The
department's system of quality improvement for long-term care
services shall use the following principles, consistent with
applicable federal laws and regulations:
(1) The system shall be client-centered and promote privacy,
independence, dignity, choice, and a home or home-like
environment for consumers consistent with chapter 392, Laws of
1997.
(2) The goal of the system is continuous quality improvement
with the focus on consumer satisfaction and outcomes for
consumers. This includes that when conducting licensing or
contract inspections, the department shall interview an
appropriate percentage of residents, family members, resident
case managers, and advocates in addition to interviewing
providers and staff.
(3) Providers should be supported in their efforts to
improve quality and address identified problems initially through
training, consultation, technical assistance, and case
management.
(4) The emphasis should be on problem prevention both in
monitoring and in screening potential providers of service.
(5) Monitoring should be outcome based and responsive to
consumer complaints and based on a clear set of health, quality
of care, and safety standards that are easily understandable and
have been made available to providers, residents, and other
interested parties.
(6) Prompt and specific enforcement remedies shall also be
implemented without delay, pursuant to RCW 74.39A.080, RCW 70.128.160, chapter 18.51 RCW, or chapter 74.42 RCW, for
providers found to have delivered care or failed to deliver care
resulting in problems that are serious, recurring, or
uncorrected, or that create a hazard that is causing or likely to
cause death or serious harm to one or more residents. These
enforcement remedies may also include, when appropriate,
reasonable conditions on a contract or license. In the selection
of remedies, the safety, health, and well-being of residents
shall be of paramount importance.
(7) All long-term care workers shall be screened through
background checks in a uniform and timely manner to ensure that
they do not have a criminal history that would disqualify them
from working with vulnerable persons. Long-term care workers who
are hired after January 1, 2012, are subject to background checks
under RCW 74.39A.055. This information will be shared with the
department of health in accordance with RCW 74.39A.055 to advance
the purposes of chapter 2, Laws of 2009.
(8) No provider, or its staff, or long-term care worker, or
prospective provider or long-term care worker, with a stipulated
finding of fact, conclusion of law, an agreed order, or finding
of fact, conclusion of law, or final order issued by a
disciplining authority, a court of law, or entered into a state
registry finding him or her guilty of abuse, neglect,
exploitation, or abandonment of a minor or a vulnerable adult as
defined in chapter 74.34 RCW shall be employed in the care of and
have unsupervised access to vulnerable adults.
(9) The department shall establish, by rule, a state
registry which contains identifying information about long-term
care workers identified under this chapter who have substantiated
findings of abuse, neglect, financial exploitation, or
abandonment of a vulnerable adult as defined in RCW 74.34.020.
The rule must include disclosure, disposition of findings,
notification, findings of fact, appeal rights, and fair hearing
requirements. The department shall disclose, upon request,
substantiated findings of abuse, neglect, financial exploitation,
or abandonment to any person so requesting this information.
This information will also be shared with the department of
health to advance the purposes of chapter 2, Laws of 2009.
(10) Until December 31, 2010, individual providers and home
care agency providers must satisfactorily complete
department-approved orientation, basic training, and continuing
education within the time period specified by the department in
rule. The department shall adopt rules by March 1, 2002, for the
implementation of this section. The department shall deny
payment to an individual provider or a home care provider who
does not complete the training requirements within the time limit
specified by the department by rule.
(11) Until December 31, 2010, in an effort to improve access
to training and education and reduce costs, especially for rural
communities, the coordinated system of long-term care training
and education must include the use of innovative types of
learning strategies such as internet resources, videotapes, and
distance learning using satellite technology coordinated through
community colleges or other entities, as defined by the
department.
(12) The department shall create an approval system by March
1, 2002, for those seeking to conduct department-approved
training.
(13) The department shall establish, by rule, background
checks and other quality assurance requirements for long-term
care workers who provide in-home services funded by medicaid
personal care as described in RCW 74.09.520, community options
program entry system waiver services as described in RCW 74.39A.030, or chore services as described in RCW 74.39A.110 that
are equivalent to requirements for individual providers.
Long-term care workers who are hired after January 1, 2012, are
subject to background checks under RCW 74.39A.055.
(14) Under existing funds the department shall establish
internally a quality improvement standards committee to monitor
the development of standards and to suggest modifications.
(15) Within existing funds, the department shall design,
develop, and implement a long-term care training program that is
flexible, relevant, and qualifies towards the requirements for a
nursing assistant certificate as established under chapter 18.88A RCW. This subsection does not require completion of the nursing
assistant certificate training program by providers or their
staff. The long-term care teaching curriculum must consist of a
fundamental module, or modules, and a range of other available
relevant training modules that provide the caregiver with
appropriate options that assist in meeting the resident's care
needs. Some of the training modules may include, but are not
limited to, specific training on the special care needs of
persons with developmental disabilities, dementia, mental
illness, and the care needs of the elderly. No less than one
training module must be dedicated to workplace violence
prevention. The nursing care quality assurance commission shall
work together with the department to develop the curriculum
modules. The nursing care quality assurance commission shall
direct the nursing assistant training programs to accept some or
all of the skills and competencies from the curriculum modules
towards meeting the requirements for a nursing assistant
certificate as defined in chapter 18.88A RCW. A process may be
developed to test persons completing modules from a caregiver's
class to verify that they have the transferable skills and
competencies for entry into a nursing assistant training program.
The department may review whether facilities can develop their
own related long-term care training programs. The department may
develop a review process for determining what previous experience
and training may be used to waive some or all of the mandatory
training. The department of social and health services and the
nursing care quality assurance commission shall work together to
develop an implementation plan by December 12, 1998.
[2009 c 580 § 7; 2009 c 2 § 14 (Initiative Measure No. 1029, approved November 4, 2008); 2004 c 140 § 6; 2000 c 121 § 10; 1999 c 336 § 5; 1998 c 85 § 1; 1997 c 392 § 209; 1995 1st sp.s. c 18 § 12.]
NOTES:
Intent -- Findings -- Construction -- Severability -- Short title -- 2009 c 2 (Initiative Measure No. 1029): See notes following RCW 18.88B.020.
Finding -- Intent -- 1999 c 336: See note following RCW 74.39.007.
Short title -- Findings -- Construction -- Conflict with federal requirements -- Part headings and captions not law -- 1997 c 392: See notes following RCW 74.39A.009.
Conflict with federal requirements -- Severability -- Effective date -- 1995 1st sp.s. c 18: See notes following RCW 74.39A.030.