title: RCW 74.39A.341

text:
(1) All long-term care workers shall complete 12 hours of continuing education training in advanced training topics each year. This requirement applies beginning July 1, 2012.
(2) Completion of continuing education as required in this section is a prerequisite to maintaining home care aide certification under chapter 18.88B RCW.
(3) Unless voluntarily certified as a home care aide under chapter 18.88B RCW, subsection (1) of this section does not apply to:
(a) An individual provider caring only for his or her biological, step, or adoptive child;
(b) An individual provider caring only for the individual provider's parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership;
(c) Registered nurses and licensed practical nurses licensed under chapter 18.79 RCW;
(d) Before January 1, 2016, a long-term care worker employed by a community residential service business;
(e) A person working as an individual provider who provides 20 hours or less of care for one person in any calendar month;
(f) A person working as an individual provider who only provides respite services and works less than 300 hours in any calendar year; or
(g) A person whose certificate has been expired for less than five years who seeks to restore the certificate to active status. The person does not need to complete continuing education requirements in order for their certificate to be restored to active status. Subsection (1) of this section applies to persons once the certificate has been restored to active status, beginning on the date the certificate is restored to active status.
(4) Individual providers covered under subsection (3) of this section may voluntarily take continuing education. The consumer directed employer must pay individual providers covered in subsection (3) of this section for any continuing education that they may take, up to 12 hours of continuing education annually.
(5) Only training curriculum approved by the department may be used to fulfill the training requirements specified in this section. The department shall only approve training curriculum that:
(a) Has been developed with input from consumer and worker representatives; and
(b) Requires comprehensive instruction by qualified instructors.
(6) Individual providers under RCW 74.39A.270 shall be compensated for training time required by this section.
(7) If a pandemic, natural disaster, or other declared state of emergency impacts the ability of long-term care workers to complete training as required by this section, the department may adopt rules to allow long-term care workers additional time to complete the training requirements.
(a) Rules adopted under this subsection are effective until the termination of the pandemic, natural disaster, or other declared state of emergency or until the department determines that all long-term care workers who were unable to complete the training required in this section have had adequate access to complete the required training, whichever is later. Once the department determines a rule adopted under this subsection is no longer necessary, it must repeal the rule under RCW 34.05.353.
(b) Within 12 months of the termination of the pandemic, natural disaster, or other declared state of emergency, the department shall conduct a review of training compliance with subsection (1) of this section and provide the legislature with a report.
(8) The department of health shall adopt rules to implement subsection (1) of this section.
(9) The department shall adopt rules to implement subsection (2) of this section.
[ 2024 c 322 s 3; 2023 c 424 s 6; 2021 c 203 s 9; 2015 c 152 s 3; 2014 c 139 s 8; 2013 c 259 s 3; 2012 c 164 s 405; 2012 c 1 s 112 (Initiative Measure No. 1163, approved November 8, 2011).]
Notes:
Effective date—2024 c 322 s 3: "Section 3 of this act takes effect January 1, 2025." [ 2024 c 322 s 6.]
Expiration date—2024 c 322 s 3: "Section 3 of this act expires January 1, 2027." [ 2024 c 322 s 7.]
Effective date—Retroactive application—2021 c 203: See notes following RCW 43.43.832.
Finding—Intent—Program development—Implementation—Program funding—2014 c 139: See notes following RCW 71A.16.050.
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.
PDF
RCW 74.39A.341
Continuing education requirements for long-term care workers. (Effective January 1, 2027.)
(1) All long-term care workers shall complete 12 hours of continuing education training in advanced training topics each year. This requirement applies beginning July 1, 2012.
(2) Completion of continuing education as required in this section is a prerequisite to maintaining home care aide certification under chapter 18.88B RCW.
(3) Unless voluntarily certified as a home care aide under chapter 18.88B RCW, subsection (1) of this section does not apply to:
(a) An individual provider caring only for his or her biological, step, or adoptive child;
(b) Registered nurses and licensed practical nurses licensed under chapter 18.79 RCW;
(c) Before January 1, 2016, a long-term care worker employed by a community residential service business;
(d) A person working as an individual provider who provides 20 hours or less of care for one person in any calendar month;
(e) A person working as an individual provider who only provides respite services and works less than 300 hours in any calendar year; or
(f) A person whose certificate has been expired for less than five years who seeks to restore the certificate to active status. The person does not need to complete continuing education requirements in order for their certificate to be restored to active status. Subsection (1) of this section applies to persons once the certificate has been restored to active status, beginning on the date the certificate is restored to active status.
(4) Individual providers covered under subsection (3) of this section may voluntarily take continuing education. The consumer directed employer must pay individual providers covered in subsection (3) of this section for any continuing education that they may take, up to 12 hours of continuing education annually.
(5) Only training curriculum approved by the department may be used to fulfill the training requirements specified in this section. The department shall only approve training curriculum that:
(a) Has been developed with input from consumer and worker representatives; and
(b) Requires comprehensive instruction by qualified instructors.
(6) Individual providers under RCW 74.39A.270 shall be compensated for training time required by this section.
(7) If a pandemic, natural disaster, or other declared state of emergency impacts the ability of long-term care workers to complete training as required by this section, the department may adopt rules to allow long-term care workers additional time to complete the training requirements.
(a) Rules adopted under this subsection are effective until the termination of the pandemic, natural disaster, or other declared state of emergency or until the department determines that all long-term care workers who were unable to complete the training required in this section have had adequate access to complete the required training, whichever is later. Once the department determines a rule adopted under this subsection is no longer necessary, it must repeal the rule under RCW 34.05.353.
(b) Within 12 months of the termination of the pandemic, natural disaster, or other declared state of emergency, the department shall conduct a review of training compliance with subsection (1) of this section and provide the legislature with a report.
(8) The department of health shall adopt rules to implement subsection (1) of this section.
(9) The department shall adopt rules to implement subsection (2) of this section.
[ 2024 c 322 s 4; 2023 c 424 s 6; 2021 c 203 s 9; 2015 c 152 s 3; 2014 c 139 s 8; 2013 c 259 s 3; 2012 c 164 s 405; 2012 c 1 s 112 (Initiative Measure No. 1163, approved November 8, 2011).]
Notes:
Effective date—2024 c 322 s 4: "Section 4 of this act takes effect January 1, 2027." [ 2024 c 322 s 8.]
Effective date—Retroactive application—2021 c 203: See notes following RCW 43.43.832.
Finding—Intent—Program development—Implementation—Program funding—2014 c 139: See notes following RCW 71A.16.050.
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: Continuing education requirements for long-term care workers. (Effective until January 1, 2027.)


doc_type: statute

jurisdiction: wa

title: RCW 74.39A.351

text:
(1) The department shall offer, directly or through contract, training opportunities sufficient for a long-term care worker to accumulate seventy hours of training within a reasonable time period. For individual providers represented by an exclusive bargaining representative, the training opportunities shall be offered through the training partnership established under RCW 74.39A.360.
(2) Training topics offered under this section shall include, but are not limited to: Client rights; personal care; mental illness; dementia; developmental disabilities; depression; medication assistance; advanced communication skills; positive client behavior support; developing or improving client-centered activities; dealing with wandering or aggressive client behaviors; medical conditions; nurse delegation core training; peer mentor training; and advocacy for quality care training.
(3) The department may not require long-term care workers to obtain the training described in this section.
[ 2018 c 278 s 24; 2012 c 164 s 404; 2012 c 1 s 113 (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.

license: public-domain-government-work

rule_set: Revised Code of Washington

catchline: Advanced training.

code: rcw

unit: section

court: Washington State Legislature


title: RCW 74.39A.360

text:
(1) If the department has any contracts for personal care services with any individual providers represented by an exclusive bargaining representative:
(a) All training and peer mentoring required under this chapter shall be provided by a training partnership;
(b) Contributions to the partnership shall be made under a collective bargaining agreement negotiated under this chapter;
(c) The training partnership shall provide reports as required by the department verifying that all individual providers have complied with all training requirements; and
(d) The exclusive bargaining representative shall designate the training partnership.
(2) When individual providers are employed by a consumer directed employer, funding for training shall be included in the labor rate component paid to the consumer directed employer as determined and funded under RCW 74.39A.530.
[ 2018 c 278 s 25; 2007 c 361 s 6.]
Notes:
Findings—Intent—2018 c 278: See note following RCW 74.39A.500.
Construction—Severability—Captions not law—Short title—2007 c 361: See notes following RCW 74.39A.009.

catchline: Training partnership.


title: RCW 74.39A.370

text:
Subject to funding provided for this specific purpose, the department of social and health services shall use additional investigative resources to address a significant growth in the long-term care complaint workload. The department shall use the resulting licensor resources to meet current statutory requirements and timelines. "Complaints," as used in this section, include both complaints about provider practice, under chapters 70.128, 18.20, 18.51, and 74.42 RCW, and complaints about individuals alleged to have abused, neglected, abandoned, or exploited residents or clients, under chapter 74.34 RCW.
[ 2011 1st sp.s. c 3 s 501.]
Notes:
Finding—Intent—2011 1st sp.s. c 3: See note following RCW 70.128.005.

catchline: Addressing long-term care complaint workload.


title: RCW 74.39A.380

text:
(1) Subject to funding provided for this specific purpose, the department of social and health services shall develop for phased-in implementation a statewide internal quality review and accountability program for residential care services. The program must be designed to enable the department to improve the accountability of staff and the consistent application of investigative activities across all long-term care settings, and must allow the systematic monitoring and evaluation of long-term care licensing and certification. The program must be designed to improve and standardize investigative outcomes for the vulnerable individuals at risk of abuse and neglect, and coordinate outcomes across the department to prevent perpetrators from changing settings and continuing to work with vulnerable adults.
(2) The department shall convene a quality assurance panel to review problems in the quality of care in adult family homes and to reduce incidents of abuse, neglect, abandonment, and financial exploitation. The state's long-term care ombuds shall chair the panel and identify appropriate stakeholders to participate. The panel must consider inspection, investigation, public complaint, and enforcement issues that relate to adult family homes. The panel must also focus on oversight issues to address de minimis violations, processes for handling unresolved citations, and better ways to oversee new providers. The panel shall meet at least quarterly, and provide a report with recommendations to the governor's office, the senate health and long-term care committee, and the house of representatives health and wellness committee by December 1, 2012.
[ 2013 c 23 s 228; 2011 1st sp.s. c 3 s 502.]
Notes:
Finding—Intent—2011 1st sp.s. c 3: See note following RCW 70.128.005.

catchline: Internal quality review and accountability program for residential care services—Quality assurance panel—Report.


title: RCW 74.39A.390

text:
(1) The legislature finds and declares that universal precautions are important health and safety protections for home care clients and workers who provide direct care for those clients. The use of personal protective equipment such as gloves is an established component of universal precautions and a key tool to protect against exposure to blood-borne pathogens such as hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Most medicaid clients are eligible to receive gloves through their medicaid benefit, yet the majority of clients are not aware of or do not use this benefit and as a result do not have gloves available in the home for individual providers to use. The legislature intends to improve the availability and usage of gloves by individual providers as part of universal precautions by ensuring that medicaid clients access gloves through their medicaid benefit.
(2) For medicaid clients, the department shall coordinate with the health care authority to assist clients receiving personal care services in accessing gloves as part of their health benefit for individual providers to use in the course of providing tasks where universal precautions are warranted. The assistance by the department and the health care authority must be designed to facilitate clients being able to access gloves on a monthly basis in a cost-effective and easy to access manner and must be consistent with requirements to receive federal matching funds under medicaid.
(3) In cases where clients are not eligible to receive such gloves under medicaid, the department shall work with the health care authority to develop a methodology to ensure clients have access to gloves on a monthly basis in a cost-effective and easy to access manner.
(4) The department shall submit a brief report with data on utilization of gloves by clients who are served by individual providers to the health care committees of the legislature by December 1, 2015.
[ 2014 c 70 s 1.]

catchline: Personal care services—Glove access.


title: RCW 74.39A.400

text:
(1) The department of social and health services shall refinance medicaid personal care services under the community first choice option. Beginning July 1, 2014, the department shall seek stakeholder input on program and system design prior to the submission of a proposal to the center for medicaid and medicare [centers for medicare and medicaid] services. The community first choice option shall be designed in such a way to meet the federal minimum maintenance of effort requirements and all service requirements as specified in federal rule. Optional services may also be included in the benefit package. In the first full year of implementation, the increase in per capita cost of services directly resulting from meeting the federal requirements of the community first choice option, as well as the cost of new optional services, shall not exceed a three percent increase over the per capita costs of personal care services in the fiscal year prior to full implementation of the community first choice option. The three percent limit on new expenditures shall not apply to cost increases that are not the result of implementing the community first choice option, including case load growth, case mix changes, inflation, vendor rate changes, expenditures necessary to meet state and federal law requirements, and any adjustments made pursuant to collective bargaining. The community first choice option must be fully implemented no later than August 30, 2015.
(2) The department shall use general fund—state savings from the refinance in this section to offset additional caseload, per capita cost increases, and staff resources necessary to implement the community first choice option. Any remaining general fund—state savings from the refinance shall be reserved for potential investments in home and community-based services for individuals with developmental disabilities or individuals with long-term care needs, including investments recommended by the joint legislative executive committee on aging and disability and the development and implementation council that the department must convene prior to submitting the proposed community first choice option to the centers for medicare and medicaid services. At a minimum, the final report to the legislature from the joint legislative executive committee on aging and disability must explore the cost and benefit of rate enhancements for providers of long-term services and supports, restoration of hours for in-home clients, additional investment in the family caregiver support program, and additional investment in the individual and family services program or other medicaid services to support individuals with developmental disabilities.
[ 2014 c 166 s 2.]
Notes:
Findings—2014 c 166: "(1) The legislature finds that the July 31, 2013, state auditor's report on developmental disabilities in Washington indicates that fifteen thousand individuals with developmental disabilities who meet the financial and physical eligibility requirements do not currently receive any services from the state. For that reason, the legislature finds that it is necessary to take action that will increase the number of eligible individuals who may access personal care services.
(2) The legislature finds that by 2030, nearly twenty percent or one out of five people in our state will be age sixty-five or older and our state is not prepared for the growing demand for long-term services and supports. Washington must plan for the future long-term services and supports needs of its residents by utilizing alternative long-term care financing options.
(3) The legislature further finds that personal care services allow individuals with significant care needs to live in their own homes and communities. By utilizing the community first choice option, an enhanced federal matching percentage would increase the funding available for these services. Further, the community first choice option may increase the self-sufficiency of clients by emphasizing the acquisition, maintenance, and enhancement of skills to complete health-related tasks. For these reasons, the legislature finds that the department of social and health services must refinance personal care services through the community first choice option." [ 2014 c 166 s 1.]

catchline: Personal care services—Community first choice option.


title: RCW 74.39A.433

text:
(1) The department shall convene a work group to review existing available continuing education courses offered to long-term care workers under RCW 74.39A.341 and provide input and recommendations for the inclusion of topics relevant to individual providers caring for a family member to be incorporated into the development of new continuing education courses. The work group must consist of stakeholders with an interest in the continuing education training requirements for individual providers, including individual providers who are caregivers to a family member with an intellectual or developmental disability, individual providers who are adult children who are caregivers to a parent, the contracted training entity providing continuing education to long-term care workers, and consumers receiving care from an individual provider who is a family member.
(2) The department shall convene the work group by July 1, 2024, and the work group shall provide recommendations for the development of new courses to the secretary and the contracted training entity by March 1, 2025. By July 1, 2025, the contracted training entity shall submit a continuing education training course development plan that includes a specific timeline for the incorporation of topics identified in subsection (1) of this section to the secretary and the relevant committees of the legislature. Beginning September 1, 2025, the contracted training entity shall prioritize the development of courses that address the topics identified in subsection (1) of this section and the continuing education course development plan when it conducts its next scheduled continuing education course update and development for long-term care workers. The contracted training entity shall continue the development of new courses that address the recommended topics identified in subsection (1) of this section and the continuing education course development plan in its regular continuing education course development.
[ 2024 c 322 s 5.]

catchline: Continuing education for long-term care workers work group.


title: RCW 74.39A.500

text:
(1) The department may establish and implement a consumer directed employer program to provide personal care, respite care, and similar services to individuals with functional impairments under programs authorized through the medicaid state plan or medicaid waiver authorities and similar state-funded in-home care programs.
(a) The consumer directed employer program is a consumer directed program and must be operated in a manner consistent with federal medicaid requirements. The consumer directed employer is the legal employer of individual providers.
(b) Under the consumer directed employer program, the consumer is the managing employer of individual providers and retains the primary right to select, dismiss, assign hours, and supervise the work of one or more individual providers, as long as the consumer's actions are consistent with the consumer's plan of care, this chapter, and state and federal law.
(2) The department shall endeavor to select and contract with one consumer directed employer to be a medicaid provider that will coemploy individual providers. The department shall make every effort to select a single qualified vendor. In the event it is not possible to contract with a single vendor, the department is authorized to contract with up to two vendors. The department's activities to identify, select, and contract with a consumer directed employer are exempt from the requirements of chapter 39.26 RCW.
(a) When contracting with a consumer directed employer, the department should seek to contract with a vendor that demonstrates:
(i) A strong commitment to consumer choice, self-direction, and maximizing consumer autonomy and control over daily decisions; and
(ii) A commitment to recruiting and retaining a high quality and diverse workforce and working with a broad coalition of stakeholders in an effort to understand the changing needs of the workforce and consumer needs and preferences.
(b) Additional factors the department should consider in selecting a vendor include, but are not limited to, the vendor's:
(i) Ability to provide maximum support to consumers to focus on directing their own services through a model that recognizes that the provision of employer responsibility and human resource administration support is integral to successful self-directed home care programs;
(ii) Commitment to engage and work closely with consumers in design, implementation, and ongoing operations through an advisory board, focus group, or other methods as approved by the department;
(iii) Focus on workforce retention and creating incentives for qualified and trained providers to meet the growing needs of state long-term care consumers;
(iv) Ability to meet the state's interest in preventing or mitigating disruptions to consumer services;
(v) Ability to deliver high quality training, health care, and retirement, which may include participation in existing trusts that deliver those benefits;
(vi) Ability to comply with the terms and conditions of employment of individual providers at the time of the transition;
(vii) Commitment to involving its home care workforce in decision making;
(viii) Vision for including and enhancing home care workers as a valued member of the consumer's care team, as desired and authorized by the consumer and reflected in the consumer's plan of care; and
(ix) Ability to build and adapt technology tools that can enhance efficiency and provide better quality of services.
(c) In order to be qualified as a consumer directed employer, an entity must meet the requirements in: (i) Its contract with the department; (ii) the medicaid state plan; (iii) rules adopted under this chapter, if any; and (iv) this section.
(d) Any qualified and willing individual may apply to become an employee of a consumer directed employer and may work as an individual provider when selected by a consumer.
(e) A consumer directed employer that holds a contract with the department to provide medicaid services through the employment of individual providers is deemed to be a certified medicaid provider.
(f) A consumer directed employer is not a home care agency under chapter 70.127 RCW.
(g) A consumer directed employer does not need a separate licensure or certification category.
(h) A consumer directed employer that also provides home care services under chapter 70.127 RCW must demonstrate to the department's satisfaction that it operates the programs under separate business units, and that its business structures, policies, and procedures will prevent any conflicts of interest.
(3) If the department selects and contracts with a consumer directed employer, the department shall determine when to terminate the department's contracts with individual providers.
(a) Until the department determines the transition to the consumer directed employer program is complete, the state shall continue to administer the individual provider program for the remaining contracted individual providers and to act as the public employer solely for the purpose of collective bargaining under RCW 74.39A.270 for those directly contracted individual providers.
(b) Once the department determines that the transition to the consumer directed employer is complete, the department may no longer contract with individual providers, unless there are not any contracted consumer directed employers available.
(4) The department of labor and industries shall initially place individual providers employed by a consumer directed employer in the classification for the home care services and home care referral registry. After the department determines that the transition to the consumer directed employer program is complete, the department of labor and industries may, if necessary, adjust the classification and rate in accordance with chapter 51.16 RCW.
(5) After the date on which the department enters into a contract with the consumer directed employer and determines the transition to the consumer directed employer program is complete, biennial funding in the next ensuing biennium for case management and social work shall be reduced by no more than: Two million nine hundred eight thousand dollars for area agencies on aging; one million three hundred sixty-one thousand dollars for home and community services; and one million two hundred eighty-nine thousand dollars for developmental disabilities.
[ 2024 c 224 s 4; 2021 c 186 s 1; 2018 c 278 s 3.]
Notes:
Retroactive application—Applicability—2024 c 224: See note following RCW 49.46.800.
Findings—Intent—2018 c 278: "The legislature finds that quality long-term in-home care services allow Washington seniors, persons with disabilities, and their families the choice of remaining in their own homes and communities, including whether to receive residential services, use licensed home care agencies, or coemploy individual providers.
The legislature further finds that long-term in-home care services are a less costly alternative to institutional care, saving Washington taxpayers significant amounts through lower reimbursement rates. Thousands of Washington seniors and persons with disabilities exercise their choice to live in their own homes and receive needed assistance through in-home services.
The legislature finds that many Washington seniors and persons with disabilities currently receive long-term in-home care services from individual providers hired directly by them under programs authorized through the medicaid state plan or medicaid waiver authorities and similar state-funded in-home care programs.
The legislature further finds that establishing a consumer directed employer program will: (1) Support the state's intent for consumers to direct their own services; (2) allow the state to focus on the provision of case management services to consumers; (3) enhance the efficient and effective delivery of home-based services by using an entity that provides the administrative functions of an employer and supports the consumer to manage the services provided in their own homes; (4) eliminate the possible classification of the state as the joint employer of individual providers; (5) prevent or reduce unnecessary and costly utilization of hospitals and institutions by taking a step toward integration of home care workers into a coordinated delivery system; and (6) support the development of new technology and interventions to enhance the skills of home care workers and services provided to consumers.
The legislature does not intend for the consumer directed employer program to replace the consumers' option to select a qualified home care agency to provide authorized in-home care." [ 2018 c 278 s 1.]
Consumer directed employer procurement process—Transition—Readiness review—Limitations—2021 c 186; 2018 c 278: "Upon the governor's signature of this act into law, the department of social and health services may begin the procurement process to select a consumer directed employer. The department shall initiate the transition of individual providers to the consumer directed employer no later than December 31, 2021, when it determines it is ready to do so based upon a readiness review conducted by the department. Nothing in this act shall be deemed to result in individual providers becoming state employees or vesting in the state's public employment retirement system." [ 2021 c 186 s 3; 2018 c 278 s 30.]

catchline: Consumer directed employer program—Establishment—Structure—Vendor qualifications—Transition—Department duties.


title: RCW 74.39A.505

text:
The department may adopt any rules as it deems necessary to implement the provisions of chapter 278, Laws of 2018.
[ 2018 c 278 s 4.]
Notes:
Findings—Intent—2018 c 278: See note following RCW 74.39A.500.

catchline: Consumer directed employer program—Rule-making authority—2018 c 278.


title: RCW 74.39A.510

text:
(1) Nothing in chapter 278, Laws of 2018 modifies the department's:
(a) Authority to establish a plan of care for each consumer, including establishing the number of hours in a week a consumer may assign to any one provider consistent with RCW 74.39A.525;
(b) Core responsibility to manage long-term in-home care services under this chapter, including determination of the level of care that each consumer is eligible to receive;
(c) Obligation to comply with the federal medicaid laws and regulations, the state medicaid plan, or any waiver granted by the federal department of health and human services; and to ensure federal financial participation in the provision of services.
(2) Nothing in chapter 278, Laws of 2018 modifies the legislature's right to make programmatic modifications to the delivery of state services under this title, including eligibility standards for consumers, standards for individual providers, and the nature of services provided.
(3) Nothing in this chapter shall cause individuals who were hired as long-term care workers prior to January 7, 2012, to lose their exemption from certification requirements under RCW 18.88B.041 solely because they became employees of a consumer directed employer.
[ 2018 c 278 s 5.]
Notes:
Findings—Intent—2018 c 278: See note following RCW 74.39A.500.

catchline: Consumer directed employer program—Limitations.


title: RCW 74.39A.515

text:
(1) If a consumer directed employer employs individual providers, then the consumer directed employer shall:
(a) Verify that each individual provider has met any training requirements established under this chapter and rules adopted under this chapter;
(b) Conduct background checks on individual providers as required under this chapter, RCW 43.43.830 through 43.43.842, 43.20A.710, and the rules adopted by the department; or verify that a background check has been conducted for each individual provider and that the background check is still valid in accordance with department rules;
(c) Implement an electronic visit verification system that complies with federal requirements, or in the absence of an electronic visit verification system, monitor a statistically valid sample of individual provider's claims to the receipt of services by the consumer;
(d) Monitor individual provider compliance with employment requirements;
(e) As authorized and determined by the consumer, provide a copy of the consumer's plan of care to the individual provider who has been selected by the consumer;
(f) Verify the individual provider is able and willing to carry out his or her responsibilities under the plan of care;
(g) Take into account information provided by the consumer or the consumer's case manager about the consumer's specific needs;
(h) Discontinue the individual provider's assignment to a consumer when the consumer directed employer has reason to believe, or the department or area agency on aging has reported, that the health, safety, or well-being of a consumer is in imminent jeopardy due to the performance of the individual provider;
(i) Reject a request by a consumer to assign a specific person as his or her individual provider, if the consumer directed employer has reason to believe that the individual will be unable to appropriately meet the care needs of the consumer; and
(j) Establish a dispute resolution process for consumers who wish to dispute decisions made under (h) and (i) of this subsection.
(2) If any individual providers are contracted with the department to provide services under this chapter, the case management responsibilities of RCW 74.39A.090 and 74.39A.095 shall include:
(a) Verifying that each individual provider has met all training requirements under this chapter and department rules;
(b) Conducting background checks on individual providers as required under this chapter, RCW 43.43.830 through 43.43.842, 43.20A.710, and department rules; or verifying that background checks have been conducted for each individual provider and that the background check is still valid in accordance with department rules;
(c) Monitoring that the individual provider is providing services as outlined in the consumer's plan of care;
(d) Attaching the consumer's plan of care to the contract with the individual provider;
(e) Verifying with the individual provider that he or she is able and willing to carry out his or her responsibilities under the plan of care;
(f) Terminating the contract between the department and the individual provider if the department, area agency on aging, or federally recognized Indian tribe finds that an individual provider's inadequate performance or inability to deliver quality care is jeopardizing the health, safety, or well-being of a consumer receiving service under this section;
(g) Summarily suspending the contract pending a fair hearing, if there is reason to believe the health, safety, or well-being of a consumer is in imminent jeopardy; and
(h) Rejecting a request by a consumer receiving services under this section to have a family member or other person serve as his or her individual provider if the department, area agency on aging, or federally recognized Indian tribe has reason to believe that the family member or other person will be unable to appropriately meet the care needs of the consumer.
(3) The consumer may request a fair hearing under chapter 34.05 RCW to contest a planned action of the department under subsection (2)(g) and (h) of this section.
(4) The department may adopt rules to implement this section.
[ 2022 c 255 s 3; 2018 c 278 s 13.]
Notes:
Findings—Intent—2018 c 278: See note following RCW 74.39A.500.

catchline: Duties of consumer directed employers that employ individual providers—Case management responsibilities—Rule making.


title: RCW 74.39A.520

text:
The following provisions apply only if individual providers are employed by a consumer directed employer:
(1) Consumers and prospective consumers have the right to select, schedule, supervise the work of, and dismiss any individual provider providing services to them consistent with the consumer's plan of care.
(2) Nothing in this section modifies:
(a) The consumer directed employer's authority to:
(i) Refuse to employ an individual provider who may not be able to meet the needs of a particular consumer;
(ii) Assign an individual provider who has been dismissed by a consumer to a different consumer who has selected the individual provider;
(iii) Provide information to a consumer about an individual provider's work history as an employee of the consumer directed employer; or
(iv) Terminate the provider's employment when the individual is not meeting the needs of the consumer.
(b) The consumer's right to:
(i) Assign hours to one or more individual providers consistent with this chapter, the rules adopted under this chapter, and his or her plan of care; or
(ii) Dismiss an individual provider.
[ 2018 c 278 s 20.]
Notes:
Findings—Intent—2018 c 278: See note following RCW 74.39A.500.

catchline: Individual providers employed by a consumer directed employer—Consumer's right to select, schedule, supervise, or dismiss individual providers.


title: RCW 74.39A.525

text:
(1) Except as authorized by subsection (3) or (4) of this section or otherwise required by law, the department may not permit a client to use a single department-contracted individual provider for more than forty hours in one workweek.
(2) A consumer directed employer that employs individual providers:
(a) Must permit a client to use a single individual provider more than forty hours in a workweek if required by rules adopted under subsection (3) of this section;
(b) May permit an individual provider to work additional hours in accordance with subsection (4) of this section; and
(c) May permit an individual provider to work more than forty hours per workweek.
(3) The department shall adopt rules describing criteria under which a consumer may be permitted to use a single individual provider for more than forty hours per week. At a minimum, the criteria shall limit the state's exposure to exceeding the expenditure limits established in this section, require consumers to use good faith efforts to locate additional providers, address travel time from worksite to worksite, and address the following needs of consumers:
(a) Emergencies that could pose a health and safety risk for consumers; and
(b) Circumstances that could increase the risk of institutionalization without the use of overtime.
(4) An individual provider may be authorized to work more than forty hours in a workweek:
(a) If the department established a permanent workweek limit between forty and one-quarter hours and sixty-five hours for an individual provider, based upon work performed by the individual provider in January 2016, as modified by an appeal, if any; or
(b) For required training under RCW 74.39A.074, 74.39A.076, and 74.39A.341, and for required travel time between clients.
(5) The cost of overtime incurred under subsections (2)(a) and (b) and (4) of this section shall be included in a consumer directed employer labor rate determined in accordance with RCW 74.39A.530. The following overtime costs shall not be included in the labor rate under RCW 74.39A.530:
(a) Costs incurred under subsection (2)(c) of this section;
(b) Costs incurred by an employee of a consumer directed employer for services provided to an individual who is not a consumer;
(c) Costs for services not authorized under this chapter; and
(d) Overtime costs incurred because an employee of a consumer directed employer performed work:
(i) For both a consumer and an individual who is not a consumer; or
(ii) Worked as both an individual provider and as an employee of the licensed home care agency affiliated with the consumer directed employer.
(6) Expenditures for hours in excess of forty hours each workweek under subsections (1) and (2) of this section shall not exceed eight and one-fourth percent of the total actual authorized personal care hours for the fiscal year as projected by the caseload forecast council.
(7) The caseload forecast council may adopt a temporary adjustment to the eight and one-fourth percent of the total average in-home personal care hours projection for that fiscal year, up to a maximum of ten percent, if it finds a higher percentage of overtime hours is necessitated by a shortage of individual providers to provide adequate client care, taking into consideration factors including the criteria in subsection (1) of this section and rules adopted by the department. If the council elects to temporarily increase the limit, it may do so only upon a majority vote of the council.
(8) The department shall prepare expenditure reports beginning September 1, 2018, and on September 1st every year thereafter. The report shall include the results of the department's monitoring of authorizations and costs of hours in excess of forty hours each workweek. If the department determines that the annual expenditures will exceed the limitation established in subsection (3) of this section, the department shall take those actions necessary to ensure compliance with the limitation.
(9) The expenditure reports must be submitted to the legislative fiscal committees and the joint legislative-executive overtime oversight task force. The joint legislative-executive overtime oversight task force members are as follows:
(a) Two members from each of the two largest caucuses of the senate, appointed by the respective caucus leaders.
(b) Two members from each of the two largest caucuses of the house of representatives, appointed by the speaker of the house of representatives.
(c) The governor shall appoint members representing the department of social and health services and the office of financial management.
(d) The governor shall appoint two members representing individual providers and two members representing consumers receiving personal care or respite care services from an individual provider.
(10) The task force shall meet when the department determines that it is projected to or is exceeding the expenditure limits established in subsection (6) of this section but may meet more frequently as desired by the task force. The task force shall choose cochairs, one from among the legislative members and one from among the executive branch members.
(11) The department may take appropriate corrective action, up to and including termination of an individual provider's contract, when the individual provider works more than his or her workweek limit in any given workweek.
[ 2018 c 278 s 26.]
Notes:
Findings—Intent—2018 c 278: See note following RCW 74.39A.500.

catchline: Overtime criteria—Department-contracted individual providers—Individual providers employed by a consumer directed employer—Rule making—Expenditure reports—Joint legislative-executive overtime oversight task force.


title: RCW 74.39A.530

text:
If the department contracts with a consumer directed employer:
(1) A rate-setting board is established which is comprised of the voting members and nonvoting members to evaluate and propose changes in the rates paid to the consumer directed employer.
(a) The following members shall be voting members:
(i) One representative from the office of the governor;
(ii) One representative from the department;
(iii) One representative from each consumer directed employer; and
(iv) One designee from the exclusive bargaining representative of individual providers or, in the absence of an exclusive bargaining representative, a designee from the consumer directed employer workforce chosen by the employees of the consumer directed employer.
(b) The following nine members of the board shall be nonvoting advisory members:
(i) Four legislators, one member from each caucus of the house of representatives and the senate;
(ii) One representative from the state council on aging, appointed by the governor;
(iii) One representative of an organization representing people with intellectual or developmental disabilities appointed by the governor;
(iv) One representative of an organization representing people with physical disabilities appointed by the governor;
(v) One representative from the licensed home care agency industry chosen by the largest association of home care agencies that primarily serves state-funded clients of the state; and
(vi) One home care worker chosen by the largest organization of home care workers of the state.
(c) The appointments by the governor shall be made by April 1st in even-numbered years. The incumbent member of the board shall serve until their replacement is appointed.
(2) When the board membership has four voting members listed in subsection (1)(a) of this section, each voting member shall have one vote. When there are five voting members due to two consumer directed employer representatives, each voting member listed in subsection (1)(a) of this section shall have two votes with the exception of the consumer directed employer representatives who shall have one vote. Voting members cannot split their votes. A majority of the voting members of the board constitutes a quorum for the transaction of business and is necessary for any action taken by the board.
(3) Beginning in the year following the establishment of the initial rate, and in every even-numbered year thereafter, the rate-setting board shall attempt to determine a proposed labor rate, including a specific amount for health and training benefits by considering the factors listed in RCW 41.56.530 (1) and (5). In addition, the rate-setting board shall attempt to determine an administrative rate for the consumer directed employer. In determining the consumer directed employer administrative rate, the rate-setting board may not recommend a rate that represents more than 20 percent of the sum of the consumer directed employer labor rate and the consumer directed employer administrative rate.
In addition, the rate-setting board shall review the projection from the department of the portion of the vendor rate dedicated to the wages and benefits for home care agency workers who provide direct care and the required employer contributions or premiums established in RCW 74.39A.310. The rate-setting board shall take testimony and shall attempt to determine a home care agency administrative rate. In determining the home care agency administrative rate, the rate-setting board may not recommend a rate that represents more than 20 percent of the projected home care agency vendor rate.
(4) The department shall provide administrative support for the board.
(a) At the commencement of the rate-setting activities of the board, the voting members must first attempt to select an additional voting member, who will chair the rate-setting board and will cast a tie-breaking vote if the voting members identified in subsection (1) of this section are unable to pass by majority vote on the labor rate.
(b) On the first occasion that the voting members identified in subsection (1)(a) of this section fail to select a tie-breaking member by a majority vote, the chair member will be selected as follows:
(i) The voting member representing the office of the governor shall request a list of five qualified arbitrators, or six if there are two consumer directed employers, from the federal mediation and conciliation service.
(ii) If a majority of the voting members of the board cannot agree on the selection of a neutral arbitrator from the list, the representative from the consumer directed employer who first contacted the department will strike a name from the list first. The representative from the office of the governor shall then strike a name from the list, the designee from the exclusive bargaining representative or, in the absence of an exclusive bargaining representative, the designee from the consumer directed employer workforce shall strike a name from the list, if there are two consumer directed employers, the second representative will strike a name from the list, and finally the representative from the department shall strike a name from the list.
(iii) The name of the arbitrator remaining after the final strike shall be the chair member of the board.
(iv) If that person is not willing or available to be the chair member, the second to last person remaining on the list shall be asked to be the chair member. If the second to last person is not willing or available, the third to last person shall be asked to be the chair member. This process of selecting an arbitrator shall be continued until a chair member of the board is appointed.
(c) On the next occasion that the voting members identified in subsection (1)(a) of this section fail to select a chair member by a majority vote, the chair member will be selected using the method described in (b) of this subsection except that the order of board members striking names from the list, described in (b)(ii) of this subsection, shall be reversed.
(d) On each successive occasion that the voting members identified in subsection (1)(a) of this section fail to select a chair member by a majority vote, the order of voting members striking names from the list will continue to alternate between the order described in (b)(ii) and (c) of this subsection.
(5)(a) If an agreement on a proposed labor rate is not reached by a majority of the voting members of the rate-setting board prior to August 1st, then the labor rate shall be determined by a majority of the voting members of the rate-setting board, including the vote of the chair member, who was selected in accordance with subsections (1) and (4)(a) of this section. If an agreement over the labor rate is not reached prior to September 1st, then the labor rate shall be determined by the sole vote of the chair member, who was selected in accordance with subsections (1) and (4)(a) of this section.
(b) If an agreement on a proposed administrative rate for the consumer directed employer or a home care agency administrative rate, or both, is not reached by a majority of the voting members of the rate-setting board prior to August 1st, then the administrative rate for the consumer directed employer or the home care agency administrative rate, or both, shall be determined by the department. In determining the home care agency administrative rate, the department may not recommend a rate that represents more than 20 percent of the home care agency vendor rate. In determining the consumer directed employer administrative rate, the department may not recommend a rate that represents more than 20 percent of the sum of the consumer directed employer labor rate and the consumer directed employer administrative rate.
(6) After the rates have been determined in accordance with subsections (2) through (5) of this section, they shall be submitted to the director of the office of financial management by October 1st prior to the legislative session during which the requests are to be considered for review. If the director of the office of financial management certifies them as being feasible financially for the state, the governor shall include a request for funds necessary to implement the proposed rates as part of the budget document submitted by the office of the governor under RCW 43.88.030 and 43.88.060. The legislature shall approve or reject the request for funds as a whole.
(7) If the legislature rejects the request under subsection (5) of this section, the matter shall return to the rate-setting board established under this section for further consideration. Until the legislature approves a request for funds under this section, the current labor rate shall stay in effect.
(8) The labor rate approved by the legislature shall be an hourly rate paid to the consumer directed employer. The labor rate shall be used exclusively for paying the wages, associated taxes, and benefits of individual providers. The consumer directed employer shall have full discretion to set wages and benefits for individual providers, except as provided in: (a) Subsections (9) and (10) of this section; (b) any specific legislative appropriation requirement; or (c) a collective bargaining agreement, if applicable.
(9) The labor rate shall include a specific hourly amount that the consumer directed employer may use only for health benefits for individual providers.
(10) The labor rate shall include a specific hourly amount that the consumer directed employer may only use for training, testing, and certification costs, and associated costs for the administration of training, testing, and certification scheduling and compliance for individual providers.
(11) The department shall have the authority to modify the labor rate, the administrative rate, and the home care agency administrative rate between the rate-setting activities of the rate-setting board without convening the rate-setting board or following the preceding rate-setting process, subject to the following conditions:
(a) The department finds the changes to the rates necessary to:
(i) Recognize changes to the required expenditures for the department or the required costs for the consumer directed employer associated with changes to tax rates, required employer contributions, mileage rate allowances, and utilization of overtime to comply with RCW 74.39A.525;
(ii) Comply with a significant change in state or federal rule or law that would impact the ability of the consumer directed employer to operate; or
(iii) Adjust the home care agency administrative rate to maintain the administrative rate at no more than 20 percent of the total home care agency vendor rate;
(b) Changes to the rates shall not exceed two percent of the combined labor and administrative rates; and
(c) Any increase to the rates is contingent on appropriation of adequate funds by the legislature.
(12) For the purpose of this section:
(a) "Labor rate" is defined as that portion of the hourly rate for the consumer directed employer that is to be used by the consumer directed employer to compensate its workers, including wages, benefits, and any associated taxes.
(b) "Administrative rate" is defined as that portion of the hourly rate for the consumer directed employer that is to be used by the consumer directed employer to perform its administrative duties including losses for bad debt, compensation for business and occupation taxes on the labor and administrative rates, and all other costs associated with operating as the consumer directed employer. Funds related to personal protective equipment for individual providers must be considered part of the administrative rate.
(c) "Home care agency administrative rate" has the same meaning as outlined in RCW 74.39A.310.
(d) "Home care agency vendor rate" is defined as the sum of the portion of the vendor rate dedicated to the wages, benefits, and required employer contributions or premiums for home care agency workers who provide direct care and the home care agency administrative rate.
[ 2026 c 85 s 2; 2021 c 186 s 2; 2018 c 278 s 27.]
Notes:
Findings—Intent—2018 c 278: See note following RCW 74.39A.500.

catchline: Consumer directed employer program—Labor and administrative rates—Rate-setting board—Funding process.


title: RCW 74.39A.540

text:
(1) The home care safety net assessment work group is established, with the following members:
(a) The director of the health care authority, or the director's designee;
(b) The secretary of the department, or the secretary's designee;
(c) The secretary of the department of health, or the secretary's designee;
(d) The director of the department of revenue, or the director's designee;
(e) A representative from the exclusive bargaining representative of individual providers;
(f) A representative of a coalition representing home care agencies serving medicaid clients;
(g) A representative of an association representing home care and home health agencies; and
(h) A representative from each consumer directed employer in Washington.
(2) The work group shall develop a home care safety net assessment proposal to secure federal matching funds under federally prescribed programs available through the state medicaid plan or a waiver. In developing the proposal, the work group shall consider the financial information provided by consumer directed employers and in-home services agencies under RCW 70.127.295 to the extent authorized under RCW 70.127.295(4)(b)(ii) and any relevant data analysis of the financial information provided by a private entity under contract with the health care authority pursuant to subsection (3) of this section.
(3) The health care authority may contract with a private entity to provide data analysis of the financial information submitted by in-home services agencies and consumer directed employers as necessary to inform the work group's development of a home care safety net assessment proposal. The data analysis must include the development of various financial modeling options that may meet federal regulations for approval of the assessment.
(4) Staff support to the work group must be provided by the health care authority.
(5) The work group shall report its findings to the governor and the appropriate committees of the legislature by December 1, 2024. The report must include recommendations related to the elements necessary to adopt and implement a home care safety net assessment proposal that meets the requirements needed for federal approval.
[ 2023 c 209 s 2.]

catchline: Home care safety net assessment work group—Securing federal funding—Contracting—Reporting.


title: RCW 74.39A.550

text:
Subject to the availability of amounts appropriated for this specific purpose, beginning June 1, 2025, the department shall annually report on the status of:
(1) The long-term care worker supply;
(2) The average wages of long-term care workers compared to entry-level positions in other industries;
(3) Projections of service demands;
(4) Geographic disparities in the supply of long-term care workers; and
(5) Any race, gender, or other worker demographic data available through preexisting administrative data sources.
[ 2023 c 424 s 9.]

catchline: Long-term care industry data—Annual report.


title: RCW 74.39A.560

text:
(1)(a) Any benefit administered by the department through contracted entities to provide medically tailored meals to clients under this chapter shall, to the extent possible, prioritize the purchase of medically tailored meals produced by medically tailored meal vendors that are nonprofit organizations or small businesses that are able to provide locally sourced, fresh, whole foods or from scratch prepared meals.
(b) Medically tailored meal vendors shall comply with the client's medically tailored meal nutrition care plan. The medically tailored meal vendor shall have a qualified medical professional review and approve the menus provided in response to a nutrition care plan for medically tailored meals.
(c) All medically tailored meals provided to clients under this chapter shall:
(i) Align with evidence-based nutritional practice guidelines for treating the specified condition;
(ii) Offer accommodations in dietary needs, allergy restrictions, and cultural preferences;
(iii) Prioritize local, whole foods or from scratch prepared meals unless otherwise required to appropriately meet the needs of a client;
(iv) Provide at least 500 calories, or otherwise meet a client's medically appropriate energy needs; and
(v) Provide one-third of the recommended dietary reference intakes for carbohydrates and protein as established by the food and nutrition board of the national academy of medicine, unless otherwise permitted.
(2) For the purposes of this section:
(a) "Locally sourced" means:
(i) Agricultural commodities that were grown, raised, harvested, caught, or otherwise derived fully or in part within the state of Washington; or
(ii) Fully or in part prepared, processed, assembled, cooked, or packaged within the state of Washington.
(b) "Medically tailored meal" means a fresh or frozen meal that is designed by a qualified medical professional for the treatment of one or more medical conditions of a client.
(c) "Medically tailored meal vendor" means a vendor that provides medically tailored meals according to specifications from a qualified medical professional.
(d) "Qualified medical professional" means a person who holds a credential issued by a disciplining authority under RCW 18.130.040 and whose credential includes the authority to establish and tailor nutrition care plans to meet the medical needs of a referred client.
[ 2026 c 200 s 2.]
Notes:
Intent—Findings—2026 c 200: "(1) The legislature finds that:
(a) Washington state recently received authority from the federal centers for medicare and medicaid services to administer a health benefit under the apple health program to provide medically tailored meals to certain medical assistance clients with health-related conditions that require nutrition supports to improve their health outcomes;
(b) The provision of fresh, locally sourced meals provides clients with proper nutrition to manage their health conditions and an example of healthier food options that can promote healthier future meal decisions;
(c) The production and delivery of medically tailored meals at the local level can reduce pollution and other impacts on the environment; and
(d) Local delivery drivers of medically tailored meals from a client's community are able to connect directly with clients and monitor their health and emotional status and alert community service providers when services may be necessary.
(2) The legislature, therefore, intends to prioritize the provision of medically tailored meals to clients enrolled in state-supported medical assistance programs by medically tailored meal vendors that are able to provide locally sourced whole foods through the use of community-based delivery drivers." [ 2026 c 200 s 1.]

catchline: Medically tailored meals.


title: RCW 74.39A.570

text:
(1)(a) Except as provided in (b) of this subsection, the department may conduct no more than one annual routine review per community residential service business provider in each of the following subject areas, and shall combine review activities in multiple subject areas where possible:
(i) Client finances;
(ii) Client service plans;
(iii) Federal compliance reviews;
(iv) Client community integration;
(v) Provider finances; and
(vi) General quality assurance.
(b) The limitation on routine reviews as described in (a) of this subsection does not apply to activities related to investigations by adult protective services, incident reports, complaint investigations, citation follow-up activities, or mortality reviews, or to monitoring and oversight activities that are otherwise required by federal or state law.
(2) The department shall adopt administrative rules or department policies that require document and record sharing between and within department divisions when performing monitoring and oversight activities in order to minimize multiple requests for documents or records that have already been provided by a community residential service business provider based on a previous request by the department. The rules or policies may identify exceptions to this requirement for ongoing investigations and other circumstances in which document or record sharing is not possible due to confidentiality requirements.
[ 2026 c 22 s 2.]
Notes:
Finding—Intent—2026 c 22: "The legislature finds that community residential service business providers, who serve over 87 percent of clients in residential services, play a vital role in ensuring that individuals with intellectual and developmental disabilities can live safely and independently in their communities. These providers are subject to multiple audits, reviews, and reporting requirements from various divisions within the department of social and health services and other state and federal oversight entities. While accountability and quality oversight are essential, duplicative and overlapping requirements divert limited administrative resources away from direct client support and create inefficiencies across the system.
It is the intent of the legislature to streamline, align, and modernize reporting and audit processes for community residential service business providers. The legislature intends that the department of social and health services identify and eliminate redundant or conflicting audit and reporting requirements, consolidate similar reviews where possible, and improve data sharing across and within the department's divisions to reduce administrative burden." [ 2026 c 22 s 1.]

catchline: Community residential service business providers—Administrative review—Rules or policies.


title: RCW 74.39A.800

text:
(1) If any provision of chapter 1, Laws of 2012 triggers changes to an agreement reached under RCW 74.39A.300, the changes must go into effect immediately without need for legislative approval.
(2) The requirements contained in RCW 74.39A.300 and chapter 1, Laws of 2012 constitute ministerial, mandatory, and nondiscretionary duties. Failure to fully perform such duties constitutes a violation of chapter 1, Laws of 2012. Any person may bring an action to require the governor or other responsible persons to perform such duties. Such action may be brought in the superior court, at the petitioner's option, for (a) Thurston county, or (b) the county of the petitioner's residence or principal place of business, or such action may be filed directly with the supreme court, which is hereby given original jurisdiction over such action.
[ 2012 c 1 s 304 (Initiative Measure No. 1163, approved November 8, 2011).]
Notes:
Intent—Findings—Performance audits—Spending limits—Construction—Effective date—Short title—2012 c 1 (Initiative Measure No. 1163): See notes following RCW 74.39A.056.

catchline: Changes to agreements—Performance of duties.


title: RCW 74.39A.900

text:
Section captions as used in this act constitute no part of the law.
[ 1993 c 508 s 10.]

catchline: Section captions—1993 c 508.


title: RCW 74.39A.901

text:
If any part of this chapter or a collective bargaining agreement under this chapter is found by a court of competent jurisdiction 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 chapter or the agreement 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 chapter or the agreement in its application to the agencies concerned. The rules under this chapter shall meet federal requirements that are a necessary condition to the receipt of federal funds by the state.
[ 2004 c 3 s 5; 1993 c 508 s 11.]
Notes:
Severability—Effective date—2004 c 3: See notes following RCW 74.39A.270.

catchline: Conflict with federal requirements.


title: RCW 74.39A.903

text:
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 immediately [May 18, 1993].
[ 1993 c 508 s 13.]

catchline: Effective date—1993 c 508.


title: RCW 74.41.010

text:
The legislature recognizes that:
(1) Most care provided for functionally disabled adults is delivered by family members or friends who are not compensated for their services. Family involvement is a crucial element for avoiding or postponing institutionalization of the disabled adult.
(2) Family or other caregivers who provide continuous care in the home are frequently under substantial stress, physical, psychological, and financial. The stress, if unrelieved by family or community support to the caregiver, may lead to premature or unnecessary nursing home placement.
(3) Respite care and other community-based supportive services for the caregiver and for the disabled adult could relieve some of the stresses, maintain and strengthen the family structure, and postpone or prevent institutionalization.
(4) With family and friends providing the primary care for the disabled adult, supplemented by community health and social services, long-term care may be less costly than if the individual were institutionalized.
[ 1984 c 158 s 1.]

catchline: Legislative findings.


title: RCW 74.41.020

text:
It is the intent of the legislature to provide a comprehensive program of long-term care information and support, including in-home and out-of-home respite care services, for family and other unpaid caregivers who provide the daily services required when caring for adults with functional disabilities. The family caregiver long-term care information and support services shall:
(1) Provide information, relief, and support to family or other unpaid caregivers of adults with functional disabilities;
(2) Encourage family and other nonpaid individuals to provide care for adults with functional disabilities at home, and thus offer a viable alternative to placement in a long-term care facility;
(3) Ensure that respite care is made generally available on a sliding-fee basis to eligible participants in the program according to priorities established by the department;
(4) Be provided in the least restrictive setting available consistent with the individually assessed needs of the adults with functional disabilities;
(5) Include services appropriate to the needs of persons caring for individuals with dementing illnesses; and
(6) Provide unpaid family and other unpaid caregivers with services that enable them to make informed decisions about current and future care plans, solve day-to-day caregiving problems, learn essential caregiving skills, and locate services that may strengthen their capacity to provide care.
[ 2000 c 207 s 2; 1987 c 409 s 1; 1984 c 158 s 2.]
Notes:
Short title—2000 c 207: "This act shall be known and cited as the Fred Mills act." [ 2000 c 207 s 1.]

catchline: Intent.


title: RCW 74.41.030

text:
Unless the context clearly indicates otherwise, the definitions in this section apply throughout this chapter.
(1) "Family caregiver long-term care information and support services" means providing long-term care information and support services to unpaid family and other unpaid caregivers of adults with functional disabilities, including but not limited to providing: (a) Information about available public and private long-term care support services; (b) assistance in gaining access to an array of appropriate long-term care family caregiver services; (c) promotion and implementation of support groups; (d) caregiver training to assist the nonpaid caregivers in making decisions and solving challenges relating to their caregiving roles; (e) respite care services; and (f) additional supportive long-term care services that may include but not be limited to translating/interpreter services, specialized transportation, coordination of health care services, help purchasing needed supplies, durable goods, or equipment, and other forms of information and support necessary to maintain the unpaid caregiving activity.
(2) "Respite care services" means relief care for families or other caregivers of adults with functional disabilities, eligibility for which shall be determined by the department by rule. The services provide temporary care or supervision of adults with functional disabilities in substitution for the caregiver. The term includes adult day services.
(3) "Eligible participant for family caregiver long-term care information and support services" means an adult who needs substantially continuous care or supervision by reason of his or her functional disability and may be at risk of placement into a long-term care facility.
(4) "Eligible participant for respite care services" means an adult who needs substantially continuous care or supervision by reason of his or her functional disability and is also assessed as requiring placement into a long-term care facility in the absence of an unpaid family or other unpaid caregiver.
(5) "Unpaid caregiver" means a spouse, relative, or friend who has primary responsibility for the care of an adult with a functional disability and who does not receive financial compensation for the care. To be eligible for respite care and for family caregiver support services, the caregiver is considered the client.
(6) "Adult day services" 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.
(7) "Department" means the department of social and health services.
[ 2000 c 207 s 3; 1987 c 409 s 2; 1984 c 158 s 3.]
Notes:
Short title—2000 c 207: See note following RCW 74.41.020.

catchline: Definitions.


title: RCW 74.41.040

text:
The department shall administer this chapter and shall establish such rules and standards as the department deems necessary in carrying out this chapter. The department shall not require the development of plans of care or discharge plans by nursing homes or adult family homes providing respite care service under this chapter. Assisted living facilities providing respite care services shall comply with the assessment and plan of care provisions of RCW 18.20.350.
The department shall develop standards for the 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 to participate in paying for respite care.
[ 2012 c 10 s 68; 2008 c 146 s 2; 1987 c 409 s 3; 1984 c 158 s 4.]
Notes:
Application—2012 c 10: See note following RCW 18.20.010.
Findings—Intent—2008 c 146: "The legislature finds that Washingtonians sixty-five years of age and older will nearly double in the next twenty years, from eleven percent of our population today to almost twenty percent of our population in 2025. Younger people with disabilities will also require supportive long-term care services. Nationally, young people with a disability account for thirty-seven percent of the total number of people who need long-term care.
The legislature further finds that to address this increasing need, the long-term care system should support autonomy and self-determination, and support the role of informal caregivers and families. It should promote personal planning and savings combined with public support, when needed. It should also include culturally appropriate, high quality information, services, and supports delivered in a cost-effective and efficient manner.
The legislature further finds that more than fifteen percent of adults over age sixty-five in Washington state have diabetes. Current nurse delegation statutes limit the ability of elderly and disabled persons with diabetes to remain in their own homes or in other home-like long-term care settings. It is the intent of the legislature to modify nurse delegation statutes to enable elderly persons and persons with disabilities who have diabetes to continue to reside in their own home or other home-like settings.
The legislature further finds that the long-term care system should utilize evidence-based practices for the prevention and management of chronic disease to improve the general health of Washingtonians over their lifetime and reduce health care and long-term care costs related to ineffective chronic care management." [ 2008 c 146 s 1.]
Severability—2008 c 146: "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." [ 2008 c 146 s 14.]

catchline: Administration—Rules—Program standards.


title: RCW 74.41.050

text:
The department shall contract with area agencies on aging or other appropriate agencies to conduct family caregiver long-term care information and support services to the extent of available funding. The responsibilities of the agencies shall include but not be limited to: (1) Administering a program of family caregiver long-term care information and support services; (2) negotiating rates of payment, administering sliding-fee scales to enable eligible participants to participate in paying for respite care, and arranging for respite care information, training, and other support services; and (3) developing an evidence-based tailored caregiver assessment and referral tool. In evaluating the need for respite services, consideration shall be given to the mental and physical ability of the caregiver to perform necessary caregiver functions.
[ 2008 c 146 s 4; 2000 c 207 s 4; 1989 c 427 s 8; 1987 c 409 s 4; 1984 c 158 s 5.]
Notes:
Findings—Intent—Severability—2008 c 146: See notes following RCW 74.41.040.
Short title—2000 c 207: See note following RCW 74.41.020.

catchline: Family caregiver long-term care information and support services—Respite services, evaluation of need, caregiver abilities.


title: RCW 74.41.060

text:
The department shall insure that the respite care program is designed to meet the following criteria:
(1) Make maximum use of services which provide care to the greatest number of eligible participants with the fewest number of staff consistent with adequate care;
(2) Provide for use of one-on-one care when necessary;
(3) Provide for both day care and overnight care;
(4) Provide personal care to continue at the same level which the caregiver ordinarily provides to the eligible participant; and
(5) Provide for the utilization of family home settings.
[ 1984 c 158 s 6.]

catchline: Respite care program—Criteria.


title: RCW 74.41.070

text:
The area agencies on aging administering family caregiver long-term care information and support services shall maintain data which indicates demand for family caregiver long-term care information and support services.
[ 2000 c 207 s 5; 1998 c 245 s 151; 1987 c 409 s 5; 1984 c 158 s 7.]
Notes:
Short title—2000 c 207: See note following RCW 74.41.020.

catchline: Family caregiver long-term care information and support services—Data.


title: RCW 74.41.080

text:
Nothing in this chapter shall impair the practice of any licensed health care practitioner or licensed health care facility.
[ 1984 c 158 s 8.]

catchline: Health care practitioners and facilities not impaired.


title: RCW 74.41.090

text:
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.
[ 1987 c 409 s 6.]

catchline: Entitlement not created.


title: RCW 74.41.900

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 182.]

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


title: RCW 74.42.010

text:
Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
(1) "Department" means the department of social and health services and the department's employees.
(2) "Direct care staff" means the staffing domain identified and defined in the center[s] for medicare and medicaid services' five-star quality rating system and as reported through the center[s] for medicare and medicaid services' payroll-based journal. For purposes of calculating hours per resident day minimum staffing standards for facilities with sixty-one or more licensed beds, the director of nursing services classification (job title code five), as identified in the centers for medicare and medicaid services' payroll-based journal, shall not be used. For facilities with sixty or fewer beds the director of nursing services classification (job title code five) shall be included in calculating hours per resident day minimum staffing standards.
(3) "Facility" refers to a nursing home as defined in RCW 18.51.010.
(4) "Geriatric behavioral health worker" means a person with a bachelor's or master's degree in social work, behavioral health, or other related areas, or a person who has received specialized training devoted to mental illness and treatment of older adults.
(5) "Licensed practical nurse" means a person licensed to practice practical nursing under chapter 18.79 RCW.
(6) "Medicaid" means Title XIX of the Social Security Act enacted by the social security amendments of 1965 (42 U.S.C. Sec. 1396; 79 Stat. 343), as amended.
(7) "Nurse practitioner" means a person licensed to practice *advanced registered nursing under chapter 18.79 RCW.
(8) "Nursing care" means that care provided by a registered nurse, an **advanced registered nurse practitioner, a licensed practical nurse, or a nursing assistant in the regular performance of their duties.
(9) "Physician" means a person practicing pursuant to chapter 18.57 or 18.71 RCW, including, but not limited to, a physician employed by the facility as provided in chapter 18.51 RCW.
(10) "Physician assistant" means a person practicing pursuant to chapter 18.71A RCW.
(11) "Qualified therapist" means:
(a) An activities specialist who has specialized education, training, or experience specified by the department.
(b) An audiologist who is eligible for a certificate of clinical competence in audiology or who has the equivalent education and clinical experience.
(c) A mental health professional as defined in chapter 71.05 RCW.
(d) An intellectual disabilities professional who is a qualified therapist or a therapist approved by the department and has specialized training or one year experience in treating or working with persons with intellectual or developmental disabilities.
(e) An occupational therapist who is a graduate of a program in occupational therapy or who has equivalent education or training.
(f) A physical therapist as defined in chapter 18.74 RCW.
(g) A social worker as defined in RCW 18.320.010(2).
(h) A speech pathologist who is eligible for a certificate of clinical competence in speech pathology or who has equivalent education and clinical experience.
(12) "Registered nurse" means a person licensed to practice registered nursing under chapter 18.79 RCW.
(13) "Resident" means an individual residing in a nursing home, as defined in RCW 18.51.010.
[ 2020 c 80 s 56. Prior: 2019 c 301 s 3; 2019 c 12 s 1; 2017 c 200 s 2; prior: 2016 c 131 s 3; prior: 2011 c 228 s 2; 2011 c 89 s 19; prior: 2010 c 94 s 27; 1994 sp.s. c 9 s 750; 1993 c 508 s 4; 1979 ex.s. c 211 s 1.]
Notes:
Reviser's note: *(1) The term "advanced registered nursing practice" was changed to "advanced practice registered nursing" by 2024 c 239 s 3, effective June 30, 2027.
**(2) The term "advanced registered nurse practitioner" was changed to "advanced practice registered nurse" by 2024 c 239 s 1, effective June 30, 2027.
Effective date—2020 c 80 ss 12-59: See note following RCW 7.68.030.
Intent—2020 c 80: See note following RCW 18.71A.010.
Effective date—2011 c 89: See note following RCW 18.320.005.
Findings—2011 c 89: See RCW 18.320.005.
Purpose—2010 c 94: See note following RCW 44.04.280.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Section captions—Severability—Effective date—1993 c 508: See RCW 74.39A.900 through 74.39A.903.
PDF
RCW 74.42.010
Definitions. (Effective June 30, 2027.)
Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.
(1) "Department" means the department of social and health services and the department's employees.
(2) "Direct care staff" means the staffing domain identified and defined in the centers for medicare and medicaid services' five-star quality rating system and as reported through the centers for medicare and medicaid services' payroll-based journal. For purposes of calculating hours per resident day minimum staffing standards for facilities with sixty-one or more licensed beds, the director of nursing services classification (job title code five), as identified in the centers for medicare and medicaid services' payroll-based journal, shall not be used. For facilities with sixty or fewer beds the director of nursing services classification (job title code five) shall be included in calculating hours per resident day minimum staffing standards.
(3) "Facility" refers to a nursing home as defined in RCW 18.51.010.
(4) "Geriatric behavioral health worker" means a person with a bachelor's or master's degree in social work, behavioral health, or other related areas, or a person who has received specialized training devoted to mental illness and treatment of older adults.
(5) "Licensed practical nurse" means a person licensed to practice practical nursing under chapter 18.79 RCW.
(6) "Medicaid" means Title XIX of the Social Security Act enacted by the social security amendments of 1965 (42 U.S.C. Sec. 1396; 79 Stat. 343), as amended.
(7) "Nurse practitioner" means a person licensed to practice advanced practice registered nursing under chapter 18.79 RCW.
(8) "Nursing care" means that care provided by a registered nurse, an advanced practice registered nurse, a licensed practical nurse, or a nursing assistant in the regular performance of their duties.
(9) "Physician" means a person practicing pursuant to chapter 18.57 or 18.71 RCW, including, but not limited to, a physician employed by the facility as provided in chapter 18.51 RCW.
(10) "Physician assistant" means a person practicing pursuant to chapter 18.71A RCW.
(11) "Qualified therapist" means:
(a) An activities specialist who has specialized education, training, or experience specified by the department.
(b) An audiologist who is eligible for a certificate of clinical competence in audiology or who has the equivalent education and clinical experience.
(c) A mental health professional as defined in chapter 71.05 RCW.
(d) An intellectual disabilities professional who is a qualified therapist or a therapist approved by the department and has specialized training or one year experience in treating or working with persons with intellectual or developmental disabilities.
(e) An occupational therapist who is a graduate of a program in occupational therapy or who has equivalent education or training.
(f) A physical therapist as defined in chapter 18.74 RCW.
(g) A social worker as defined in RCW 18.320.010(2).
(h) A speech pathologist who is eligible for a certificate of clinical competence in speech pathology or who has equivalent education and clinical experience.
(12) "Registered nurse" means a person licensed to practice registered nursing under chapter 18.79 RCW.
(13) "Resident" means an individual residing in a nursing home, as defined in RCW 18.51.010.
[ 2025 c 58 s 5169; 2020 c 80 s 56. Prior: 2019 c 301 s 3; 2019 c 12 s 1; 2017 c 200 s 2; prior: 2016 c 131 s 3; prior: 2011 c 228 s 2; 2011 c 89 s 19; prior: 2010 c 94 s 27; 1994 sp.s. c 9 s 750; 1993 c 508 s 4; 1979 ex.s. c 211 s 1.]
Notes:
Effective date—2025 c 58 ss 5058-5170: See note following RCW 7.68.030.
Explanatory note—2025 c 58: See note following RCW 1.16.050.
Effective date—2020 c 80 ss 12-59: See note following RCW 7.68.030.
Intent—2020 c 80: See note following RCW 18.71A.010.
Effective date—2011 c 89: See note following RCW 18.320.005.
Findings—2011 c 89: See RCW 18.320.005.
Purpose—2010 c 94: See note following RCW 44.04.280.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Section captions—Severability—Effective date—1993 c 508: See RCW 74.39A.900 through 74.39A.903.

catchline: Definitions. (Effective until June 30, 2027.)


title: RCW 74.42.020

text:
The standards in RCW 74.42.030 through 74.42.570 are the minimum standards for facilities licensed under chapter 18.51 RCW: PROVIDED, HOWEVER, That RCW 74.42.040, 74.42.140 through 74.42.280, 74.42.300, 74.42.360, 74.42.370, 74.42.380, 74.42.420 (2), (4), (5), (6) and (7), 74.42.430(3), 74.42.450 (2) and (3), 74.42.520, 74.42.530, 74.42.540, 74.42.570, and 74.42.580 shall not apply to any nursing home or institution conducted for those who rely upon treatment by prayer or spiritual means in accordance with the creed or tenets of any well-recognized church or religious denomination, or for any nursing home or institution operated for the exclusive care of members of a convent as defined in RCW 84.36.800 or rectory, monastery, or other institution operated for the care of members of the clergy.
[ 1995 1st sp.s. c 18 s 68; 1982 c 120 s 1; 1980 c 184 s 6; 1979 ex.s. c 211 s 2.]
Notes:
Conflict with federal requirements—Severability—Effective date—1995 1st sp.s. c 18: See notes following RCW 74.39A.030.

catchline: Minimum standards.


title: RCW 74.42.030

text:
Each resident or guardian or legal representative, if any, shall be fully informed and receive in writing, in a language the resident or his or her representative understands, the following information:
(1) The resident's rights and responsibilities in the facility;
(2) Rules governing resident conduct;
(3) Services, items, and activities available in the facility; and
(4) Charges for services, items, and activities, including those not included in the facility's basic daily rate or not paid by medicaid.
The facility shall provide this information before admission, or at the time of admission in case of emergency, and as changes occur during the resident's stay. The resident and his or her representative must be informed in writing in advance of changes in the availability or charges for services, items, or activities, or of changes in the facility's rules. Except in unusual circumstances, thirty days' advance notice must be given prior to the change. The resident or legal guardian or representative shall acknowledge in writing receipt of this information.
The written information provided by the facility pursuant to this section, and the terms of any admission contract executed between the facility and an individual seeking admission to the facility, must be consistent with the requirements of this chapter and chapter 18.51 RCW and, for facilities certified under medicaid or medicare, with the applicable federal requirements.
[ 1997 c 392 s 212; 1979 ex.s. c 211 s 3.]
Notes:
Short title—Findings—Construction—Conflict with federal requirements—Part headings and captions not law—1997 c 392: See notes following RCW 74.39A.009.

catchline: Resident to receive statement of rights, rules, services, and charges.


title: RCW 74.42.040

text:
The facility shall insure that each resident and guardian, if any:
(1) Is fully informed by a physician about his or her health and medical condition unless the physician decides that informing the resident is medically contraindicated and the physician documents this decision in the resident's record;
(2) Has the opportunity to participate in his or her total care and treatment;
(3) Has the opportunity to refuse treatment; and
(4) Gives informed, written consent before participating in experimental research.
[ 1979 ex.s. c 211 s 4.]

catchline: Resident's rights regarding medical condition, care, and treatment.


title: RCW 74.42.050

text:
(1) Residents shall be treated with consideration, respect, and full recognition of their dignity and individuality. Residents shall be encouraged and assisted in the exercise of their rights as residents of the facility and as citizens.
(2) A resident or guardian, if any, may submit complaints or recommendations concerning the policies of the facility to the staff and to outside representatives of the resident's choice. No facility may restrain, interfere, coerce, discriminate, or retaliate in any manner against a resident who submits a complaint or recommendation.
[ 1979 ex.s. c 211 s 5.]

catchline: Residents to be treated with consideration, respect—Complaints.


title: RCW 74.42.055

text:
(1) The purpose of this section is to prohibit discrimination against medicaid recipients by nursing homes which have contracted with the department to provide skilled or intermediate nursing care services to medicaid recipients.
(2) A nursing facility shall readmit a resident, who has been hospitalized or on therapeutic leave, immediately to the first available bed in a semiprivate room if the resident:
(a) Requires the services provided by the facility; and
(b) Is eligible for medicaid nursing facility services.
(3) It shall be unlawful for any nursing home which has a medicaid contract with the department:
(a) To require, as a condition of admission, assurance from the patient or any other person that the patient is not eligible for or will not apply for medicaid;
(b) To deny or delay admission or readmission of a person to a nursing home because of his or her status as a medicaid recipient;
(c) To transfer a patient, except from a private room to another room within the nursing home, because of his or her status as a medicaid recipient;
(d) To transfer a patient to another nursing home because of his or her status as a medicaid recipient;
(e) To discharge a patient from a nursing home because of his or her status as a medicaid recipient; or
(f) To charge any amounts in excess of the medicaid rate from the date of eligibility, except for any supplementation permitted by the department pursuant to RCW 18.51.070.
(4) Any nursing home which has a medicaid contract with the department shall maintain one list of names of persons seeking admission to the facility, which is ordered by the date of request for admission. This information shall be retained for one year from the month admission was requested. However, except as provided in subsection (2) of this section, a nursing facility is permitted to give preferential admission to individuals who seek admission from an assisted living facility, licensed under chapter 18.20 RCW, or from independent retirement housing, provided the nursing facility is owned by the same entity that owns the assisted living facility or independent housing which are located within the same proximate geographic area; and provided further, the purpose of such preferential admission is to allow continued provision of: (a) Culturally or faith-based services, or (b) services provided by a continuing care retirement community as defined in RCW 70.38.025.
(5) The department may assess monetary penalties of a civil nature, not to exceed three thousand dollars for each violation of this section.
(6) Because it is a matter of great public importance to protect senior citizens who need medicaid services from discriminatory treatment in obtaining long-term health care, any violation of this section shall be construed for purposes of the application of the consumer protection act, chapter 19.86 RCW, to constitute an unfair or deceptive act or practice or unfair method of competition in the conduct of trade or commerce.
(7) It is not an act of discrimination under this chapter to refuse to admit a patient if admitting that patient would prevent the needs of the other patients residing in that facility from being met at that facility, or if the facility's refusal is consistent with subsection (4) of this section.
[ 2012 c 10 s 69; 2004 c 34 s 1; 1987 c 476 s 30; 1985 c 284 s 3.]
Notes:
Application—2012 c 10: See note following RCW 18.20.010.
Effective date—2004 c 34: "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 takes effect immediately [March 22, 2004]." [ 2004 c 34 s 2.]

catchline: Discrimination against medicaid recipients prohibited.