FINAL BILL REPORT
SHB 1341
C 269 L 01
Synopsis as Enacted
Brief Description: Developing a home and community‑based waiver for persons in community residential settings.
Sponsors: By House Committee on Appropriations (originally sponsored by Representatives Campbell, Conway, Boldt, Ruderman and Van Luven; by request of Department of Social and Health Services).
House Committee on Health Care
House Committee on Appropriations
Senate Committee on Health & Long‑Term Care
Background:
The Community Options Program Entry System (COPES) is a federally matched long-term care waiver program. The COPES program provides long-term care services to individuals in adult family homes, boarding homes, nursing homes, or in their own home. Medicaid-funded long-term care in a person=s own home or in a community residential facility (boarding home or adult family home) is only available for people with income under $1,590 per month. However, individuals with income in excess of $1,590 per month, while not able to participate in the COPES for community-based care, are eligible for the COPES Medicaid-funded nursing home care. For individuals who want community-based care but are over the $1,590 per month income limit, their options are to pay privately for services if possible, to enter a nursing facility, or to go without services if they are unwilling to be placed in a nursing facility.
Individuals who have been admitted into a nursing home with incomes above $1,590 are referred to as "medically needy" and the program under which they are served is referred to as the "medically needy" program. They are eligible under this program because their income is less than the cost of that care. Since the state pays an average of about $3,600 per month for nursing home care, this means that single people with incomes below about $43,000 per year ($3,588 per month), and $60,000 per year for couples, can qualify for publicly funded nursing home care under this program. This same income standard is not applied to community care. The "medically needy" program is provided under a waiver of federal rules that allows Washington to limit the total number of persons served.
Summary:
A new waiver program is established that will allow nursing home-eligible individuals with income above $1,590 per month (the COPES standard) to receive long-term care services in boarding homes and adult family homes. The Department of Social and Health Services is given authority to set the level of participation in this program.
No current resident of a nursing facility who requires a nursing facility level of care is required to be discharged against his or her will due to the availability of home and community service alternatives. The option of seeking admission to a nursing facility for prospective residents requiring a nursing facility level of care is preserved. Individuals eligible for waiver services under this act must be given full disclosure of the services available to make an informed decision in choosing an appropriate care setting.
Votes on Final Passage:
House940
Senate450(Senate amended)
House920(House concurred)
Effective: July 22, 2001