SENATE BILL REPORT

SB 5839

As Reported by Senate Committee On:

Human Services, Reentry & Rehabilitation, February 19, 2019

Title: An act relating to personal care services for homeless seniors and persons with disabilities.

Brief Description: Creating a pilot project to provide personal care services for homeless seniors and persons with disabilities.

Sponsors: Senators Darneille, Nguyen, Hasegawa, Palumbo and Wilson, C..

Brief History:

Committee Activity: Human Services, Reentry & Rehabilitation: 2/13/19, 2/19/19 [DPS].

Majority Report: That Substitute Senate Bill No. 5839 be substituted therefor, and the substitute bill do pass.

Signed by Senators Darneille, Chair; Nguyen, Vice Chair; Walsh, Ranking Member; Cleveland, O'Ban, Wilson, C. and Zeiger.

Staff: Alison Mendiola (786-7488)

Background: Medicaid Personal Care Services. Medicaid personal care (MPC) is a state-plan benefit available to a client, who is deemed eligible by rule. Personal care services means physical or verbal assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL) due to functional limitations.

ADL includes:

• bathing;

• bed mobility;

• dressing;

• eating;

• locomotion in room and immediate living environment, including how a client moved between locations in the client's room and immediate living environment;

• locomotion outside room, including how a client moved to and returned from their immediate living environment, outdoors, and more distant areas;

• walk in room, hallway, and the rest of immediate living environment;

• medication management;

• toilet use;

• transfer moved, including how a client moved between surfaces, such as their bed, chair, wheelchair, standing position; and

• personal hygiene, which does not include hygiene in baths and showers.

IADL means routine activities performed around the home or in the community in 30 days prior to the assessment and includes the following:

• meal preparation;

• ordinary housework;

• essential shopping, including shopping with or for the client;

• wood supply;

• travel to medical services;

• managing finances; and

• telephone use.

MPC services may be provided to a client residing at home, in a Department of Social and Health Services (DSHS) contracted adult family home, or in a licensed assisted living facility that is contracted with DSHS to provide adult residential care services.

Summary of Bill (First Substitute): Personal Care Services Pilot Program. A pilot program is created in DSHS to provide personal care services (PCS) to homeless seniors and persons with disabilities from the time the person presents at a shelter to the time they become eligible for Medicaid personal care services.

DSHS is to contract with a single non-profit that provides PCS to homeless persons and operates a 24 hour homeless shelter and is currently partnering with DSHS to bring Medicaid PCS to homeless seniors and persons with disabilities.

The pilot program is to fund two personal care aides—at 30 hours per week each, added to the staff of the homeless shelter. The services provided are to match what PCS provides.

DSHS must submit a report with the following information to the Governor and the Legislature by December 1, 2020:

• the number of people served in the pilot;

• the number of people served in the pilot who transitioned to Medicaid PCS;

• the number of people in the pilot who found stable housing;

• the number of visits a person had to the emergency room (ER) in the six months prior to entering the shelter, and how may visits to the ER since receiving PCS under the pilot, if available; and

• any additional data and information deemed relevant by the contractor or DSHS.

The act expires December 31, 2020.

EFFECT OF CHANGES MADE BY HUMAN SERVICES, REENTRY & REHABILITATION COMMITTEE (First Substitute): Two personal care aides are reduced from two FTEs to two .75 FTEs—30 hours per week. Information is added to the report regarding a how many visits the person had to the ER in the six months prior to entering the shelter and how many visits to the ER since receiving personal care services. The report is due December 1, 2020.

Appropriation: None.

Fiscal Note: Available.

Creates Committee/Commission/Task Force that includes Legislative members: No.

Effective Date: Ninety days after adjournment of session in which bill is passed.

Staff Summary of Public Testimony on Original Bill: The committee recommended a different version of the bill than what was heard. PRO: This is a small bill to address a big problem. There is a growing population of seniors at homeless shelters, it almost looks like you are at a hospital or nursing home, not a shelter. One shelter in Tacoma has been helping seniors experiencing homelessness and persons with disabilities with going through the assessment process. Seven went through the assessment, six found permanent housing and all were previously chronically homeless. In 18 months, 30 people assisted with a success rate of 72 percent. The shelter can do personal care services and transportation—which is used at higher rates than those in other settings. These services offer stability, right now if someone presents needing these services the shelter has to have the person come back in a week. This bill would allow the shelter to provide personal care services immediately while the person waits for their Medicaid personal care services eligibility. This bill would provide bridge funding until eligibility and arguably saves money with decreased ER visits. Push back due date of report, and include data about ER usage, or how many visits in the ER in the prior six months.

Persons Testifying: PRO: Senator Jeannie Darneille, Prime Sponsor; Peter Nazzal, Catholic Community Services of Western Washington.

Persons Signed In To Testify But Not Testifying: No one.