SENATE BILL REPORT

                  2SHB 1546

              As Reported By Senate Committee On:

            Health & Long-Term Care, March 31, 1999

                  Ways & Means, April 5, 1999

Title:  An act relating to in‑home care services.

Brief Description:  Modifying provisions related to long‑term care of adults.

Sponsors:  House Committee on Appropriations (originally sponsored by Representatives Cody, Parlette, Doumit, Ballasiotes, Conway, D. Schmidt, Dickerson, Campbell, Wolfe, Kenney, Ogden, Radcliff, Kessler, Veloria, Ruderman, Linville, Santos, Haigh, Cooper, Miloscia, Edmonds, Keiser, Lantz, Hurst, Schual‑Berke, Quall, Van Luven, Rockefeller, O'Brien, Wood, Murray, Fortunato and McIntire).

Brief History:

Committee Activity:  Health & Long‑Term Care:  3/24/99, 3/31/99 [DP-WM].

Ways & Means:  4/2/99, 4/5/99 [DP].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report:  Do pass and be referred to Committee on Ways & Means.

  Signed by Senators Thibaudeau, Chair; Wojahn, Vice Chair; Costa, Deccio, Franklin, Johnson and Winsley.

Staff:  Rhoda Jones (786-7198)

SENATE COMMITTEE ON WAYS & MEANS

Majority Report:  Do pass.

  Signed by Senators Loveland, Chair; Bauer, Vice Chair; Brown, Vice Chair; Fairley, Fraser, Honeyford, Kline, Kohl-Welles, Long, McDonald, Rasmussen, Rossi, B. Sheldon, Snyder, Spanel, West, Winsley, Wojahn and Zarelli.

Staff:  Tim Yowell (786-7435)

Background:  Over the last decade there has been a 60 percent increase in the number of people who receive state-funded long-term care in their own homes.

Services delivered to state-funded long-term care clients are provided through home care agencies, home health agencies, and individual providers who do not have any affiliation with an agency.  In most cases, when a state client needs more than 112 hours of care a month, the department requires they use individual providers, whose hourly rate is lower than care givers  hired through agencies.

Home care agencies are licensed by the Department of Health (DOH).  Area Agencies on Aging (AAA) monitor contract compliance of the agencies.  Individual providers are not licensed by the state.  The client serves as the direct supervisor of these care givers, with authority to hire, fire and monitor their own care.  AAA case managers are responsible for managing clients under the individual provider program, including facilitating changes in the service plan, reassess services, and updating payment authorizations.  Currently, the ratio of case managers to clients is one to 100.

Summary of Bill:  The Department of Social and Health Services is authorized to oversee and assess the quality of case management services provided by the Area Agencies on Aging. DSHS must develop specific oversight assessments and quality indicators for the Area Agencies on Aging who provide case management services for clients receiving in home care services.

The Area Agencies on Aging must assess the quality of in-home care services for state-funded clients. Quality indicators are described.  Oversight requirements include verifying that individual providers have met training requirements, reassessing and reauthorizing services, monitoring individual provider performance, conducting criminal background checks.

DSHS must develop model language for the plan of care for clients receiving in-home services from individual providers.  The plan of care must be in clear language and at a reading level that ensures consumer ability to understand.  The plan of care components are listed.

The department or the AAAs may terminate a contract with an individual provider for inadequate performance or inability to deliver quality care.

AAAs may reject a request from a client that a family member serve as their individual provider.

The bill has a null and void clause.

Appropriation:  None.

Fiscal Note:  Available.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For (Health & Long-Term Care):  The individual provider program needs to be more closely monitored and this will increase necessary oversight.

Testimony Against (Health & Long-Term Care):  None.

Testified (Health & Long-Term Care):  PRO:  Rep. Eileen Cody; Peter Nazzal, CCS-WW; Majken Ryherd Keira, Gail McGaffick, Home Care Assn.; Raymond Wilson, Disability Resource Center; Katrinka Gentile.

Testimony For (Ways & Means):  A recent JLARC study concluded that significant improvements are needed in the way we monitor delivery of in-home care.  This bill would help assure that consumers get appropriate and quality in-home care.

Testimony Against (Ways & Means):  None.

Testified (Ways & Means):  PRO:  Representative Cody, prime sponsor; Sarah Scanlon, SEIU; Majken Ryherd Keira, WA Assn. of Home Care Services; Kathy Leitch, DSHS Aging and Adult Services Administration.