AN ACT Relating to long-term care services; amending section 2, chapter 158, Laws of 1984 (uncodified); amending section 3, chapter 158, Laws of 1984 (uncodified); amending section 4, chapter 158, Laws of 1984 (uncodified); amending section 5, chapter 158, Laws of 1984 (uncodified); amending section 7, chapter 158, Laws of 1984 (uncodified); creating new chapters in Title 74 RCW; and declaring an emergency.

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

NEW SECTION. Sec. 1. The legislature reaffirms its declaration under RCW 74.38.010 that individuals in this state be maintained at the highest level of independent living they are capable of maintaining. The legislature recognizes and finds that the number of disabled adults and older persons requiring government-assisted long-term care services is projected to increase significantly. Long-term care is a program which may include acute, diagnostic, preventive, therapeutic, rehabilitative, supportive, and maintenance services for individuals (and their supportive families) who have chronic physical and/or mental impairments. Long-term care may be provided in the home, in community-based settings or in the variety of medical and nonmedical residential facilities with the goal of promoting the optimal level of physical, social, and psychological functioning. The legislature declares that it is a high priority goal of the state to support and assure the quality of long-term care services. However, nothing in this chapter creates or provides any individual with an entitlement to services or benefits. It is the intent of the legislature that services under this chapter be made available only to the extent of the appropriation made by the legislature for such services.

NEW SECTION. Sec. 2. The department shall address the long-term care needs of disabled adults and older persons, consistent with the availability of funds, by:

(1) Developing programs designed to sustain and increase the care given by family and friends;

(2) Recognizing that social services as well as health and acute medical care are integral factors in promoting the well-being of disabled adults and older persons;

(3) Increasing the availability of long-term care services, with appropriate financial participation by clients, which emphasize the highest degree of individual autonomy by:

(a) Pursuing a modest growth in medical residential facilities accompanied by the replacement of obsolete medical residential facilities in the long-term care system;

(b) Expanding both the availability and types of nonmedical residential facilities; and

(4) Developing a coordinated long-term care system in conjunction with the area agencies on aging which will ensure that persons receiving long-term care services achieve and maintain the highest possible degree of independence, avoid unnecessary institutionalization, and avoid undue reliance upon state supplied services. The long-term care system will:

(a) Provide for sufficient, cost-effective preventive, in-home, nonmedical residential care as well as medical residential care services;

(b) Provide for a quality assurance program for all long-term care services;

(d) Offer case management services, counseling and referral to community services for all adults in need of long-term care services or protection from abuse, neglect, or exploitation; and

(e) Establish similar placement, assessment, and discharge criteria for all long-term care services.

NEW SECTION. Sec. 3. The department may develop and implement demonstration projects for the long-term care system. The purpose of such projects shall be to produce innovative, high quality, cost-effective social and health services within the long-term care system for disabled adults and older persons. In carrying out this section, the department may request from the federal government a waiver from any regulation or administrative guideline which may impede the development or implementation of such projects. Consistent with state law, the department may request the technical assistance and cooperation of local governments and other entities to carry out the purposes of this section.

NEW SECTION. Sec. 4. The department shall administer this chapter and shall establish such rules and standards as are necessary in carrying out its purpose.

NEW SECTION. Sec. 5. This chapter will be known and may be cited as the "long-term care act of 1987."

NEW SECTION. Sec. 6. If any provision of this chapter or its application to any person or circumstance is held invalid, the remainder of this chapter or the application of the provision to other persons or circumstances shall not be affected.

NEW SECTION. Sec. 7. Sections 1 through 6 of this act shall constitute a new chapter in Title 74 RCW.

Sec. 8. Section 2, chapter 158, Laws of 1984 (uncodified) is amended to read as follows:

It is the intent of the legislature to provide for ((~~a demonstration of the possible cost-effectiveness of~~)) both in-home and out-of-home respite care services which are provided by a range of service providers. The respite care services shall:

(1) Provide relief and support to family or other unpaid caregivers of disabled adults;

(2) Encourage individuals to provide care for disabled adults at home, and thus offer a viable alternative to institutionalization;

(3) Ensure that respite care is made generally available on a sliding-fee basis to eligible participants ((~~and caregivers~~)) in the program according to priorities established by the department; and

(4) Be provided in the least restrictive setting available consistent with the individually assessed needs of the functionally disabled adult.

Sec. 9. Section 3, chapter 158, Laws of 1984 (uncodified) is amended to read as follows:

Unless the context clearly indicates otherwise, the definitions in this section apply throughout ((~~sections 1 through 7 of~~)) this ((~~act~~)) chapter.

(1) "Respite care services" means relief care for families or other caregivers of disabled adults, not exceeding five hundred seventy-six hours ((~~in not more than twenty-four days~~)) in any twelve-month period for each household. The services provide temporary care or supervision of disabled adults in substitution for the caregiver. The term includes social day care.

(2) "Eligible participant" means an adult (a) who needs substantially continuous care or supervision by reason of his or her functional disability, and (b) who is assessed as requiring institutionalization in the absence of a caregiver assisted by home and community support services, including respite care.

(3) "Caregiver" means a spouse, relative, or friend who has primary responsibility for the care of a functionally disabled adult, who does not receive financial compensation for the care, and who is assessed as being at risk of placing the eligible participant in a long-term care facility if respite care is not available.

(4) "Institutionalization" means placement in a long-term care facility.

(5) "Social day care" means nonmedical services to persons who live with their families, cannot be left unsupervised, and are at risk of being placed in a twenty-four-hour care facility if their families do not receive some relief from constant care.

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

Sec. 10. Section 4, chapter 158, Laws of 1984 (uncodified) is amended to read as follows:

The department shall administer ((~~sections 1 through 8 of~~)) this ((~~act~~)) chapter and shall establish such rules and standards as the department deems necessary in carrying out ((~~sections 1 through 8 of~~)) this ((~~act~~)) chapter. The department shall not require the development of plans of care or discharge plans by nursing homes providing respite care service under this chapter.

The department shall develop ((~~program~~)) standards for the ((~~demonstration projects~~)) respite program in conjunction with the selected area agencies on aging. The program standards shall serve as the basis for soliciting bids, entering into subcontracts, and developing sliding fee scales to be used in determining the ability of eligible participants ((~~and caregivers~~)) to participate in paying for respite care.

Sec. 11. Section 5, chapter 158, Laws of 1984 (uncodified) is amended to read as follows:

The department shall ((select at least two but not more than three area agencies on aging to conduct one-year respite care demonstration projects ending June 30, 1985. One of the selected area agencies on aging shall be east of the crest of the Cascade range and one shall be west of the crest of the Cascade range)) select area agencies on aging to conduct respite care projects until July 1, 1989. The responsibilities of the selected area agencies on aging ((~~will be responsible for~~)) shall include but not be limited to: Negotiating rates of payment ((~~and developing~~)), administering sliding-fee scales to enable eligible participants ((~~and caregivers~~)) to participate in paying for respite care, and arranging for respite care services. Rates of payment to respite care service providers shall not exceed, and may be less than, rates paid by the department to ((~~the same~~)) providers for ((~~other than respite care~~)) the same level of service.

Sec. 12. Section 7, chapter 158, Laws of 1984 (uncodified) is amended to read as follows:

(1) The area agencies administering respite care ((~~demonstration projects~~)) programs shall((:

~~(a)~~)) maintain data which indicates demand for respite care, and which includes information on in-home and out-of-home day care and in-home and out-of-home overnight care demand((~~; and~~

~~(b) Make a comparison of the relative cost-effectiveness of the several types of respite care with all other programs and services which are intended to forestall institutionalization~~)).

(2) ((The department shall conduct a survey of all public assistance patients accepted by long-term care facilities in each participating planning and service area to determine the extent to which each of them availed themselves of services designed to defer institutionalization.

~~(3)~~)) The department shall provide a progress report to the legislature on the respite care ((~~demonstration projects~~)) programs authorized in this ((~~act, not later than January 1, 1985~~)) chapter. The ((~~department~~)) report shall ((~~report the results of the data collection, cost comparison, and survey as required in this section~~)) be provided to the legislature not later than thirty days prior to the ((~~1986~~)) 1989 legislative session.

NEW SECTION. Sec. 13. Nothing in this chapter creates or provides any individual with an entitlement to services or benefits. It is the intent of the legislature that services under this chapter shall be made available only to the extent of the availability and level of appropriation made by the legislature.

NEW SECTION. Sec. 14. Sections 8 through 13 of this act, and sections 1, 6, and 8, chapter 158, Laws of 1984, shall constitute a new chapter in Title 74 RCW.

NEW SECTION. Sec. 15. This act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect immediately.