AGING AND DISABILITY SERVICES ADMINISTRATION
October 7, 2004
ADSA: BH #2004-020
WAC 388-78A-2340 AND REASONABLE POLICIES
Dear Boarding Home Provider:
New situations related to resident arranged services have been brought to my attention. This letter will provide you with an outline of how RCS will analyze these situations.
According to Washington State laws and rules, boarding homes must allow residents to arrange to receive on-site care and services from a licensed health care practitioner or home health, home care or hospice agency. (Revised Code of Washington [RCW] 18.20.380 and Washington Administrative Code [WAC] 388-78A-2340(1))
RCW 18.20.380 (1) provides, “ The boarding home licensee shall permit the resident, or the resident's legal representative if any, to independently arrange for or contract with a practitioner licensed under Title 18 RCW regulating health care professions, or a home health, hospice, or home care agency licensed under chapter 70.127 RCW, to provide on-site care and services to the resident, consistent with RCW 18.20.160 and chapter 70.129 RCW. The boarding home licensee may permit the resident, or the resident's legal representative if any, to independently arrange for other persons to provide on-site care and services to the resident.”
WAC 388-78A-2340 states:
(1) The boarding home must allow a resident to arrange to receive on-site care and services from: (a) A practitioner, licensed under Title 18 RCW regulating health care professions; and (b) A home health, hospice, or home care agency licensed under chapter 70.127 RCW…
(4) The boarding home may establish policies and procedures that describe reasonable limitations, conditions, or requirements that must be met prior to an outside service provider being allowed on-site.
The Long Term Care Resident Rights statute, Chapter 70.129 RCW also addresses this issue. RCW 70.129.140(2)(a) states, “Within reasonable facility rules designed to protect the rights and quality of life of residents, the resident has the right to: Choose activities, schedules, and health care consistent with his or her interests, assessments, and plans of care.”
In addition, RCW 70.129.020 states, “The resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility. A facility must protect and promote the rights of each resident and assist the resident which include: (2) The resident has the right to be free of interference, coercion, discrimination, and reprisal from the facility in exercising his or her rights.”
Based upon an analysis of the above referenced WACs and RCWs, boarding home residents have the right to access to persons and services inside and outside the boarding home, the right to choose health care consistent with their assessments and plans of care, and the right to be free of interference with the exercise of these rights.
A boarding home may establish policies and procedures that set limitations, conditions, or requirements that must be met prior to an outside service provider being allowed on-site. The rules require these limitations, conditions or requirements to be reasonable. Additionally, the facilities’ policies and procedures must be designed to meet the intent of state and federal laws, including the laws that establish the rights of boarding home residents.
Policies and procedures are not reasonable if they, in effect, eliminate the ability of residents to exercise their right to bring in outside service providers of their choice, or if they interfere with residents’ rights to receive on-site care and services from qualified outside providers, as allowed by statute and rule. Facilities may establish policy and procedures that facilitate and protect resident rights and that allow the facility to meet its other responsibilities.
Please contact your Residential Care Services Field Manager if you have questions regarding your boarding home’s policies on resident-arranged services.
Sincerely,
Patricia K. Lashway, Director
Residential Care Services
