AN
ACT Relating to human services; modifying the nursing home certificate of need
bed ratio; amending 1999 c ... (ESSB 5180) s 207 (uncodified); adding new
sections to chapter 70.38 RCW; creating a new section; making an appropriation;
providing an effective date; providing an expiration date; providing a
contingent expiration date; and declaring an emergency.
BE IT
ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW
SECTION. Sec. 1. A
new section is added to chapter 70.38 RCW to read as follows:
(1)
In determining the need for nursing home beds on a state-wide basis and a
planning area specific basis, the department shall calculate the need for
nursing home beds based on the bed-to-population ratio of forty beds per one
thousand persons age sixty-five and older. The department shall find no need
for additional nursing home beds if the state is at or above the state-wide
estimated bed need, unless the department finds that additional beds are needed
in order to be located reasonably close to the people they serve, and the
department explains such approval in writing.
(2)
The department may put under review and subsequently approve or deny an
application that proposes to redistribute nursing home bed capacity to a planning
area that has a bed-to-population ratio that is under the established ratio.
(3)
The department may put under review and subsequently approve or deny an
application that proposes to add beds in a planning area that has a
bed-to-population ratio that is under the established ratio using beds banked
under the provisions of RCW 70.38.115(13).
(4)
The department may not consider applications that would redistribute existing
nursing home capacity within a planning area that is above the established
bed-to-population ratio.
(5)
This section expires June 30, 2004.
NEW
SECTION. Sec. 2. A
new section is added to chapter 70.38 RCW to read as follows:
(1)
The need for projects identified in section 1 of this act shall be determined
using the individual planning area's estimated nursing home bed need ratio and
includes but is not limited to the following criteria:
(a)
The current capacity of nursing homes and other long-term care services;
(b)
The occupancy rates of nursing homes and other long-term care services over the
previous two-year period; and
(c)
The ability of the other long-term care services to serve all people regardless
of payor source.
(2)
For the purposes of this section, nursing home beds include long-term care units
or distinct part long-term care units located in a hospital that is licensed
under chapter 70.41 RCW.
Sec.
3. 1999
c ... (ESSB 5180) s 207 (uncodified) is amended to read as follows:
FOR
THE DEPARTMENT OF SOCIAL AND HEALTH SERVICES‑-AGING
AND ADULT SERVICES PROGRAM
General
Fund‑-State Appropriation (FY 2000).... $ ((451,758,000))
452,044,000
General
Fund‑-State Appropriation (FY 2001).... $ ((476,187,000))
476,761,000
General
Fund‑-Federal Appropriation............. $.................................. ((1,000,701,000))
1,001,629,000
General
Fund‑-Private/Local Appropriation...... $ 4,274,000
Health
Services Account‑-State Appropriation... $ 2,104,000
TOTAL
APPROPRIATION................. $ ((1,935,024,000))
1,936,812,000
The
appropriations in this section are subject to the following conditions and
limitations:
(1)
The entire health services account appropriation, $2,118,000 of the general
fund‑-federal appropriation, $923,000 of the general fund‑-state
appropriation for fiscal year 2000, and $958,000 of the general fund‑-state
appropriation for fiscal year 2001 are provided solely for health care benefits
for home care workers who are employed through state contracts for at least
twenty hours per week. Premium payments for individual provider home care
workers shall be made only to the subsidized basic health plan. Home care
agencies may obtain coverage either through the basic health plan or through an
alternative plan with substantially equivalent benefits.
(2)
$1,640,000 of the general fund‑-state appropriation for fiscal year 2000
and $1,640,000 of the general fund‑-state appropriation for fiscal year
2001, plus the associated vendor rate increase for each year, are provided
solely for operation of the volunteer chore services program.
(3)
For purposes of implementing Engrossed Second Substitute House Bill No. 1484
(nursing home payment rates), the weighted average nursing facility payment
rate for fiscal year 2000 shall be no more than $10.36 for the capital portion
of the rate and no more than $108.20 for the noncapital portion of the rate.
For fiscal year ((2000)) 2001, the weighted average nursing facility
payment rate shall be no more than $10.57 for the capital portion of the rate
and no more than $110.91 for the noncapital portion of the rate. These rates
include vendor rate increases, but exclude nurse's aide training.
(4)
((If Engrossed Second Substitute House Bill No. 1484 is not enacted by June
30, 1999, for purposes of implementing chapter 322, Laws of 1998 (nursing home
payment rates), the weighted average nursing home payment rate shall be no more
than $118.39 for fiscal year 2000 and no more than $120.36 for fiscal year
2001, including vendor rate increases but excluding nurse's aide training. The
appropriations in this section include $69,173,000 for fiscal year 2000 and
$68,123,000 for fiscal year 2001 for the department of social and health
services to include a property component, a financing allowance component, and
a variable return component in the rate it pays to nursing facilities. By July
1, 1999, the department shall adopt rules on an emergency basis pursuant to RCW
34.05.350 under which each nursing facility contractor shall continue to be
paid the property, the financing allowance, and the variable return rate which
it was paid on June 30, 1999. Each nursing facility contractor's June 30,
1999, variable return rate shall be increased by 1 percent effective July 1,
1999. Each nursing facility contractor's June 30, 2000 variable return rate
shall be increased by 1 percent effective July 1, 2000. With respect to a
nursing facility which enters the medicaid program for the first time on or
after July 1, 1999, the department shall pay the lesser of (a) the property,
the financing allowance, and the variable return rate for which the facility
would qualify under chapter 388-96 WAC; or (b) the state-wide average rate for
each of those rate components, weighted by medicaid patient days. With respect
to a nursing facility which makes a capitalized addition or replacement which
requires a certificate of need and which is approved by the department of
health on or after July 1, 1999, the department shall pay the lesser of (a) the
property, the financing allowance, and the variable return rate for which the
facility would qualify under chapter 388-96 WAC; or (b) the state-wide average
rate for each of those rate components, weighted by medicaid patient days.))In
addition to the rates set forth in subsection (3), $286,000 of the general
fund--state appropriation for fiscal year 2000, $574,000 of the general
fund--state appropriation for fiscal year 2001, and $928,000 of the
general fund--federal appropriation are provided solely for supplemental rate
adjustments for certain nursing facilities. In accordance with RCW 74.46.431,
the department shall use these funds to apply an additional economic trends and
conditions adjustment factor to the rate of any facility whose total rate
allocation would otherwise be less than its April 1, 1999, total rate, adjusted
for case-mix changes. This supplemental adjustment factor shall be the
percentage by which the facility's April 1, 1999, rate would otherwise exceed
the rate calculated in accordance with chapter 74.46 RCW and sub-section (3) of
this section, except that (a) no adjustment shall be provided for any amounts
by which a facility's rate is lower due to a reduction in its facility-average
medicaid case-mix score; and (b) the adjustment factor shall be reduced
proportionately for all facilities by the percentage by which total
supplemental payments would otherwise exceed the funds provided for such
payments in this sub-section.
(5)
$50,000 of the general fund‑-state appropriation for fiscal year 2000 and
$50,000 of the general fund‑-state appropriation for fiscal year 2001 are
provided solely for payments to any nursing facility licensed under chapter
18.51 RCW which meets all of the following criteria: (a) The nursing home
entered into an arm's length agreement for a facility lease prior to January 1,
1980; (b) the lessee purchased the leased nursing home after January 1, 1980;
and (c) the lessor defaulted on its loan or mortgage for the assets of the home
after January 1, 1991, and prior to January 1, 1992. Payments provided
pursuant to this subsection shall not be subject to the settlement, audit, or
rate-setting requirements contained in chapter 74.46 RCW.
(6)
$6,264,000 of the general fund‑-state appropriation for fiscal year 2000,
$13,860,000 of the general fund‑-state appropriation for fiscal year
2001, and $21,795,000 of the general fund‑-federal appropriation are
provided solely to increase compensation for individual and for agency home care
providers. Payments to individual home care providers are to be increased from
$6.18 per hour to $6.68 per hour on July 1, 1999, and to $7.18 per hour on July
1, 2000. Payments to agency providers are to increase to $11.97 per hour on
July 1, 1999, and to $12.62 per hour on July 1, 2000. All but 14 cents per
hour of the July 1, 1999, increase to agency providers, and all but 15 cents
per hour of the additional July 1, 2000, increase is to be used to increase
wages for direct care workers. The appropriations in this subsection also
include the funds needed for the employer share of unemployment and social
security taxes on the amount of the increase.
(7)
$200,000 of the general fund‑-state appropriation for fiscal year 2000,
$80,000 of the general fund‑-state appropriation for fiscal year 2001,
and $280,000 of the general fund‑-federal appropriation are provided
solely for enhancement and integration of existing management information
systems to (a) provide data at the local office level on service utilization,
costs, and recipient characteristics; and (b) reduce the staff time devoted to
data entry.
(8)
The department of social and health services shall provide access and choice to
consumers of adult day health services for the purposes of nursing services,
physical therapy, occupational therapy, and psychosocial therapy. Adult day
health services shall not be considered a duplication of services for persons
receiving care in long-term care settings licensed under chapter 18.20, 72.36,
or 70.128 RCW.
(9)
$1,452,000 of the general fund‑-state appropriation for fiscal year 2000,
$1,528,000 of the general fund‑-state appropriation for fiscal year 2001,
and $2,980,000 of the general fund‑-federal appropriation are provided
solely for implementation of Second Substitute House Bill No. 1546 (in-home
care services). If Second Substitute House Bill No. 1546 is not enacted by
June 30, 1999, the amounts provided in this subsection shall lapse.
NEW
SECTION. Sec. 4. This
act is necessary for the immediate preservation of the public peace, health, or
safety, or support of the state government and its existing public
institutions, and takes effect July 1, 1999.
