H-2355              _______________________________________________

                                           SUBSTITUTE HOUSE BILL NO. 524

                        _______________________________________________

State of Washington                              50th Legislature                              1987 Regular Session

By House Committee on Health Care (originally sponsored by Representatives Braddock, Lewis, Moyer, Kremen, Sprenkle, D. Sommers, Bumgarner, Spanel, Lux, Holm, P. King, Doty, Brough and Todd; by request of Department of Social and Health Services)

Read first time 3/6/87 and passed to Committee on Rules.

AN ACT Relating to long-term care services; amending section 2, chapter 158, Laws of 1984 (uncodified); amending section 3, chapter 158, Laws of 1984 (uncodified); amending section 4, chapter 158, Laws of 1984 (uncodified); amending section 5, chapter 158, Laws of 1984 (uncodified); amending section 7, chapter 158, Laws of 1984 (uncodified); creating a new chapter in Title 74 RCW; and declaring an emergency.

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

        Sec. 1.  Section 2, chapter 158, Laws of 1984 (uncodified) is amended to read as follows:

          It is the intent of the legislature to provide for ((a demonstration of the possible cost-effectiveness of)) both in-home and out-of-home respite care services which are provided by a range of service providers.  The respite care services shall:

          (1) Provide relief and support to family or other unpaid caregivers of disabled adults;

          (2) Encourage individuals to provide care for disabled adults at home, and thus offer a viable alternative to institutionalization;

          (3) Ensure that respite care is made generally available on a sliding-fee basis to eligible participants ((and caregivers)) in the program according to priorities established by the department; and

          (4) Be provided in the least restrictive setting available consistent with the individually assessed needs of the functionally disabled adult.

        Sec. 2.  Section 3, chapter 158, Laws of 1984 (uncodified) is amended to read as follows:

          Unless the context clearly indicates otherwise, the definitions in this section apply throughout ((sections 1 through 7 of)) this ((act)) chapter.

          (1) "Respite care services" means relief care for families or other caregivers of disabled adults, ((not exceeding five hundred seventy-six hours in not more than twenty-four days in any twelve-month period for each household)) eligibility for which shall be determined by the department by rule.  The services provide temporary care or supervision of disabled adults in substitution for the caregiver.  The term includes social day care.

          (2) "Eligible participant" means an adult (a) who needs substantially continuous care or supervision by reason of his or her functional disability, and (b) who is assessed as requiring institutionalization in the absence of a caregiver assisted by home and community support services, including respite care.

          (3) "Caregiver" means a spouse, relative, or friend who has primary responsibility for the care of a functionally disabled adult, who does not receive financial compensation for the care, and who is assessed as being at risk of placing the eligible participant in a long-term care facility if respite care is not available.

          (4) "Institutionalization" means placement in a long-term care facility.

          (5) "Social day care" means nonmedical services to persons who live with their families, cannot be left unsupervised, and are at risk of being placed in a twenty-four-hour care facility if their families do not receive some relief from constant care.

          (6) "Department" means the department of social and health services.

        Sec. 3.  Section 4, chapter 158, Laws of 1984 (uncodified) is amended to read as follows:

          The department shall administer ((sections 1 through 8 of)) this ((act)) chapter and shall establish such rules and standards as the department deems necessary in carrying out ((sections 1 through 8 of)) this ((act)) chapter.  The department shall not require the development of plans of care or discharge plans by nursing homes providing respite care service under this chapter.

          The department shall develop ((program)) standards for the ((demonstration projects)) respite program in conjunction with the selected area agencies on aging.  The program standards shall serve as the basis for soliciting bids, entering into subcontracts, and developing sliding fee scales to be used in determining the ability of eligible participants ((and caregivers)) to participate in paying for respite care.

        Sec. 4.  Section 5, chapter 158, Laws of 1984 (uncodified) is amended to read as follows:

          The department shall ((select at least two but not more than three area agencies on aging to conduct one-year respite care demonstration projects ending June 30, 1985.  One of the selected area agencies on aging shall be east of the crest of the Cascade range and one shall be west of the crest of the Cascade range)) select area agencies on aging to conduct respite care projects until July 1, 1989.  The responsibilities of the selected area agencies on aging ((will be responsible for)) shall include but not be limited to:  Negotiating rates of payment ((and developing)), administering sliding-fee scales to enable eligible participants ((and caregivers)) to participate in paying for respite care, and arranging for respite care services.  Rates of payment to respite care service providers shall not exceed, and may be less than, rates paid by the department to ((the same)) providers for ((other than respite care)) the same level of service.

        Sec. 5.  Section 7, chapter 158, Laws of 1984 (uncodified) is amended to read as follows:

          (1) The area agencies administering respite care ((demonstration projects)) programs shall((:

          (a))) maintain data which indicates demand for respite care, and which includes information on in-home and out-of-home day care and in-home and out-of-home overnight care demand((; and

          (b) Make a comparison of the relative cost-effectiveness of the several types of respite care with all other programs and services which are intended to forestall institutionalization)).

          (2) ((The department shall conduct a survey of all public assistance patients accepted by long-term care facilities in each participating planning and service area to determine the extent to which each of them availed themselves of services designed to defer institutionalization.

          (3))) The department shall provide a progress report to the legislature on the respite care ((demonstration projects)) programs authorized in this ((act, not later than January 1, 1985)) chapter.  The ((department)) report shall ((report the results of the data collection, cost comparison, and survey as required in this section)) be provided to the legislature not later than thirty days prior to the ((1986)) 1989 legislative session.

NEW SECTION. Sec. 6.     Nothing in this chapter creates or provides any individual with an entitlement to services or benefits.  It is the intent of the legislature that services under this chapter shall be made available only to the extent of the availability and level of appropriation made by the legislature.

NEW SECTION. Sec. 7.     Sections 1 through 6 of this act, and sections 1, 6, and 8, chapter 158, Laws of 1984, shall constitute a new chapter in Title 74 RCW.

NEW SECTION. Sec. 8.     This act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect immediately.