title: RCW 74.34.200

text:
(1) In addition to other remedies available under the law, a vulnerable adult who has been subjected to abandonment, abuse, financial exploitation, or neglect either while residing in a facility or in the case of a person residing at home who receives care from a home health, hospice, or home care agency, or an individual provider, shall have a cause of action for damages on account of his or her injuries, pain and suffering, and loss of property sustained thereby. This action shall be available where the defendant is or was a corporation, trust, unincorporated association, partnership, administrator, employee, agent, officer, partner, or director of a facility, or of a home health, hospice, or home care agency licensed or required to be licensed under chapter 70.127 RCW, as now or subsequently designated, or an individual provider.
(2) It is the intent of the legislature, however, that where there is a dispute about the care or treatment of a vulnerable adult, the parties should use the least formal means available to try to resolve the dispute. Where feasible, parties are encouraged but not mandated to employ direct discussion with the health care provider, use of the long-term care ombuds or other intermediaries, and, when necessary, recourse through licensing or other regulatory authorities.
(3) In an action brought under this section, a prevailing plaintiff shall be awarded his or her actual damages, together with the costs of the suit, including a reasonable attorneys' fee. The term "costs" includes, but is not limited to, the reasonable fees for a guardian, guardian ad litem, and experts, if any, that may be necessary to the litigation of a claim brought under this section.
[ 2013 c 23 s 219; 1999 c 176 s 15; 1995 1st sp.s. c 18 s 85.]
Notes:
Findings—Purpose—Severability—Conflict with federal requirements—1999 c 176: See notes following RCW 74.34.005.
Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.

catchline: Abandonment, abuse, financial exploitation, or neglect of a vulnerable adult—Cause of action for damages—Legislative intent.


doc_type: statute

jurisdiction: wa

title: RCW 74.34.205

text:
(1) Any vulnerable adult who relies upon and is being provided spiritual treatment in lieu of medical treatment in accordance with the tenets and practices of a well-recognized religious denomination may not for that reason alone be considered abandoned, abused, or neglected.
(2) Any vulnerable adult may not be considered abandoned, abused, or neglected under this chapter by any health care provider, facility, facility employee, agency, agency employee, or individual provider who participates in good faith in the withholding or withdrawing of life-sustaining treatment from a vulnerable adult under chapter 70.122 RCW, or who acts in accordance with chapter 7.70 RCW or other state laws to withhold or withdraw treatment, goods, or services.
[ 1999 c 176 s 16.]
Notes:
Findings—Purpose—Severability—Conflict with federal requirements—1999 c 176: See notes following RCW 74.34.005.

license: public-domain-government-work

rule_set: Revised Code of Washington

catchline: Abandonment, abuse, or neglect—Exceptions.

code: rcw

unit: section

court: Washington State Legislature


title: RCW 74.34.215

text:
(1) Pending an investigation by the financial institution, the department, or law enforcement, if a financial institution reasonably believes that financial exploitation of a vulnerable adult may have occurred, may have been attempted, or is being attempted, the financial institution may, but is not required to, refuse a transaction requiring disbursal of funds contained in the account:
(a) Of the vulnerable adult;
(b) On which the vulnerable adult is a beneficiary, including a trust or guardianship account; or
(c) Of a person suspected of perpetrating financial exploitation of a vulnerable adult.
(2) A financial institution may also refuse to disburse funds under this section if the department, law enforcement, or the prosecuting attorney's office provides information to the financial institution demonstrating that it is reasonable to believe that financial exploitation of a vulnerable adult may have occurred, may have been attempted, or is being attempted.
(3) A financial institution is not required to refuse to disburse funds when provided with information alleging that financial exploitation may have occurred, may have been attempted, or is being attempted, but may use its discretion to determine whether or not to refuse to disburse funds based on the information available to the financial institution.
(4) A financial institution that refuses to disburse funds based on a reasonable belief that financial exploitation of a vulnerable adult may have occurred, may have been attempted, or is being attempted shall:
(a) Make a reasonable effort to notify all parties authorized to transact business on the account orally or in writing; and
(b) Report the incident to the adult protective services division of the department and local law enforcement.
(5) Any refusal to disburse funds as authorized by this section based on the reasonable belief of a financial institution that financial exploitation of a vulnerable adult may have occurred, may have been attempted, or is being attempted will expire upon the sooner of:
(a) Ten business days after the date on which the financial institution first refused to disburse the funds if the transaction involved the sale of a security or offer to sell a security, as defined in RCW 21.20.005, unless sooner terminated by an order of a court of competent jurisdiction;
(b) Five business days after the date on which the financial institution first refused to disburse the funds if the transaction did not involve the sale of a security or offer to sell a security, as defined in RCW 21.20.005, unless sooner terminated by an order of a court of competent jurisdiction; or
(c) The time when the financial institution is satisfied that the disbursement will not result in financial exploitation of a vulnerable adult.
(6) A court of competent jurisdiction may enter an order extending the refusal by the financial institution to disburse funds based on a reasonable belief that financial exploitation of a vulnerable adult may have occurred, may have been attempted, or is being attempted. A court of competent jurisdiction may also order other protective relief as authorized by RCW 7.40.010 and * 74.34.130.
(7) A financial institution or an employee of a financial institution is immune from criminal, civil, and administrative liability for refusing to disburse funds or disbursing funds under this section and for actions taken in furtherance of that determination if the determination of whether or not to disburse funds was made in good faith.
[ 2010 c 133 s 3.]
Notes:
*Reviser's note: RCW 74.34.130 was repealed by 2021 c 215 s 170, effective July 1, 2022.

catchline: Financial exploitation of vulnerable adults.


title: RCW 74.34.220

text:
(1) A financial institution shall provide training concerning the financial exploitation of vulnerable adults to the employees specified in subsection (2) of this section within one year of June 10, 2010, and shall thereafter provide such training to the new employees specified in subsection (2) of this section within the first three months of their employment.
(2) A financial institution that is a broker-dealer or investment adviser as defined in RCW 21.20.005 shall provide training concerning the financial exploitation of vulnerable adults to employees who are required to be registered in the state of Washington as salespersons or investment adviser representatives under RCW 21.20.040 and who have contact with customers and access to account information on a regular basis and as part of their job. All other financial institutions shall provide training concerning the financial exploitation of vulnerable adults to employees who have contact with customers and access to account information on a regular basis and as part of their job.
(3) The training must include recognition of indicators of financial exploitation of a vulnerable adult, the manner in which employees may report suspected financial exploitation to the department and law enforcement as permissive reporters, and steps employees may take to prevent suspected financial exploitation of a vulnerable adult as authorized by law or agreements between the financial institution and customers of the financial institution. The office of the attorney general and the department shall develop a standardized training that financial institutions may offer, or the financial institution may develop its own training.
(4) A financial institution may provide access to or copies of records that are relevant to suspected financial exploitation or attempted financial exploitation of a vulnerable adult to the department, law enforcement, or the prosecuting attorney's office, either as part of a referral to the department, law enforcement, or the prosecuting attorney's office, or upon request of the department, law enforcement, or the prosecuting attorney's office pursuant to an investigation. The records may include historical records as well as records relating to the most recent transaction or transactions that may comprise financial exploitation.
(5) A financial institution or employee of a financial institution participating in good faith in making a report or providing documentation or access to information to the department, law enforcement, or the prosecuting attorney's office under this chapter shall be immune from criminal, civil, or administrative liability.
[ 2010 c 133 s 5.]

catchline: Financial exploitation of vulnerable adults—Training—Reporting.


title: RCW 74.34.300

text:
(1) The department shall conduct a vulnerable adult fatality review in the event of a death of a vulnerable adult when the department has reason to believe that the death of the vulnerable adult may be related to the abuse, abandonment, exploitation, or neglect of the vulnerable adult, or may be related to the vulnerable adult's self-neglect, and the vulnerable adult was:
(a) Receiving home and community-based services in his or her own home or licensed or certified settings, described under chapters 74.39, 74.39A, 18.20, 70.128, and 71A.12 RCW, within sixty days preceding his or her death; or
(b) Living in his or her own home or licensed or certified settings described under chapters 74.39, 74.39A, 18.20, 70.128, and 71A.12 RCW and was the subject of a report under this chapter received by the department within twelve months preceding his or her death.
(2) When conducting a vulnerable adult fatality review of a person who had been receiving hospice care services before the person's death, the review shall provide particular consideration to the similarities between the signs and symptoms of abuse and those of many patients receiving hospice care services.
(3) All files, reports, records, communications, and working papers used or developed for purposes of a fatality review are confidential and not subject to disclosure pursuant to RCW 74.34.095.
(4) The department may adopt rules to implement this section.
[ 2016 c 172 s 4; 2008 c 146 s 10.]
Notes:
Finding—2016 c 172: See note following RCW 43.382.005.
Findings—Intent—Severability—2008 c 146: See notes following RCW 74.41.040.

catchline: Vulnerable adult fatality reviews.


title: RCW 74.34.305

text:
(1) When the department opens an investigation of a report of abandonment, abuse, financial exploitation, or neglect of a vulnerable adult, the department shall, at the time of the interview of the vulnerable adult who is an alleged victim, provide a written statement of the rights afforded under this chapter and other applicable law to alleged victims or legal guardians. This statement must include the department's name, address, and telephone number and may include other appropriate referrals. The statement must be substantially in the following form:
"You are entitled to be free from abandonment, abuse, financial exploitation, and neglect. If there is a reason to believe that you have experienced abandonment, abuse, financial exploitation, or neglect, you have the right to:
(a) Make a report to the department of social and health services and law enforcement and share any information you believe could be relevant to the investigation, and identify any persons you believe could have relevant information.
(b) Be free from retaliation for reporting or causing a report of abandonment, abuse, financial exploitation, or neglect.
(c) Be treated with dignity and addressed with respectful language.
(d) Reasonable accommodation for your disability when reporting, and during investigations and administrative proceedings.
(e) Request an order that prohibits anyone who has abandoned, abused, financially exploited, or neglected you from remaining in your home, having contact with you, or accessing your money or property.
(f) Receive from the department of social and health services information and appropriate referrals to other agencies that can advocate, investigate, or take action.
(g) Be informed of the status of investigations, proceedings, court actions, and outcomes by the agency that is handling any case in which you are a victim.
(h) Request referrals for advocacy or legal assistance to help with safety planning, investigations, and hearings.
(i) Complain to the department of social and health services, formally or informally, about investigations or proceedings, and receive a prompt response."
(2) This section shall not be construed to create any new cause of action or limit any existing remedy.
[ 2011 c 170 s 3.]

catchline: Statement to vulnerable adults.


title: RCW 74.34.310

text:
A public agency may not charge a fee for filing or service of process to petitioners seeking relief under this chapter. Petitioners must be provided the necessary number of certified copies at no cost.
[ 2012 c 156 s 1.]

catchline: Service of process or filing fees prohibited—Certified copies.


title: RCW 74.34.320

text:
(1) Each county is encouraged to develop a written protocol for handling criminal cases involving vulnerable adults. The protocol shall:
(a) Address the coordination of vulnerable adult mistreatment investigations among the following groups as appropriate and when available: The prosecutor's office; law enforcement; adult protective services; vulnerable adult advocacy centers; local advocacy groups; community victim advocacy programs; professional guardians; medical examiners or coroners; financial analysts or forensic accountants; social workers with experience or training related to the mistreatment of vulnerable adults; medical personnel; the state long-term care ombuds or a regional long-term care ombuds specifically designated by the state long-term care ombuds; developmental disabilities ombuds; the attorney general's office; and any other local agency involved in the criminal investigation of vulnerable adult mistreatment;
(b) Be developed by the prosecuting attorney with the assistance of the agencies referenced in this subsection;
(c) Provide that participation as a member of the vulnerable adult advocacy team is voluntary;
(d) Include a brief statement provided by the state long-term care ombuds, without alteration, that describes the confidentiality laws and policies governing the state long-term care ombuds program, and includes citations to relevant federal and state laws;
(e) Require the development and use of a confidentiality agreement, in compliance with this section, that includes, but is not limited to, terms governing the type of information that must be shared, and the means by which it is shared; the existing confidentiality obligations of team members; and the circumstances under which team members may disclose information outside of the team;
(f) Require the vulnerable adult advocacy team to make a good faith effort to obtain the participation of the state long-term care ombuds prior to addressing any issue related to abuse, neglect, or financial exploitation of a vulnerable adult residing in a long-term care facility during the relevant time period.
(2) Members of a vulnerable adult advocacy team must disclose to each other confidential or sensitive information and records, if the team member disclosing the information or records reasonably believes the disclosure is relevant to the duties of the vulnerable adult advocacy team. The disclosure and receipt of confidential information between vulnerable adult advocacy team members shall be governed by the requirements of this section, and by the county protocol developed pursuant to this section.
(3) Prior to participation, each member of the vulnerable adult advocacy team must sign a confidentiality agreement that requires compliance with all governing federal and state confidentiality laws.
(4) The information or records obtained shall be maintained in a manner that ensures the maximum protection of privacy and confidentiality rights.
(5) Information and records communicated or provided to vulnerable adult advocacy team members, as well as information and records created in the course of an investigation, shall be deemed private and confidential and shall be protected from discovery and disclosure by all applicable statutory and common law protections. The disclosed information may not be further disclosed except by law or by court order.
[ 2017 c 266 s 13.]
Notes:
Finding—Intent—2017 c 266: See note following RCW 9A.42.020.

catchline: Written protocol—Counties encouraged to develop for handling criminal cases involving vulnerable adults—Vulnerable adult advocacy teams—Confidentiality—Disclosure of information.


title: RCW 74.34.902

text:
For the purposes of this chapter, the terms spouse, marriage, marital, husband, wife, widow, widower, next of kin, and family shall be interpreted as applying equally to state registered domestic partnerships or individuals in state registered domestic partnerships as well as to marital relationships and married persons, and references to dissolution of marriage shall apply equally to state registered domestic partnerships that have been terminated, dissolved, or invalidated, to the extent that such interpretation does not conflict with federal law. Where necessary to implement chapter 521, Laws of 2009, gender-specific terms such as husband and wife used in any statute, rule, or other law shall be construed to be gender neutral, and applicable to individuals in state registered domestic partnerships.
[ 2009 c 521 s 181.]

catchline: Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.


title: RCW 74.36.100

text:
The department of social and health services is authorized to take advantage of and participate in the Federal Older Americans Act of 1965 (Public Law 89-73, 89th Congress, 79 Stat. 220) and to accept, administer and disburse any federal funds that may be available under said act.
[ 1970 ex.s. c 18 s 27; 1967 ex.s. c 33 s 1.]
Notes:
Effective date—Severability—1970 ex.s. c 18: See notes following RCW 43.20A.010.

catchline: Department to participate in and administer Federal Older Americans Act of 1965.


title: RCW 74.36.110

text:
The secretary of the department of social and health services or his or her designee is authorized to allot for such purposes all or a portion of whatever state funds the legislature appropriates or are otherwise made available for the purpose of matching local funds dedicated to community programs and projects for the aging. The purpose of RCW 74.36.110 through 74.36.130 is to stimulate and assist local communities to obtain federal funds made available under the federal older Americans act of 1965 as amended.
[ 2013 c 23 s 222; 1971 ex.s. c 169 s 10.]
Notes:
Moneys in possession of secretary not subject to certain proceedings: RCW 74.13.070.

catchline: Community programs and projects for the aging—Allotments for—Purpose.


title: RCW 74.36.120

text:
(1) The secretary or his or her designee shall adopt and set forth standards for determining the eligibility and approval of community projects and priorities therefor, and shall have final authority to approve or deny such projects and funding requested under RCW 74.36.110 through 74.36.130.
(2) Only community project proposals submitted by local public agencies, by private nonprofit agencies or organizations, or by public or other nonprofit institutions of higher education, shall be eligible for approval.
(3) Any community project applicant whose application for approval is denied will be afforded an opportunity for an informal hearing before the secretary or his or her designee, but the administrative procedure act, chapter 34.05 RCW, shall not apply.
[ 2013 c 23 s 223; 1971 ex.s. c 169 s 11.]

catchline: Community programs and projects for the aging—Standards for eligibility and approval—Informal hearing on denial of approval.


title: RCW 74.36.130

text:
(1) State funds made available under RCW 74.36.110 through 74.36.130 for any project shall not exceed fifty per centum of the nonfederal share of the costs. To the extent that federal law permits, and the secretary or his or her designee deems appropriate, the local community share and/or the state share may be in the form of cash or in-kind resources.
(2) Payments made under RCW 74.36.110 through 74.36.130 may be made in advance or by way of reimbursement, and in such installments and on such conditions as the secretary or his or her designee may determine, including provisions for adequate accounting systems, reasonable record retention periods, and financial audits.
[ 2013 c 23 s 224; 1971 ex.s. c 169 s 12.]
Notes:
Moneys in possession of secretary not subject to certain proceedings: RCW 74.13.070.

catchline: Community programs and projects for the aging—State funding, limitations—Payments, type.


title: RCW 74.38.010

text:
The legislature recognizes the need for the development and expansion of alternative services and forms of care for senior citizens. Such services should be designed to restore individuals to, or maintain them at, the level of independent living they are capable of attaining. These alternative services and forms of care should be designed to both complement the present forms of institutional care and create a system whereby appropriate services can be rendered according to the care needs of an individual. The provision of service should continue until the client is able to function independently, moves to an institution, moves from the state, dies, or withdraws from the program.
Therefore, it shall be the policy of this state to develop, expand, or maintain those programs which provide an alternative to institutional care when that form of care is premature, unnecessary, or inappropriate.
[ 1977 ex.s. c 321 s 1; 1975-'76 2nd ex.s. c 131 s 1.]

catchline: Legislative recognition—Public policy.


title: RCW 74.38.020

text:
As used in this chapter, the following words and phrases shall have the following meaning unless the content clearly requires otherwise:
(1) "Area agency" means an agency, other than a state agency, designated by the department to carry out programs or services approved by the department in a designated geographical area of the state.
(2) "Area plan" means the document submitted annually by an area agency to the department for approval which sets forth (a) goals and measurable objectives, (b) review of past expenditures and accounting of revenue for the previous year, (c) estimated revenue and expenditures for the ensuing year, and (d) the planning, coordination, administration, social services, and evaluation activities to be undertaken to carry out the purposes of the Older Americans Act of 1965 (42 U.S.C. Sec. 3024 et seq.), as now or hereafter amended.
(3) "Department" means the department of social and health services.
(4) "Office" shall mean the office on aging which is the organizational unit within the department responsible for coordinating and administering aging problems.
(5) "Eligible persons" means senior citizens who are:
(a) Sixty-five years of age or more; or
(b) Sixty years of age or more and are either (i) nonemployed, or (ii) employed for twenty hours per week or less; and
(c) In need of services to enable them to remain in their customary homes because of physical, mental, or other debilitating impairments.
(6) "Low income" means initial resources or subsequent income at or below forty percent of the state median income as promulgated by the secretary of the United States department of health, education and welfare for Title XX of the Social Security Act, or, in the alternative, a level determined by the department and approved by the legislature.
(7) "Income" shall have the same meaning as in chapter 74.04 RCW, as now or hereafter amended; except, that money received from RCW 74.38.060 shall be excluded from this definition.
(8) "Resource" shall have the same meaning as in chapter 74.04 RCW, as now or hereafter amended.
(9) "Need" shall have the same meaning as in chapter 74.04 RCW, as now or hereafter amended.
[ 1989 1st ex.s. c 9 s 817; 1977 ex.s. c 321 s 2; 1975-'76 2nd ex.s. c 131 s 2.]
Notes:
Effective date—Severability—1989 1st ex.s. c 9: See RCW 43.70.910 and 43.70.920.

catchline: Definitions.


title: RCW 74.38.030

text:
(1) The program of community-based services authorized under this chapter shall be administered by the department. Such services may be provided by the department or through purchase of service contracts, vendor payments or direct client grants.
The department shall, under stipend or grant programs provided under RCW 74.38.060, utilize, to the maximum staffing level possible, eligible persons in its administration, supervision, and operation.
(2) The department shall be responsible for planning, coordination, monitoring and evaluation of services provided under this chapter but shall avoid duplication of services.
(3) The department may designate area agencies in cities of not less than twenty thousand population or in regional areas within the state. These agencies shall submit area plans, as required by the department. For area plans prepared for submission in 2009, and thereafter, the area agencies may include the findings and recommendations of area-wide planning initiatives that they may undertake with appropriate local and regional partners regarding the changing age demographics of their area and the implications of this demographic change for public policies and public services. They shall also submit, in the manner prescribed by the department, such other program or fiscal data as may be required.
(4) The department shall develop an annual state plan pursuant to the Older Americans Act of 1965, as now or hereafter amended. This plan shall include, but not be limited to:
(a) Area agencies' programs and services approved by the department;
(b) Other programs and services authorized by the department; and
(c) Coordination of all programs and services.
(5) The department shall establish rules and regulations for the determination of low-income eligible persons. Such determination shall be related to need based on the initial resources and subsequent income of the person entering into a program or service. This determination shall not prevent the eligible person from utilizing a program or service provided by the department or area agency. However, if the determination is that such eligible person is nonlow income, the provision of RCW 74.38.050 shall be applied as of the date of such determination.
[ 2008 c 146 s 5; 1975-'76 2nd ex.s. c 131 s 3.]
Notes:
Findings—Intent—Severability—2008 c 146: See notes following RCW 74.41.040.

catchline: Administration of community-based services program—Area plans—Annual state plan—Determination of low-income eligible persons.


title: RCW 74.38.040

text:
The community-based services for low-income eligible persons provided by the department or the respective area agencies may include:
(1) Access services designed to provide identification of eligible persons, assessment of individual needs, reference to the appropriate service, and follow-up service where required. These services shall include information and referral, outreach, transportation, and counseling;
(2) Day care offered on a regular, recurrent basis. General nursing, rehabilitation, personal care, nutritional services, social casework, mental health as provided pursuant to chapter 71.24 RCW, and/or limited transportation services may be made available within this program;
(3) In-home care for persons, including basic health care; performance of various household tasks and other necessary chores, or, a combination of these services;
(4) Counseling on death for the terminally ill and care and attendance at the time of death; except, that this is not to include reimbursement for the use of life-sustaining mechanisms;
(5) Health services which will identify health needs and which are designed to avoid institutionalization; assist in securing admission to medical institutions or other health related facilities when required; and, assist in obtaining health services from public or private agencies or providers of health services. These services shall include health screening and evaluation, in-home services, health education, and such health appliances which will further the independence and well-being of the person;
(6) The provision of low-cost, nutritionally sound meals in central locations or in the person's home in the instance of incapacity. Also, supportive services may be provided in nutritional education, shopping assistance, diet counseling, and other services to sustain the nutritional well-being of these persons;
(7) The provisions of services to maintain a person's home in a state of adequate repair, insofar as is possible, for their safety and comfort. These services shall be limited, but may include housing counseling, minor repair and maintenance, and moving assistance when such repair will not attain standards of health and safety, as determined by the department;
(8) Civil legal services, as limited by RCW 2.50.100, for counseling and representation in the areas of housing, consumer protection, public entitlements, property, and related fields of law;
(9) Long-term care ombuds programs for residents of all long-term care facilities.
[ 2013 c 23 s 225; 1983 c 290 s 14; 1977 ex.s. c 321 s 3; 1975-'76 2nd ex.s. c 131 s 4.]

catchline: Scope and extent of community-based services program.


title: RCW 74.38.050

text:
The services provided in RCW 74.38.040 may be provided to nonlow-income eligible persons: PROVIDED, That the department and the area agencies on aging shall utilize volunteer workers and public assistant recipients to the maximum extent possible to provide the services provided in RCW 74.38.040: PROVIDED, FURTHER, That the department and the area agencies shall utilize the bid procedure pursuant to chapter 43.19 RCW for providing such services to low-income and nonlow-income persons whenever the services to be provided are available through private agencies at a cost savings to the department. The department shall establish a fee schedule based on the ability to pay and graduated to full recovery of the cost of the service provided; except, that nutritional services, health screening, services under the long-term care ombuds program under chapter 43.190 RCW, and access services provided in RCW 74.38.040 shall not be based on need and no fee shall be charged; except further, notwithstanding any other provision of this chapter, that well-adult clinic services may be provided in lieu of health screening services if such clinics use the fee schedule established by this section.
[ 2013 c 23 s 226; 1983 c 290 s 15; 1979 ex.s. c 147 s 1; 1977 ex.s. c 321 s 4; 1975-'76 2nd ex.s. c 131 s 5.]
Notes:
Effective date—1979 ex.s. c 147: "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 July 1, 1979." [ 1979 ex.s. c 147 s 4.]

catchline: Availability of services for persons other than those of low income—Utilization of volunteers and public assistance recipients—Private agencies—Well-adult clinics—Fee schedule, exceptions.


title: RCW 74.38.060

text:
The department may expand the foster grandparent, senior companion and retired senior volunteer programs funded under the Federal Volunteer Agency (ACTION) (P.L. 93-113 Title II), or its successor agency, which provide senior citizens with volunteer stipends, out-of-pocket expenses, or wages to perform services in the community.
[1975-'76 2nd ex.s. c 131 s 6.]
Notes:
RSVP funding: RCW 43.63A.275.

catchline: Expansion of federal programs authorized.


title: RCW 74.38.061

text:
The department may expand the foster grandparent, senior companion, and retired senior volunteer programs funded under the Federal Volunteer Agency (ACTION) (P.L. 93-113 Title II), or its successor agency, which provide senior citizens with volunteer stipends, out-of-pocket expenses, or wages to perform services in the community.
[ 1977 ex.s. c 321 s 5.]


title: RCW 74.38.070

text:
Notwithstanding any other provision of law, any county, city, town, public utility district or other municipal corporation, or quasi municipal corporation providing utility services may provide such services at reduced rates for low-income senior citizens or other low-income citizens: PROVIDED, That, for the purposes of this section, "low-income senior citizen" or "other low-income citizen" shall be defined by appropriate ordinance or resolution adopted by the governing body of the county, city, town, public utility district or other municipal corporation, or quasi municipal corporation providing the utility services. Any reduction in rates granted in whatever manner to low-income senior citizens or other low-income citizens in one part of a service area shall be uniformly extended to low-income senior citizens or other low-income citizens in all other parts of the service area.
[ 2002 c 270 s 1; 1998 c 300 s 8; 1990 c 164 s 1; 1988 c 44 s 1; 1980 c 160 s 1; 1979 c 116 s 1.]
Notes:
Findings—Intent—1998 c 300: See RCW 19.29A.005.
Construction—1998 c 300: See RCW 19.29A.900.

catchline: Reduced utility rates for low-income senior citizens and other low-income citizens.


title: RCW 74.38.900

text:
Sections 1 through 6 of this act shall be known and may be cited as the "Senior Citizens Services Act".
[1975-'76 2nd ex.s. c 131 s 7.]

catchline: Short title.


title: RCW 74.39.001

text:
The legislature finds that:
Washington's chronically functionally disabled population is growing at a rapid pace. This growth, along with economic and social changes and the coming age wave, presents opportunities for the development of long-term care community services networks and enhanced volunteer participation in those networks, and creates a need for different approaches to currently fragmented long-term care programs. The legislature further recognizes that persons with functional disabilities should receive long-term care services that encourage individual dignity, autonomy, and development of their fullest human potential.
[ 1989 c 427 s 1.]

catchline: Finding.


title: RCW 74.39.005

text:
The purpose of this chapter is to:
(1) Establish a balanced range of health, social, and supportive services that deliver long-term care services to persons with chronic functional disabilities of all ages;
(2) Ensure that functional ability shall be the determining factor in defining long-term care service needs and that these needs will be determined by a uniform system for comprehensively assessing functional disability;
(3) Ensure that services are provided in the most independent living situation consistent with individual needs;
(4) Ensure that long-term care service options shall be developed and made available that enable persons with functional disabilities to continue to live in their homes or other community residential facilities while in the care of their families or other volunteer support persons;
(5) Ensure that long-term care services are coordinated in a way that minimizes administrative cost, eliminates unnecessarily complex organization, minimizes program and service duplication, and maximizes the use of financial resources in directly meeting the needs of persons with functional limitations;
(6) Develop a systematic plan for the coordination, planning, budgeting, and administration of long-term care services now fragmented between the division of developmental disabilities, division of mental health, aging and adult services administration, division of children and family services, division of vocational rehabilitation, division of health, bureau of alcohol and substance abuse, and the department of health;
(7) Encourage the development of a statewide long-term care case management system that effectively coordinates the plan of care and services provided to eligible clients;
(8) Ensure that individuals and organizations affected by or interested in long-term care programs have an opportunity to participate in identification of needs and priorities, policy development, planning, and development, implementation, and monitoring of state-supported long-term care programs;
(9) Support educational institutions in Washington state to assist in the procurement of federal support for expanded research and training in long-term care; and
(10) Facilitate the development of a coordinated system of long-term care education that is clearly articulated between all levels of higher education and reflective of both in-home care needs and institutional care needs of persons with functional disabilities.
[ 2020 c 76 s 21; 1995 1st sp.s. c 18 s 10; 1989 c 427 s 2.]
Notes:
Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.

catchline: Purpose.


title: RCW 74.39.007

text:
The definitions in this section apply throughout this section, RCW 74.39.050, 74.39.070, 43.190.060, and section 1, chapter 336, Laws of 1999 unless the context clearly requires otherwise.
(1) "Self-directed care" means the process in which an adult person, who is prevented by a functional disability from performing a manual function related to health care that an individual would otherwise perform for himself or herself, chooses to direct and supervise a paid personal aide to perform those tasks.
(2) "Personal aide" means an individual, working privately, as an individual provider as defined in RCW 74.39A.240, or as a qualified family member paid through the long-term services and supports trust as described in RCW 50B.04.010, who acts at the direction of an adult person with a functional disability living in his or her own home to assist with the physical performance of a health care task, as described in RCW 74.39.050, that persons without a functional disability can perform themselves.
[ 2025 c 380 s 45; 2022 c 86 s 1; 1999 c 336 s 2.]
Notes:
Effective date—2025 c 380 ss 1-11, 15, 16, and 40-46: See note following RCW 50B.04.180.
Finding—Intent—1999 c 336: "(1) The legislature finds that certain aspects of health licensure laws have the unintended consequence of limiting the right of persons with functional disabilities to care for themselves in their own home, and of securing assistance from other persons in performing routine health-related tasks that persons without these disabilities customarily perform.
(2) It is the intent of the legislature to clarify the right of adults with functional disabilities to choose to self-direct their own health-related tasks through personal aides, and to describe the circumstances under which self-directed care may take place in the home setting. The legislature declares that it is in the public interest to preserve the autonomy and dignity of persons with functional disabilities to care for themselves in their own homes, among the continuum of options for health care services where the judgment and control over the care rests with the individual." [ 1999 c 336 s 1.]


title: RCW 74.39.010

text:
A valuable option available to Washington state to achieve the goals of RCW 74.39.001 and 74.39.005 is the flexibility in personal care and other long-term care services encouraged by the federal government under Title XIX of the federal social security act. These services include options to expand community-based long-term care services, such as adult family homes, congregate care facilities, respite, chore services, hospice, and case management.
[ 1989 c 427 s 3.]

catchline: Option—Flexibility—Title XIX of the federal social security act.


title: RCW 74.39.020

text:
Title XIX of the federal social security act offers valuable opportunities to increase federal funds available to provide community-based long-term care services to functionally disabled persons in their homes, and in noninstitutional residential facilities, such as adult family homes and congregate care facilities.
[ 1989 c 427 s 9.]

catchline: Opportunities—Increase of federal funds—Title XIX of the federal social security act.


title: RCW 74.39.030

text:
The department shall request an amendment to its community options program entry system waiver under section 1905(c) of the federal social security act to include respite services as a service available under the waiver.
[ 1989 c 427 s 11.]

catchline: Community options program entry system—Waiver—Respite services.


title: RCW 74.39.041

text:
(1) To the extent of available funds and subject to any conditions placed on appropriations for this purpose, the department may provide one or more home and community-based waiver programs in accordance with section 1915(c) of the federal social security act for Washington residents who have a gross income in excess of three hundred percent of the federal supplemental security income benefit level. The waiver services provided in accordance with this section may differ from, and shall operate with a separate limit or limits on total enrollment than, those provided for persons who are categorically needy as defined in Title XIX of the federal social security act. The department shall adopt rules to establish eligibility criteria, applicable income standards, and the specific waiver services to be provided. Total annual enrollment levels and the services to be provided shall be as specified in the waiver agreement or agreements with the federal government, subject to any conditions on appropriations for this purpose.
(2) If a nursing facility resident becomes eligible for home and community-based waiver service alternatives to nursing facility care, but chooses to continue to reside in a nursing facility, the department must allow that choice. However, if the resident is a medicaid recipient, the resident must require a nursing facility level of care.
(3) If a recipient of home and community-based waiver services may continue to receive home and community-based waiver services, despite an otherwise disqualifying level of income, but chooses to seek admission to a nursing facility, the department must allow that choice. However, if the resident is a medicaid recipient, the resident must require a nursing facility level of care.
(4) The department will fully disclose to all individuals eligible for waiver services under this section the services available in different long-term care settings.
[ 2001 c 269 s 2.]

catchline: Community residential options—Nursing facility eligible clients.


title: RCW 74.39.050

text:
(1) An adult person with a functional disability living in his or her own home may direct and supervise a paid personal aide in the performance of a health care task.
(2) The following requirements shall guide the provision of self-directed care under chapter 336, Laws of 1999:
(a) Health care tasks are those medical, nursing, or home health services that enable the person to maintain independence, personal hygiene, and safety in his or her own home, and that are services that a person without a functional disability would customarily and personally perform without the assistance of a licensed health care provider.
(b) The individual who chooses to self-direct a health care task is responsible for initiating self-direction by informing the health care professional who has ordered the treatment which involves that task of the individual's intent to perform that task through self-direction.
(c) When state funds are used to pay for self-directed tasks, a description of those tasks will be included in the client's comprehensive assessment, and subject to review with each annual reassessment.
(d) When a licensed health care provider orders treatment involving a health care task to be performed through self-directed care, the responsibility to ascertain that the patient understands the treatment and will be able to follow through on the self-directed care task is the same as it would be for a patient who performs the health care task for himself or herself, and the licensed health care provider incurs no additional liability when ordering a health care task which is to be performed through self-directed care.
(e) The role of the personal aide in self-directed care is limited to performing the physical aspect of health care tasks under the direction of the person for whom the tasks are being done. This shall not affect the ability of a person who acts as a personal aide by performing self-directed health care tasks to also provide other home care services, such as personal care or homemaker services, which enable the client to remain at home.
(f) The responsibility to initiate self-directed health care tasks, to possess the necessary knowledge and training for those tasks, and to exercise judgment regarding the manner of their performance rests and remains with the person who has chosen to self-direct those tasks, including the decision to employ and dismiss a personal aide.
[ 2022 c 86 s 2; 1999 c 336 s 3.]
Notes:
Finding—Intent—1999 c 336: See note following RCW 74.39.007.

catchline: Individuals with functional disabilities—Self-directed care.


title: RCW 74.39.070

text:
A personal aide, in the performance of a health care task, who is directed and supervised by a person with a functional disability in his or her own home, is exempt from any legal requirement to qualify and be credentialed by the department of health as a health care provider under Title 18 RCW to the extent of the responsibilities provided and health care tasks performed under chapter 336, Laws of 1999. Nothing in this section exempts an individual provider from being required to become a certified home care aide under chapter 18.88B RCW.
[ 2022 c 86 s 3; 1999 c 336 s 8.]
Notes:
Finding—Intent—1999 c 336: See note following RCW 74.39.007.

catchline: Personal aide—Qualification exemptions.


title: RCW 74.39A.005

text:
The legislature finds that the aging of the population and advanced medical technology have resulted in a growing number of persons who require assistance. The primary resource for long-term care continues to be family and friends. However, these traditional caregivers are increasingly employed outside the home. There is a growing demand for improvement and expansion of home and community-based long-term care services to support and complement the services provided by these informal caregivers.
The legislature further finds that the public interest would best be served by a broad array of long-term care services that support persons who need such services at home or in the community whenever practicable and that promote individual autonomy, dignity, and choice.
The legislature finds that as other long-term care options become more available, the relative need for nursing home beds is likely to decline. The legislature recognizes, however, that nursing home care will continue to be a critical part of the state's long-term care options, and that such services should promote individual dignity, autonomy, and a homelike environment.
The legislature finds that many recipients of in-home services are vulnerable and their health and well-being are dependent on their caregivers. The quality, skills, and knowledge of their caregivers are often the key to good care. The legislature finds that the need for well-trained caregivers is growing as the state's population ages and clients' needs increase. The legislature intends that current training standards be enhanced.
[ 2000 c 121 s 9; 1993 c 508 s 1.]

catchline: Findings.


title: RCW 74.39A.007

text:
It is the legislature's intent that:
(1) Long-term care services administered by the department of social and health services include a balanced array of health, social, and supportive services that promote individual choice, dignity, and the highest practicable level of independence;
(2) Home and community-based services be developed, expanded, or maintained in order to meet the needs of consumers and to maximize effective use of limited resources;
(3) Long-term care services be responsive and appropriate to individual need and also cost-effective for the state;
(4) Nursing home care is provided in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident and timely discharge to a less restrictive care setting when appropriate; and
(5) State health planning for nursing home bed supply take into account increased availability of other home and community-based service options.
[ 1993 c 508 s 2.]

catchline: Purpose and intent.


title: RCW 74.39A.009

text:
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Adult family home" means a home licensed under chapter 70.128 RCW.
(2) "Adult residential care" means services provided by an assisted living facility 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 facility" means a facility licensed under chapter 18.20 RCW.
(4) "Assisted living services" means services provided by an assisted living facility 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 facility provides these services to residents who are living in private apartment-like units.
(5) "Community residential service business" means a business that:
(a) Is certified by the department of social and health services to provide to individuals who have a developmental disability as defined in RCW 71A.10.020(6):
(i) Group home services;
(ii) Group training home services;
(iii) Supported living services; or
(iv) Voluntary placement services provided in a licensed staff residential facility for children;
(b) Has a contract with the developmental disabilities administration to provide the services identified in (a) of this subsection; and
(c) All of the business's long-term care workers are subject to statutory or regulatory training requirements that are required to provide the services identified in (a) of this subsection.
(6) "Consumer" or "client" means a person who is receiving or has applied for services under this chapter, including a person who is receiving services from an individual provider.
(7) "Consumer directed employer" is a private entity that contracts with the department to be the legal employer of individual providers. The consumer directed employer is patterned after the agency with choice model, recognized by the federal centers for medicare and medicaid services for financial management in consumer directed programs. The entity's responsibilities are described in RCW 74.39A.515 and throughout this chapter and include: (a) Coordination with the consumer, who is the individual provider's managing employer; (b) withholding, filing, and paying income and employment taxes, including workers' compensation premiums and unemployment taxes, for individual providers; (c) verifying an individual provider's qualifications; and (d) providing other administrative and employment-related supports. The consumer directed employer is a social service agency and its employees are mandated reporters as defined in RCW 74.34.020.
(8) "Core competencies" means basic training topics, including but not limited to, communication skills, worker self-care, problem solving, maintaining dignity, consumer directed care, cultural sensitivity, body mechanics, fall prevention, skin and body care, long-term care worker roles and boundaries, supporting activities of daily living, and food preparation and handling.
(9) "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.
(10) "Department" means the department of social and health services.
(11) "Developmental disability" has the same meaning as defined in RCW 71A.10.020.
(12) "Direct care worker" means a paid caregiver who provides direct, hands-on personal care services to persons with disabilities or the elderly requiring long-term care.
(13) "Enhanced adult residential care" means services provided by an assisted living facility 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.
(14) "Facility" means an adult family home, an assisted living facility, a nursing home, an enhanced services facility licensed under chapter 70.97 RCW, or a facility certified to provide medicare or medicaid services in nursing facilities or intermediate care facilities for individuals with intellectual disabilities under 42 C.F.R. Part 483.
(15) "Home and community-based services" means services provided in 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 federally recognized Indian tribes, or similar services provided by facilities and agencies licensed or certified by the department.
(16) "Home care aide" means a long-term care worker who is certified as a home care aide by the department of health under chapter 18.88B RCW.
(17) "Individual provider" is defined according to RCW 74.39A.240.
(18) "Legal employer" means the consumer directed employer, which along with the consumer, coemploys individual providers. The legal employer is responsible for setting wages and benefits for individual providers and must comply with applicable laws including, but not limited to, state minimum wage laws, workers compensation, and unemployment insurance laws.
(19) "Long-term care" means care and supports delivered indefinitely, intermittently, or over a sustained time to persons of any age who are functionally disabled due to chronic mental or physical illness, disease, chemical dependency, or a medical condition that is permanent, not 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 provided by any individuals, groups, residential care settings, or professions unless otherwise required by law.
(20)(a) "Long-term care workers" include all persons who provide paid, hands-on personal care services for the elderly or persons with disabilities, including but not limited to individual providers of home care services, direct care workers employed by home care agencies or a consumer directed employer, providers of home care services to persons with developmental disabilities under Title 71A RCW, all direct care workers in state-licensed assisted living facilities, enhanced services facilities, and adult family homes, respite care providers, direct care workers employed by community residential service businesses, medical foster home caregivers as under 38 C.F.R. 17.73, 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: (i) Persons employed by the following facilities or agencies: Nursing homes licensed under chapter 18.51 RCW, hospitals or other acute care settings, residential habilitation centers under chapter 71A.20 RCW, facilities certified under 42 C.F.R., Part 483, hospice agencies subject to chapter 70.127 RCW, adult day care centers, and adult day health care centers; or (ii) persons who are not paid by the state or by a private agency or facility licensed or certified by the state to provide personal care services.
(21) "Managing employer" means a consumer who coemploys one or more individual providers and whose responsibilities include (a) choosing potential individual providers and referring them to the consumer directed employer; (b) overseeing the day-to-day management and scheduling of the individual provider's tasks consistent with the plan of care; and (c) dismissing the individual provider when desired.
(22) "Nursing home" or "nursing facility" means a facility licensed under chapter 18.51 RCW or certified as a medicaid nursing facility under 42 C.F.R. Part 483, or both.
(23) "Person who is functionally disabled" means a person who because of a recognized chronic physical or mental condition or disease, including chemical dependency or developmental disability, is 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 such as cooking, shopping, house cleaning, doing laundry, working, and managing personal finances may also be considered when assessing a person's functional ability to perform activities in the home and the community.
(24) "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 disability.
(25) "Population specific competencies" means basic training topics unique to the care needs of the population the long-term care worker is serving, including but not limited to, mental health, dementia, developmental disabilities, young adults with physical disabilities, and older adults.
(26) "Qualified instructor" means a registered nurse or other person with specific knowledge, training, and work experience in the provision of direct, hands-on personal care and other assistance services to the elderly or persons with disabilities requiring long-term care.
(27) "Secretary" means the secretary of social and health services.
(28) "Training partnership" means a joint partnership or trust that includes the office of the governor and the exclusive bargaining representative of individual providers under RCW 74.39A.270 with the capacity to provide training, peer mentoring, and workforce development, or other services to individual providers.
(29) "Tribally licensed assisted living facility" means an assisted living facility licensed by a federally recognized Indian tribe in which a facility provides services similar to services provided by assisted living facilities licensed under chapter 18.20 RCW.
[ 2025 c 108 s 2; 2024 c 224 s 3; 2022 c 255 s 5; 2018 c 278 s 2. Prior: 2012 c 164 s 202; 2012 c 10 s 63; 2009 c 580 s 1; 2009 c 2 s 2 (Initiative Measure No. 1029, approved November 4, 2008); 2007 c 361 s 2; 2004 c 142 s 14; 1997 c 392 s 103.]
Notes:
Retroactive application—Applicability—2024 c 224: See note following RCW 49.46.800.
Findings—Intent—2018 c 278: See note following RCW 74.39A.500.
Finding—Intent—Rules—Effective date—2012 c 164: See notes following RCW 18.88B.010.
Application—2012 c 10: See note following RCW 18.20.010.
Intent—Findings—Construction—Short title—2009 c 2 (Initiative Measure No. 1029): See notes following RCW 18.88B.050.
Construction—2007 c 361: "The provisions of this act are to be liberally construed to effectuate the intent, policies, and purposes of this act." [ 2007 c 361 s 11.]
Severability—2007 c 361: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [ 2007 c 361 s 12.]
Captions not law—2007 c 361: "Captions used in this act are not any part of the law." [ 2007 c 361 s 15.]
Short title—2007 c 361: "This act may be known and cited as the establishing quality in long-term care services act." [ 2007 c 361 s 16.]
Effective dates—2004 c 142: See note following RCW 18.20.020.
Short title—1997 c 392: "This act shall be known and may be cited as the Clara act." [ 1997 c 392 s 101.]
Findings—1997 c 392: "The legislature finds and declares that the state's current fragmented categorical system for administering services to persons with disabilities and the elderly is not client and family-centered and has created significant organizational barriers to providing high quality, safe, and effective care and support. The present fragmented system results in uncoordinated enforcement of regulations designed to protect the health and safety of disabled persons, lacks accountability due to the absence of management information systems' client tracking data, and perpetuates difficulty in matching client needs and services to multiple categorical funding sources.
The legislature further finds that Washington's chronically functionally disabled population of all ages is growing at a rapid pace due to a population of the very old and increased incidence of disability due in large measure to technological improvements in acute care causing people to live longer. Further, to meet the significant and growing long-term care needs into the near future, rapid, fundamental changes must take place in the way we finance, organize, and provide long-term care services to the chronically functionally disabled.
The legislature further finds that the public demands that long-term care services be safe, client and family-centered, and designed to encourage individual dignity, autonomy, and development of the fullest human potential at home or in other residential settings, whenever practicable." [ 1997 c 392 s 102.]
Construction—Conflict with federal requirements—1997 c 392: "Any section or provision of this act that may be susceptible to more than one construction shall be interpreted in favor of the construction most likely to comply with federal laws entitling this state to receive federal funds for the various programs of the department of health or the department of social and health services. If any section of this act is found to be in conflict with federal requirements that are a prescribed condition of the allocation of federal funds to the state, or to any departments or agencies thereof, the conflicting part is declared to be inoperative solely to the extent of the conflict. The rules issued under this act shall meet federal requirements that are a necessary condition to the receipt of federal funds by the state." [ 1997 c 392 s 504.]
Part headings and captions not law—1997 c 392: "Part headings and captions used in this act are not part of the law." [ 1997 c 392 s 531.]

catchline: Definitions.


title: RCW 74.39A.010

text:
(1) To the extent of available funding, the department of social and health services may contract with licensed assisted living facilities under chapter 18.20 RCW and tribally licensed assisted living facilities for assisted living services and enhanced adult residential care. The department shall develop rules for facilities that contract with the department for assisted living services or enhanced adult residential care to establish:
(a) Facility service standards consistent with the principles in RCW 74.39A.051 and consistent with chapter 70.129 RCW;
(b) Standards for resident living areas consistent with RCW 74.39A.030;
(c) Training requirements for providers and their staff.
(2) The department's rules shall provide that services in assisted living and enhanced adult residential care:
(a) Recognize individual needs, privacy, and autonomy;
(b) Include, but not be limited to, personal care, nursing services, medication administration, and supportive services that promote independence and self-sufficiency;
(c) Are of sufficient scope to assure that each resident who chooses to remain in the assisted living or enhanced adult residential care may do so, to the extent that the care provided continues to be cost-effective and safe and promote the most appropriate level of physical, mental, and psychosocial well-being consistent with client choice;
(d) Are directed first to those persons most likely, in the absence of enhanced adult residential care or assisted living services, to need hospital, nursing facility, or other out-of-home placement; and
(e) Are provided in compliance with applicable facility and professional licensing laws and rules.
(3) When a facility contracts with the department for assisted living services or enhanced adult residential care, only services and facility standards that are provided to or in behalf of the assisted living services or enhanced adult residential care client shall be subject to the department's rules.
[ 2012 c 164 s 706; 2012 c 10 s 64; 1995 1st sp.s. c 18 s 14; 1993 c 508 s 3.]
Notes:
Reviser's note: This section was amended by 2012 c 10 s 64 and by 2012 c 164 s 706, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025(2). For rule of construction, see RCW 1.12.025(1).
Finding—Intent—Rules—Effective date—2012 c 164: See notes following RCW 18.88B.010.
Application—2012 c 10: See note following RCW 18.20.010.
Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.

catchline: Assisted living services and enhanced adult residential care—Contracts—Rules.


title: RCW 74.39A.020

text:
(1) To the extent of available funding, the department of social and health services may contract for adult residential care.
(2) The department shall, by rule, develop terms and conditions for facilities that contract with the department for adult residential care to establish:
(a) Facility service standards consistent with the principles in RCW 74.39A.051 and consistent with chapter 70.129 RCW; and
(b) Training requirements for providers and their staff.
(3) The department shall, by rule, provide that services in adult residential care facilities:
(a) Recognize individual needs, privacy, and autonomy;
(b) Include personal care and other services that promote independence and self-sufficiency and aging in place;
(c) Are directed first to those persons most likely, in the absence of adult residential care services, to need hospital, nursing facility, or other out-of-home placement; and
(d) Are provided in compliance with applicable facility and professional licensing laws and rules.
(4) When a facility contracts with the department for adult residential care, only services and facility standards that are provided to or in behalf of the adult residential care client shall be subject to the adult residential care rules.
(5) To the extent of available funding, the department may also contract under this section with a tribally licensed assisted living facility for the provision of services of the same nature as the services provided by adult residential care facilities. The provisions of subsections (2)(a) and (b) and (3)(a) through (d) of this section apply to such a contract.
[ 2012 c 164 s 707; 2012 c 10 s 65; 2004 c 142 s 15; 1995 1st sp.s. c 18 s 15.]
Notes:
Reviser's note: This section was amended by 2012 c 10 s 65 and by 2012 c 164 s 707, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025(2). For rule of construction, see RCW 1.12.025(1).
Finding—Intent—Rules—Effective date—2012 c 164: See notes following RCW 18.88B.010.
Application—2012 c 10: See note following RCW 18.20.010.
Effective dates—2004 c 142: See note following RCW 18.20.020.
Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.

catchline: Adult residential care—Contracts—Rules.


title: RCW 74.39A.030

text:
(1) To the extent of available funding, the department shall expand cost-effective options for home and community services for consumers for whom the state participates in the cost of their care.
(2) In expanding home and community services, the department shall take full advantage of federal funding available under Title XVIII and Title XIX of the federal social security act, including home health, adult day care, waiver options, and state plan services and expand the availability of in-home services and residential services, including services in adult family homes, assisted living facilities, and enhanced services facilities.
(3)(a) The department shall by rule establish payment rates for home and community services that support the provision of cost-effective care. Beginning July 1, 2019, the department shall adopt a data-driven medicaid payment methodology as specified in RCW 74.39A.032 for contracted assisted living, adult residential care, and enhanced adult residential care. In the event of any conflict between any such rule and a collective bargaining agreement entered into under RCW 74.39A.270 and 74.39A.300, the collective bargaining agreement prevails.
(b) The department may authorize an enhanced adult residential care rate for nursing homes that temporarily or permanently convert their bed use under chapter 70.38 RCW for the purposes of providing assisted living, enhanced adult residential care, or adult residential care, when the department determines that payment of an enhanced rate is cost-effective and necessary to foster expansion of these contracted services. As an incentive for nursing homes to permanently convert a portion of their nursing home bed capacity for the purposes of providing assisted living, enhanced adult residential care, or adult residential care, including but not limited to serving individuals with behavioral health treatment needs, the department may authorize a supplemental add-on to the residential care rate.
[ 2019 c 324 s 11. Prior: 2018 c 278 s 6; 2018 c 225 s 2; 2012 c 10 s 66; 2002 c 3 s 10 (Initiative Measure No. 775, approved November 6, 2001); 1995 1st sp.s. c 18 s 2.]
Notes:
Recommendations—Residential intensive behavioral health and developmental disability services—2019 c 324: "By July 1, 2020, the health care authority and the department of social and health services, in consultation with the department of health, the department of children, youth, and families, representatives from providers serving children's inpatient psychiatric needs in each of the three largest cities in Washington, representatives from behavioral health and developmental disability service providers, and representatives from developmental disability advocacy organizations including individuals and families of individuals who need or receive behavioral health and developmental disability services, must provide recommendations to the governor's office and the appropriate committees of the legislature relating to short-term and long-term residential intensive behavioral health and developmental disability services for youth and adults with developmental disabilities and behavioral health needs who are experiencing, or are in danger of experiencing, barriers discharging from inpatient behavioral health treatment received in community hospitals or state hospitals. The recommendations must address the needs of youth and adults with developmental or intellectual disabilities separately and: (1) Consider services necessary to support the youth or adult, the youth or adult's family, and the residential service provider in preparation for and after discharge, including in-home behavioral health and developmental disability supports that may be needed after discharge to maintain stability; (2) establish staffing and funding requirements that provide an appropriate level of treatment for residents in facilities, including both licensed mental health professionals and developmental disability professionals; and (3) for youth clients, consider how to successfully transition a youth to adult services without service disruption." [ 2019 c 324 s 10.]
Findings—Intent—2019 c 324: See note following RCW 71.24.648.
Mental health drop-in center services pilot program—2019 c 324: See note following RCW 71.24.649.
Report—2019 c 324: See note following RCW 70.38.111.
Findings—Intent—2018 c 278: See note following RCW 74.39A.500.
Findings—Intent—2018 c 225: See note following RCW 74.39A.032.
Application—2012 c 10: See note following RCW 18.20.010.
Conflict with federal requirements—1995 1st sp.s. c 18: "If any part of this act is found to be in conflict with federal requirements that are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this act is inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and this finding does not affect the operation of the remainder of this act in its application to the agencies concerned. The rules under this act shall meet federal requirements that are a necessary condition to the receipt of federal funds by the state." [ 1995 1st sp.s. c 18 s 74.]
Severability—1995 1st sp.s. c 18: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [ 1995 1st sp.s. c 18 s 119.]
Effective date—1995 1st sp.s. c 18: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect July 1, 1995." [ 1995 1st sp.s. c 18 s 120.]

catchline: Expansion of home and community services—Payment rates.


title: RCW 74.39A.032

text:
(1) The department shall establish in rule a new medicaid payment system for contracted assisted living, adult residential care, and enhanced adult residential care. Beginning July 1, 2019, payments for these contracts must be based on the new methodology which must be phased-in to full implementation according to funding made available by the legislature for this purpose. The new payment system must have these components: Client care, operations, and room and board.
(2) Client care is the labor component of the system and must include variables to recognize the time and intensity of client care and services, staff wages, and associated fringe benefits. The wage variable in the client care component must be adjusted according to service areas based on labor costs.
(a) The time variable is used to weight the client care payment to client acuity and must be scaled according to the classification levels utilized in the department's assessment tool. The initial system shall establish a variable for time using the residential care time study conducted in 2001 and the department's corresponding estimate of the average staff hours per client by job position.
(b) The wage variable shall include recognition of staff positions needed to perform the functions required by contract, including nursing services. Data used to establish the wage variable must be adjusted so that no baseline wage is below the state minimum in effect at the time of implementation. The wage variable is a blended wage based on the federal bureau of labor statistics wage data and the distribution of time according to staff position. Blended wages are established for each county and then counties are arrayed from highest to lowest. Service areas are established and the median blended wage in each service area becomes the wage variable for all the assigned counties in that service area. The system must have no less than two service areas, one of which shall be a high labor cost service area and shall include counties at or above the ninety-fifth percentile in the array of blended wages.
(c) The fringe benefit variable recognizes employee benefits and payroll taxes. The factor to calculate the percentage of fringe benefits shall be established using the statewide nursing facility cost ratio of benefits and payroll taxes to in-house wages.
(3) The operations component must recognize costs that are allowable under federal medicaid rules for the federal matching percentage. The operations component is calculated at ninety percent or greater of the statewide median nursing facility costs associated with the following:
(a) Supplies;
(b) Nonlabor administrative expenses;
(c) Staff education and in-service training; and
(d) Operational overhead including licenses, insurance, and business and occupation taxes.
(4) The room and board component recognizes costs that do not qualify for federal financial participation under medicaid rules by compensating providers for the medicaid client's share of raw food and shelter costs including expenses related to the physical plant such as property taxes, property and liability insurance, debt service, and major capital repairs. The room and board component is subject to the department's and the Washington state health care authority's rules related to client financial responsibility.
(5) Subsections (2) and (3) of this section establish the rate for medicaid covered services. Subsection (4) of this section establishes the rate for nonmedicaid covered services.
(6) The rates paid on July 1, 2019, shall be based on data from the 2016 calendar year, except for the time variable under subsection (2)(a) of this section. The client care and operations components must be rebased in even-numbered years. Beginning with rates paid on July 1, 2020, wages, benefits and taxes, and operations costs shall be rebased using 2018 data.
(7) Notwithstanding any other provision of this section, the department shall not implement the scheduled rebase of assisted living facility rates that would have otherwise taken effect July 1, 2026, until the following fiscal biennium, beginning July 1, 2027. Following the delayed rebase for rates effective July 1, 2027, the department shall resume adherence to the existing statutory biennial rebasing schedule established in this section.
(8) Beginning July 1, 2020, the room and board component shall be updated annually subject to the department's and the Washington state health care authority's rules related to client financial responsibility.
[ 2026 c 268 s 938; 2018 c 225 s 3.]
Notes:
Effective date—2026 c 268: See note following RCW 28B.15.210.
Findings—Intent—2018 c 225: "(1) The legislature recognizes that Washington state has done an exemplary service for its citizens by expanding long-term care options for home and community-based services. Thousands of vulnerable low-income adults and seniors that would otherwise be in nursing facilities are able to receive the care they need in their own home, an assisted living unit, or an adult family home located near their family and friends, religious groups or other affiliations, and the neighborhoods they are familiar with. The legislature also recognizes that within the next ten years, the number of Washingtonians age seventy-one and older will grow by approximately sixty-three percent and within the next twenty-three years, this population will be about one hundred twenty percent of what it is today. In order to maintain and grow the current level of cost-effective options for long-term care, it is critical to update state policies including provider payment rates to ensure the availability of enrolled providers is sufficient to serve the number of beneficiaries who wish to remain within geographic proximity to their home community.
(2) The legislature intends to replace the outdated payment system with a new methodology that is:
(a) Transparent and understandable to the providers and the public;
(b) Aligns payments to client acuity and contractual requirements; and
(c) Is supported by relevant, verifiable, and independent data to the extent possible." [ 2018 c 225 s 1.]

catchline: Medicaid payment methodology for certain contracted assisted living facilities—Established by rule—Required components.


title: RCW 74.39A.035

text:
(1) Subject to the availability of amounts appropriated for this specific purpose, the department of social and health services must develop a program to expand nutrition services through the meals on wheels program.
(a) At least sixty-five percent of the moneys may be distributed according to formulae to existing providers of meals on wheels programs to expand the number of people served.
(b) Up to twenty-five percent of the moneys may be distributed by a competitive grant process to expand the meals on wheels program into areas not presently being served.
(c) Up to five percent of the moneys may be used by the department administration, monitoring of the grants, and providing technical assistance to existing and new meals on wheels providers.
(2) The department must develop criteria for awarding grants under subsection (1)(b) of this section. The criteria must include, but is not limited to:
(a) Expanding service in areas with the greatest need to assist low-income homebound seniors who are unable to prepare food for themselves and lack a caregiver that prepares meals;
(b) Expanding services in areas where senior citizens have limited access to community support services and facilities; and
(c) Geographic diversity within the state and between rural and urban areas.
(3) None of the grant moneys awarded under subsection (1)(b) of this section may be used to supplant existing funds the provider receives for the meals on wheels program.
[ 2017 c 287 s 2.]
Notes:
Findings—2017 c 287: "The legislature finds that:
(1) Washingtonians sixty-five years of age and older will nearly double in the next twenty-five years, from twelve percent of our population in 2015 to almost twenty-two percent of our population in 2040. Younger people with disabilities will also require supportive long-term care services.
(2) The long-term care system should support autonomy and self-determination. Furthermore, the long-term care system should promote personal planning and savings combined with public support, when needed.
(3) Whenever possible, the long-term care system should utilize evidence-based practices to improve the general health of Washingtonians over their lifetime[s] and reduce related health care and long-term care costs.
(4) Nutrition programs, such as the meals on wheels program, are a low-cost method of helping seniors remain independent." [ 2017 c 287 s 1.]

catchline: Expansion of nutrition services through the meals on wheels program.


title: RCW 74.39A.040

text:
The department shall work in partnership with hospitals in assisting patients and their families to find long-term care services of their choice. The department shall not delay hospital discharges but shall assist and support the activities of hospital discharge planners. The department also shall coordinate with home health and hospice agencies whenever appropriate. The role of the department is to assist the hospital and to assist patients and their families in making informed choices by providing information regarding home and community options to individuals who are hospitalized and likely to need long-term care.
(1) To the extent of available funds, the department shall assess individuals who:
(a) Are medicaid clients, medicaid applicants, or eligible for both medicare and medicaid; and
(b) Apply or are likely to apply for admission to a nursing facility.
(2) For individuals who are reasonably expected to become medicaid recipients within one hundred eighty days of admission to a nursing facility, the department shall, to the extent of available funds, offer an assessment and information regarding appropriate in-home and community services.
(3) When the department finds, based on assessment, that the individual prefers and could live appropriately and cost-effectively at home or in some other community-based setting, the department shall:
(a) Advise the individual that an in-home or other community service is appropriate;
(b) Develop, with the individual or the individual's representative, a comprehensive community service plan;
(c) Inform the individual regarding the availability of services that could meet the applicant's needs as set forth in the community service plan and explain the cost to the applicant of the available in-home and community services relative to nursing facility care; and
(d) Discuss and evaluate the need for ongoing involvement with the individual or the individual's representative.
(4) When the department finds, based on assessment, that the individual prefers and needs nursing facility care, the department shall:
(a) Advise the individual that nursing facility care is appropriate and inform the individual of the available nursing facility vacancies;
(b) If appropriate, advise the individual that the stay in the nursing facility may be short term; and
(c) Describe the role of the department in providing nursing facility case management.
[ 1995 1st sp.s. c 18 s 6.]
Notes:
Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.

catchline: Department assessment of and assistance to hospital patients in need of long-term care.


title: RCW 74.39A.051

text:
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 70.97.110, 71A.12.300, 74.39A.080, or 70.128.160, or chapter 18.51 or 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) Background checks of long-term care workers must be conducted as provided in RCW 74.39A.056.
(8) Except as provided in RCW 74.39A.074 and 74.39A.076, 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 to implement this section. The department shall deny payment to a consumer directed employer or a home care agency for services provided by employees who have not completed the training requirements within the time limit specified by department rules. The department shall deny payment to any individual providers who provide services under a contract with the department if they have been notified that they are no longer permitted to work because they have not completed the training requirements within the time period required by department rules.
(9) Under existing funds the department shall establish internally a quality improvement standards committee to monitor the development of standards and to suggest modifications.
[ 2018 c 278 s 7; 2012 c 164 s 701; 2012 c 1 s 106 (Initiative Measure No. 1163, approved November 8, 2011).]
Notes:
Findings—Intent—2018 c 278: See note following RCW 74.39A.500.
Finding—Intent—Rules—Effective date—2012 c 164: See notes following RCW 18.88B.010.
Intent—Findings—Performance audits—Spending limits—Contingent effective dates—Application—Construction—Effective date—Short title—2012 c 1 (Initiative Measure No. 1163): See notes following RCW 74.39A.056.

catchline: Quality improvement principles.