BP BHEAD INT S [atlas:bill]

AN ACT Relating to in-home care services; adding new sections to chapter 74.39A RCW; adding a new section to chapter 70.47 RCW; and creating a new section.

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

NEW SECTION. Sec. 1. The legislature finds that the care services provided to, and protection of Washington's low-income elderly and disabled residents is of great importance to the state. The legislature further finds that the quality of in-home care service is being jeopardized by many factors, including low wages and benefits paid to home care workers, high costs borne by agencies contracting with the state to provide these services, vast increases in the severity of need of eligible elderly and disabled people, and the rapidly increasing elderly population. The legislature further finds that policies regarding in-home care services by agencies and independent providers could further address quality assurances for service users.

NEW SECTION. Sec. 2. A new section is added to chapter 74.39A RCW to read as follows:

The compensation for all persons who provide state-funded long-term care services through contract with the department of social and health services, including the medicaid personal care program, COPES, chore, individual provider program, and respite care, shall be increased by fifty cents per hour and increased annually each year thereafter according to the inflation rate identified by the annual consumer price index as established by the office of financial management.

NEW SECTION. Sec. 3. A new section is added to chapter 74.39A RCW to read as follows:

The vendor rate for licensed home care agencies that provide state-funded long-term care and in-home services through contract with the department of social and health services for the medicaid personal care program, COPES, chore, and respite care, shall be equalized for all agencies to an hourly rate of eleven dollars and seventy-one cents. Beginning in fiscal year 1999, and annually each year thereafter, the vendor rate shall be increased according to the inflation rate identified by the annual consumer price index as established by the office of financial management.

NEW SECTION. Sec. 4. A new section is added to chapter 70.47 RCW to read as follows:

The Washington state health care authority shall make the Washington basic health plan available to all home care agency employees who provide state-funded in-home medicaid personal care, COPES, chore, or respite care for twenty hours or more per week. All home care agencies who hire employees to provide state-funded in-home medicaid personal care, COPES, chore, and respite care shall provide the subsidized basic health plan or a substantially equivalent health care benefits plan to all in-home care employees who provide twenty hours per week or more of state-funded in-home care services. A "substantially equivalent health care benefits plan" means an equal or better health care benefits package as compared to the benefits package provided under the basic health plan. All in-home care workers who qualify for the basic health plan, yet receive health care benefits other than the basic health plan through their employer, shall not pay more than the out-of-pocket patient expenses, such as, but not limited to, patient copay and deductible charges, equal to the amount of out-of-pocket patient expenses required under the basic health plan. The cost for providing health benefits for in-home care employees who qualify under this section shall be added to and above the current vendor rate of in-home care services as established by the department of social and health services and shall be indexed annually to the standard medical inflation rate as established by the office of financial management.

NEW SECTION. Sec. 5. A new section is added to chapter 74.39A RCW to read as follows:

The following health, safety, and quality of care standards apply to all persons receiving in-home care services through the state medicaid individual provider program administered by the department of social and health services:

(1) All nondevelopmentally disabled service users or their legal representative must display the cognitive ability to verify the hours provided;

(2) The department shall conduct a follow-up visit or telephone call with the service user within sixty days after the initial authorization to ensure that the service plan is being implemented and assess the health, safety, and well-being of the service user;

(3) All individual providers contracted to conduct in-home care services for persons in the individual provider program shall be required to successfully meet all the same training requirements established by the department for in-home care workers in the COPES, medicaid personal care, and chore program;

(4) All in-home care service providers contracted to conduct in-home care for persons in the individual provider program are required to provide proof of a current valid Washington state driver's license and current liability insurance, if transportation services are authorized for their service users;

(5) All service users shall provide their signature on a time sheet for each day of services to confirm the actual hours of in-home care service provided;

(6) Case managers shall randomly monitor the validity of the documentation of the hours of service provided;

(7) Persons shall not be automatically transferred into the individual provider program from other programs or referred to the individual provider program based on the number of hours of services required without their consent;

(8) Service users or their legal representative selecting their own family members as individual providers shall be reviewed and approved by the department according to their exception to policy rules; and

(9) The department shall develop and distribute to all service users or their legal representative in the individual provider program an individual provider program consumer's bill of rights at the time of authorization or within sixty days from the effective date of this section for those consumers already authorized. The consumer's bill of rights shall contain, but not be limited to the following information:

(a) Service users or their legal representative have the right to the name, address, and telephone number of the person responsible for the development of their service plan;

(b) Service users or their legal representative have the right to the name, address, and telephone number of the person who should be contacted if their health status changes or their service plan needs to be changed;

(c) Service users or their legal representative have the right to the name, address, and telephone number of the person who should be contacted if their provider fails to provide adequate or safe care;

(d) Service users or their legal representative have the right to clear and understandable information about who to call in the event of an emergency or a violation of their rights, including but not limited to police and fire, adult protective services, the long-term care ombudsman, and the Washington protection and advocacy system;

(e) Service users or their legal representative have the right to receive from the department, in a language that is clear and understandable to the consumer or their legal representative, a service plan and provider contract agreement that lists the authorized in-home services and the amount of hours of services to be provided, and any other pertinent information;

(f) Service users or their legal representative have the right to a clear and understandable explanation, orally and in writing, of the terms of their service plan and how the service plan can be modified or terminated;

(g) Service users or their legal representative shall be provided by the department, orally and in writing, with information on other long-term care options and how to select other long-term care options that will best meet their needs;

(h) Service users or their legal representative shall be provided assistance with completing any documents required to qualify for this program by the department;

(i) Service users or their legal representative have the right to arrange a work schedule that is convenient for them and meets their individual needs and preferences;

(j) Service users or their legal representative have the right to clear and understandable oral and written information prior to the authorization of individual provider services, concerning those costs that will be charged to the service user's estate while receiving individual provider program services, including but not limited to wages, benefits, case manager, and any administrative costs directly related to the oversight and supervision of this program;

(k) Service users or their legal representative have the right to receive a monthly written accounting of all the costs incurred by the person's estate while a recipient of services in this program consistent with (j) of this subsection;

(l) Service users or their legal representative shall have the right to be free of verbal, physical, and sexual abuse and neglect and be treated with consideration, respect, and full recognition of their dignity and individuality. Service users shall be encouraged and assisted in the exercise of their rights as consumers in need of services and as citizens;

(m) A service user may submit complaints or recommendations concerning the policies of the program to the department and to outside representatives of the service user's choice. No services provider may restrain, interfere, coerce, discriminate, or retaliate in any manner against a service user who submits a complaint or recommendation;

(n) A service user or their legal representative has the right to clear and understandable information about a grievance process to grieve or appeal any decision by a program or the department related to services. The service user has the right to use such grievance processes without retaliation or fear of retaliation. The service user has the right to assistance as needed to use such a grievance process;

(o) Service users or their legal representative have the right to choose their provider as long as the provider meets the terms and conditions established by the department;

(p) Service users or their legal representative must be fully informed about the nature and amount of authorized care through a written plan of care;

(q) Service users or their legal representative have the right to direct and participate in the planning of their services to the maximum extent of their abilities and desires, and to be provided with the time and necessary supports to facilitate such participation;

(r) Service users or their legal representative have the right to their personal and medical privacy;

(s) Service users or their legal representative have the right to trained and competent employees to provide their care;

(t) Service users or their legal representative have the right to know if individual providers are covered by workers' compensation, bonded for theft, and have personal liability insurance;

(u) Service users or their legal representative have the right to refuse some or all services offered;

(v) Service users or their legal representative have the right to receive services from the agency or individual provider of their choice;

(w) Service users or their legal representative have the right to receive materials in alternative formats upon request; and

(x) Service users or their legal representative have the right to appeal the denial, termination, reduction, modification, or suspension of services, using an internal grievance process and a fair hearing process.