SHB 2693 -
By Representative Morrell
ADOPTED 02/18/2008
Strike everything after the enacting clause and insert the following:
"NEW SECTION. Sec. 1 (1) The legislature finds that:
(a) An underlying premise of Washington's long-term care system is
the value of consumer choice across a full continuum of care with the
right to accessible, quality care;
(b) An appropriately trained and motivated long-term care workforce
contributes to the quality of long-term care services;
(c) The level and content of basic training should be focused upon
the client with respect to client care needs, health status, choice,
and flexibility;
(d) There is a need for increased workforce diversity throughout
the long-term care system;
(e) Long-term care worker training should acknowledge cultural
diversity and strive to achieve a greater understanding of the
relationships between culture and health;
(f) The long-term care workforce has diverse work-life expectations
such as career advancement and quality job performance;
(g) The long-term care workforce has variable learning styles, and
can benefit from flexibility in training settings, modalities,
accessibility, and methods;
(h) Long-term care training should prepare workers and caregivers
to perform in as many long-term care settings as possible with economic
security and safety, but also should accommodate the interests of those
workers who intend to care exclusively for their family members;
(i) The care and support provided by unpaid long-term caregivers
should not be disrupted, but enhanced and stabilized by any changes to
long-term care training and credentialing; and
(j) The long-term care workforce should be increased and enhanced
to meet current and future needs. New policies and requirements should
not result in decreasing the available workforce or the services
available to consumers.
(2) The legislature intends to establish long-term care worker
training standards that are consistent with the findings of subsection
(1) of this section and to establish a credentialing program that will
allow for career advancement in the long-term care work force.
Sec. 2 RCW 74.39A.009 and 2007 c 361 s 2 are each amended to read
as follows:
Unless the context clearly requires otherwise, the definitions in
this section apply throughout this chapter.
(1) "Adult family home" means a home licensed under chapter 70.128
RCW.
(2) "Adult residential care" means services provided by a boarding
home that is licensed under chapter 18.20 RCW and that has a contract
with the department under RCW 74.39A.020 to provide personal care
services.
(3) "Assisted living services" means services provided by a
boarding home that has a contract with the department under RCW
74.39A.010 to provide personal care services, intermittent nursing
services, and medication administration services, and the resident is
housed in a private apartment-like unit.
(4) "Boarding home" means a facility licensed under chapter 18.20
RCW.
(5) "Cost-effective care" means care provided in a setting of an
individual's choice that is necessary to promote the most appropriate
level of physical, mental, and psychosocial well-being consistent with
client choice, in an environment that is appropriate to the care and
safety needs of the individual, and such care cannot be provided at a
lower cost in any other setting. But this in no way precludes an
individual from choosing a different residential setting to achieve his
or her desired quality of life.
(6) "Department" means the department of social and health
services.
(7) "Enhanced adult residential care" means services provided by a
boarding home that is licensed under chapter 18.20 RCW and that has a
contract with the department under RCW 74.39A.010 to provide personal
care services, intermittent nursing services, and medication
administration services.
(8) "Functionally disabled person" or "person who is functionally
disabled" is synonymous with chronic functionally disabled and means a
person who because of a recognized chronic physical or mental condition
or disease, including chemical dependency, is impaired to the extent of
being dependent upon others for direct care, support, supervision, or
monitoring to perform activities of daily living. "Activities of daily
living", in this context, means self-care abilities related to personal
care such as bathing, eating, using the toilet, dressing, and transfer.
Instrumental activities of daily living may also be used to assess a
person's functional abilities as they are related to the mental
capacity to perform activities in the home and the community such as
cooking, shopping, house cleaning, doing laundry, working, and managing
personal finances.
(9) "Home and community services" means adult family homes, in-home
services, and other services administered or provided by contract by
the department directly or through contract with area agencies on aging
or similar services provided by facilities and agencies licensed by the
department.
(10) "Long-term care" is synonymous with chronic care and means
care and supports delivered indefinitely, intermittently, or over a
sustained time to persons of any age disabled by chronic mental or
physical illness, disease, chemical dependency, or a medical condition
that is permanent, not reversible or curable, or is long-lasting and
severely limits their mental or physical capacity for self-care. The
use of this definition is not intended to expand the scope of services,
care, or assistance by any individuals, groups, residential care
settings, or professions unless otherwise expressed by law.
(11)(a) "Long-term care workers" includes all persons who are
((long-term care workers for the elderly or)) paid to provide personal
care services to persons with functional disabilities, including but
not limited to individual providers of home care services, direct care
employees of home care agencies, providers of home care services to
persons with developmental disabilities under Title 71 RCW, all direct
care workers in state-licensed boarding homes, assisted living
facilities, and adult family homes, respite care providers, community
residential service providers, and any other direct care worker
providing home or community-based services to ((the elderly or))
persons with functional disabilities or developmental disabilities.
(b) "Long-term care workers" do not include persons employed in
nursing homes subject to chapter 18.51 RCW, hospitals or other acute
care settings, hospice agencies subject to chapter 70.127 RCW, adult
day care centers, and adult day health care centers.
(12) "Nursing home" means a facility licensed under chapter 18.51
RCW.
(13) "Personal care services" means physical or verbal assistance
with activities of daily living and instrumental activities of daily
living provided because of a person's functional limitations.
(14) "Secretary" means the secretary of social and health services.
(((14))) (15) "Training partnership" means a joint partnership or
trust established and maintained jointly by the office of the governor
and the exclusive bargaining representative of individual providers
under RCW 74.39A.270 to provide training((,)) and peer mentoring((, and
examinations)) required under this chapter, and educational, career
development, or other related services to individual providers.
(((15))) (16) "Tribally licensed boarding home" means a boarding
home licensed by a federally recognized Indian tribe which home
provides services similar to boarding homes licensed under chapter
18.20 RCW.
NEW SECTION. Sec. 3 A new section is added to chapter 74.39A RCW
to read as follows:
(1)(a) This section establishes the basic training requirements for
long-term care workers initially contracted or employed on or after
January 1, 2010. Except as provided otherwise in this section, these
long-term care workers must complete:
(i) Worker orientation under (b)(i) of this subsection before the
worker has routine interaction with the person or persons the worker
will be caring for; and
(ii) The remaining hours of basic training required in this section
within one hundred twenty days after the date of the long-term care
worker's initial contracting or employment as a long-term care worker
unless the department, for good cause, extends the time period by up to
sixty days.
(b) Basic training:
(i) Consists of thirty-five hours of classroom training on a set of
modules covering the core knowledge and competencies that caregivers
need to learn and understand to meet the needs of and to provide care
effectively and safely to persons with functional disabilities. Basic
training must include a worker orientation consisting of introductory
information on residents' rights, communication skills, fire and life
safety, and universal precautions; and
(ii) Must be outcome-based, and the effectiveness of the training
must be measured through the use of a competency test.
(2) Training standards and the delivery system for basic training
must be relevant to the varied needs of persons served by long-term
care workers and be sufficient to ensure that long-term care workers
have the skills and knowledge necessary to provide high quality,
appropriate care in a manner that respects the preferences of each
person served. In an effort to improve the quality of training,
increase access to training, and reduce costs, especially for rural
communities, the classroom training provided in a coordinated system of
long-term care training and education should include:
(a) The use of innovative learning strategies such as internet
resources, videotapes, and distance learning using satellite technology
coordinated through community colleges or other entities, as defined by
the department; and
(b) The use of varied adult learner strategies, such as
opportunities to practice or demonstrate skills, role playing, and
group discussions.
(3) As specified in this section, the following persons are fully
or partially exempt from the basic training requirements of this
section:
(a) As specified by the department in rule, registered nurses,
licensed practical nurses, certified nursing assistants, medicare
certified home health aides, or persons who hold a similar health
certification or license. However, these persons must complete worker
orientation training as described in subsection (1)(b)(i) of this
section;
(b) Persons who successfully challenge the competency test for
basic training. Such persons shall be deemed to have completed the
relevant hours of basic training. However, these persons must complete
worker orientation training as described in subsection (1)(b)(i) of
this section;
(c) Long-term care workers employed by supportive living providers
regulated under chapter 388-101 WAC who are subject to the training
required in WAC 388-101-1680;
(d) Biological, step, or adoptive parents who are the individual
provider for only their son or daughter who is developmentally disabled
or functionally disabled, and persons who provide respite care on an
intermittent basis to such son or daughter of a biological, step, or
adoptive parent who is either an individual provider or an unpaid
caregiver. However, these workers must complete: (i) Six hours of
training relevant to the needs of adults with developmental
disabilities and related functional disabilities, as appropriate; and
(ii) safety training, which may be completed using distance learning or
other alternative methods of training. As used in this subsection,
"intermittent basis" means care provided exclusively to one individual
for not more than an average of twenty-four hours per month; and
(e) Long-term care workers who were initially contracted or
employed as long-term care workers before January 1, 2010. However,
these long-term care workers must complete all training requirements in
effect before that date.
NEW SECTION. Sec. 4 A new section is added to chapter 74.39A RCW
to read as follows:
(1)(a) The department shall develop qualification requirements for
trainers and criteria for the approval of basic training programs under
section 3 of this act. Only training curricula approved by the
department may be used to fulfill the requirements of section 3 of this
act.
(b)(i) The department shall develop criteria for reviewing and
approving trainers and training materials that are substantially
similar to or better than the materials developed by the department.
The department may approve a curriculum based upon attestation by a
boarding home administrator, an adult family home provider or resident
manager, a home care agency administrator, or the administrator of the
training partnership designated in RCW 74.39A.360 that the facility's,
agency's, or training partnership's training curriculum addresses
required training competencies identified by the department, and shall
review a curriculum to verify that it meets these requirements. The
department, or the department of health, as applicable, may conduct the
review as part of the regularly scheduled inspection and investigation
required under RCW 18.20.110, 70.128.090, or 70.127.100. The
department shall rescind approval of any curriculum if it determines
that the curriculum does not meet these requirements.
(ii) A facility, agency, or the training partnership with an
approved curriculum must provide reports as required by the department
on the long-term care workers who began training and those who
completed training, and verifying that all long-term care workers
required to do so have complied with all training requirements.
(c) Boarding homes, adult family homes, home care agencies, or
other entities employing long-term care workers that desire to deliver
facility or agency-based required basic training with facility or
agency designated trainers, or facilities and agencies that desire to
pool their resources to create shared training systems, must be
encouraged by the department in their efforts.
(d) The department shall consult with the state board for community
and technical colleges, the superintendent of public instruction, and
the training partnership to ensure, to the extent possible, that long-term care worker training programs approved by the department assist
with opportunities to articulate to relevant degree or skills programs
offered in community colleges, vocational-technical institutes, skill
centers, and secondary schools, as defined in chapter 28B.50 RCW.
(2) The department shall adopt rules by September 1, 2009,
necessary to implement the training provisions of section 3 of this
act. In developing rules, the department shall consult with the
department of health, the nursing care quality assurance commission,
adult family home providers, boarding home providers, in-home personal
care providers, affected labor organizations, community and technical
colleges, and long-term care consumers and other interested
organizations.
Sec. 5 RCW 74.39A.340 and 2007 c 361 s 4 are each amended to read
as follows:
(1) Except as provided in subsection (2) of this section, beginning
January 1, 2010, long-term care workers shall complete twelve hours of
continuing education training in advanced training topics each year.
((This requirement applies beginning on January 1, 2010.))
(2) This section does not apply to persons described in section
3(3)(d) of this act. However, this subsection does not prohibit
requiring continuing education for such persons who elect to become
registered or certified under chapter 18.-- RCW (the chapter created in
section 31 of this act).
Sec. 6 RCW 74.39A.360 and 2007 c 361 s 6 are each amended to read
as follows:
(1) Beginning January 1, 2010, for individual providers represented
by an exclusive bargaining representative under RCW 74.39A.270, all
training and peer mentoring required under this chapter shall be
provided by a training partnership. Contributions to the partnership
pursuant to a collective bargaining agreement negotiated under this
chapter shall be made beginning July 1, 2009. The training partnership
shall provide reports as required by the department on the individual
providers who began training and those who completed training, and
verifying that all individual providers required to do so have complied
with all training requirements. The exclusive bargaining
representative shall designate the training partnership.
(2) The training partnership shall offer persons who are acting as
unpaid informal caregivers for family members or friends the
opportunity to attend training offered through the partnership at no
cost to the individual caregiver or the state. Attendance
opportunities may be limited to the extent that:
(a) There is fixed maximum seating or participation capacity for a
training module that satisfies long-term care worker basic training or
continuing education requirements under this chapter; and
(b) The maximum capacity for a particular training module is fully
reserved twenty-four hours in advance of the scheduled date and time of
the module.
NEW SECTION. Sec. 7 (1) The legislature finds that:
(a) It is in the public interest to promote quality long-term care
services through registration for long-term care workers; and
(b) An additional level of credentialing for those long-term care
workers who seek to increase their skills and knowledge or enter a
health care professional career track will increase, stabilize, and
enhance the long-term care workforce and further promote quality long-term care services.
(2) The legislature, therefore, intends to provide opportunities to
increase skills and knowledge or to pursue a career track through
certification and specialty endorsements, and potential articulation
from long-term care worker certification to other health care
credentialing or degrees.
NEW SECTION. Sec. 8 The definitions in this section apply
throughout this chapter unless the context clearly requires otherwise.
(1) "Department" means the department of health.
(2) "Secretary" means the secretary of health.
(3) "Long-term care worker" has the same meaning as in RCW
74.39A.009. There are two levels of credentialed long-term care
workers:
(a) "Registered long-term care worker" is an individual registered
under this chapter; and
(b) "Certified long-term care worker" is an individual certified
under this chapter.
(4) "Individual provider" has the same meaning as in RCW
74.39A.240.
(5) "Personal care services" has the same meaning as in RCW
74.39A.009.
(6) "Approved training program" means a program of not less than
eighty-five hours of training that is approved by the secretary in
consultation with the department of social and health services, the
state board for community and technical colleges, and the
superintendent of public instruction. The department shall ensure, to
the extent possible, that long-term care worker training programs
approved by the department assist with opportunities to articulate to
relevant degree or skill programs offered in community colleges,
vocational-technical institutes, skill centers, and secondary schools
as defined in chapter 28B.50 RCW. A training program approved under
this section may include, but is not limited to, the following
elements:
(a) Basic training under section 3 of this act, which is a required
element of an approved training program. For purposes of this
subsection, a person who successfully challenges the competency test
for basic training shall be deemed to have completed the relevant hours
of basic training other than worker orientation training;
(b) Hours that individual providers spend with peer mentors under
RCW 74.39A.330;
(c) Advanced training offered under RCW 74.39A.350;
(d) Up to ten hours spent being trained by the person to whom a
worker is providing care regarding the person's caregiving preferences
and needs;
(e) On-the-job training provided by the worker's employer,
including specialty training required under RCW 18.20.270(5) and
70.128.230(5);
(f) Structured training in population or setting specific
competencies that allow long-term care workers to acquire competencies
unique to the persons they will be serving or the care setting in which
they will be working;
(g) Attendance at relevant conferences sponsored by national or
state professional associations, governmental agencies, or institutions
of higher education; and
(h) Other structured or documented training approved by the
secretary. For the purposes of this subsection, "documented training"
means a written training program that describes the subject covered by
the training, the methods by which the training is conducted, and the
qualifications of the instructor.
(7) "Certification examination" means the measurement of an
individual's knowledge and skills as related to safe, competent
performance as a long-term care worker.
NEW SECTION. Sec. 9 (1)(a) Registration under this chapter
commences January 1, 2010. If the department determines that
administrative capacities essential to implementation of long-term care
worker registration under this chapter will not be fully functional by
January 1, 2010, the department may defer the implementation date to no
later than July 1, 2010.
(b) Except as provided otherwise in this chapter, long-term care
workers contracted or employed on or after January 1, 2010, must
register within one hundred twenty days after the date of the long-term
care worker's initial contracting or employment as a long-term care
worker, except that workers initially contracted or employed before
January 1, 2010, must register within one hundred twenty days after
January 1, 2010. However, the department, for good cause, may extend
the one hundred twenty day time period by up to sixty days.
(2) Beginning January 1, 2012, long-term care workers may elect to
be certified, with or without a specialty endorsement under section 14
of this act.
NEW SECTION. Sec. 10 (1) A registered or certified long-term
care worker may provide direct, hands-on personal care services to
persons with functional disabilities requiring long-term care services.
(2) No person may practice or, by use of any title or description,
represent himself or herself as:
(a) A registered long-term care worker without being registered
pursuant to this chapter; or
(b) A certified long-term care worker without applying for
certification, meeting the qualifications, and being certified pursuant
to this chapter.
NEW SECTION. Sec. 11 In addition to any other authority provided
by law, the secretary has the authority to:
(1) Set all certification, registration, and renewal fees in
accordance with RCW 43.70.250 and to collect and deposit all such fees
in the health professions account established under RCW 43.70.320;
(2) Establish forms, procedures, and examinations necessary to
administer this chapter;
(3) Hire clerical, administrative, and investigative staff as
needed to implement this chapter;
(4) Issue a registration to any applicant who has met the
requirements for registration;
(5) Issue a certificate to any applicant who has met the education,
training, and conduct requirements for certification;
(6) Maintain the official record for the department of all
applicants and persons with registrations and certificates;
(7) Exercise disciplinary authority as authorized in chapter 18.130
RCW;
(8) Deny registration to any applicant who fails to meet
requirement for registration; and
(9) Deny certification to applicants who do not meet the education,
training, competency evaluation, and conduct requirements for
certification.
NEW SECTION. Sec. 12 The secretary shall issue a registration to
any applicant who:
(1) Pays any applicable fees;
(2) Submits, on forms provided by the secretary, the applicant's
name, address, and other information as determined by the secretary;
and
(3) Establishes, to the secretary's satisfaction, that:
(a) The applicant has successfully completed the basic training
required under section 3 of this act. For purposes of this subsection,
a person who successfully challenges the competency test for basic
training shall be deemed to have completed the relevant hours of basic
training other than worker orientation training;
(b) The applicant has completed any required background check; and
(c) There are no grounds for denial of registration or issuance of
a conditional registration under this chapter or chapter 18.130 RCW.
NEW SECTION. Sec. 13 (1) The secretary shall issue a certificate
to any applicant who:
(a) Pays any applicable fees;
(b) Submits, on forms provided by the secretary, the applicant's
name, address, and other information as determined by the secretary;
(c) Establishes to the secretary's satisfaction that:
(i) The applicant has successfully completed an approved training
program;
(ii) The applicant has successfully completed a certification
examination;
(iii) The applicant has completed any required background check;
and
(iv) There exist no grounds for denial of certification under
chapter 18.130 RCW.
(2) The date and location of examinations shall be established by
the secretary. Applicants who have been found by the secretary to meet
the requirements for certification shall be scheduled for the next
examination following the filing of the application. The secretary
shall establish by rule the examination application deadline.
(3) The examination must include both a skills demonstration and a
written or oral knowledge test. Examinations shall be limited to the
purpose of determining whether the applicant possesses the minimum
skill and knowledge necessary to practice competently.
(4) The examination papers, all grading of the papers, and the
grading of skills demonstration shall be preserved for a period of not
less than one year after the secretary has made and published the
decisions. All examinations shall be conducted under fair and wholly
impartial methods.
(5) Any applicant failing to make the required grade in the first
examination may take up to three subsequent examinations as the
applicant desires upon prepaying a fee determined by the secretary
under RCW 43.70.250 for each subsequent examination. Upon failing four
examinations, the secretary may invalidate the original application and
require such remedial education before the person may take future
examinations.
(6) The certification examination must be administered and
evaluated by the department or by a contractor to the department that
is neither an employer of long-term care workers, a private contractor
providing training services under this chapter or section 3 of this
act, or the training partnership defined in RCW 74.39A.009.
NEW SECTION. Sec. 14 (1) A long-term care worker certified under
this chapter may apply for a specialty endorsement in the specialty
areas identified by the secretary in consultation with the department
of social and health services. The secretary shall issue an
endorsement to an applicant who:
(a) Completes the hours of training and practical experience
required in rules adopted by the secretary for the relevant specialty
endorsement;
(b) Pays any applicable fee; and
(c) Submits any other information as determined by the secretary.
(2) A certified long-term care worker who has been granted a
specialty endorsement under this section may include the specialty in
his or her title, as permitted under rules adopted by the secretary.
NEW SECTION. Sec. 15 An applicant holding a credential in
another state may be certified in this state without examination if the
secretary determines that the other state's credentialing standards for
long-term care workers are substantially equivalent to the standards in
this state.
NEW SECTION. Sec. 16 (1) Registrations and certifications shall
be renewed according to administrative procedures, administrative
requirements, and fees determined by the secretary under RCW 43.70.250
and 43.70.280.
(2) Completion of continuing education as required in RCW
74.39A.340 is a prerequisite to renewing a registration or
certification under this chapter.
NEW SECTION. Sec. 17 (1) This chapter does not apply to:
(a) Registered nurses, licensed practical nurses, certified nursing
assistants, medicare certified home health aides, or other persons who
hold a similar health credential, as determined by the secretary, or
persons with special education training and an endorsement granted by
the superintendent of public instruction that is recognized by the
secretary as appropriate to specified personal care services
circumstances;
(b) Biological, step, or adoptive parents who are the individual
provider for only their son or daughter who is developmentally disabled
or functionally disabled, and persons who provide respite care on an
intermittent basis to such son or daughter of a biological, step, or
adoptive parent who is either an individual provider or an unpaid
caregiver. As used in this subsection, "intermittent basis" means the
same as the definition in section 3(3)(d) of this act.
(2) Nothing in this chapter may be construed to prohibit or
restrict:
(a) The practice by an individual licensed, certified, or
registered under the laws of this state and performing services within
their authorized scope of practice;
(b) The practice by an individual employed by the government of the
United States while engaged in the performance of duties prescribed by
the laws of the United States;
(c) The practice by a person who is a regular student in an
educational program approved by the secretary, and whose performance of
services is pursuant to a regular course of instruction or assignments
from an instructor and under the general supervision of the instructor;
(d) A registered or certified long-term care worker from accepting
direction from a person who is self-directing his or her care; or
(e) A long-term care worker exempt under subsection (1) of this
section from applying for registration or certification, subject to
meeting the requirements for such application.
NEW SECTION. Sec. 18 (1) The uniform disciplinary act, chapter
18.130 RCW, governs unregistered or uncertified practice, issuance of
certificates and registrations, and the discipline of persons
registered or with certificates under this chapter. The secretary
shall be the disciplinary authority under this chapter.
(2)(a) The secretary may take action to immediately suspend the
registration or certification of a long-term care worker upon finding
that conduct of the long-term care worker has caused or presents an
imminent threat of harm to a functionally disabled person in his or her
care.
(b) If the secretary imposes suspension or conditions for
continuation of a registration or certification, the suspension or
conditions for continuation are effective immediately upon notice and
shall continue in effect pending the outcome of any hearing.
NEW SECTION. Sec. 19 (1) The department shall adopt rules by
September 1, 2009, necessary to implement the registration provisions
of this chapter. In developing rules, the department shall consult
with the department of social and health services, the nursing care
quality assurance commission, adult family home providers, boarding
home providers, in-home personal care providers, the training
partnership defined in RCW 74.39A.009, affected labor organizations,
community and technical colleges, and long-term care consumers and
other interested organizations.
(2)(a) The department shall also consult with these parties on a
plan to implement the voluntary certification program under this
chapter by January 1, 2012, in a cost-effective manner considering the
following:
(i) The certification program should assist a long-term care worker
to enter, if desired, a career path to other health care or allied
health professions, including articulation, to the maximum extent
possible under federal law, from long-term care worker certification to
nursing assistant certification under chapter 18.88A RCW;
(ii) The department should consider the relative merits of
certification and/or specialty endorsement examinations and of
practical work experience for certification and/or specialty
endorsements. If recommendations are made for practical work
experience requirements, the department's plan should include
recommendations on the hours and type of practical work experience that
would be appropriate for the credential sought.
(b) The department shall report on the certification plan to the
appropriate committees of the legislature by December 1, 2009.
Sec. 20 RCW 18.130.040 and 2007 c 269 s 17 and 2007 c 70 s 11 are
each reenacted and amended to read as follows:
(1) This chapter applies only to the secretary and the boards and
commissions having jurisdiction in relation to the professions licensed
under the chapters specified in this section. This chapter does not
apply to any business or profession not licensed under the chapters
specified in this section.
(2)(a) The secretary has authority under this chapter in relation
to the following professions:
(i) Dispensing opticians licensed and designated apprentices under
chapter 18.34 RCW;
(ii) Naturopaths licensed under chapter 18.36A RCW;
(iii) Midwives licensed under chapter 18.50 RCW;
(iv) Ocularists licensed under chapter 18.55 RCW;
(v) Massage operators and businesses licensed under chapter 18.108
RCW;
(vi) Dental hygienists licensed under chapter 18.29 RCW;
(vii) Acupuncturists licensed under chapter 18.06 RCW;
(viii) Radiologic technologists certified and X-ray technicians
registered under chapter 18.84 RCW;
(ix) Respiratory care practitioners licensed under chapter 18.89
RCW;
(x) Persons registered under chapter 18.19 RCW;
(xi) Persons licensed as mental health counselors, marriage and
family therapists, and social workers under chapter 18.225 RCW;
(xii) Persons registered as nursing pool operators under chapter
18.52C RCW;
(xiii) Nursing assistants registered or certified under chapter
18.88A RCW;
(xiv) Health care assistants certified under chapter 18.135 RCW;
(xv) Dietitians and nutritionists certified under chapter 18.138
RCW;
(xvi) Chemical dependency professionals certified under chapter
18.205 RCW;
(xvii) Sex offender treatment providers and certified affiliate sex
offender treatment providers certified under chapter 18.155 RCW;
(xviii) Persons licensed and certified under chapter 18.73 RCW or
RCW 18.71.205;
(xix) Denturists licensed under chapter 18.30 RCW;
(xx) Orthotists and prosthetists licensed under chapter 18.200 RCW;
(xxi) Surgical technologists registered under chapter 18.215 RCW;
(xxii) Recreational therapists; ((and))
(xxiii) Animal massage practitioners certified under chapter 18.240
RCW; and
(xxiv) Long-term care workers registered or certified under chapter
18.-- RCW (the new chapter created in section 31 of this act).
(b) The boards and commissions having authority under this chapter
are as follows:
(i) The podiatric medical board as established in chapter 18.22
RCW;
(ii) The chiropractic quality assurance commission as established
in chapter 18.25 RCW;
(iii) The dental quality assurance commission as established in
chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW and
licenses and registrations issued under chapter 18.260 RCW;
(iv) The board of hearing and speech as established in chapter
18.35 RCW;
(v) The board of examiners for nursing home administrators as
established in chapter 18.52 RCW;
(vi) The optometry board as established in chapter 18.54 RCW
governing licenses issued under chapter 18.53 RCW;
(vii) The board of osteopathic medicine and surgery as established
in chapter 18.57 RCW governing licenses issued under chapters 18.57 and
18.57A RCW;
(viii) The board of pharmacy as established in chapter 18.64 RCW
governing licenses issued under chapters 18.64 and 18.64A RCW;
(ix) The medical quality assurance commission as established in
chapter 18.71 RCW governing licenses and registrations issued under
chapters 18.71 and 18.71A RCW;
(x) The board of physical therapy as established in chapter 18.74
RCW;
(xi) The board of occupational therapy practice as established in
chapter 18.59 RCW;
(xii) The nursing care quality assurance commission as established
in chapter 18.79 RCW governing licenses and registrations issued under
that chapter;
(xiii) The examining board of psychology and its disciplinary
committee as established in chapter 18.83 RCW; and
(xiv) The veterinary board of governors as established in chapter
18.92 RCW.
(3) In addition to the authority to discipline license holders, the
disciplining authority has the authority to grant or deny licenses
based on the conditions and criteria established in this chapter and
the chapters specified in subsection (2) of this section. This chapter
also governs any investigation, hearing, or proceeding relating to
denial of licensure or issuance of a license conditioned on the
applicant's compliance with an order entered pursuant to RCW 18.130.160
by the disciplining authority.
(4) All disciplining authorities shall adopt procedures to ensure
substantially consistent application of this chapter, the Uniform
Disciplinary Act, among the disciplining authorities listed in
subsection (2) of this section.
Sec. 21 RCW 18.130.040 and 2007 c 269 s 17, 2007 c 253 s 13, and
2007 c 70 s 11 are each reenacted and amended to read as follows:
(1) This chapter applies only to the secretary and the boards and
commissions having jurisdiction in relation to the professions licensed
under the chapters specified in this section. This chapter does not
apply to any business or profession not licensed under the chapters
specified in this section.
(2)(a) The secretary has authority under this chapter in relation
to the following professions:
(i) Dispensing opticians licensed and designated apprentices under
chapter 18.34 RCW;
(ii) Naturopaths licensed under chapter 18.36A RCW;
(iii) Midwives licensed under chapter 18.50 RCW;
(iv) Ocularists licensed under chapter 18.55 RCW;
(v) Massage operators and businesses licensed under chapter 18.108
RCW;
(vi) Dental hygienists licensed under chapter 18.29 RCW;
(vii) Acupuncturists licensed under chapter 18.06 RCW;
(viii) Radiologic technologists certified and X-ray technicians
registered under chapter 18.84 RCW;
(ix) Respiratory care practitioners licensed under chapter 18.89
RCW;
(x) Persons registered under chapter 18.19 RCW;
(xi) Persons licensed as mental health counselors, marriage and
family therapists, and social workers under chapter 18.225 RCW;
(xii) Persons registered as nursing pool operators under chapter
18.52C RCW;
(xiii) Nursing assistants registered or certified under chapter
18.88A RCW;
(xiv) Health care assistants certified under chapter 18.135 RCW;
(xv) Dietitians and nutritionists certified under chapter 18.138
RCW;
(xvi) Chemical dependency professionals certified under chapter
18.205 RCW;
(xvii) Sex offender treatment providers and certified affiliate sex
offender treatment providers certified under chapter 18.155 RCW;
(xviii) Persons licensed and certified under chapter 18.73 RCW or
RCW 18.71.205;
(xix) Denturists licensed under chapter 18.30 RCW;
(xx) Orthotists and prosthetists licensed under chapter 18.200 RCW;
(xxi) Surgical technologists registered under chapter 18.215 RCW;
(xxii) Recreational therapists;
(xxiii) Animal massage practitioners certified under chapter 18.240
RCW; ((and))
(xxiv) Athletic trainers licensed under chapter 18.250 RCW; and
(xxv) Long-term care workers registered or certified under chapter
18.-- RCW (the new chapter created in section 31 of this act).
(b) The boards and commissions having authority under this chapter
are as follows:
(i) The podiatric medical board as established in chapter 18.22
RCW;
(ii) The chiropractic quality assurance commission as established
in chapter 18.25 RCW;
(iii) The dental quality assurance commission as established in
chapter 18.32 RCW governing licenses issued under chapter 18.32 RCW and
licenses and registrations issued under chapter 18.260 RCW;
(iv) The board of hearing and speech as established in chapter
18.35 RCW;
(v) The board of examiners for nursing home administrators as
established in chapter 18.52 RCW;
(vi) The optometry board as established in chapter 18.54 RCW
governing licenses issued under chapter 18.53 RCW;
(vii) The board of osteopathic medicine and surgery as established
in chapter 18.57 RCW governing licenses issued under chapters 18.57 and
18.57A RCW;
(viii) The board of pharmacy as established in chapter 18.64 RCW
governing licenses issued under chapters 18.64 and 18.64A RCW;
(ix) The medical quality assurance commission as established in
chapter 18.71 RCW governing licenses and registrations issued under
chapters 18.71 and 18.71A RCW;
(x) The board of physical therapy as established in chapter 18.74
RCW;
(xi) The board of occupational therapy practice as established in
chapter 18.59 RCW;
(xii) The nursing care quality assurance commission as established
in chapter 18.79 RCW governing licenses and registrations issued under
that chapter;
(xiii) The examining board of psychology and its disciplinary
committee as established in chapter 18.83 RCW; and
(xiv) The veterinary board of governors as established in chapter
18.92 RCW.
(3) In addition to the authority to discipline license holders, the
disciplining authority has the authority to grant or deny licenses
based on the conditions and criteria established in this chapter and
the chapters specified in subsection (2) of this section. This chapter
also governs any investigation, hearing, or proceeding relating to
denial of licensure or issuance of a license conditioned on the
applicant's compliance with an order entered pursuant to RCW 18.130.160
by the disciplining authority.
(4) All disciplining authorities shall adopt procedures to ensure
substantially consistent application of this chapter, the Uniform
Disciplinary Act, among the disciplining authorities listed in
subsection (2) of this section.
Sec. 22 RCW 74.39A.240 and 2002 c 3 s 3 are each amended to read
as follows:
The definitions in this section apply throughout RCW 74.39A.030 and
74.39A.095 and 74.39A.220 through 74.39A.300, sections 3 and 23 of this
act, 41.56.026, 70.127.041, and 74.09.740 unless the context clearly
requires otherwise.
(1) "Authority" means the home care quality authority.
(2) "Board" means the board created under RCW 74.39A.230.
(3) "Consumer" means a person to whom an individual provider
provides any such services.
(4) "Individual provider" means a person, including a personal
aide, who has contracted with the department to provide personal care
or respite care services to ((functionally disabled persons)) persons
with functional disabilities under the medicaid personal care,
community options program entry system, chore services program, or
respite care program, or to provide respite care or residential
services and support to persons with developmental disabilities under
chapter 71A.12 RCW, or to provide respite care as defined in RCW
74.13.270.
NEW SECTION. Sec. 23 A new section is added to chapter 74.39A
RCW to read as follows:
(1) The department shall deny payment to any individual provider of
home care services who does not complete the training requirements of
section 3 of this act or obtain registration as a long-term care worker
as specified in chapter 18.-- RCW (the new chapter created in section
31 of this act).
(2) The department may terminate the contract of any individual
provider of home care services, or take any other enforcement measure
deemed appropriate by the department if the individual provider's
registration or certification is revoked under chapter 18.-- RCW (the
new chapter created in section 31 of this act).
(3) The department may take action to immediately terminate the
contract of an individual provider of home care services upon finding
that conduct of the individual provider has caused or presents an
imminent threat of harm to a functionally disabled person in their
care.
(4) The department shall take appropriate enforcement action
related to the contract or licensure of a provider of home and
community-based services, other than an individual provider, who
knowingly employs a long-term care worker who has failed to complete
the training requirements of section 3 of this act or obtain
registration as a long-term care worker as specified in chapter 18.--
RCW (the new chapter created in section 31 of this act).
(5) Chapter 34.05 RCW shall govern department actions under this
section.
Sec. 24 RCW 74.39A.050 and 2004 c 140 s 6 are each amended to
read as follows:
The department's system of quality improvement for long-term care
services shall use the following principles, consistent with applicable
federal laws and regulations:
(1) The system shall be client-centered and promote privacy,
independence, dignity, choice, and a home or home-like environment for
consumers consistent with chapter 392, Laws of 1997.
(2) The goal of the system is continuous quality improvement with
the focus on consumer satisfaction and outcomes for consumers. This
includes that when conducting licensing or contract inspections, the
department shall interview an appropriate percentage of residents,
family members, resident case managers, and advocates in addition to
interviewing providers and staff.
(3) Providers should be supported in their efforts to improve
quality and address identified problems initially through training,
consultation, technical assistance, and case management.
(4) The emphasis should be on problem prevention both in monitoring
and in screening potential providers of service.
(5) Monitoring should be outcome based and responsive to consumer
complaints and based on a clear set of health, quality of care, and
safety standards that are easily understandable and have been made
available to providers, residents, and other interested parties.
(6) Prompt and specific enforcement remedies shall also be
implemented without delay, pursuant to RCW 74.39A.080, RCW 70.128.160,
chapter 18.51 RCW, or chapter 74.42 RCW, for providers found to have
delivered care or failed to deliver care resulting in problems that are
serious, recurring, or uncorrected, or that create a hazard that is
causing or likely to cause death or serious harm to one or more
residents. These enforcement remedies may also include, when
appropriate, reasonable conditions on a contract or license. In the
selection of remedies, the safety, health, and well-being of residents
shall be of paramount importance.
(7) To the extent funding is available, all long-term care staff
directly responsible for the care, supervision, or treatment of
vulnerable persons should be screened through background checks in a
uniform and timely manner to ensure that they do not have a criminal
history that would disqualify them from working with vulnerable
persons. Whenever a state conviction record check is required by state
law, persons may be employed or engaged as volunteers or independent
contractors on a conditional basis according to law and rules adopted
by the department.
(8) No provider or staff, or prospective provider or staff, with a
stipulated finding of fact, conclusion of law, an agreed order, or
finding of fact, conclusion of law, or final order issued by a
disciplining authority, a court of law, or entered into a state
registry finding him or her guilty of abuse, neglect, exploitation, or
abandonment of a minor or a vulnerable adult as defined in chapter
74.34 RCW shall be employed in the care of and have unsupervised access
to vulnerable adults.
(9) The department shall establish, by rule, a state registry which
contains identifying information about personal care aides identified
under this chapter who have substantiated findings of abuse, neglect,
financial exploitation, or abandonment of a vulnerable adult as defined
in RCW 74.34.020. The rule must include disclosure, disposition of
findings, notification, findings of fact, appeal rights, and fair
hearing requirements. The department shall disclose, upon request,
substantiated findings of abuse, neglect, financial exploitation, or
abandonment to any person so requesting this information.
(10) ((The department shall by rule develop training requirements
for individual providers and home care agency providers. Effective
March 1, 2002, individual providers and home care agency providers must
satisfactorily complete department-approved orientation, basic
training, and continuing education within the time period specified by
the department in rule. The department shall adopt rules by March 1,
2002, for the implementation of this section based on the
recommendations of the community long-term care training and education
steering committee established in RCW 74.39A.190. The department shall
deny payment to an individual provider or a home care provider who does
not complete the training requirements within the time limit specified
by the department by rule.)) The department shall establish, by rule, ((
(11) In an effort to improve access to training and education and
reduce costs, especially for rural communities, the coordinated system
of long-term care training and education must include the use of
innovative types of learning strategies such as internet resources,
videotapes, and distance learning using satellite technology
coordinated through community colleges or other entities, as defined by
the department.
(12) The department shall create an approval system by March 1,
2002, for those seeking to conduct department-approved training. In
the rule-making process, the department shall adopt rules based on the
recommendations of the community long-term care training and education
steering committee established in RCW 74.39A.190.
(13)training,))
background checks((,)) and other quality assurance requirements for
personal aides who provide in-home services funded by medicaid personal
care as described in RCW 74.09.520, community options program entry
system waiver services as described in RCW 74.39A.030, or chore
services as described in RCW 74.39A.110 that are equivalent to
requirements for individual providers.
(((14))) (11) Under existing funds the department shall establish
internally a quality improvement standards committee to monitor the
development of standards and to suggest modifications.
(((15) Within existing funds, the department shall design, develop,
and implement a long-term care training program that is flexible,
relevant, and qualifies towards the requirements for a nursing
assistant certificate as established under chapter 18.88A RCW. This
subsection does not require completion of the nursing assistant
certificate training program by providers or their staff. The long-term care teaching curriculum must consist of a fundamental module, or
modules, and a range of other available relevant training modules that
provide the caregiver with appropriate options that assist in meeting
the resident's care needs. Some of the training modules may include,
but are not limited to, specific training on the special care needs of
persons with developmental disabilities, dementia, mental illness, and
the care needs of the elderly. No less than one training module must
be dedicated to workplace violence prevention. The nursing care
quality assurance commission shall work together with the department to
develop the curriculum modules. The nursing care quality assurance
commission shall direct the nursing assistant training programs to
accept some or all of the skills and competencies from the curriculum
modules towards meeting the requirements for a nursing assistant
certificate as defined in chapter 18.88A RCW. A process may be
developed to test persons completing modules from a caregiver's class
to verify that they have the transferable skills and competencies for
entry into a nursing assistant training program. The department may
review whether facilities can develop their own related long-term care
training programs. The department may develop a review process for
determining what previous experience and training may be used to waive
some or all of the mandatory training. The department of social and
health services and the nursing care quality assurance commission shall
work together to develop an implementation plan by December 12, 1998.))
Sec. 25 RCW 70.127.100 and 2000 c 175 s 9 are each amended to
read as follows:
Upon receipt of an application under RCW 70.127.080 for a license
and the license fee, the department shall issue a license if the
applicant meets the requirements established under this chapter. A
license issued under this chapter shall not be transferred or assigned
without thirty days prior notice to the department and the department's
approval. A license, unless suspended or revoked, is effective for a
period of two years, however an initial license is only effective for
twelve months. The department shall conduct a survey within each
licensure period, and may conduct a licensure survey after ownership
transfer, to assure compliance with this chapter and the rules adopted
under this chapter and under section 3 of this act, and to enforce
section 23(4) of this act.
Sec. 26 RCW 18.20.110 and 2004 c 144 s 3 are each amended to read
as follows:
(1) The department shall make or cause to be made, at least every
eighteen months with an annual average of fifteen months, an inspection
and investigation of all boarding homes. However, the department may
delay an inspection to twenty-four months if the boarding home has had
three consecutive inspections with no written notice of violations and
has received no written notice of violations resulting from complaint
investigation during that same time period. The department may at
anytime make an unannounced inspection of a licensed home to assure
that the licensee is in compliance with this chapter and the rules
adopted under this chapter and section 3 of this act, and to enforce
section 23(4) of this act. Every inspection shall focus primarily on
actual or potential resident outcomes, and may include an inspection of
every part of the premises and an examination of all records, methods
of administration, the general and special dietary, and the stores and
methods of supply; however, the department shall not have access to
financial records or to other records or reports described in RCW
18.20.390. Financial records of the boarding home may be examined when
the department has reasonable cause to believe that a financial
obligation related to resident care or services will not be met, such
as a complaint that staff wages or utility costs have not been paid, or
when necessary for the department to investigate alleged financial
exploitation of a resident.
(2) Following such an inspection or inspections, written notice of
any violation of this law or the rules adopted hereunder shall be given
to the applicant or licensee and the department.
(3) The department may prescribe by rule that any licensee or
applicant desiring to make specified types of alterations or additions
to its facilities or to construct new facilities shall, before
commencing such alteration, addition, or new construction, submit plans
and specifications therefor to the agencies responsible for plan
reviews for preliminary inspection and approval or recommendations with
respect to compliance with the rules and standards herein authorized.
Sec. 27 RCW 18.20.270 and 2002 c 233 s 1 are each amended to read
as follows:
(1) The definitions in this subsection apply throughout this
section unless the context clearly requires otherwise.
(a) "Caregiver" includes any ((person)) long-term care worker who
provides residents with hands-on personal care on behalf of a boarding
home, except volunteers who are directly supervised.
(b) "Direct supervision" means oversight by a person who has
demonstrated competency in the core areas or has been fully exempted
from the training requirements pursuant to this section, is on the
premises, and is quickly and easily available to the caregiver.
(c) "Long-term care worker" has the same meaning as defined in RCW
74.39A.009(11).
(2) Training must have the following components: Orientation,
basic training, specialty training as appropriate, and continuing
education. All boarding home employees or volunteers who routinely
interact with residents shall complete orientation. Boarding home
administrators, or their designees, and caregivers shall complete
orientation, basic training, specialty training as appropriate, and
continuing education. Training of caregivers employed by boarding
homes is governed by chapter 74.39A RCW. Any caregiver who has
satisfied the training and competency testing requirements of section
3 of this act or the continuing education requirements of RCW
74.39A.340 shall be deemed to have satisfied, as applicable, the
orientation, basic training, and continuing education requirements of
this section.
(3) Orientation consists of introductory information on residents'
rights, communication skills, fire and life safety, and universal
precautions. Orientation must be provided at the facility by
appropriate boarding home staff to all boarding home employees before
the employees have routine interaction with residents.
(4) Basic training consists of modules on the core knowledge and
skills that caregivers need to learn and understand to effectively and
safely provide care to residents. Basic training must be outcome-based, and the effectiveness of the basic training must be measured by
demonstrated competency in the core areas through the use of a
competency test. ((Basic training must be completed by caregivers
within one hundred twenty days of the date on which they begin to
provide hands-on care or within one hundred twenty days of September 1,
2002, whichever is later.)) Until ((competency in the core areas has
been demonstrated, caregivers)) a caregiver provides verification that
he or she has met the basic training requirements under section 3 of
this act, a caregiver shall not provide hands-on personal care to
residents without direct supervision. Boarding home administrators, or
their designees, must complete basic training and demonstrate
competency within one hundred twenty days of employment or within one
hundred twenty days of September 1, 2002, whichever is later.
(5)(a) For boarding homes that serve residents with special needs
such as dementia, developmental disabilities, or mental illness,
specialty training is required of administrators, or designees, and
caregivers. Specialty training consists of modules on the core
knowledge and skills that caregivers need to effectively and safely
provide care to residents with special needs. Specialty training
should be integrated into basic training wherever appropriate.
Specialty training must be outcome-based, and the effectiveness of the
specialty training measured by demonstrated competency in the core
specialty areas through the use of a competency test.
(b) Specialty training must be completed by caregivers within one
hundred twenty days of the date on which they begin to provide hands-on
care to a resident having special needs or within one hundred twenty
days of September 1, 2002, whichever is later. However, if specialty
training is not integrated with basic training, the specialty training
must be completed within ninety days of completion of basic training.
Until competency in the core specialty areas has been demonstrated,
caregivers shall not provide hands-on personal care to residents with
special needs without direct supervision. If training received by a
caregiver under section 3 of this act involves core knowledge and
skills to effectively and safely provide care to residents of the
boarding home with special needs, the hours of training received by the
caregiver shall apply toward meeting the specialty training
requirements under this section. Boarding home administrators, or
their designees, must complete specialty training and demonstrate
competency within one hundred twenty days of September 1, 2002, or one
hundred twenty days from the date on which the administrator or his or
her designee is hired, whichever is later, if the boarding home serves
one or more residents with special needs.
(((6) Continuing education consists of ongoing delivery of
information to caregivers on various topics relevant to the care
setting and care needs of residents. Competency testing is not
required for continuing education. Continuing education is not
required in the same calendar year in which basic or modified basic
training is successfully completed. Continuing education is required
in each calendar year thereafter.)) (c) If specialty training is
completed, the specialty training applies toward any continuing
education requirement for up to two years following the completion of
the specialty training.
(((7))) (6) Persons who successfully challenge the competency test
for basic training are fully exempt from the basic training
requirements of this section. Persons who successfully challenge the
specialty training competency test are fully exempt from the specialty
training requirements of this section.
(((8))) (7) Licensed persons who perform the tasks for which they
are licensed are fully or partially exempt from the training
requirements of this section, as specified by the department in rule.
(((9))) (8) In an effort to improve access to training and
education and reduce costs, especially for rural communities, the
coordinated system of long-term care training and education must
include the use of innovative types of learning strategies such as
internet resources, videotapes, and distance learning using satellite
technology coordinated through community colleges or other entities, as
defined by the department.
(((10))) (9) The department shall develop criteria for the approval
of orientation, basic training, and specialty training programs.
(((11) Boarding homes that desire to deliver facility-based
training with facility designated trainers, or boarding homes that
desire to pool their resources to create shared training systems, must
be encouraged by the department in their efforts. The department shall
develop criteria for reviewing and approving trainers and training
materials that are substantially similar to or better than the
materials developed by the department. The department may approve a
curriculum based upon attestation by a boarding home administrator that
the boarding home's training curriculum addresses basic and specialty
training competencies identified by the department, and shall review a
curriculum to verify that it meets these requirements. The department
may conduct the review as part of the next regularly scheduled yearly
inspection and investigation required under RCW 18.20.110. The
department shall rescind approval of any curriculum if it determines
that the curriculum does not meet these requirements.)) (10) The orientation, basic training, specialty training,
and continuing education requirements of this section commence
September 1, 2002, or one hundred twenty days from the date of
employment, whichever is later, and shall be applied to (a) employees
hired subsequent to September 1, 2002; and (b) existing employees that
on September 1, 2002, have not successfully completed the training
requirements under RCW 74.39A.010 or 74.39A.020 and this section.
Existing employees who have not successfully completed the training
requirements under RCW 74.39A.010 or 74.39A.020 shall be subject to all
applicable requirements of this section. ((
(12) The department shall adopt rules by September 1, 2002, for the
implementation of this section.
(13)However, prior to September
1, 2002, nothing in this section affects the current training
requirements under RCW 74.39A.010.))
Sec. 28 RCW 70.128.090 and 2001 c 319 s 7 are each amended to
read as follows:
(1) During inspections of an adult family home, the department
shall have access and authority to examine areas and articles in the
home used to provide care or support to residents, including residents'
records, accounts, and the physical premises, including the buildings,
grounds, and equipment. The personal records of the provider are not
subject to department inspection nor is the separate bedroom of the
provider, not used in direct care of a client, subject to review. The
department may inspect all rooms during the initial licensing of the
home. However, during a complaint investigation, the department shall
have access to the entire premises and all pertinent records when
necessary to conduct official business. The department also shall have
the authority to interview the provider and residents of an adult
family home.
(2) Whenever an inspection is conducted, the department shall
prepare a written report that summarizes all information obtained
during the inspection, and if the home is in violation of this chapter
or the rules adopted under this chapter or under section 3 of this act,
or the department is enforcing section 23(4) of this act, serve a copy
of the inspection report upon the provider at the same time as a notice
of violation. This notice shall be mailed to the provider within ten
working days of the completion of the inspection process. If the home
is not in violation of this chapter, a copy of the inspection report
shall be mailed to the provider within ten calendar days of the
inspection of the home. All inspection reports shall be made available
to the public at the department during business hours.
(3) The provider shall develop corrective measures for any
violations found by the department's inspection. The department shall
upon request provide consultation and technical assistance to assist
the provider in developing effective corrective measures. The
department shall include a statement of the provider's corrective
measures in the department's inspection report.
NEW SECTION. Sec. 29 A new section is added to chapter 70.128
RCW to read as follows:
(1) Adult family homes may participate in a voluntary adult family
home certification program through the University of Washington
geriatric education center. In addition to the minimum qualifications
required under RCW 70.128.120, individuals participating in the
voluntary adult family home certification program must complete
fifty-two hours of class requirements as established by the University
of Washington geriatric education center. Subjects covered by the
class requirements must include: Specific age-related physical or
mental health conditions that can be prevented, postponed, or
alleviated by a health promotion intervention, how to establish health
promotion programs in residential settings and communities, preventing
falls, addressing health issues of aging families, and issues and
health concerns of ethnic older adults and those with developmental
disabilities.
(2) Individuals completing the requirements of RCW 70.128.120 and
the voluntary adult family home certification program shall be issued
a certified adult family home license by the department.
(3) The department shall adopt rules implementing this section.
Sec. 30 RCW 70.128.120 and 2006 c 249 s 1 are each amended to
read as follows:
Each adult family home provider and each resident manager shall
have the following minimum qualifications, except that only providers
are required to meet the provisions of subsection (10) of this section:
(1) Twenty-one years of age or older;
(2) For those applying after September 1, 2001, to be licensed as
providers, and for resident managers whose employment begins after
September 1, 2001, a United States high school diploma or general
educational development (GED) certificate or any English or translated
government documentation of the following:
(a) Successful completion of government-approved public or private
school education in a foreign country that includes an annual average
of one thousand hours of instruction over twelve years or no less than
twelve thousand hours of instruction;
(b) A foreign college, foreign university, or United States
community college two-year diploma;
(c) Admission to, or completion of coursework at, a foreign
university or college for which credit was granted;
(d) Admission to, or completion of coursework at, a United States
college or university for which credits were awarded;
(e) Admission to, or completion of postgraduate coursework at, a
United States college or university for which credits were awarded; or
(f) Successful passage of the United States board examination for
registered nursing, or any professional medical occupation for which
college or university education preparation was required;
(3) Good moral and responsible character and reputation;
(4) Literacy in the English language((,)). However, a person not
literate in the English language may meet the requirements of this
subsection by assuring that there is a person on staff and available
who is able to communicate or make provisions for communicating with
the resident in his or her primary language and capable of
understanding and speaking English well enough to be able to respond
appropriately to emergency situations and be able to read and
understand resident care plans;
(5) Management and administrative ability to carry out the
requirements of this chapter;
(6) Satisfactory completion of department-approved basic training
and continuing education training as specified by the department in
rule, based on recommendations of the community long-term care training
and education steering committee and working in collaboration with
providers, consumers, caregivers, advocates, family members, educators,
and other interested parties in the rule-making process;
(7) Satisfactory completion of department-approved, or equivalent,
special care training before a provider may provide special care
services to a resident;
(8) Not been convicted of any crime listed in RCW 43.43.830 and
43.43.842;
(9) For those applying after September 1, 2001, to be licensed as
providers, and for resident managers whose employment begins after
September 1, 2001, at least three hundred twenty hours of successful,
direct caregiving experience obtained after age eighteen to vulnerable
adults in a licensed or contracted setting prior to operating or
managing an adult family home; ((and))
(10) Prior to being granted a license, providers applying after
January 1, 2007, must complete a department-approved forty-eight hour
adult family home administration and business planning class. The
department shall promote and prioritize bilingual capabilities within
available resources and when materials are available for this purpose;
and
(11) Following licensure, completion annually of two hours of
administrative continuing education administered by the department in
collaboration with the adult family home advisory committee and taught
by adult family home association providers with five or more years of
experience, or by another entity as determined by the department. For
the purpose of this subsection, "adult family home association" means
an organized group of adult family home providers with a proven history
of advocacy of at least five years with a sustained membership of at
least one hundred members as approved by the department. Internet
access and bilingual training materials shall be promoted and
prioritized when available and appropriate. The department shall
ensure balanced participation by the appointment of stakeholders
equally between adult family home providers and consumers to the adult
family home advisory committee.
Sec. 31 RCW 70.128.230 and 2002 c 233 s 3 are each amended to
read as follows:
(1) The definitions in this subsection apply throughout this
section unless the context clearly requires otherwise.
(a) "Caregiver" includes all adult family home resident managers
and any ((person)) long-term care worker who provides residents with
hands-on personal care on behalf of an adult family home, except
volunteers who are directly supervised.
(b) "Indirect supervision" means oversight by a person who has
demonstrated competency in the core areas or has been fully exempted
from the training requirements pursuant to this section and is quickly
and easily available to the caregiver, but not necessarily on-site.
(c) "Long-term care worker" has the same meaning as defined in RCW
74.39A.009(11).
(2) Training must have three components: Orientation, basic
training, and continuing education. All adult family home providers,
resident managers, and employees, or volunteers who routinely interact
with residents shall complete orientation. Caregivers shall complete
orientation, basic training, and continuing education. Training of
caregivers employed by adult family homes is governed by chapter 74.39A
RCW. Any caregiver who has satisfied the training and competency
testing requirements of section 3 of this act or the continuing
education requirements of RCW 74.39A.340 shall be deemed to have
satisfied, as applicable, the orientation, basic training, and
continuing education requirements of this section.
(3) Orientation consists of introductory information on residents'
rights, communication skills, fire and life safety, and universal
precautions. Orientation must be provided at the facility by
appropriate adult family home staff to all adult family home employees
before the employees have routine interaction with residents.
(4) Basic training consists of modules on the core knowledge and
skills that caregivers need to learn and understand to effectively and
safely provide care to residents. Basic training must be outcome-based, and the effectiveness of the basic training must be measured by
demonstrated competency in the core areas through the use of a
competency test. ((Basic training must be completed by caregivers
within one hundred twenty days of the date on which they begin to
provide hands-on care or within one hundred twenty days of September 1,
2002, whichever is later.)) Until ((competency in the core areas has
been demonstrated, caregivers)) a caregiver provides verification that
he or she has satisfied the basic training requirements under section
3 of this act, a caregiver shall not provide hands-on personal care to
residents without indirect supervision.
(5)(a) For adult family homes that serve residents with special
needs such as dementia, developmental disabilities, or mental illness,
specialty training is required of providers and resident managers.
Specialty training consists of modules on the core knowledge and skills
that providers and resident managers need to effectively and safely
provide care to residents with special needs. Specialty training
should be integrated into basic training wherever appropriate.
Specialty training must be outcome-based, and the effectiveness of the
specialty training measured by demonstrated competency in the core
specialty areas through the use of a competency test.
(b) Specialty training must be completed by providers and resident
managers before admitting and serving residents who have been
determined to have special needs related to mental illness, dementia,
or a developmental disability. Should a resident develop special needs
while living in a home without specialty designation, the provider and
resident manager have one hundred twenty days to complete specialty
training.
(((6) Continuing education consists of ongoing delivery of
information to caregivers on various topics relevant to the care
setting and care needs of residents. Competency testing is not
required for continuing education. Continuing education is not
required in the same calendar year in which basic or modified basic
training is successfully completed. Continuing education is required
in each calendar year thereafter.)) If training received by a
caregiver under section 3 of this act involves core knowledge and
skills to effectively and safely provide care to residents of the adult
family home with special needs, the hours of training received by the
caregiver shall apply toward meeting the specialty training
requirements under this section.
(c) If specialty training is completed, the specialty training
applies toward any continuing education requirement for up to two years
following the completion of the specialty training.
(((7))) (6) Persons who successfully challenge the competency test
for basic training are fully exempt from the basic training
requirements of this section. Persons who successfully challenge the
specialty training competency test are fully exempt from the specialty
training requirements of this section.
(((8))) (7) Licensed persons who perform the tasks for which they
are licensed are fully or partially exempt from the training
requirements of this section, as specified by the department in rule.
(((9))) (8) In an effort to improve access to training and
education and reduce costs, especially for rural communities, the
coordinated system of long-term care training and education must
include the use of innovative types of learning strategies such as
internet resources, videotapes, and distance learning using satellite
technology coordinated through community colleges, private
associations, or other entities, as defined by the department.
(((10) Adult family homes that desire to deliver facility-based
training with facility designated trainers, or adult family homes that
desire to pool their resources to create shared training systems, must
be encouraged by the department in their efforts. The department shall
develop criteria for reviewing and approving trainers and training
materials. The department may approve a curriculum based upon
attestation by an adult family home administrator that the adult family
home's training curriculum addresses basic and specialty training
competencies identified by the department, and shall review a
curriculum to verify that it meets these requirements. The department
may conduct the review as part of the next regularly scheduled
inspection authorized under RCW 70.128.070. The department shall
rescind approval of any curriculum if it determines that the curriculum
does not meet these requirements.)) (9) The department shall adopt rules by September 1, 2002,
for the implementation of this section.
(11)
(((12))) (10) The orientation, basic training, specialty training,
and continuing education requirements of this section commence
September 1, 2002, and shall be applied to (a) employees hired
subsequent to September 1, 2002; or (b) existing employees that on
September 1, 2002, have not successfully completed the training
requirements under RCW 70.128.120 or 70.128.130 and this section.
Existing employees who have not successfully completed the training
requirements under RCW 70.128.120 or 70.128.130 shall be subject to all
applicable requirements of this section. ((However, until September 1,
2002, nothing in this section affects the current training requirements
under RCW 70.128.120 and 70.128.130.))
NEW SECTION. Sec. 32 The following acts or parts of acts are
each repealed:
(1) RCW 18.20.230 (Training standards review -- Proposed
enhancements) and 1999 c 372 s 3 & 1998 c 272 s 2; and
(2) RCW 70.128.210 (Training standards review -- Delivery system--Issues reviewed -- Report to the legislature) and 1998 c 272 s 3.
NEW SECTION. Sec. 33 Sections 7 through 19 of this act
constitute a new chapter in Title
NEW SECTION. Sec. 34 Section 20 of this act expires July 1,
2008.
NEW SECTION. Sec. 35 Section 21 of this act takes effect July 1,
2008.
NEW SECTION. Sec. 36 If specific funding for the purposes of
this act, referencing this act by bill or chapter number, is not
provided by June 30, 2008, in the omnibus appropriations act, this act
is null and void."
Correct the title.
EFFECT: The striking amendment makes the following major changes
to the substitute bill:
Training
(1) Beginning with initial hire after January 1, 2010, requires
long-term care workers to complete basic training (classroom training)
of 35 hours, but makes the additional 50 hours of experiential training
a prerequisite to taking a certification examination under a voluntary
certification program.
(2) For purposes of the exemption from basic training for parent
caregivers for their adult children: (a) Expands the exemption to
include all such caregivers, whether the child is developmentally or
functionally disabled; (b) adds a requirement to complete safety
training, which may be completed by distance learning; and (c)increases
the average number of hours that their exempt "intermittent" respite
caregivers can provide from 16 to 24 hours per month.
(3) Requires boarding homes, adult family homes, and the Training
Partnership that develop their own training programs to report to DSHS
on the workers who start training and those who complete training, and
to verify the completion of training.
(4) Requires adult family home providers and resident managers,
following licensure, to complete two hours of administrative continuing
education administered by DSHS, with collaboration by an advisory
committee, and taught by adult family home association providers with
five or more years of experience or by another entity determined by
DSHS.
Registration
(1) Beginning January 1, 2010, adds a requirement for the
registration of all long-term care workers with the Department of
Health (DOH) within 120 days of initial hire or within 120 days after
January 1, 2010, if the worker was hired before that date (with
exemptions for parents who are caregivers for only their
developmentally or functionally disabled adult children and certain
respite caregivers, and certain credentialed personnel).
(2) To apply for registration, requires long-term care workers to
complete basic training or successfully challenge the basic training
competency test.
Certification
(1) Beginning January 1, 2012, allows long-term care workers to
elect certification, and provides for specialty endorsements; requires
the DOH to report on a plan for implementing the certification program
by December 1, 2009.
(2) Moves administration of the certification program from DSHS to
DOH.
(3) Defines the "approved training" that is required for the
certification examination to be not less than 85 hours of training,
including basic training, that will assist with opportunities to
articulate to relevant degree or skill programs in community colleges
or similar schools.
Technical
(1) Makes various technical clarifications to the training and
credentialing programs, including: (a) Clarifying or adding
definitions; (b) adding title and practice protection for both
registered and certified long-term care workers; (c) granting authority
for DOH to deny, as well as issue, certifications and registrations;
(d) specifying that continuing education is a requirement for renewal
of registration or certification; (e) making the Uniform Disciplinary
Act apply under Secretary of Health's authority; (f) allowing four
attempts to pass the certification examination; and (g) allowing
reciprocity for an equivalent out-of-state credential.
(2) Adds a cross-reference to DSHS authority to take licensure
enforcement action against adult family homes and boarding homes that
have workers who fail to complete required training or registration.
(3) Allows adult family homes that meet specified training to
participate in a voluntary adult family home certification program
through the University of Washington Geriatric Education Center.