AGING AND DISABILITY SERVICES ADMINISTRATION

September 26, 2003

ADSA: BH #2003-020
IMPLEMENTATION OF SUBSTITUTE SENATE BILL 5579

Dear Boarding Home Provider:

The 2003 Legislature passed, and the Governor signed, Substitute Senate Bill (SSB) 5579, an act relating to boarding homes. The bill became Chapter 231 of the 2003 Session Laws, and was effective May 12, 2003. The bill, which was supported by both industry representatives, the department, and other resident advocates, amends Chapter 18.20 Revised Code of Washington and:

• Replaces the definition of “aged person” with a clarifying definition of “resident,” and defines “domiciliary care” and “general responsibility for the safety and well being of the resident.”
• Clarifies that a boarding home license is not required to provide housing to independent individuals.
• Authorizes the department to impose a limited stop-placement on a boarding home for a specific category of residents related to violations.
• Requires the boarding home to assume general responsibility for residents.
• Requires the boarding home to coordinate services with providers of resident-arranged services.
• Requires the department to report to the legislature by December 12, 2004 on the payment system to boarding homes.
• Requires the department to report to the legislature by December 12, 2003 the results of the Dementia Care Pilot Program.
• Permits a two-year statewide informal dispute resolution pilot program.
• Requires a boarding home with contracts with the department to hold a Medicaid resident’s bed for up to 20 days if the resident requires hospital or nursing home care.
• Allows boarding homes to seek third party payment to hold a bed beyond 20 days.

There have been questions regarding how Residential Care Services (RCS) interprets the requirement for boarding homes to coordinate services with providers of resident-arranged services. RCS interprets this requirement as an affirmative duty of the boarding home to initiate contact with other known health care providers who work with the boarding home’s residents. The boarding home is expected to exchange sufficient information with the outside provider to ensure that at a minimum, the respective parties’ actions are not counterproductive for the other provider, and optimally, the actions of the boarding home and outside provider mutually support or enhance the other’s interventions. Specifically:

• The coordination of care and services should be done only with the resident’s permission or as otherwise authorized by law.
• When a boarding home becomes aware that a resident is receiving health care services from an outside provider, the boarding home should ask (but not require) the resident to sign an authorization to release information between the boarding home and the outside provider.
• When authorized to do so (either by the resident or resident’s legal representative or by law), the boarding home should contact the outside provider and coordinate services to the resident, as necessary, consistent with the resident’s negotiated service agreement.
• When authorizations to release health care information are not obtained, or when an outside health care provider does not respond to the boarding home’s attempts to coordinate services, the boarding home must document its efforts to coordinate the services.

Initial stakeholder work has been done related to the Informal Dispute Resolution pilot program. Additional stakeholder work will be done prior to the planned implementation date in January 2004. You will be advised later regarding the details of the pilot program.

The implementation of the bed-hold provisions of SSB 5579 was previously explained in a Dear Provider Letter ADSA: BH #2003-015. Questions regarding bed-hold payments should be directed to Dick Rosage at (360) 725-2442 or George Zimmerman at (360) 725-2534.

Other questions about the implementation of SSB 5579 should be directed to the Regional Administrator for Residential Care Services:

• Region 1 Shirlee Steiner (509) 329-3984
• Region 2 David Moon (509) 225-2804
• Region 3 Robert McClintock (360) 651-6855
• Region 4 Pat Jennings (206) 341-7820
• Region 5 Elaine Odom (253) 983-3848
• Region 6 Pat Bossert (360) 725-2343

Sincerely,

Patricia K. Lashway, Director
Residential Care Services