ESHB 2693 -
By Committee on Ways & Means
ADOPTED 03/06/2008
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. The department shall also adopt rules to implement peer mentorship
under RCW 74.39A.330, advanced training under RCW 74.39A.350, and
on-the-job training provided by the worker's employer, and may adopt
rules for specialty endorsements. 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 33 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 33 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 33 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 33 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 33 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 33 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.
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."
ESHB 2693 -
By Committee on Ways & Means
ADOPTED 03/06/2008
On page 1, line 2 of the title, after "workers;" strike the remainder of the title and insert "amending RCW 74.39A.009, 74.39A.340, 74.39A.360, 74.39A.240, 74.39A.050, 70.127.100, 18.20.110, 18.20.270, 70.128.090, 70.128.120, and 70.128.230; reenacting and amending RCW 18.130.040 and 18.130.040; adding new sections to chapter 74.39A RCW; adding a new section to chapter 70.128 RCW; adding a new chapter to Title 18 RCW; creating new sections; repealing RCW 18.20.230 and 70.128.210; providing an effective date; and providing an expiration date."
EFFECT: Makes two technical changes to the Senate Health and Long-Term Care Committee adopted striking amendment: (1) Corrects section references; and (2) provides direction to DSHS on rule making for on-the-job training, peer mentoring, and advanced training. For reference, the Senate Health and Long-Term Care Committee adopted striking amendment made one change to ESHB 2693; it removed the requirement for two extra hours of administrative continuing education for Adult Family Home providers.