[atlas:bill]

AN ACT Relating to providing for self-directed care of persons with disabilities; amending RCW 43.190.060; adding new sections to chapter 70.126 RCW; and creating a new section.

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

NEW SECTION. Sec. 1. (1) The legislature finds that certain aspects of health licensure laws have the unintended consequence of limiting the right of persons with functional disabilities to care for themselves in their own home, and of securing assistance from other persons in performing routine health-related tasks that persons without these disabilities customarily perform.

(2) It is the intent of the legislature to clarify the right of adults with functional disabilities to choose to self-direct their own health-related tasks through personal aides, and to describe the circumstances under which self-directed care may take place in the home setting. The legislature declares that it is in the public interest to preserve the autonomy and dignity of persons with functional disabilities to care for themselves in their own homes, among the continuum of options for health care services where the judgment and control over the care rests with the individual.

NEW SECTION. Sec. 2. The definitions in this section apply throughout sections 1 through 4 and 6 of this act and RCW 43.190.060 unless the context clearly requires otherwise.

(1) "Self-directed care" means the process in which an adult person, who is prevented by a functional disability from performing a manual function related to health care that an individual would otherwise perform for himself or herself, chooses to direct and supervise a paid personal aide to perform those tasks.

(2) "Personal aide" means an individual who acts at the direction of an adult person with a functional disability living in his or her own home and provides that person with health care services that a person without a functional disability can perform, and who is identified as a personal aide on the registry maintained by the department of social and health services under section 4 of this act.

NEW SECTION. Sec. 3. (1) An adult person with a functional disability living in his or her own home may direct and supervise a paid personal aide in the performance of a health care task.

(2) The following requirements shall guide the provision of self-directed care under this act:

(a) Health care tasks are those medical, nursing, or home health services that enable the person to maintain independence, personal hygiene, and safety in his or her own home, and that are services that a person without a functional disability would customarily and personally perform without the assistance of a licensed health care provider.

(b) When a licensed health care provider orders treatment involving a health care task to be performed through self-directed care, the responsibility to ascertain that the patient understands the treatment and will be able to follow through on the self-directed care task is the same as it would be for a patient who performs the health care task for himself or herself, and the licensed health care provider incurs no additional liability when ordering a health care task which is to be performed through self-directed care.

(c) The role of the personal aide in self-directed care is limited to performing physical health care tasks under the direction of the person for whom the tasks are being done.

(d) The responsibility to initiate health care tasks and to exercise judgment regarding the manner of their performance rests and remains with the person who has chosen to self-direct those tasks, including the decision to employ and dismiss a personal aide.

NEW SECTION. Sec. 4. (1) Any individual who, for compensation, serves as a personal aide to a person who self-directs his or her own care in his or her own home shall register with the department of social and health services, and no person may perform a directed health care task under the provisions of this act unless and until he or she is duly registered with the department as a personal aide.

(2) The department of social and health services shall maintain a registry of personal aides providing services under this act. The purpose of the registry is to record any complaints or findings of abuse, neglect, or misappropriation of property belonging to, or otherwise in the custody of, the person who directs and supervises a personal aide providing health care tasks at the person's own home.

(3) The registry shall contain the following information:

(a) The personal aide's name and information necessary to identify him or her;

(b) The date the personal aide became eligible for placement on this registry, and the name and identity of the person who directs and supervises the personal aide providing health care tasks; and

(c) Information on any allegation and finding of abuse, neglect, or misappropriation of property by the personal aide, including documentation of the department's investigation, the nature of the allegation and the evidence which the department relies upon to validate the allegation, the date of the hearing, if any, and its outcome, and any statement by the personal aide disputing the allegation.

(4) Information pertaining to an allegation of abuse, neglect, or misappropriation of property and its disposition shall be included in the registry as soon as possible, but in any event, within ten days from the finding, and must remain in the registry indefinitely, unless the finding was made in error, the personal aide was found not guilty in a court of law, or the department is notified of the death of the personal aide. A personal aide on the registry must be accorded a fair and sufficient opportunity to rebut any allegation and correct any misstatements or inaccuracies contained in the record.

(5) The registry shall remove the entry for a personal aide who has not performed any services for a period of thirty-six consecutive months, unless the record includes documented findings of abuse, neglect, or misappropriation of property.

(6) The department shall disclose upon request all information on the registry to any person so requesting, and may disclose such additional information it deems necessary. The department shall promptly provide personal aides listed on the registry with all information contained in the record when adverse findings are placed on the record.

(7) The administrative procedure act, chapter 34.05 RCW, governs the procedures under this section.

Sec. 5. RCW 43.190.060 and 1995 1st sp.s. c 18 s 33 are each amended to read as follows:

A long-term care ombudsman shall:

(1) Investigate and resolve complaints made by or on behalf of residents of long-term care facilities, including persons directing and supervising health care tasks in their residence through personal aides under to this act, relating to administrative action which may adversely affect the health, safety, welfare, and rights of these individuals;

(2) Monitor the development and implementation of federal, state, and local laws, rules, regulations, and policies with respect to long-term care facilities in this state;

(3) Provide information as appropriate to public agencies regarding the problems of individuals residing in long-term care facilities; and

(4) Provide for training volunteers and promoting the development of citizen organizations to participate in the ombudsman program. A volunteer long-term care ombudsman shall be able to identify and resolve problems regarding the care of residents in long-term care facilities and to assist such residents in the assertion of their civil and human rights. However, volunteers shall not be used for complaint investigations but may engage in fact-finding activities to determine whether a formal complaint should be submitted to the department.

NEW SECTION. Sec. 6. A personal aide, in the performance of a health care task, who is directed and supervised by a person with a functional disability in his or her own home, and who is registered with the department of social and health services as a personal aide, is exempt from any legal requirement to qualify and be credentialed by the department of health as a health care provider under Title 18 RCW to the extent of the responsibilities provided and health care tasks performed under this act.

NEW SECTION. Sec. 7. Sections 2 through 4 and 6 of this act are each added to chapter 70.126 RCW.