Washington State House of Representatives Office of Program Research	BILL ANALYSIS
Health Care Committee

HB 1341

Brief Description:  Developing a home and community‑based waiver for persons in community residential settings.

Sponsors:  Representatives Campbell, Conway, Boldt, Ruderman and Van Luven; by request of Department of Social and Health Services.

Brief Summary of Bill

$Establishes a new COPES waiver program allowing nursing home eligible individuals with income above $1,590 per month to receive long-term care services in boarding homes and adult family homes.

Hearing Date:  2/22/01

Staff:  Antonio Sanchez (786‑7383).

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 persons own home or in a community residential facility (boarding home or adult family home) is currently 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 COPES for community based care, are eligible for COPES Medicaid-funded nursing home care.  This is the result of a special program called ?medically needy@ which is only applied in 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 publically funded nursing home care under this program.  This same income standard is not applied to community care.  ?Medically needy@ is provided under a waiver of federal rules that allows our state to limit the total number of persons served.

Summary of Bill: 

A new waiver program is established that will allow nursing home eligible individuals with income above $1,590 per month (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.

Appropriation:  None.

Fiscal Note:  Requested on February 18, 2001.

Effective Date:  The bill contains an emergency clause and takes effect immediately.