AN ACT Relating to residential care facilities; amending RCW 18.51.010, 18.100.140, 19.27.080, 35A.70.070, 70.127.040, 71.24.025, 71A.12.080, and 71A.22.020; adding a new chapter to Title 71 RCW; repealing RCW 18.20.010, 18.20.020, 18.20.030, 18.20.040, 18.20.050, 18.20.060, 18.20.070, 18.20.090, 18.20.100, 18.20.110, 18.20.120, 18.20.130, 18.20.140, 18.20.150, 18.20.160, 18.20.170, 18.20.900, 35A.66.010, 35A.70.020, 70.96A.090, and 74.08.044; and prescribing penalties.

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

NEW SECTION. Sec. 1. The legislature finds that:

(1) Persons with functional limitations have broadly varying service needs, and residential care facilities that can meet those needs, directly or by subcontract, are an essential component of a long-term care system;

(2) The development and operation of residential care facilities that can provide quality personal care and specialized services, directly or by subcontract, should be encouraged; and

(3) The specialized service needs of residential care facility residents can be met through facility staff, or through facility subcontracts with qualified providers of specialized services serving the community.

NEW SECTION. Sec. 2. The purposes of this chapter are to:

(1) Encourage the establishment and operation of high quality residential care facilities that provide personal care and specialized services, but do not provide the intensity of nursing services provided in a nursing home licensed under chapter 18.51 RCW;

(2) Permit some flexibility in the services provided and the individuals served in residential care facilities by allowing facilities to contract with the department to provide, directly or by subcontract with qualified community providers, specialized services needed by their residents;

(3) Establish standards for regulating residential care facilities that meet residents' needs, but are consistent with the abilities and resources of a residential care facility;

(4) Establish standards for the operation of adult family homes that meet residents' needs, but recognize that care is being provided in the adult family home provider's own residence;

(5) Ensure that residential care facility providers have the training and resources necessary to meet the needs of their residents and understand and comply with this chapter and rules adopted pursuant to this chapter;

(6) Monitor a residential care facility's compliance with this chapter through routine inspections and, unless residents are in imminent danger, provide to facilities in violation of this chapter an opportunity to correct violations before sanctions are imposed;

(7) Provide the department and residents with alternative mechanisms to enforce compliance with this chapter; and

(8) Provide information to consumers and their families, providers, and the public and encourage their full participation in developing and enforcing standards under this chapter in order to ensure support for residential care facility providers and residents.

NEW SECTION. Sec. 3. Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Residential care facility" means any facility that is advertised, announced, or maintained for the express or implied purpose of providing personal care, room, and board to one or more persons not related by blood or marriage to the person or persons providing the services. For purposes of this chapter, "residential care facility" does not include any house, institution, hotel, or other similar living situation that supplies room and board only, room only, or board only and where no residents require any specialized services.

(2) "Adult family home" means a type of residential care facility that is the regular family residence of the person or persons operating the facility and has four or fewer residents who are not related by blood or marriage to the person or persons providing the services: PROVIDED, That exceptions to resident capacity may be authorized by the department for good cause.

(3) "Provider" means any person who is licensed under this chapter to operate a residential care facility.

(4) "Department" means the department of health.

(5) "Personal care" means the provision by the residential care facility provider of one or more of the following services:

(a) Helping the resident with activities of daily living;

(b) Assisting the resident with daily living activities, such as making appointments and arranging transportation, that are necessary in order for the resident to receive necessary services;

(c) Being aware of the resident's general whereabouts, although residents should be encouraged to exercise maximum independence, given their functional limitations;

(d) Monitoring the activities of the resident while on the premises of the residence to ensure his or her health, safety, and well-being.

(6) "Specialized services" means services beyond personal care, provided on an intermittent basis to residents of a residential care facility, including but not limited to nursing, habilitation, and counseling services, provided that such services shall not include the provision of skilled nursing services on a twenty-four hour basis. Specialized services may be delivered by the provider, facility staff, or community providers by subcontract who have demonstrated qualifications to provide such services, including licensure or certification under applicable Washington law.

(7) "Functional limitation" means a disability or other condition that limits an individual's ability to meet all of his or her personal or health care needs.

(8) "Imminent danger" means serious physical harm to or death of a resident has occurred, or there is a serious threat to resident life, health, or safety, or the residential care facility's capacity to render adequate care is substantially limited.

(9) "Facility" means a residential care facility.

(10) "Resident" means the individual receiving services in a residential care facility, that individual's attorney-in-fact acting within the scope of authority granted in a power of attorney executed by the individual, or that individual's guardian acting pursuant to the powers contained in an order of guardianship.

NEW SECTION. Sec. 4. The following residential facilities shall be exempt from the operation of this chapter:

(1) Nursing homes licensed under chapter 18.51 RCW;

(2) Residential habilitation centers licensed under chapter 71A.20 RCW;

(3) Facilities approved and certified under chapter 71A.22 RCW;

(4) Residential treatment centers for the mentally ill licensed under chapter 71.24 RCW;

(5) Evaluation and treatment centers for minors licensed under chapter 71.34 RCW;

(6) Soldiers and veterans homes licensed under chapter 72.36 RCW;

(7) State schools for the deaf and blind, licensed under chapter 72.40 RCW;

(8) Drug treatment and rehabilitation programs at institutions pursuant to chapter 72.49 RCW;

(9) Treatment facilities licensed under chapter 70.96A RCW;

(10) Maternity homes licensed under chapter 18.46 RCW;

(11) Crisis residential centers for children licensed under chapter 74.13 RCW;

(12) Foster care and group care facilities for children licensed under chapter 74.15 RCW.

NEW SECTION. Sec. 5. (1) The department shall adopt rules and standards with respect to all residential care facilities and the operators thereof to be licensed under this chapter to carry out the purposes and requirements of this chapter.

(2) During the initial stages of development of proposed rules, the department shall provide notice of development of the rules to organizations representing residential care facilities and their residents, and other groups that the department finds appropriate. The notice shall state the subject of the rules under consideration and solicit written recommendations regarding their form and content.

(3) Except where provided otherwise, chapter 34.05 RCW shall govern all department rule-making and adjudicative activities under this chapter.

NEW SECTION. Sec. 6. After July 1, 1990, no person shall operate or maintain a residential care facility in this state without a license under this chapter.

NEW SECTION. Sec. 7. (1) An application for license shall be made to the department upon forms provided by it and shall contain such information as the department reasonably requires, which may include affirmative evidence of ability to comply with this chapter and the rules adopted under this chapter.

(2) The department shall issue a license to a residential care facility if, after inspection and any discretionary investigation, the department finds that the applicant and the facility are in compliance with this chapter and the rules adopted under this chapter; and that the applicant has no prior violations of this chapter relating to the residential care facility subject to the application or any other residential care facility, or of any other law regulating residential care facilities within the past five years that resulted in revocation or nonrenewal of a license.

(3) Each license shall be issued only for the exact location of the residential care facility and for the person or persons named in the application. The license shall state the maximum capacity of residents that the facility is licensed for, and shall not be transferable or assignable.

(4) The license fee established by the department shall be submitted with the application: PROVIDED, That no license fee shall be charged to adult family home license applicants.

(5) In consultation with law enforcement personnel, the department shall investigate the conviction record or pending charges of each applicant or provider, and their staff. The investigation shall include a criminal check completed by the Washington state patrol. The department shall not use the information for other than department purposes of determining eligibility for a license. Criminal justice agencies shall provide the department such information that the department may require for such purpose.

(6) The department shall serve upon the applicant personally or by certified mail a copy of the decision granting or denying an application for a license. An applicant shall have the right to contest denial of his or her application for a license as provided in chapter 34.05 RCW by requesting a hearing in writing within ten days after receipt of the notice of denial.

NEW SECTION. Sec. 8. (1) A residential care facility shall post conspicuously in an area of the facility accessible to the residents and visitors:

(a) Its license to operate;

(b) A notice that a copy of each inspection report received by the facility from the department for the past three years is available for public inspection;

(c) A notice containing the name and telephone number of the office of the long-term care ombudsman and the department staffperson responsible for licensing oversight of the facility;

(d) A list of the residents' rights as provided in section 20 of this act; and

(e) A copy of any house rules developed by the facility, as provided in section 21 of this act.

An adult family home provider shall not be required to post the items identified in this subsection, but these items shall be readily available for review by the department, any resident of the adult family home, and any person seeking admission to the adult family home, or their family members.

(2) A residential care facility shall retain for public inspection a complete copy of each inspection report received by the facility from the department for the past three years.

NEW SECTION. Sec. 9. (1) A license shall be valid for two years.

(2) At least ninety days prior to expiration of the license, the department shall send a license renewal application to the facility. The facility shall complete and submit the application within sixty days of expiration of the license. The department shall have the authority to investigate any information included in the application for renewal of a license, and shall conduct an inspection of the applicant facility at least thirty days prior to expiration of the license. If the department fails to act by the expiration date of the license, the license shall continue in effect until the department acts.

(3) If the department finds that the applicant facility is not in compliance with this chapter, it shall require the facility to correct any violations as provided in section 24 of this act. If the department finds that the applicant is in compliance with this chapter and the rules adopted under this chapter, the department shall renew the license of the facility.

(4) The department shall conduct a monitoring inspection of each residential care facility at least annually.

NEW SECTION. Sec. 10. (1) A provider shall provide written notice to the department of its intent to voluntarily close a residential care facility at least sixty days prior to the date of closure of the facility.

(2) The department shall provide the residents of the facility that is closing with transfer assistance as provided in section 28(3) of this act upon receipt of the notice provided in subsection (1) of this section.

NEW SECTION. Sec. 11. (1) No public or private agency contractor or employee shall place, refer, or recommend placement of a person into a residential care facility that is operating without a license.

(2) Any public or private agency contractor or employee who knows or should know that a residential care facility is operating without a license shall report the name and address of the facility to the department. The department shall investigate any report filed under this section.

NEW SECTION. Sec. 12. (1) A residential care facility provider shall have the following minimum qualifications to provide personal care services:

(a) Twenty-one years of age or older;

(b) Good moral and responsible character and reputation;

(c) Adequate education, training, and experience to carry out the requirements of this chapter including completion of the training program as provided in section 14 of this act;

(d) Literacy;

(e) Management and administrative ability to carry out the requirements of this chapter; and

(f) Sufficient physical, mental, and emotional capacity to carry out the requirements of this chapter.

(2) Staff of a residential care facility shall have the following minimum qualifications to provide personal care services:

(a) Sixteen years of age or older;

(b) Literacy;

(d) Adequate education, training, or experience to carry out the requirements of this chapter; and

(e) Sufficient physical, emotional, and mental capacity to carry out the requirements of this chapter.

(3) A residential care facility may directly provide specialized services only to the extent that the provider or staff of the facility have demonstrated qualifications to provide such services, including licensure or certification under applicable Washington law.

NEW SECTION. Sec. 13. (1) Residential care facilities shall be maintained internally and externally in good repair and condition. Such facilities shall have safe and functioning systems for heating, cooling, hot and cold water, electricity, plumbing, garbage disposal, sewage, cooking, laundry, artificial and natural light, ventilation, and any other feature of the facility.

(2) Residential care facilities shall be maintained in a clean and sanitary manner, including proper sewage disposal, food handling, and hygiene practices.

(3) The director of community development, through the director of fire protection, in consultation with the department, shall develop state-wide minimum standards for fire protection for residential care facilities to be licensed under this chapter. Local fire departments may conduct inspections of applicant facilities using the standards developed pursuant to this section and shall certify compliance with such standards to the department. The department shall not issue a license until such certification has been received.

(4) Residential care facilities shall have clean, functioning, and safe household items and furnishings.

(5) Residential care facilities shall provide a nutritious and balanced diet and shall recognize residents' needs for special diets.

(6) Residential care facility residents shall be permitted to self- administer medications, unless otherwise indicated in a physician's orders. The department shall develop standards to ensure that medications are self-administered in a safe and accurate manner. The standards shall include uniform state-wide recordkeeping procedures and forms for medication management. The department shall make such forms available to all residential care facilities licensed pursuant to this chapter.

(7) Residential care facilities shall have distinct living and sleeping areas. Bedrooms shall be of adequate size.

(8) The department shall establish by regulation staff/resident ratios and physical plant standards for residential care facilities based upon the number of residents served in the facility, the needs of the residents served in the facility, and the specialized services, if any, delivered directly by the provider or facility staff. In developing physical plant standards for adult family homes, the department shall recognize the goal of maintaining a home-like environment for residents and their providers.

(9) In developing regulations to implement this section, the department shall recognize the needs for enhanced standards and provider oversight when the residential care facility provider is a licensed professional providing specialized services pursuant to his or her licensed status to residents in need of such services.

NEW SECTION. Sec. 14. (1) The department, directly or through an approved program, shall provide training programs for residential care facility providers prior to issuance of a license other than a renewal license under this chapter. The department also may require a provider to attend the training program in the subject area of deficiencies in the facility.

(2) The training program shall include but not be limited to thorough coverage of the requirements of this chapter and the rules adopted under this chapter, fire safety, recognition of resident health care and mental health problems, identification and use of community resources, abuse and neglect prevention, and management of medications.

NEW SECTION. Sec. 15. (1) A residential care facility provider may apply to the department for a variance from a rule or provision of this chapter. The application for a variance shall state:

(a) The specific rule or provision of this chapter from which the variance is sought;

(b) The reasons why strict compliance with the rule or provision of this chapter would impose a substantial hardship on the provider; and

(c) The alternative method the provider will use to meet the requirements of this chapter, and the way in which the provider's alternative method meets the same goal as the rule or provision from which the variance is sought is designed to meet, and protects the health, safety, and welfare of the residents.

(2) The department shall notify each resident of the facility of the application within five working days of receipt of the application by the department. A copy of the application shall be attached to the notice to each resident, and the notice shall state the right of each resident to comment verbally or in writing on whether the application for a variance should be granted or denied; and the date by which comments on the application must be received. The department shall consider the comments received as provided in this section in determining whether the application for a variance shall be granted or denied.

(3) The department shall grant a variance upon a determination that:

(a) Strict compliance with the rule or statutory provision of this chapter would impose a substantial hardship on the provider;

(b) The provider's alternative method of compliance will meet the same goal that the rule or provision of this chapter from which the provider seeks the variance was designed to meet; and

(c) The provider's alternative method for compliance with this chapter protects the health, safety, and welfare of the residents as well as they would be protected if strict compliance with this chapter was required.

(4) The decision to grant or deny a variance shall be in writing and shall state the findings upon which the decision was based. The department may impose any conditions upon the variance it determines are necessary to meet the policies of this chapter, and may limit the duration of the variance. Any conditions imposed shall be stated in the decision granting the variance. The provider shall be served personally or by certified mail with a copy of the decision, and with written notice of the provider's right to contest the decision as provided in chapter 34.05 RCW. Notice of the decision shall be given to all interested parties.

(5) A provider who fails to comply with a decision granting a variance shall be subject to the procedures and sanctions for failure to comply with this chapter.

(6) No variance shall be granted from a rule or provision of this chapter pertaining to inspections or resident rights.

NEW SECTION. Sec. 16. (1) Each facility shall keep a record of pertinent information for each resident, as defined by the department in rule. The department shall assist residential care facilities in complying with the requirements of this section and shall provide forms to these facilities upon which the required information can be recorded.

(2) Each resident shall have the right, at reasonable times, or during ordinary business hours to inspect and copy, or have a copy provided for him or her by the facility, of any or all of the records referred to in subsection (1) of this section. The facility may charge the resident the cost of copies made pursuant to this subsection.

(3) Neither the facility nor the department shall disclose the name of any resident except as may be necessary, or disclose any resident's records to any person or department other than the personnel of the facility or the department for their exclusive use except upon express written consent of the resident or court order unless the disclosure is required by state or federal law.

NEW SECTION. Sec. 17. (1) Each resident shall have the right:

(a) To privacy in every aspect of daily living;

(b) To have guests or other residents in his or her room;

(c) To humane care and a humane environment, including but not limited to the right to a diet that is consistent with any religious or health-related restrictions and to refuse a restricted diet;

(d) To be treated with dignity and respect;

(e) To wear his or her own clothing and determine his or her own dress, hair style, or other personal effects according to individual preference;

(f) To retain and use his or her own personal property in the resident's own living area so as to maintain individuality and personal dignity, with consideration given to the space available in the facility for large items such as furniture;

(i) Each resident shall have a separate storage area in his or her own living area and at least one locked container or drawer for keeping personal property;

(ii) A facility may provide a place and written procedures for safekeeping of residents' valuable personal possessions upon request of the resident;

(g) To interact freely with others both within the facility and in the community including but not limited to the following:

(i) The right to receive and send unopened correspondence and to be provided with pen, paper, envelopes, and stamps at the resident's own expense if the resident is unable to obtain them for himself or herself;

(ii) The right to access to a telephone for outgoing and incoming calls;

(iii) The right to unrestricted communication including personal visits with any person of the resident's choice;

(iv) The right to make contacts with the community, and to achieve the highest level of independence, autonomy, and interaction with the community of which the resident is capable; and

(v) The right to leave and return freely to the facility unless specifically restricted by physician's orders;

(h) To refuse to perform services for the facility except as agreed to by the resident and the provider;

(i) To practice the religion of his or her choice or to abstain from religious practice;

(j) To control his or her receipt of health-related services including but not limited to the right to retain the services of his or her own personal health care providers. Each resident shall have the right to confidentiality and privacy concerning his or her medical or dental condition and treatment;

(k) To voice grievances and recommend changes in policies and services to the provider, and to outside representatives of his or her choice, free from restraint, interference, coercion, discrimination, or reprisal;

(l) To be free from discrimination as provided by state and federal law.

(2) Exercise of the rights included in this section shall not result in danger to the safety or welfare of other residents of the facility or infringement of the rights of other residents in the facility.

(3) Services shall be provided to residents so as to attain or maintain each resident's highest degree of functioning possible and to be compatible with individual safety and welfare.

NEW SECTION. Sec. 18. (1) Each resident shall have the right to manage his or her personal funds unless the rights of the resident are otherwise restricted by state or federal law.

(2) If the resident wishes to entrust funds to the facility to protect the resident's funds, the facility:

(a) Shall accept funds from a resident for safekeeping and managing, if the facility receives written authorization from the resident;

(b) Shall maintain and allow each resident access to a written record of all financial arrangements and transactions involving the individual resident's funds;

(c) Shall keep any funds received from a resident for safekeeping in an account separate from all other funds of the facility that clearly indicates that the facility has only a fiduciary interest in the funds and any interest from the account shall accrue to the resident. The facility may keep up to one hundred dollars of a resident's money in a noninterest-bearing account or petty cash fund, to be readily available for the resident's current expenditures. Upon written request of the resident, the facility may increase the amount of that resident's money in a noninterest-bearing account or petty cash fund;

(d) Shall return to the resident upon written request, all or any part of the resident's funds given to the facility for safekeeping, including the interest accrued from deposits;

(e) Shall place any monthly allowance to which a resident is entitled in that resident's personal account, or give it to the resident, unless the facility has written authorization from the resident to handle it differently;

(f) Upon the death of a resident, shall provide the executor or administrator of the resident's estate with a complete accounting of all the resident's funds and personal property, including any funds and personal property of the resident being held by the facility; and

(g) May charge a reasonable fee for handling the funds of residential care facility residents whose costs of care are not subsidized by the department of social and health services.

(3) No residential care facility may require advance payment by a resident of more than one month's fees. If a resident leaves the facility or has died before the last day of a month, and the facility has been paid the full month's fee for that resident's care, the facility shall refund a pro rata portion of the fee representing that portion of the month during which the resident was not cared for by the facility.

NEW SECTION. Sec. 19. (1) The facility shall take reasonable actions to ensure that residents are not physically, sexually, or otherwise abused or exploited.

(2) The facility shall not neglect any needs of the residents.

(3) Physical restraints shall not be used on a resident by a residential care facility provider, except when a resident's actions present an imminent danger to himself or herself, or others, and only until appropriate action can be taken by medical, emergency, or police personnel. It is the responsibility of the facility to seek assistance immediately.

(4) Chemical restraints shall not be used on a resident by a residential care facility provider, except that this section shall not prohibit a resident from voluntarily taking tranquilizers or other medication which is prescribed by a licensed physician.

NEW SECTION. Sec. 20. (1) The department shall give each facility licensed under this chapter a copy of all the resident rights enumerated in sections 16 through 19 of this act and the names, addresses, and telephone numbers of the office of the long-term care ombudsman and any other advocates who are available to assist residents in understanding and enforcing these rights.

(2) The facility shall be responsible for making copies of such rights and distributing them to each resident and the resident's immediate family members, if known, upon admission to the facility.

(3) If a resident is unable to read the list of rights, the rights shall be read to the resident in a language the resident understands. The provider shall answer any questions the resident may have regarding the rights.

(4) After a copy of the rights has been given or read to the resident, the resident shall sign and date a written acknowledgement that the resident has read or has been read the rights, that the resident understands the rights, and that any questions which the resident has regarding the rights have been answered by the facility. A copy of the written acknowledgement signed and dated by the resident shall be placed in the resident's records.

NEW SECTION. Sec. 21. Each facility may have house rules regarding the operation of the facility. Prior to admission to a facility, a resident and the resident's immediate family, if known, shall be given a copy of the house rules of the facility to which he or she is seeking admission. Any house rules which unreasonably restrict the rights of any resident as provided in sections 16 through 20 of this act shall be null and void.

NEW SECTION. Sec. 22. (1) The department, or the city, county, or district health department designated by the department, is authorized to conduct inspections to carry out this chapter and the rules adopted hereunder. During inspections of a residential care facility, the department shall have full access and authority to examine, among other things, a residential care facility's resident records and accounts, and physical premises, including the buildings, grounds, equipment, or any vehicles used to care for or provide support of residents of the facility. The department also shall have the authority to interview the provider and residents of a residential care facility.

(2) Whenever an inspection is conducted, the department shall prepare a written report that summarizes all information obtained during the inspection, and if the facility is in violation of this chapter, serve a copy of the inspection report upon the provider at the same time as the notice of violation as provided in section 24 of this act. If the facility is not in violation of this chapter, a copy of the inspection report shall be mailed to the provider within ten days of the inspection of the facility. All inspection reports shall be made available to the public at the department during business hours.

NEW SECTION. Sec. 23. (1) A person who believes that this chapter has been violated may file a complaint with the department or the office of the long-term care ombudsman. The department shall investigate any complaint filed under this section.

(2) A complaint filed with the department or the office of the long-term care ombudsman under subsection (1) of this section which is subsequently released to the facility that is the subject of the complaint or to any member of the public shall not disclose the name or identifying characteristics of the complainant or the name of the resident who is the subject of the complaint, unless:

(a) The complainant or resident consents in writing to the disclosure; or

(b) The investigation results in a judicial proceeding and disclosure is ordered by the court.

If disclosure is essential to the investigation, the complainant shall be given an opportunity to withdraw the complaint before disclosure.

(3) Upon request of the complainant, the department or the office of the long-term care ombudsman shall inform the complainant or, if requested by the complainant, the complainant's designated representative, of the results of the investigation and any action taken by the department.

NEW SECTION. Sec. 24. (1) If, as a result of an inspection, the department determines that a condition in the facility violates a rule or provision of this chapter, the department shall prepare a notice of violation in writing.

(2) The notice of violation shall state the following:

(a) A description of each condition in the facility that constitutes a violation;

(b) Each regulation or statutory provision alleged to have been violated;

(c) Except as provided in section 25 of this act, the date by which violations must be corrected as specified in the notice of violation;

(d) Sanctions that may be imposed against the facility for failure to correct the violations by the date specified in the notice of violation;

(e) The right to contest the violations if an administrative sanction is imposed; and

(f) The right to apply for a variance.

(3) Except as provided in section 25 of this act, the notice of violation shall be served upon the licensee personally or by certified mail within five working days of the inspection.

(4) Upon request, the department shall assist facilities in developing a plan of correction for the violations stated in the notice of violation.

(5) The department shall conduct an inspection of the facility within thirty days after the date by which violations must be corrected as specified in the notice of violation.

NEW SECTION. Sec. 25. If the department finds that violations present an imminent danger, the residential care facility shall be so notified and enforcement actions shall be taken by the department without prior opportunity to correct the violations.

NEW SECTION. Sec. 26. (1) The department is authorized to take one or more of the actions listed in subsection (2) of this section in any case in which the department finds that a residential care facility provider has:

(a) After following the procedures in sections 24 and 25 of this act, failed or refused to comply with the requirements of this chapter or the rules adopted under this chapter;

(b) Operated a residential care facility without a license or under a revoked license;

(c) Knowingly or with reason to know made a false statement of material fact on his or her application for license or any data attached thereto, or in any matter under investigation by the department; or

(d) Willfully prevented or interfered with any inspection or investigation by the department.

(2) When authorized by subsection (1) of this section, the department may take one or more of the following actions:

(a) Suspend, revoke, or refuse to renew a license;

(b) Suspend admissions to the residential care facility, as provided in section 27 of this act;

(d) Assess civil monetary penalties, as provided in section 29 of this act.

NEW SECTION. Sec. 27. (1) The department may suspend admissions to a residential care facility on the following grounds:

(a) As a result of a violation of a rule or provision of this chapter, the facility is unable to provide an adequate level of meals, lodging, and personal care to persons residing in the facility at the time of the violation;

(b) A violation of a resident's rights as provided in sections 16 through 19 of this act;

(d) The facility is operating without a license; or

(e) A violation of a rule or provision of this chapter results in conditions that present an imminent danger.

(2) The department shall remove the suspension of admissions when department staff confirms that the deficiencies necessitating suspension of admissions have been corrected, and the provider exhibits the capacity to maintain adequate care and service. The department may approve a readmission to the facility from a hospital when the department determines that such readmission would be in the best interests of the individual.

NEW SECTION. Sec. 28. (1) The department may transfer residents from a residential care facility to an alternative placement on the following grounds:

(a) As a result of a violation of a rule or provision of this chapter, the facility is unable to provide an adequate level of meals, lodgings, and personal assistance to the persons residing in the facility at the time of the violation;

(b) A violation of a resident's rights as provided in sections 16 through 19 of this act;

(c) The number of residents currently in the facility exceeds the maximum number of residents the facility is licensed to serve;

(d) The facility is operating without a license; or

(e) A violation of a rule or provision of this chapter results in conditions that present an imminent danger.

(2) The department shall make available assistance in relocating as provided in subsection (3) of this section to any resident who:

(a) Is being transferred under this section;

(b) Is being transferred as a result of an injunction issued under section 33 of this act;

(3) Assistance in relocating shall include the following:

(a) A resident shall be involved in planning his or her move and shall have the right to choose among available alternative placements; except that if a situation presenting an imminent danger makes prior involvement of the resident impossible, the department may make a temporary placement until a final placement can be arranged;

(b) The resident and the department shall prepare a plan to assure a safe move and to protect the resident's health, safety, welfare, and rights before and during the move and the department shall provide assistance to the resident in moving to the new placement.

(4) In any resident transfer conducted under this section, the department shall provide prior written notice to the resident being transferred. The notice shall state the basis for the transfer and shall inform the resident of his or her right to contest the transfer in accordance with chapter 34.05 RCW. If the resident wishes to contest the transfer, he or she shall request a hearing within ten days following receipt of the notice, except that in any resident transfer conducted under subsection (1)(e) of this section, if the resident wishes to contest the transfer, he or she shall request a hearing within three working days following receipt of the notice.

NEW SECTION. Sec. 29. (1) The department may assess civil monetary penalties not to exceed five hundred dollars per violation for violations of the requirements of this chapter and the rules adopted under this chapter. Each day upon which the same or a substantially similar violation occurs is a separate violation subject to the assessment of a separate penalty.

(2) Any civil penalty assessed under this section shall bear a reasonable rate of interest from the date of notification of the violation. The department may administer civil monetary penalties under this section by:

(a) Requiring payment in full;

(b) Permitting installment payments;

(c) Requiring that the full amount or a portion of the assessed civil penalty be expended to ameliorate the violation or to improve the nonadministrative services within the residential care facility; or

(d) Deferring the penalty or a portion thereof until one year after corrective action has been completed to assure maintenance of such action. At the end of such year, the penalty may be reduced all or in part if corrective action has been maintained. The penalty may be trebled if such corrective action is not maintained for one year.

NEW SECTION. Sec. 30. (1) Except as provided in subsection (2) of this section, all orders of the department issued under the authority of section 26 of this act shall become final twenty days after the same has been served upon the residential care facility provider, unless a hearing is requested.

(2) Orders of the department imposing suspension of admissions, or transfer of residents, shall be effective immediately upon notice and pending any hearing, if the basis for the issuance of such orders was the existence of violations presenting an imminent danger.

(3) All hearings under this chapter and judicial review of such determinations shall be in accordance with chapter 34.05 RCW.

NEW SECTION. Sec. 31. In addition to other remedies provided by law, the department may seek enforcement of its final orders by filing an action for civil enforcement in a court of competent jurisdiction.

NEW SECTION. Sec. 32. (1) Except as provided in subsection (2) of this section, the department shall provide written notice of a final order imposing an administrative sanction to:

(a) The residents of the facility subject to the administrative sanction and their immediate family members, if known;

(b) All public or private agencies involved in placement or referral of persons to residential care facilities; and

(2) If a department order to immediately suspend admissions or immediately transfer residents is imposed, the notice shall be provided to the agencies listed in subsection (1) of this section pending a hearing to contest the order.

(3) The department shall provide written notice to the agencies listed in subsection (1) of this section when a previously imposed sanction has been lifted.

NEW SECTION. Sec. 33. A resident or the department may bring an action for a temporary restraining order, preliminary injunction, or permanent injunction against a residential care facility to enjoin:

(1) Any act or omission which constitutes a violation of this chapter; or

(2) Operation of:

(a) An unlicensed facility;

(b) A licensed facility against which procedures for renewal or revocation of the facility's license have been initiated and that has violations that have resulted in conditions that present an imminent danger or violate residents' rights.

NEW SECTION. Sec. 34. A resident or residential care facility provider may bring a civil action for mandamus to order the department to carry out any act which is required to be performed by the department under this chapter.

NEW SECTION. Sec. 35. (1)(a) No person shall:

(i) Operate a residential care facility without a license; or

(ii) Commingle, borrow from, or pledge any funds of a resident required to be held in a separate account as provided in section 18 of this act.

(b) No person shall purposely or knowingly:

(i) Interfere with or attempt to interfere with or obstruct or attempt to obstruct by unlawful means any investigation under or enforcement of this chapter;

(ii) Retaliate or discriminate against a resident or employee of a residential care facility for initiating, participating in, or testifying in any action against a residential care facility;

(iii) File false, incomplete, or misleading information or fail or refuse to file information required to be filed under this chapter; or

(iv) Commit any act that violates a provision of this chapter and that creates a risk of death or serious harm to a resident.

(c) A violation of this subsection constitutes a misdemeanor. A violation of this subsection for which there has been a previous conviction constitutes a felony and shall be punished as a class C felony under chapter 9A.20 RCW.

(2)(a) No person shall purposely, knowingly, recklessly, or negligently commit any act that violates a provision of this chapter and that results in death or serious harm to a resident.

(b) A violation of (a) of this subsection constitutes a felony and shall be punished as a class C felony under chapter 9A.20 RCW.

NEW SECTION. Sec. 36. The remedies provided in this chapter are cumulative and shall not restrict any agency or person from seeking any remedy provided by law or from obtaining additional relief based upon the same facts.

Sec. 37. Section 2, chapter 117, Laws of 1951 as last amended by section 1, chapter 236, Laws of 1983 and RCW 18.51.010 are each amended to read as follows:

(1) "Nursing home" means any home, place or institution which operates or maintains facilities providing convalescent or chronic care, or both, for a period in excess of twenty-four consecutive hours for three or more patients not related by blood or marriage to the operator, who by reason of illness or infirmity, are unable properly to care for themselves. Convalescent and chronic care may include but not be limited to any or all procedures commonly employed in waiting on the sick, such as administration of medicines, preparation of special diets, giving of bedside nursing care, application of dressings and bandages, and carrying out of treatment prescribed by a duly licensed practitioner of the healing arts. It may also include care of mentally incompetent persons. It may also include community-based care. Nothing in this definition shall be construed to include general hospitals or other places which provide care and treatment for the acutely ill and maintain and operate facilities for major surgery or obstetrics, or both. Nothing in this definition shall be construed to include any ((~~boarding home~~)) residential care facility, guest home, hotel or related institution which is held forth to the public as providing, and which is operated to give only board, room and laundry to persons not in need of medical or nursing treatment or supervision except in the case of temporary acute illness. The mere designation by the operator of any place or institution as a hospital, sanitarium, or any other similar name, which does not provide care for the acutely ill and maintain and operate facilities for major surgery or obstetrics, or both, shall not exclude such place or institution from the provisions of this chapter: PROVIDED, That any nursing home providing psychiatric treatment shall, with respect to patients receiving such treatment, comply with the provisions of RCW 71.12.560 and 71.12.570.

(2) "Person" means any individual, firm, partnership, corporation, company, association, or joint stock association, and the legal successor thereof.

(3) "Secretary" means the secretary of the department of social and health services.

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

(5) "Community-based care" means but is not limited to the following:

(a) Home delivered nursing services;

(b) Personal care;

(d) Nutritional services, both in-home and in a communal dining setting;

(e) Habilitation care; and

(f) Respite care.

Sec. 38. Section 14, chapter 122, Laws of 1969 as last amended by section 16, chapter 447, Laws of 1987 and RCW 18.100.140 are each amended to read as follows:

Nothing in this chapter shall authorize a director, officer, shareholder, agent or employee of a corporation organized under this chapter, or a corporation itself organized under this chapter, to do or perform any act which would be illegal, unethical or unauthorized conduct under the provisions of the following acts: (1) Medical disciplinary act, chapter 18.72 RCW; (2) Anti-rebating act, chapter 19.68 RCW; (3) State bar act, chapter 2.48 RCW; (4) Professional accounting act, chapter 18.04 RCW; (5) Professional architects act, chapter 18.08 RCW; (6) Professional auctioneers act, chapter 18.11 RCW; (7) Cosmetologists, barbers, and manicurists, chapter 18.16 RCW; (8) ((~~Boarding homes act, chapter 18.20 RCW~~)) Residential care facilities, chapter 71.-- RCW (sections 1 through 36 of this act); (9) Podiatry, chapter 18.22 RCW; (10) Chiropractic act, chapter 18.25 RCW; (11) Registration of contractors, chapter 18.27 RCW; (12) Debt adjusting act, chapter 18.28 RCW; (13) Dental hygienist act, chapter 18.29 RCW; (14) Dentistry, chapter 18.32 RCW; (15) Dispensing opticians, chapter 18.34 RCW; (16) Naturopathic act, chapter 18.36A RCW; (17) Embalmers and funeral directors, chapter 18.39 RCW; (18) Engineers and land surveyors, chapter 18.43 RCW; (19) Escrow agents registration act, chapter 18.44 RCW; (20) Maternity homes, chapter 18.46 RCW; (21) Midwifery, chapter 18.50 RCW; (22) Nursing homes, chapter 18.51 RCW; (23) Optometry, chapter 18.53 RCW; (24) Osteopathy, chapter 18.57 RCW; (25) Pharmacists, chapter 18.64 RCW; (26) Physical therapy, chapter 18.74 RCW; (27) Practical nurses, chapter 18.78 RCW; (28) Psychologists, chapter 18.83 RCW; (29) Real estate brokers and salesmen, chapter 18.85 RCW; (30) Registered professional nurses, chapter 18.88 RCW; (31) Veterinarians, chapter 18.92 RCW.

Sec. 39. Section 8, chapter 96, Laws of 1974 ex. sess. as amended by section 1, chapter 282, Laws of 1975 1st ex. sess. and RCW 19.27.080 are each amended to read as follows:

Nothing in this 1974 act shall affect the provisions of chapters 19.28, 43.22, 70.77, 70.79, 70.87, 48.48, ((~~18.20,~~)) 18.46, 18.51, 28A.02, 28A.04, 70.41, 70.62, 70.75, 70.108, 71.12, 74.15, 70.94, or 76.04 RCW or grant rights to duplicate the authorities provided under chapters 70.94 or 76.04 RCW.

Sec. 40. Section 35A.70.070, chapter 119, Laws of 1967 ex. sess. as last amended by section 4, chapter 223, Laws of 1987 and RCW 35A.70.070 are each amended to read as follows:

Every code city may exercise the powers authorized and shall perform the duties imposed upon cities of like population relating to the public health and safety as provided by Title 70 RCW and, without limiting the generality of the foregoing, shall: (1) Organize boards of health and appoint a health officer with the authority, duties and functions as provided in chapter 70.05 RCW, or provide for combined city-county health departments as provided and in accordance with the provisions of chapter 70.08 RCW; (2) contribute and participate in public health pooling funds as authorized by chapter 70.12 RCW; (3) control and provide for treatment of ((~~venereal~~)) sexually transmitted diseases as authorized by chapter 70.24 RCW; (4) provide for the care and control of tuberculosis as provided in chapters 70.28, 70.30, 70.32, and 70.54 RCW; (5) participate in health districts as authorized by chapter 70.46 RCW; (6) exercise control over water pollution as provided in chapter 35.88 RCW; (7) for all code cities having a population of more than twenty thousand serve as a primary district for registration of vital statistics in accordance with the provisions of chapter 70.58 RCW; (8) observe and enforce the provisions relating to fireworks as provided in chapter 70.77 RCW; (9) enforce the provisions relating to swimming pools provided in chapter 70.90 RCW; (10) enforce the provisions of chapter ((~~18.20~~)) 71.-- RCW (sections 1 through 36 of this act) when applicable; (11) perform the functions relating to mentally ill prescribed in chapter((s)) 72.06 ((~~and 71.12~~)) RCW; (12) cooperate with the state department of social and health services in mosquito control as authorized by RCW 70.22.060; and (13) inspect nursing homes as authorized by RCW 18.51.145.

Sec. 41. Section 5, chapter 245, Laws of 1988 and RCW 70.127.040 are each amended to read as follows:

The following are not subject to regulation for the purposes of this chapter:

(1) A family member;

(2) An organization that provides only meal services in a person's residence;

(3) Entities furnishing durable medical equipment that does not involve the delivery of professional services beyond those necessary to set up and monitor the proper functioning of the equipment and educate the user on its proper use;

(4) A person who provides services through a contract with a licensed agency;

(5) An employee or volunteer of a licensed agency who provides services only as an employee or volunteer;

(6) Facilities and institutions, including but not limited to nursing homes under chapter 18.51 RCW, hospitals under chapter 70.41 RCW, ((~~boarding homes under chapter 18.20 RCW, developmental disability~~)) residential ((~~programs~~)) care facilities under chapter ((~~71.12~~)) 71.-- RCW (sections 1 through 36 of this act), or other facilities and institutions, only when providing services to persons residing within the facility or institution if the delivery of the services is regulated by the state;

(7) Persons providing care to disabled persons through a contract with the department;

(8) Nursing homes, hospitals, or other institutions, agencies, organizations, or persons that contract with licensed home health, hospice, or home care agencies for the delivery of services;

(9) In-home assessments of an ill, disabled, or infirm person's ability to adapt to the home environment that does not result in regular ongoing care at home;

(10) Services conducted by and for the adherents of a church or religious denomination that rely upon spiritual means alone through prayer for healing in accordance with the tenets and practices of such church or religious denomination and the bona fide religious beliefs genuinely held by such adherents;

(11) A medicare-approved dialysis center operating a medicare-approved home dialysis program;

(12) Case management services which do not include the direct delivery of home health, hospice, or home care services.

Sec. 42. Section 3, chapter 204, Laws of 1982 as amended by section 2, chapter 274, Laws of 1986 and RCW 71.24.025 are each amended to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Acutely mentally ill" means a condition which is limited to a short-term severe crisis episode of:

(a) A mental disorder as defined in RCW 71.05.020(2) or, in the case of a child, as defined in RCW 71.34.020(12);

(b) Being gravely disabled as defined in RCW 71.05.020(1) or, in the case of a child, as defined in RCW 71.34.020(8); or

(c) Presenting a likelihood of serious harm as defined in RCW 71.05.020(3) or, in the case of a child, as defined in RCW 71.34.020(11).

(2) "Available resources" means those funds which shall be appropriated under this chapter by the legislature during any biennium for the purpose of providing community mental health programs under RCW 71.24.045.

(3) "Licensed service provider" means an entity licensed by the department according to state minimum standards or individuals licensed under chapter 18.71, 18.83, or 18.88 RCW.

(4) "Child" means a person under the age of eighteen years.

(5) "Chronically mentally ill person" means a child or adult who has a mental disorder, in the case of a child as defined by chapter 71.34 RCW, and meets at least one of the following criteria:

(a) Has undergone two or more episodes of hospital care for a mental disorder within the preceding two years or, in the case of a child, has been placed by the department or its designee two or more times outside of the home, where the placements are related to a mental disorder, as defined in chapter 71.34 RCW, and where the placements progress toward a more restrictive setting. Placements by the department include but are not limited to placements by child protective services and child welfare services;

(b) Has experienced a continuous psychiatric hospitalization or residential treatment exceeding six months' duration within the preceding year;

(c) Has been unable to engage in any substantial gainful activity by reason of any mental disorder which has lasted for a continuous period of not less than twelve months. "Substantial gainful activity" shall be defined by the department by rule consistent with Public Law 92-603, as amended, and shall include school attendance in the case of a child; or

(d) In the case of a child, has been subjected to continual distress as indicated by repeated physical or sexual abuse or neglect.

(6) "Community mental health program" means all mental health services established by a county authority.

(7) "County authority" means the board of county commissioners, county council, or county executive having authority to establish a community mental health program, or two or more of the county authorities specified in this subsection which have entered into an agreement to provide a community mental health program.

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

(9) "Mental health services" means community services pursuant to RCW 71.24.035(5)(b) and other services provided by the state for the mentally ill.

(10) "Mentally ill persons" and "the mentally ill" mean persons and conditions defined in subsections (1), (5), and (12) of this section.

(11) "Residential services" means a facility or distinct part thereof licensed as a residential care facility under chapter 71.-- RCW (sections 1 through 36 of this act) which provides food, clothing, and shelter, and may include day treatment services as defined in RCW 71.24.045, for acutely mentally ill, chronically mentally ill, or seriously disturbed persons as defined in this section. ((~~Such facilities include, but are not limited to, congregate care facilities providing mental health client services as stipulated by contract with the department beginning January 1, 1982.~~))

(12) "Seriously disturbed person" means a person who:

(a) Is gravely disabled or presents a likelihood of serious harm to himself or others as a result of a mental disorder as defined in chapter 71.05 RCW;

(b) Has been on conditional release status at some time during the preceding two years from an evaluation and treatment facility or a state mental health hospital;

(d) Exhibits suicidal preoccupation or attempts; or

(e) Is a child diagnosed by a mental health professional, as defined in RCW 71.05.020, as experiencing a mental disorder which is clearly interfering with the child's functioning in family or school or with peers or is clearly interfering with the child's personality development and learning.

(13) "Secretary" means the secretary of social and health services.

(14) "State minimum standards" means: (a) Minimum requirements for management and delivery of mental health services as established by departmental rules and necessary to implement this chapter, including but not limited to county administration, licensing service providers, information, accountability, contracts, and services; and (b) minimum service requirements for licensed service providers for the provision of mental health services as established by departmental rules pursuant to chapter ((~~34.04~~)) 34.05 RCW as necessary to implement this chapter, including, but not limited to: Qualifications for staff providing services directly to mentally ill persons; the intended result of each service for those priority groups identified in RCW 71.24.035(5)(b); and the rights and responsibilities of persons receiving mental health services pursuant to this chapter.

Sec. 43. Section 208, chapter 176, Laws of 1988 and RCW 71A.12.080 are each amended to read as follows:

(1) The secretary shall adopt rules concerning the eligibility of residents of residential habilitation centers for placement in community residential programs under this title; determination of ability of such persons or their estates to pay all or a portion of the cost of care, support, and training; the manner and method of ((~~licensing or~~)) certification and inspection and approval of specialized services provided by residential care facilities licensed under chapter 71.-- RCW (sections 1 through 36 of this act) and such other community residential programs for placement under this title; and procedures for the payment of costs of care, maintenance, and training in community residential programs. The rules shall include standards for care, maintenance, and training to be met by such community residential programs.

(2) The secretary shall coordinate state activities and resources relating to placement in community residential programs to help efficiently expend state and local resources and, to the extent designated funds are available, create an effective community residential program.

Sec. 44. Section 802, chapter 176, Laws of 1988 and RCW 71A.22.020 are each amended to read as follows:

As used in this chapter:

(1) "Day training center" means a facility equipped, supervised, managed, and operated at least three days per week by any person, association, or corporation on a nonprofit basis for the day-care, treatment, training, and maintenance of persons with developmental disabilities, and approved under this chapter and the standards under rules adopted by the secretary.

(2) "Group training home" means a facility equipped, supervised, managed, and operated on a full-time basis by any person, association, or corporation on a nonprofit basis for the full-time care, treatment, training, and maintenance of persons with developmental disabilities, licensed as a residential care facility under chapter 71.-- RCW (sections 1 through 36 of this act) and approved under this chapter ((~~and the standards under the rules adopted by the secretary~~)) to provide specialized services to its residents.

NEW SECTION. Sec. 45. The following acts or parts of acts are each repealed:

(1) Section 1, chapter 253, Laws of 1957, section 1, chapter 297, Laws of 1985 and RCW 18.20.010;

(2) Section 2, chapter 253, Laws of 1957, section 25, chapter 141, Laws of 1979, section 4, chapter 213, Laws of 1985 and RCW 18.20.020;

(3) Section 3, chapter 253, Laws of 1957 and RCW 18.20.030;

(4) Section 4, chapter 253, Laws of 1957 and RCW 18.20.040;

(5) Section 5, chapter 253, Laws of 1957, section 1, chapter 247, Laws of 1971 ex. sess., section 4, chapter 201, Laws of 1982, section 3, chapter 75, Laws of 1987 and RCW 18.20.050;

(6) Section 6, chapter 253, Laws of 1957, section 5, chapter 213, Laws of 1985 and RCW 18.20.060;

(7) Section 7, chapter 253, Laws of 1957 and RCW 18.20.070;

(8) Section 9, chapter 253, Laws of 1957, section 3, chapter 189, Laws of 1971 ex. sess., section 6, chapter 213, Laws of 1985 and RCW 18.20.090;

(9) Section 10, chapter 253, Laws of 1957, section 26, chapter 141, Laws of 1979 and RCW 18.20.100;

(10) Section 11, chapter 253, Laws of 1957, section 7, chapter 213, Laws of 1985 and RCW 18.20.110;

(11) Section 12, chapter 253, Laws of 1957 and RCW 18.20.120;

(12) Section 13, chapter 253, Laws of 1957, section 81, chapter 266, Laws of 1986 and RCW 18.20.130;

(13) Section 14, chapter 253, Laws of 1957 and RCW 18.20.140;

(14) Section 15, chapter 253, Laws of 1957 and RCW 18.20.150;

(15) Section 16, chapter 253, Laws of 1957, section 1, chapter 43, Laws of 1975 1st ex. sess., section 2, chapter 297, Laws of 1985 and RCW 18.20.160;

(16) Section 17, chapter 253, Laws of 1957 and RCW 18.20.170;

(17) Section 20, chapter 253, Laws of 1957 and RCW 18.20.900;

(18) Section 35A.66.010, chapter 119, Laws of 1967 ex. sess. and RCW 35A.66.010;

(19) Section 35A.70.020, chapter 119, Laws of 1967 ex. sess. and RCW 35A.70.020;

(20) Section 9, chapter 122, Laws of 1972 ex. sess. and RCW 70.96A.090; and

(21) Section 11, chapter 172, Laws of 1969 ex. sess., section 1, chapter 52, Laws of 1975-'76 2nd ex. sess. and RCW 74.08.044.

NEW SECTION. Sec. 46. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.

NEW SECTION. Sec. 47. Sections 1 through 36 of this act shall constitute a new chapter in Title 71 RCW.