FINAL BILL REPORT

SB 6271

                                  C 245 L 88

BYSenators Deccio, Wojahn, Smith, Kreidler and Nelson

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

Senate Committee on Health Care & Corrections

House Committe on Health Care

SYNOPSIS AS ENACTED

BACKGROUND:

In-home services for the ill, disabled and aged population are classified into home health care, home care, and hospice care categories.  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 homebound person.  Hospice care refers to physical, social and emotional care for the terminally ill, and emotional support to the family during the bereavement period.

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 which establishes standards for each type of agency.  A certificate of need is not required for licensure.  DSHS is given enforcement authority and may revoke a license or assess a penalty in order to assure compliance.  The Secretary of DSHS is authorized to establish licensure fees.

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 nonmedical in-home services.  Hospice agencies provide medical and home care services to the terminally ill.

Exemptions from licensure are provided for family members, certain entities furnishing durable medical equipment; providers who contract with a licensed agency; employees, volunteers or contract providers of a licensed agency; certain facilities and institutions already licensed by the state; medically approved kidney dialysis programs; volunteer home care agencies; case management services and individuals providing home care through a direct agreement with third-party payers where home care services are not readily available through an agency.

Volunteer hospice programs established before January 1, 1988, that do not meet licensure requirements may use the term "volunteer hospice."  All volunteer hospice agencies that apply for licensure are exempt from professional liability, public liability and property damage insurance requirements.

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.

Insurance requirements are established.

In-home service agencies must submit applications for licensure with licensure fee to DSHS by July 1, 1989.  DSHS must license these applicants by July 1, 1990.

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

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

Third party payment may be made only to licensed home health and hospice agencies, though third-party payments may also require adherence to Medicare standards as a condition for payment.

The act will sunset on July 1, 1993.  The Legislative Budget Committee is directed to conduct a fiscal and program review on this act by December 31, 1992.

A surcharge to license fees may be added to cover initial implementation costs.

Appropriation:    An appropriation of $38,875 is made from the general fund-state.

VOTES ON FINAL PASSAGE:

      Senate    46     0

      House 95   0 (House amended)

      Senate    48     0 (Senate concurred)

EFFECTIVE:July 1, 1989