AGING AND DISABILITY SERVICES ADMINISTRATION

2007 BH "Dear Provider" Letters

February 19, 2007

ADSA: BH #2007-002
Revised “Disclosure of ServiceS” Form

Dear Boarding Home Provider:

State statute (RCW 18.20.300) and rules (WAC 388-78A-2710) require Boarding Home Providers to make available to residents a written disclosure of services, and changes in those services.

Boarding Homes use the “Disclosure of Services” Form as part of disclosure to residents prior to admission, or prior to changing services to existing residents.

Initiative 901 became state law effective December 8, 2005. The law prohibits smoking in a “public place” or in any “place of employment” within a “reasonable minimum distance” from the public portion of a boarding home facility. The “reasonable minimum distance” is defined in law as “twenty-five feet from 1) entrances, 2) exits, 3) windows that open, and 4) ventilation intakes that serve the area where smoking is prohibited”.

The Department has revised Section X (Services Related to Smoking) of the “Disclosure of Services” Form to be consistent with Initiative 901.

Effective immediately:

• Begin using the revised “Disclosure of Services” Form (DSHS 10-351 - Rev. 02/07); available online at http://www.adsa.dshs.wa.gov/professional/bh.htm
• Contact your BH Licensor if you have questions about using this form.

Thank you for your continued commitment to the boarding home residents in the state of Washington.

Sincerely,

Joyce Pashley Stockwell, Director
Residential Care Services