SENATE BILL REPORT

SB 5404

BYSenators Wojahn, Stratton, Nelson, Halsan, Rasmussen and Moore

Regulating care provided in the home to ill, infirm, or disabled persons.

Senate Committee on Human Services & Corrections

Senate Hearing Date(s):February 12, 1987; February 19, 1987

Majority Report:  That Substitute Senate Bill No. 5404 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.

      Signed by Senators Wojahn, Chairman; Stratton, Vice Chairman; Anderson, Deccio, Johnson, Kiskaddon, Kreidler, Tanner.

Senate Staff:Scott Plack (786-7409)

                  February 20, 1987

Senate Committee on Ways & Means

Senate Hearing Date(s):February 25, 1987

Majority Report:  That Substitute Senate Bill No. 5404 as recommended by Committee on Human Services & Corrections be substituted therefor, and the substitute bill do pass.

      Signed by Senators McDermott, Chairman; Gaspard, Vice Chairman; Bauer, Deccio, Fleming, Kreidler, Moore, Rinehart, Talmadge, Williams, Wojahn, Zimmerman.

Senate Staff:Suzanne Petersen (786-7715)

                  March 13, 1987

AS REPORTED BY COMMITTEE ON WAYS & MEANS, FEBRUARY 25, 1987

BACKGROUND:

In-home services for the ill, disabled and aged population are classified into three categories:  home health care, home care and hospice care.  Home health care refers to health and medical services such as nursing rehabilitation therapies, nutritional therapy, and a variety of other vital health services.  Home care refers to supportive services such as personal care assistance which help maintain the independence of the home bound person.  Hospice care refers to physical, social and emotional care for the terminally ill, and emotional support to the family during the bereavement period.

Currently, there are no minimum mandatory state standards for providers of in-home services.  Home health and hospice services are subject to a voluntary certification program administered by the Department of Social and Health Services.  Present certification standards are based upon federal Medicare requirements.  Certification is often required for third-party reimbursement.

The growing elderly population plus potential cost- containment benefits of providing in-home services are expected to increase future demand for home health, home care and hospice services.

SUMMARY:

The in-home health care industry is regulated by separately licensing home health, hospice and home care agencies. The Department of Social and Health Services (DSHS) is the designated licensure authority.

Home health agencies provide home health aide services or two or more medical or health related services.  Home care agencies provide personal care, homemaker services, respite care or other non-medical in-home services.  Hospice agencies provide medical and home care services to the terminally ill.

Exemptions from licensure are provided for family members, certain medical equipment companies; providers who contract with a licensed agency; and employees, volunteers or contract providers of a licensed agency.

Nursing homes and hospitals are required to be licensed for home health, home care and hospice services provided outside the nursing home or hospital facility.

Licensure standards are established for each type of agency.

Bonding and insurance requirements are established.

The Secretary of DSHS is authorized to establish licensure fees.

DSHS collects data on services provided by licensed agencies.  DSHS may also combine applications, on-site inspections and audits for agencies applying for more than one in-home service license.

The Home Health, Hospice and Home Care Advisory Committee is created to advise DSHS on matters of policy affecting the delivery of in-home services.

Each in-home agency is required to issue clients a consumer bill of rights.

Revenue:    Licensure fees will be established.

Fiscal Note:      available

EFFECT OF PROPOSED SUBSTITUTE:

The following facilities are exempt from licensure:  Certain facilities and institutions already licensed by the state, medically approved kidney dialysis programs and volunteer home care agencies.

Volunteer hospice programs established before January 1, 1987 that do not meet licensure requirements may use the term "hospice."  All volunteer hospice agencies that apply for licensure are exempted from bonding, professional liability, public liability and property damage insurance requirements.

An appropriation is made of $38,365 from the general fund-state and $65,500 from the general fund-local.  The act will sunset on July 1, 1991.  The LBC is directed to conduct a fiscal and program review on this act by December 31, 1990.

Senate Committee - Testified: HUMAN SERVICES & CORRECTIONS:  Margret Shepard, Home Care Association of Washington; Ken Lewis, DSHS; Betty Thorton, Group Health; Phyllis Houghton, DSHS; Janet Brown, Lower Valley Hospice; Patty Joynes, Washington State Nurses Association; Patrick Hayes, Washington State Chore Association; Lars Hennum, Washington Pharmacists; Mike Ryherd, WSMA

Senate Committee - Testified: WAYS & MEANS:  Margret Shepherd and Gail Toraason, Home Care Association of Washington; Gloria Rodriquez, Chore Providers Coalition