wa-law.org > bill > 2023-24 > HB 1694 > Original Bill

HB 1694 - Home care workforce shortage

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Section 1

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.

Section 2

  1. Beginning January 7, 2012, except as provided in RCW 18.88B.041, any person hired as a long-term care worker must be certified as a home care aide as provided in this chapter within 200 calendar days after the date of hire. A long-term care worker who is not currently certified or eligible to reactivate an expired credential shall receive a new date of hire when beginning work with either a new employer or returning to a former employer after prior employment has ended.

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    1. No person may practice or, by use of any title or description, represent himself or herself as a certified home care aide without being certified as provided in this chapter.

    2. This section does not prohibit a person: (i) From practicing a profession for which the person has been issued a license or which is specifically authorized under this state's laws; or (ii) who is exempt from certification under RCW 18.88B.041 from providing services as a long-term care worker.

    3. In consultation with consumer and worker representatives, the department shall, by January 1, 2013, establish by rule a single scope of practice that encompasses both long-term care workers who are certified home care aides and long-term care workers who are exempted from certification under RCW 18.88B.041.

  3. If a pandemic, natural disaster, or other declared state of emergency impacts the ability of long-term care workers to complete certification as required by this section, the department may adopt rules to allow long-term care workers additional time to become certified.

    1. Rules adopted under this subsection (3) are effective until the termination of the pandemic, natural disaster, or other declared state of emergency or until the department determines that additional time for long-term care workers to become certified is no longer necessary, whichever is later. Once the department determines a rule adopted under this subsection (3) is no longer necessary, it must repeal the rule under RCW 34.05.353.

    2. Within 12 months of the termination of the pandemic, natural disaster, or other declared state of emergency, the department shall conduct a review of certification compliance with subsection (1) of this section and rules adopted under this subsection (3) and provide the legislature with a report.

  4. The department shall adopt rules to implement this section.

Section 3

  1. Except as provided in RCW 18.88B.041 and subject to the other requirements of this chapter, to be certified as a home care aide, a long-term care worker must successfully complete the training required under RCW 74.39A.074(1) and a certification examination. Any long-term care worker failing to make the required grade for the examination may not be certified as a home care aide.

  2. The department, in consultation with consumer and worker representatives, shall develop a home care aide certification examination to evaluate whether an applicant possesses the skills and knowledge necessary to practice competently.

  3. The examination or series of examinations shall include both a skills demonstration and a written or oral knowledge test. The skills demonstration, the knowledge test, or both, may be administered on the last day of a student's formal training. The examination papers, all grading of the papers, and records related to the grading of skills demonstration shall be preserved for a period of not less than one year. The department shall establish rules governing the number of times and under what circumstances individuals who have failed the examination may sit for the examination, including whether any intermediate remedial steps should be required.

  4. All examinations shall be conducted by fair and wholly impartial methods. The certification examination shall be administered and evaluated by the department , by a contractor to the department that is not an employer of long‑term care workers

, or by a high school or community college that has met department standards for administering the examination.

  1. In addition to the standards under subsection (4) of this section, the department shall examine and authorize innovative ways to reduce barriers to certification and testing, including allowing for remote proctoring of the knowledge examination, allowing long-term care workers to sign up for testing at the time of hire contingent on completion of training, and expanding the number and type of testing locations.

  2. The department shall adopt rules to implement this section.

Section 4

  1. The following long-term care workers are not required to become a certified home care aide pursuant to this chapter:

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      i.(A) Registered nurses, licensed practical nurses, certified nursing assistants or persons who are in an approved training program for certified nursing assistants under chapter 18.88A RCW, medicare-certified home health aides, or other persons who hold a similar health credential, as determined by the secretary, or persons with special education training and an endorsement granted by the superintendent of public instruction, as described in RCW 28A.300.010, if the secretary determines that the circumstances do not require certification.

(B) A person who was initially hired as a long‑term care worker prior to January 7, 2012, and who completes all of the training requirements in effect as of the date the person was hired.

    ii. Individuals exempted by (a)(i) of this subsection may obtain certification as a home care aide without fulfilling the training requirements in RCW 74.39A.074(1)(d)(ii) but must successfully complete a certification examination pursuant to RCW 18.88B.031.

b. All long-term care workers employed by community residential service businesses.

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    i. An individual provider caring only for the individual provider's biological, step, or adoptive child or parent; and

    ii. For individual providers hired after September 1, 2023, an individual provider caring only for the individual provider's sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership.

d. A person working as an individual provider who provides twenty hours or less of care for one person in any calendar month.

e. A person working as an individual provider who only provides respite services and works less than three hundred hours in any calendar year.

f. A long-term care worker providing approved services only for a spouse or registered domestic partner, pursuant to the long-term services and supports trust program established in chapter 50B.04 RCW.
  1. A long-term care worker exempted by this section from the training requirements contained in RCW 74.39A.074 may not be prohibited from enrolling in training pursuant to that section.

  2. The department shall adopt rules to implement this section.

Section 5

  1. Beginning January 7, 2012, except for long-term care workers exempt from certification under RCW 18.88B.041(1)(a):

    1. A biological, step, or adoptive parent who is the individual provider only for the person's developmentally disabled son or daughter must receive twelve hours of training relevant to the needs of adults with developmental disabilities within the first one hundred twenty days after becoming an individual provider.

    2. A spouse or registered domestic partner who is a long-term care worker only for a spouse or domestic partner, pursuant to the long-term services and supports trust program established in chapter 50B.04 RCW, must receive fifteen hours of basic training, and at least six hours of additional focused training based on the care-receiving spouse's or partner's needs, within the first one hundred twenty days after becoming a long-term care worker.

    3. A person working as an individual provider who (i) provides respite care services only for individuals with developmental disabilities receiving services under Title 71A RCW or only for individuals who receive services under this chapter, and (ii) works three hundred hours or less in any calendar year, must complete fourteen hours of training within the first one hundred twenty days after becoming an individual provider. Five of the fourteen hours must be completed before becoming eligible to provide care, including two hours of orientation training regarding the caregiving role and terms of employment and three hours of safety training. The training partnership identified in RCW 74.39A.360 must offer at least twelve of the fourteen hours online, and five of those online hours must be individually selected from elective courses.

    4. Individual providers identified in (d)(i) or (ii) of this subsection must complete thirty‑five hours of training within the first one hundred twenty days after becoming an individual provider. Five of the thirty‑five hours must be completed before becoming eligible to provide care. Two of these five hours shall be devoted to an orientation training regarding an individual provider's role as caregiver and the applicable terms of employment, and three hours shall be devoted to safety training, including basic safety precautions, emergency procedures, and infection control. Individual providers subject to this requirement include:

      i.(A) An individual provider caring only for the individual provider's biological, step, or adoptive child or parent unless covered by (a) of this subsection; and

(B) For individual providers hired after September 1, 2023, an individual provider caring only for the individual provider's sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership; and

    ii. A person working as an individual provider who provides twenty hours or less of care for one person in any calendar month.
  1. In computing the time periods in this section, the first day is the date of hire.

  2. Only training curriculum approved by the department may be used to fulfill the training requirements specified in this section. The department shall only approve training curriculum that:

    1. Has been developed with input from consumer and worker representatives; and

    2. Requires comprehensive instruction by qualified instructors.

  3. If a pandemic, natural disaster, or other declared state of emergency impacts the ability of long-term care workers to complete training as required by this section, the department may adopt rules to allow long-term care workers additional time to complete the training requirements.

    1. Rules adopted under this subsection (4) are effective until the termination of the pandemic, natural disaster, or other declared state of emergency or until the department determines that all long-term care workers who were unable to complete the training required in subsection (1) of this section have had adequate access to complete the required training, whichever is later. Once the department determines a rule adopted under this subsection (4) is no longer necessary, it must repeal the rule under RCW 34.05.353.

    2. Within 12 months of the termination of the pandemic, natural disaster, or other declared state of emergency, the department shall conduct a review of training compliance with subsection (1) of this section and provide the legislature with a report.

  4. The department shall adopt rules to implement this section.

Section 6

  1. By June 1, 2025, the department shall establish a workforce data collection and public reporting monitoring system to accurately determine the status of:

    1. The long-term care worker supply;

    2. Long-term care worker shortages;

    3. Delays in the ability for long-term care workers to receive required training, testing, and certification;

    4. Unmet service demands; and

    5. Geographic areas and populations for which there are disparities in long-term care workers and services.

  2. The monitoring system shall be capable of tracking and understanding long-term care workforce data trends in Washington and providing regular reports.

Section 7

The department of social and health services shall design a pilot project to allow the spouse of a person with complex medical needs who is eligible for long-term services and supports through the department of social and health services to receive payment for providing home care services to the spouse. The design shall consider the appropriate acuity level of the care-receiving spouse, the training needs of the care-providing spouse, payment parameters, fiscal considerations and use of medicaid matching funds, geographic locations for implementing the pilot project, ways to design the project to aid in future statewide implementation, cost estimates for implementing the pilot project, projected number of individuals to be served, and proposed timeline for implementation. The department of social and health services shall submit the pilot project design to the office of financial management and the appropriate fiscal committees of the legislature by November 1, 2023.

Section 8

The department of social and health services shall study the feasibility and cost of paying the parents of children under 18 years old who are medically complex or have complex support needs related to their behaviors. The department of social and health services must submit a report to the office of financial management and the appropriate fiscal committees of the legislature by December 31, 2023. The report shall address any statutory or regulatory changes needed to authorize the payments, necessary information technology changes for the agency and associated costs, elements needed to prepare a federal waiver or state plan amendments to allow for the use of federal matching funds for the payments to parents, estimates of the number of children expected to be served, the anticipated annual cost to the state both if federal matching funds are available and if they are not available, recommendations on the types of training needed for parents to support their children's care needs, and a proposed timeline for implementation which may be phased, if necessary.


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