5652-S2 AMS COST S2356

5652-S2 AMS COST S2356.1

2SSB 5652 - S AMD 176

By Senators Costa and Thibaudeau

Strike everything after the enacting clause and insert the following:

"Sec. 1. RCW 74.39A.005 and 2000 c 121 s 9 are each amended to read as follows:

The legislature finds that the aging of the population and advanced medical technology have resulted in a growing number of persons who require assistance. The primary resource for long-term care continues to be family and friends. However, these traditional caregivers are increasingly employed outside the home. There is a growing demand for improvement and expansion of home and community-based long-term care services to support and complement the services provided by these informal caregivers.

The legislature further finds that the public interest would best be served by ((~~a broad~~)) an array of long-term care services that support persons who need such services at home or in the community whenever practicable and that promote individual autonomy, dignity, and choice. An integrated long-term care system provided through a continuum of care is the most effective means of providing quality long-term care services to the residents of Washington state. The services provided should be based upon consumer choice and care needs, within available resources, with consumers moving through the continuum as their needs change. Each service included in the long-term care services continuum, including informal caregiver support, in-home services provided through individual providers or home care agencies, residential care, and nursing home care, plays an important role in the continuum of care.

The legislature finds that as other long-term care options become more available, the relative need for nursing homes ((~~beds~~)) or institutional settings is likely to decline. The legislature recognizes, however, that nursing home care will continue to be a critical part of the state's long-term care options, and that such services should promote individual dignity, autonomy, and a homelike environment.

The legislature finds that many recipients of in-home services are vulnerable and their health and well-being are dependent on their caregivers. The quality, skills, and knowledge of their caregivers are often the key to good care. The legislature finds that the need for well-trained caregivers is growing as the state's population ages and clients' needs increase. The legislature intends that current training standards be enhanced and that an entity be established that has the authority to recruit, stabilize, and improve the individual provider work force.

NEW SECTION. Sec. 2. AUTHORIZATION OF INDIVIDUAL PROVIDER QUALITY AUTHORITY. (1) The governor shall establish an individual provider quality authority to recruit, stabilize, and improve the individual provider work force as provided in this act. The authority shall be established as an instrumentality of the state exercising essential governmental functions, however it may not bind or obligate the state to fund the provisions of any collective bargaining agreement pursuant to this act. The authority shall be established within six months of the enactment of this act.

(2) The individual provider quality authority shall consist of nine members appointed by the governor. The governing board of the authority shall be as follows: Five members of the governing board shall be current or former consumers of home care services for the elderly or people with disabilities, at least one of whom shall be a person with a developmental disability; one member of the governing board shall be a representative of the developmental disabilities planning council; one member shall be a representative of the governor's committee on disability issues and employment; one member shall be a representative of the state council on aging; and one member shall be a representative of the Washington state association of area agencies on aging. The term of office of each member will be three years. If there is a vacancy for any cause, the governor shall make an appointment to become immediately effective for the unexpired term. A member is eligible for reappointment and may serve no more than two consecutive terms. In making appointments to the authority, the governor shall take into consideration any nominations or recommendations made by the representative groups or agencies.

(3) To assist in carrying out its duties under section 3 of this act, the governing board may establish technical advisory committees.

(4) As used in this chapter and RCW 70.127.040, "individual provider" means a person who has contracted with the department to provide personal care services to functionally disabled persons under the medicaid personal care, community options program entry system, or chore services program; or to provide respite, attendant care, individual alternatives living, or companion home services for people with developmental disabilities under chapter 71A.12 RCW, or to provide services as defined in RCW 74.13.270.

NEW SECTION. Sec. 3. DUTIES. By August 1, 2002, the individual provider quality authority shall develop and present to the governor an implementation plan to carry out the following duties:

(1) Systematically recruit new individual providers into the work force through an outreach program that focuses on the needs of low-income recipients;

(2) Establish a referral service that will provide timely access to qualified individual providers in every part of the state;

(3) Develop a method for securing relevant background information about individuals on the referral list, including assessing the value of a new abuse registry and establishing an interface with the department's current background check programs;

(4) Expand current respite care services to meet emergency and routine needs of caregivers through the use of trained providers who may be paid or unpaid;

(5) Improve access to training for both caregivers and clients incorporating existing qualified training programs in any facility, agency, school, or private business;

(6) Cooperate with any agency or entity currently providing long-term care services through contracting or by any other appropriate means;

(7) Augment current case management of individual providers in both aging and developmental disabilities programs; and

(8) Maintain autonomy in representing the interests of clients in directing their care.

NEW SECTION. Sec. 4. EMPLOYMENT RELATIONSHIP AND CONSUMER RIGHTS. (1) The office of financial management shall be deemed to be the employer of individual providers for the purpose of the application of chapter 41.56 RCW. The office of financial management shall be deemed to be a public employer as that term is defined in RCW 41.56.030(1) and the individual providers shall be deemed to be public employees as that term is defined in RCW 41.56.030(2). The individual provider authority authorized by this act will act as an adviser to the office of financial management for collective bargaining purposes under chapter 41.56 RCW. The provisions of chapter 41.56 RCW shall govern the relations between the office of financial management and the individual providers except: (a) The only unit appropriate for the purpose of collective bargaining under RCW 41.56.060 shall be a statewide unit of all individual providers; (b) the showing of interest needed to request an election under RCW 41.56.060 shall be ten percent of the unit and any intervener seeking to appear on the ballot shall make the same showing of interest; (c) the mediation and interest arbitration provisions of RCW 41.56.430 through 41.56.470 and 41.56.480 shall apply to the extent they do not conflict with this act; (d) individual providers shall not have a right to strike; and (e) as otherwise expressly provided in this act.

(2) The individual providers shall not be considered employees of the state of Washington for any purpose.

(3) Functionally disabled persons retain the right to select, supervise, and terminate the work of any individual provider providing services to them. Functionally disabled persons may elect to receive services from individual providers who are not referred to them by the individual provider quality authority. Those providers shall be referred to the authority for the purposes of wages, benefits, and other terms and conditions of employment.

(4) In implementing and administering this act, no individual provider quality authority, any of its subcontractors, or a combination thereof, shall reduce or increase the authorized hours of service for any functionally disabled person below the amount determined to be necessary under any assessment prepared by the department or an area agency on aging.

(5) The individual provider quality authority authorized under this act may enter into contracts and adopt rules under chapter 34.05 RCW as are necessary or proper to carry out this chapter.

(6) To the extent permitted by federal law, federal matching funds under Title XIX of the federal social security act may be used to establish and operate the individual provider quality authority authorized by this act.

(7)(a) The individual provider quality authority authorized under this act shall be deemed not to be the employer of individual providers referred to functionally disabled persons under this act for purposes of vicarious liability due to the negligence or intentional torts of the individual provider. Neither the individual provider quality authority, nor its subcontractors, nor the state, nor the area agencies on aging, nor their case management subcontractors, nor their employees, shall be held vicariously liable for the acts or omissions of any individual provider, whether or not the authority included the individual provider on its referral list or otherwise referred him or her to a functionally disabled person receiving services in his or her home under the medicaid personal care, community options program entry system, chore services program, programs under Title 71A RCW through which persons with developmental disabilities receive services from individual providers, or programs under RCW 74.13.270.

(b) The state is immune from any liability resulting from implementation of this act. Any obligation of the individual provider quality authority under this act, whether statutory, contractual, or otherwise, is the obligation solely of the individual provider quality authority, and is not the obligation of the state.

(8) Nothing in this section shall be construed to affect the state's responsibility with respect to the state payroll system or unemployment insurance for individual providers.

NEW SECTION. Sec. 5. LEGISLATIVE AUTHORITY OVER COMPENSATION PROVISIONS. Any increase in compensation negotiated or imposed through arbitration for individual providers in the bargaining unit shall be subject to the following:

(1) Compensation increases shall not be implemented unless funds are appropriated for that purpose by the legislature.

(2) The exclusive bargaining representative shall meet before a legislative session with the governor or governor's designee and the representative of the individual provider quality authority concerning the total dollar amount for compensation increases recommended by the authority for inclusion in the appropriations proposed by the governor under RCW 43.88.060;

(3) Any provisions of the collective bargaining agreements pertaining to compensation increases shall be subject to modification by the legislature. If any provision of a compensation increase is changed by subsequent modification of the appropriations act by the legislature, both parties shall immediately enter into collective bargaining for the sole purpose of arriving at a mutually agreed upon replacement for the modified provision.

Sec. 6. RCW 74.39A.030 and 1995 1st sp.s. c 18 s 2 are each amended to read as follows:

(1) To the extent of available funding, the department shall expand cost-effective options for home and community services for consumers for whom the state participates in the cost of their care.

(2) In expanding home and community services, the department shall: (a) Take full advantage of federal funding available under Title XVIII and Title XIX of the federal social security act, including home health, adult day care, waiver options, and state plan services; and (b) be authorized to use funds available under its community options program entry system waiver granted under section 1915(c) of the federal social security act to expand the availability of in-home, adult residential care, adult family homes, enhanced adult residential care, and assisted living services. By June 30, 1997, the department shall undertake to reduce the nursing home medicaid census by at least one thousand six hundred by assisting individuals who would otherwise require nursing facility services to obtain services of their choice, including assisted living services, enhanced adult residential care, and other home and community services. If a resident, or his or her legal representative, objects to a discharge decision initiated by the department, the resident shall not be discharged if the resident has been assessed and determined to require nursing facility services. In contracting with nursing homes and boarding homes for enhanced adult residential care placements, the department shall not require, by contract or through other means, structural modifications to existing building construction.

(3)(a) Except to the extent provided otherwise in section 5 of this act, the department shall by rule establish payment rates for home and community services that support the provision of cost-effective care.

(b) The department may authorize an enhanced adult residential care rate for nursing homes that temporarily or permanently convert their bed use for the purpose of providing enhanced adult residential care under chapter 70.38 RCW, when the department determines that payment of an enhanced rate is cost-effective and necessary to foster expansion of contracted enhanced adult residential care services. As an incentive for nursing homes to permanently convert a portion of its nursing home bed capacity for the purpose of providing enhanced adult residential care, the department may authorize a supplemental add-on to the enhanced adult residential care rate.

(c) The department may authorize a supplemental assisted living services rate for up to four years for facilities that convert from nursing home use and do not retain rights to the converted nursing home beds under chapter 70.38 RCW, if the department determines that payment of a supplemental rate is cost-effective and necessary to foster expansion of contracted assisted living services.

NEW SECTION. Sec. 7. Sections 2 through 5 of this act are each added to chapter 74.39A RCW.

NEW SECTION. Sec. 8. Captions used in this act are not any part of the law."

2SSB 5652 - S AMD 176

By Senators Costa and Thibaudeau

On page 1, beginning on line 2 of the title, after "providers;" strike the remainder of the title and insert "amending RCW 74.39A.005 and 74.39A.030; adding new sections to chapter 74.39A RCW; and creating a new section."