BILL REQ. #:  H-0946.1 

Read first time 01/27/11.   Referred to Committee on Early Learning & Human Services.

     AN ACT Relating to protecting residents of state facilities during discharges and reductions in service, ensuring admissions pursuant to federal law; amending RCW 71A.20.020; and adding a new chapter to Title 71A RCW.

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

Sec. 1   RCW 71A.20.020 and 1994 c 215 s 1 are each amended to read as follows:
     (1) This section implements Article XIII of the state Constitution. The following residential habilitation centers are permanently established to provide services to persons with developmental disabilities: Lakeland Village, located at Medical Lake, Spokane county; Rainier School, located at Buckley, Pierce county; Yakima Valley School, located at Selah, Yakima county; Fircrest School, located at Seattle, King county; and Frances Haddon Morgan Children's Center, located at Bremerton, Kitsap county.
     (2) Residential habilitation centers must be fostered and supported by the state.
     (3) Eligibility for admission to residential habilitation centers must exclusively be determined under the requirements of federal law and regulations.
     (4) Any individual entitled to admission to a residential habilitation center is entitled to a fully informed choice between admission to a residential habilitation center or appropriate alternatives.

NEW SECTION.  Sec. 2   DEFINITIONS. The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
     (1) "Closure" means the decision to permanently cease operations of a facility and terminate participation of the facility in the Title XIX medicaid program;
     (2) "Discharge" or "relocation" means the permanent movement of an individual to another facility or place which operates independently from the facility.
     (3) "Facility" means a state-operated nursing facility or an intermediate care facility for individuals with intellectual disabilities participating in the Title XIX medicaid program.
     (4) "Resident" means a person admitted to a facility and includes the resident's guardian or other legal representative;
     (5) "Secretary" means the secretary of social and health services;
     (6) "Transfer" means the permanent movement of an entire facility, including residents served, staff, and records, to a new location.

NEW SECTION.  Sec. 3   NOTIFICATION OF FACILITY CLOSURE AND GENERAL PLAN OF CLOSURE. (1) The secretary shall submit written notification of an impending voluntary closure of the facility to all of the following:
     (a) Federal agencies as required by law;
     (b) The state long-term care ombudsman; and
     (c) Residents of the facility.
     (2) The written notification must be provided not later than the date that is one hundred twenty days prior to the date of the closure.
     (3) The written notification must include:
     (a) A general plan for the discharge and adequate relocation of the residents by a specified date prior to closure, including:
     (i) A description of the organization and staffing implementing the requirements in this chapter; and
     (ii) Assurances that the residents will be relocated to the most appropriate facility or other residential setting in terms of quality, services, and location, and taking into consideration the needs, choice, and best interests of each resident; and
     (b) A description of all the steps the administrator of the facility is required to take under section 4 of this act and the right to a hearing under section 5 of this act.

NEW SECTION.  Sec. 4   IMPLEMENTATION OF DISCHARGE AND RELOCATION OF RESIDENTS. The secretary shall, with respect to each resident, take all of the following steps:
     (1) Prepare and ensure the safe and orderly discharge and relocation of a resident from the facility on a case-by-case basis;
     (2) Prepare a final summary of the resident's developmental, behavioral, social, health, and nutritional status, and, with the consent of the resident, parents (if the client is a minor), or legal guardian, provide a copy to staff implementing this section and alternative facilities;
     (3) Involve the resident and his or her family in all care, benefit, and service decisions prompted by the transition; fully identify, inform, and disclose the resident of all alternative facilities and service options; and ensure that the resident exercises a fully informed choice whether he or she wishes to move and to what facility or place;
     (4) Consistent with the requirements of an individual plan of care under 42 C.F.R. Sec. 456.380, develop a postdischarge plan of care based on an independent current assessment of the resident's needs for facility care and the type of care needed, and documenting each resident's needs and preferences and outlining plans to assist the resident's adjustment to the new living environment;
     (5) In the postdischarge plan, include the following:
     (a) An assessment of the resident's medical and psychological condition and needs, including the necessity and to prepare the resident for discharge and relocation;
     (b) The assessment in (a) of this subsection must include analysis and mediation of any risk of death or injury resulting due to changes in the location and extent of medical or behavioral needs and support and any risk of shock or posttraumatic stress or the like resulting from change of location, including unfamiliarity with staff, surroundings, and peers;
     (c) The resident's new facility or residential setting is advised in writing in advance of the resident's conditions and needs;
     (d) Adequate and appropriate transportation on the day of transfer or discharge; and
     (e) Documentation that the discharge and relocation is in the best interests of the resident; and
     (6) Execute the closure, discharge, and relocation of all residents in compliance with federal and state law, including this chapter.

NEW SECTION.  Sec. 5   RIGHT TO HEARING. (1) A resident has a right to a hearing in the event:
     (a) A proposal is made to relocate to a facility where equal or greater services will not be provided to the resident;
     (b) The secretary fails to comply with any of the requirements of this chapter; or
     (c) A resident disagrees with the postdischarge plan.
     (2) The right to hearing is not exclusive of other remedies available to the resident under state or federal law.

NEW SECTION.  Sec. 6   RELOCATION PRIOR TO CLOSURE. (1) The secretary shall ensure that, before a facility closes, all residents of the facility have been successfully relocated to another facility or an alternative home and community-based setting.
     (2) The secretary shall apply for all available continued payments under Title XIX of the federal social security act with respect to residents of a facility that has submitted a notification under subsection (1) of this section during the period beginning on the date such notification is submitted and ending on the date on which the resident is successfully relocated.

NEW SECTION.  Sec. 7   In the event of an overlap between this chapter and other applicable federal and state law, the law that is more beneficial to the resident prevails.

NEW SECTION.  Sec. 8   This chapter applies retroactively to residents notified of closure prior to the effective date of this section. Such prior notices must be perfected by following the requirements of this chapter.

NEW SECTION.  Sec. 9   Sections 2 through 8 of this act constitute a new chapter in Title 71A RCW.