BILL REQ. #:  H-3546.1 

Read first time 01/12/2006.   Referred to Committee on Appropriations.

     AN ACT Relating to the adjustment of boarding home rates; and amending RCW 74.39A.030.

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

Sec. 1   RCW 74.39A.030 and 2002 c 3 s 10 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) The department shall by rule establish payment rates for home and community services that support the provision of cost-effective care. In the event of any conflict between any such rule and a collective bargaining agreement entered into under RCW 74.39A.270 and 74.39A.300, the collective bargaining agreement prevails.
     (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.
     (4) When a person, upon admission to a boarding home, has been determined to be eligible for medicaid funded boarding home care and the boarding home subsequently submits a request to the department for a change in condition reassessment, the boarding home shall receive payment from the department beginning on whichever date is later:
     (a) The date that the boarding home requested a department reassessment; or
     (b) The date on which the boarding home begins to provide the care and services necessary to meet the resident's change in condition.
     (5) If a person becomes financially eligible for medicaid after admission to the boarding home and the boarding home has a medicaid contract with the department under this chapter, the boarding home shall receive payment from the department beginning on whichever of the following dates is later:
     (a) The date of the request for assessment or financial application, whichever is earlier; or
     (b) The date the person is determined to have been financially eligible.
     When a financial application for medicaid is requested, payment back to the request date is limited to three months prior to the month that the financial application is received by the department.