Revised Code of Washington
Chapter 74.39A - Long-Term Care Services Options—Expansion.
74.39A.326 - In-home personal care or respite services to family members—Department not authorized to pay—Exceptions—Enforcement—Rules.

RCW 74.39A.326
In-home personal care or respite services to family members—Department not authorized to pay—Exceptions—Enforcement—Rules.

(1)(a) Except as provided under (b) of this subsection, the department shall not pay a home care agency licensed under chapter 70.127 RCW for in-home personal care or respite services provided under this chapter, Title 71A RCW, or chapter 74.39 RCW if the care is provided to a client by a family member of the client. To the extent permitted under federal law, the provisions of this subsection shall not apply if the family member providing care is older than the client.
(b) The department may, on a case-by-case basis based on the client's health and safety, make exceptions to (a) of this subsection to authorize payment or to provide for payment during a transition period of up to three months. Within available funds, the restrictions under (a) of this subsection do not apply when the care is provided to: (i) A client who is an enrolled member of a federally recognized Indian tribe; or (ii) a client who resides in the household of an enrolled member of a federally recognized Indian tribe.
(2) The department shall take appropriate enforcement action against a home care agency found to have charged the state for hours of service for which the department is not authorized to pay under this section, including requiring recoupment of any payment made for those hours and, under criteria adopted by the department by rule, terminating the contract of an agency that violates a recoupment requirement.
(3) For purposes of this section:
(a) "Client" means a person who has been deemed eligible by the department to receive in-home personal care or respite services.
(b) "Family member" shall be liberally construed to include, but not be limited to, a parent, child, sibling, aunt, uncle, cousin, grandparent, grandchild, grandniece, or grandnephew, or such relatives when related by marriage.
(4) The department shall adopt rules to implement this section. The rules shall not result in affecting the amount, duration, or scope of the personal care or respite services benefit to which a client may be entitled pursuant to RCW 74.09.520 or Title XIX of the federal social security act.

[ 2017 3rd sp.s. c 34 § 3; 2009 c 571 § 1.]
NOTES:

Findings—Intent—2017 3rd sp.s. c 34: "The legislature finds that the most common form of long-term care provided to persons who are elderly, disabled, or have a developmental disability is provided by a family member in a personal residence. The legislature also finds that care provided by a family member who is chosen by the recipient is often the most appropriate form of care, allowing vulnerable individuals to remain independent while maintaining a sense of dignity and choice. The current system of medicaid services has complexities that may create obstacles for consumers who wish to be cared for by a family member and for family members who enter the system solely to provide care for their loved ones.
Therefore, the legislature intends to direct a study of the current options allowing for the delivery of medicaid personal care services by caregivers who are family members of the state's citizens who are aging, disabled, or who have a developmental disability. The legislature intends to promote more flexibility for clients to access their benefits and to reduce obstacles for clients who wish to hire family members to provide their care." [ 2017 3rd sp.s. c 34 § 1.]


Conflict with federal requirements—2009 c 571: "If any part of this act is found to be in conflict with federal requirements that are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this act is inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and this finding does not affect the operation of the remainder of this act in its application to the agencies concerned. Rules adopted under this act must meet federal requirements that are a necessary condition to the receipt of federal funds by the state." [ 2009 c 571 § 3.]


Effective date—2009 c 571: "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 [May 19, 2009]." [ 2009 c 571 § 4.]

Structure Revised Code of Washington

Revised Code of Washington

Title 74 - Public Assistance

Chapter 74.39A - Long-Term Care Services Options—Expansion.

74.39A.005 - Findings.

74.39A.007 - Purpose and intent.

74.39A.009 - Definitions.

74.39A.010 - Assisted living services and enhanced adult residential care—Contracts—Rules.

74.39A.020 - Adult residential care—Contracts—Rules.

74.39A.030 - Expansion of home and community services—Payment rates.

74.39A.032 - Medicaid payment methodology for certain contracted assisted living facilities—Established by rule—Required components.

74.39A.035 - Expansion of nutrition services through the meals on wheels program.

74.39A.040 - Department assessment of and assistance to hospital patients in need of long-term care.

74.39A.051 - Quality improvement principles.

74.39A.056 - Background checks on long-term care workers.

74.39A.058 - Long-term care workforce work group.

74.39A.060 - Toll-free telephone number for complaints—Investigation and referral—Rules—Discrimination or retaliation prohibited.

74.39A.070 - Rules for qualifications and training requirements—Requirement that contractors comply with federal and state regulations.

74.39A.074 - Training requirements for long-term care workers—Rules.

74.39A.076 - Training requirements for individual providers caring for family members.

74.39A.078 - Rules for the approval of curricula for facility-based caregivers serving persons with behavioral health needs and geriatric behavioral health workers—Curricula requirements.

74.39A.080 - Department authority to take actions in response to noncompliance or violations.

74.39A.086 - Enforcement actions against persons not certified as home care aides and their employers—Rule-making authority.

74.39A.090 - Discharge planning—Contracts for case management services and reassessment and reauthorization—Assessment of case management roles and quality of in-home care services—Plan of care model language.

74.39A.095 - Case management services—Contractual requirements—Consumers' plans of care—Notification to consumer directed employer.

74.39A.100 - Chore services—Legislative finding, intent.

74.39A.110 - Chore services—Legislative policy and intent regarding available funds—Levels of service.

74.39A.120 - Chore services—Expenditure limitation—Priorities—Rule on patient resource limit.

74.39A.130 - Chore services—Department to develop program.

74.39A.140 - Chore services—Employment of public assistance recipients.

74.39A.150 - Chore services for persons with disabilities—Eligibility.

74.39A.155 - Support for persons at risk of institutional placement.

74.39A.160 - Transfer of assets—Penalties.

74.39A.170 - Recovery of payments—Transfer of assets rules for eligibility—Disclosure of estate recovery costs, terms, and conditions.

74.39A.180 - Authority to pay for probate actions and collection of bad debts.

74.39A.200 - Training curricula, materials—In public domain—Exceptions.

74.39A.210 - Disclosure of employee information—Employer immunity—Rebuttable presumption.

74.39A.240 - Definitions.

74.39A.250 - Individual provider referral registry—Consumer directed employer duties—Department duties.

74.39A.261 - Background checks on individual providers—Department duties.

74.39A.270 - Individual providers contracted with the department—Collective bargaining—Circumstances in which individual providers are considered public employees—Exceptions—Limitations.

74.39A.275 - Individual provider overtime—Annual expenditure reports to legislature and joint legislative-executive overtime oversight task force.

74.39A.300 - Funding process—Department-contracted individual providers.

74.39A.310 - Contract for individual home care services providers—Cost of change in wages and benefits funded or increase in labor rates.

74.39A.320 - Establishment of capital add-on rate—Determination of medicaid occupancy percentage.

74.39A.326 - In-home personal care or respite services to family members—Department not authorized to pay—Exceptions—Enforcement—Rules.

74.39A.331 - Peer mentoring.

74.39A.341 - Continuing education requirements for long-term care workers.

74.39A.351 - Advanced training.

74.39A.360 - Training partnership.

74.39A.370 - Addressing long-term care complaint workload.

74.39A.380 - Internal quality review and accountability program for residential care services—Quality assurance panel—Report.

74.39A.390 - Personal care services—Glove access.

74.39A.400 - Personal care services—Community first choice option.

74.39A.500 - Consumer directed employer program—Establishment—Structure—Vendor qualifications—Transition—Department duties.

74.39A.505 - Consumer directed employer program—Rule-making authority—2018 c 278.

74.39A.510 - Consumer directed employer program—Limitations.

74.39A.515 - Duties of consumer directed employers that employ individual providers—Case management responsibilities—Rule making.

74.39A.520 - Individual providers employed by a consumer directed employer—Consumer's right to select, schedule, supervise, or dismiss individual providers.

74.39A.525 - 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.

74.39A.530 - Consumer directed employer program—Labor and administrative rates—Rate-setting board—Funding process.

74.39A.800 - Changes to agreements—Performance of duties.

74.39A.900 - Section captions—1993 c 508.

74.39A.901 - Conflict with federal requirements.

74.39A.903 - Effective date—1993 c 508.