.73 RCW or

 9RCW 18.71.205;

10(xix) Denturists licensed under chapter 18.30 RCW;

11(xx) Orthotists and prosthetists licensed under chapter 18.200 RCW;

12(xxi) Surgical technologists registered under chapter 18.215 RCW;

13(xxii) Recreational therapists;

14(xxiii) Animal massage practitioners certified under chapter 18.240

15RCW; ((and))

16(xxiv) Athletic trainers licensed under chapter 18.250 RCW; and

17(xxv) Home care aides certified under chapter 18.-- RCW (the new

18chapter created in section 18 of this act).

19(b) The boards and commissions having authority under this chapter

20are as follows:

21(i) The podiatric medical board as established in chapter 18.22

22RCW;

23(ii) The chiropractic quality assurance commission as established

24in chapter 18.25 RCW;

25(iii) The dental quality assurance commission as established in

26chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW and

27licenses and registrations issued under chapter 18.260 RCW;

28(iv) The board of hearing and speech as established in chapter

2918.35 RCW;

30(v) The board of examiners for nursing home administrators as

31established in chapter 18.52 RCW;

32(vi) The optometry board as established in chapter 18.54 RCW

33governing licenses issued under chapter 18.53 RCW;

34(vii) The board of osteopathic medicine and surgery as established

35in chapter 18.57 RCW governing licenses issued under chapters 18.57 and

3618.57A RCW;

37(viii) The board of pharmacy as established in chapter 18.64 RCW

38governing licenses issued under chapters 18.64 and 18.64A RCW;


 1(ix) The medical quality assurance commission as established in

 2chapter 18.71 RCW governing licenses and registrations issued under

 3chapters 18.71 and 18.71A RCW;

 4(x) The board of physical therapy as established in chapter 18.74

 5RCW;

 6(xi) The board of occupational therapy practice as established in

 7chapter 18.59 RCW;

 8(xii) The nursing care quality assurance commission as established

 9in chapter 18.79 RCW governing licenses and registrations issued under

10that chapter;

11(xiii) The examining board of psychology and its disciplinary

12committee as established in chapter 18.83 RCW; and

13(xiv) The veterinary board of governors as established in chapter

1418.92 RCW.

15(3) In addition to the authority to discipline license holders, the

16disciplining authority has the authority to grant or deny licenses.

17The disciplining authority may also grant a license subject to

18conditions.

19(4) All disciplining authorities shall adopt procedures to ensure

20substantially consistent application of this chapter, the Uniform

21Disciplinary Act, among the disciplining authorities listed in

22subsection (2) of this section.

 

23NEW SECTION. Sec. 17. The definitions in RCW 74.39A.009 apply

24throughout chapter 18.-- RCW (the new chapter created in section 18 of

25this act) unless the context clearly requires otherwise.

 

26NEW SECTION. Sec. 18. Sections 4, 6, 7, 13, and 17 of this act

27constitute a new chapter in Title 18 RCW.

 

28NEW SECTION. Sec. 19. The provisions of this act are to be

29liberally construed to effectuate the intent, policies, and purposes of

30this act.

 

31NEW SECTION. Sec. 20. If any provision of this act or its

32application to any person or circumstance is held invalid, the

33remainder of the act or the application of the provision to other

34persons or circumstances is not affected.


 1NEW SECTION. Sec. 21. This act may be known and cited as the

 2better background checks and improved training for long-term care

 3workers for the elderly and persons with disabilities initiative of

 42008.

 

 5NEW SECTION. Sec. 22. Section 11 of this act takes effect

 6September 1, 2009.

 

 7NEW SECTION. Sec. 23. Section 15 of this act does not take effect

 8if section 18, chapter ... (Fourth Substitute House Bill No. 1103),

 9Laws of 2008 is signed into law by April 6, 2008.

 

10NEW SECTION. Sec. 24. Section 16 of this act takes effect if

11section 18, chapter ... (Fourth Substitute House Bill No. 1103), Laws

12of 2008 is signed into law by April 6, 2008.Originally filed in Office of Secretary of State March 28, 2008.

Approved by the People of the State of Washington in the General Election on November 4, 2008.