SENATE BILL REPORT

SB 5056

BYSenators Rinehart, West, Kreidler, Johnson and Smitherman

Revising provisions for long-term care for persons with functional limitations.

Senate Committee on Health Care & Corrections

Senate Hearing Date(s):February 20, 1989

Senate Staff:Don Sloma (786-7414)

AS OF FEBRUARY 20, 1989

BACKGROUND:

Nearly 80 percent of long term care services are now provided by family and friends.  However, between now and the year 2000, 46 percent growth is projected in the population 85 years old and above.  More than 30 percent growth is projected in the population 75 to 85.  In addition to these major increases in the proportion of the population likely to need long term care, major changes in family structure are resulting in increased demand for publicly funded long term care services. 

Current long term care policy provides a federal entitlement (Title XIX) for nursing home care for persons who meet income and disability requirements.  The entitlement combined with state nursing home reimbursement statutes results in major increases in state and federal funds for nursing home services.  Other types of long term care such as chore services and respite care have not expanded to meet demand.

SUMMARY:

The Legislature recognizes that persons with functional disabilities should receive long term care that respects their dignity, encourages their autonomy and helps them meet their maximum potential.  The Legislature finds that these services should be delivered comprehensively, through community based service providers.

Chore services are redefined as those tasks included in the Department of Social and Health Services (DSHS) medical assistance plan (Title XIX) for personal care.  Additional tasks may be included as the Legislature provides funds for them, specifically.

The Department of Social and Health Services must amend the state plan for Title XIX to provide for personal care and case management services.  The plan must be operational by July 1, 1989.

The requirement that chore services be provided only to the extent necessary to maintain a safe and healthy living environment is deleted.

The requirement that DSHS consider the availability and capability of relatives, friends and other community resources in determining the level of needed services is replaced by the requirement that DSHS consider whether such alternative help is being provided.

DSHS must promulgate rules consistent with federal law concerning the transfer of income and assets between institutionalized persons and their spouses remaining in the community.  Community income and assets may be transferred to and retained by the spouse of an institutionalized person up to the federal maximums which are $60,000 in assets, a home, car and personal belongings and income up to $1,500 per month.

DSHS must promulgate rules consistent with federal law concerning due process in fair hearings regarding income and asset valuation and transfer.

The respite care pilot program is expanded statewide.

Counties, client advocacy groups, service providers and DSHS must collaborate in a review of long term care services, organization and financing in Washington.  The Governor must report to the Legislature on the results of the review, together with recommendations for statutory and financial changes by December 1, 1990.

Appropriation:    none

Revenue:    none

Fiscal Note:      available