This has been a busy summer for HCAW! There is an abundance of agency rulemaking, which updates the Washington Administrative Code (WAC), on issues affecting our membership. The state is still in a dismal financial state with the latest state revenue report, issued on Monday July 12, by the Economic and Revenue Forecast Council. The revenue collections for the past month were $91.3 million less than predicted just a few weeks ago for the state's general fund.
Governor Gregoire has already been facing the possibility of having to order across-the-board cuts or even a special legislative session to deal with the increasing prospect of losing $480 million in federal medical aid that the 2010 supplemental budget assumed. Without the aid, the state’s ledger would show about $240 million in red ink by June 2011, and this news only makes that red ink deeper. (The Olympian, 7/12/10)
This may impact services related to state agencies, in particular DSHS who will be losing the most staffing. This week DSHS was shut down on 7/12/10 for its first employee furlough and another one is expected in early August to try and save jobs instead of cutting positions. Here are the agency rules that HCAW is working on at this time.
Hospice CON Methodology
The Department of Health (DOH) hosted its first workshop on June 29, 2010. The work session was an over overview of the process for rulemaking and a brainstorming session for the broader issues associated with the Hospice Certificate of Need methodology. Here are the upcoming dates for the Rules Workshops on Hospice Certificate of Need. Here is the link to the DOH webpage: http://www.doh.wa.gov/hsqa/FSL/CertNeed/Hospice.htm
Workshop #2: July 28th, Workshop #3: August 26th, Workshop #4: September 27th, Draft Revised Hospice Rules: October 18th, Informal Stakeholder review of draft rules: November 1st
The rules workshops will be at the Department of Health offices located at Point Plaza East, 310 Israel Road - Rooms 152 & 153 Tumwater, WA 98501, 8:30 am to 12:30pm
Pain Management Standards Rulemaking
Washington State has one of the highest incident rates of death by opiates, in particular Oxycotin, in the US. The legislature passed ESHB 2876 during the 2010 legislative session to try and require additional consultation for patients requiring the use of narcotics for pain. The main issue for HCAW is that this does not spill over into hospice or palliative care for patients with a terminal illness. The bill specifically excludes this care, but we want to make sure that the definitions in rule also reflect the exclusion of hospice and palliative care.
The bill requires five Department of Health boards and commissions to develop pain management standards in rule. The Medical Quality Assurance Commission (MQAC), Board of Osteopathic Medicine and Surgery (BOMS), Nursing Care Quality Assurance Commission (NCQAC), Dental Quality Assurance Commission (DQAC), and the Podiatric Medical Board (PMB) must adopt rules by June 30, 2011. In addition, MQAC, BOMS, and PMB must repeal existing pain management rules by June 30, 2011. These five boards and commissions will use a joint collaborative process and selected representatives to participate in a workgroup. The second meeting of the workgroup was last week.
I-1029 Implementation, CR 102 Hearing on July 6th in Olympia
In a final round of rulemaking regarding the implementation of Initiative 1029 related to home care aide training, Sam Miller and I testified on behalf of HCAW at the hearing. We expressed our concerns about the cost and complication of the curriculum and that it will create barriers for persons trying to enter into the home care industry, and in particular, private duty home care.
Interestingly enough, SEIU expressed concerns about home care aides who might have to pay the cost of any training and that they would be forced to leave the workforce due to the inability to pay. We concur that this would be the case for all private duty home care aides entering the profession.
State-wide Video Conference with the DOH and DSHS, August 4th, 9 – Noon
TOPIC: New Training and Certification Requirements for Long Term Care Workers
DOH and DSHS are holding a joint state-wide video conference to help people understand the new training and certification requirements and begin planning on how to meet them. Staff from both agencies will outline and clarify the requirements and next steps. Time will be allotted for audience questions. These changes impact adult family homes, boarding homes, home care agencies (both those accepting Medicaid and private pay), individual providers, DSHS contracted community instructors, and the Area Agencies on Aging.
Background Checks-Initiative 1029 Implementation
DSHS had a CR 102 rules hearing on June 22, 2010 in Olympia. We expressed concerns about delays for FBI background checks and private duty agencies having access to BCCU database. We also suggested doing background checks first before training begins to weed out poor candidates prior to investing in training them.
Nursing Commission Continuing Competency
NCQAC is moving forward with rulemaking related to continuing competency for RNs. There will be a very small percentage of nurses actually audited for evidence of simple requirements for continuing education. The new rules being proposed are not punitive, and the department will work with practitioner to meet objectives.
Federal Health Reform Implementation
There will be a Joint Legislative Select Committee on Health Care Reform on 7/30/10 at 10:00 am in Senate Hearing Room 4, J.A. Cherberg Building, Olympia, WA. State legislators are trying to determine how to implement the federal health care legislation coming to our state. The agenda for the meeting is:
- Health care work force development.
- Health care exchange.
- Health cabinet update.
- Public comment.
This meeting will also be available on TVW in the media archives files under Senate or House Health Care Committees 2010 after the meeting date for anyone who may be interested in seeing the discussion without attending the meeting.
