Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Appropriations Committee

HB 1792

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Summary of Bill

Requires providers of residential services and supports to Department of Social and Health Services (DSHS) Developmental Disabilities Administration (DDA) clients to pay an initial and annual certification fee beginning July 1, 2017.
Establishes that the fee amount may not exceed the DSHS' costs to investigate complaints about provider practice issues and individuals alleged to have abused or neglected, and that it must include the DSHS' costs to reimburse providers for fees attributable to Medicaid clients.
Requires the DSHS to use additional resources from the fees to address growth in their complaint workload and to intervene in a timelier manner when abuse or neglect has occurred.

Background:

Residential Services and Supports.

The Department of Social and Health Services (DSHS) Developmental Disabilities Administration (DDA) provides residential services and supports for clients who meet Medicaid functional and financial eligibility requirements. A "community residential service business" means a business that is certified by and contracted with the DSHS DDA to provide instruction and support to DDA clients. Residential services and supports may include assistance with activities of daily living (such as bathing, dressing, and eating), instrumental activities of daily living (such as meal preparation and ordinary housework), and habilitation services.

Supported living is one type of certified community residential service business. Supported living providers serve up to four clients living in homes that are owned, rented, or leased by the clients or their legal representatives

Residential Care Services.

The Residential Care Services (RCS) unit within the DSHS Aging and Long-Term Support Administration (ALTSA) is responsible for licensing adult family homes, assisted living facilities, nursing facilities, enhanced services facilities (ESFs), and intermediate care facilities for individuals with intellectual disabilities, and for certifying community residential services businesses. The RCS is also responsible for investigating potential provider practice issues, and taking enforcement action when provider practice issues are found.

Adult family homes, assisted living facilities, nursing homes, and ESFs pay per-bed fees at initial licensure and renewal that are used to support RCS activities. The fee levels are established in the omnibus operating appropriations act and may not exceed the DSHS' costs for licensing and oversight. Providers are reimbursed using federal matching funds for fees paid on Medicaid client beds.

The RCS costs that are not funded by provider fee revenue are funded with State General Fund and federal Medicaid funds.

The DSHS reports that the number of RCS investigations among supported living providers has increased from 806 in fiscal year (FY) 2013 to 2,212 investigations in FY 2016.

Certification for Community Residential Services and Supports.

A certification means that the provider has complied with certain administrative requirements such as staffing, liability insurance, and the practices used by the provider to deliver services, as outlined in provisions in the Washington Administrative Code. The certification provided by the RCS allows a provider to continue to receive referrals and to provide services under a contract with the DDA. Certification may be granted to providers for up to two years. There is no fee for certification. Supported living is the only type of certified residential services and support that does not require licensure as an adult family home or assisted living facility.

Summary of Bill:

Beginning July 1, 2017, providers of DDA community residential services and supports must pay an initial and annual certification fee. The fee amount must be established in the omnibus operating appropriations act and may not exceed the DSHS' costs to investigate complaints about provider practice and individuals alleged to have been abused, neglected, abandoned, or exploited.

The initial and subsequent annual certification fee must be established in the omnibus operating appropriations act. No certification fee will be required for government-operated programs, court-appointed receivers, or the portion of certified residential services and supports in which providers pay adult family home or assisted living facility licensing fees.

The DSHS must use the additional resources from certification fees to address growth in the complaint workload and to intervene for clients in a timelier manner when there is possible abuse or neglect.