Complex care serv./children

AN ACT Relating to supporting caregivers who provide complex care 1
services to children with heightened medical needs; and adding a new 2
section to chapter 74.09 RCW. 3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
NEW SECTION. Sec. 1. A new section is added to chapter 74.09 5
RCW to read as follows: 6
(1) Beginning September 1, 2026, the authority shall require or 7
provide payment to a home health agency for complex care services as 8
a component of the private duty nursing benefit when provided to an 9
enrollee under 18 years old receiving private duty nursing in a 10
medical assistance program under this chapter when:11
(a) The caregiver providing the complex care services is a 12
parent, guardian, family member, or other close association that is 13
the equivalent of a family relation of the enrollee;14
(b) The caregiver has successfully completed at least 75 total 15
hours of instruction offered by a home care agency that is accredited 16
by an organization recognized by the authority under subsection (2) 17
of this section and has been determined to be competent to provide 18
complex care services; 19
(c) The complex care services are provided by the caregiver as 20
delegated by a registered nurse licensed under chapter 18.79 RCW; and21
H-0617.2
HOUSE BILL 1521
State of Washington 69th Legislature 2025 Regular Session
By Representatives Rule, Callan, Taylor, Hunt, Davis, Reed, Simmons,
Springer, Hill, Thai, and Timmons
Read first time 01/22/25. Referred to Committee on Health Care &
Wellness.
p. 1 HB 1521
(d) The caregiver providing the complex care services is employed 1
by a home health agency licensed under chapter 70.126 RCW with a 2
provider agreement with the authority or a managed care organization.3
(2) The authority shall recognize accrediting organizations that 4
it determines have standards that allow home health agencies to 5
properly train caregivers under subsection (1)(b) of this section to 6
safely provide complex care services in accordance with the nursing 7
aide training and competency evaluation program standards established 8
under 42 C.F.R. Secs. 483.151 through 154 and 42 C.F.R. Sec. 484.80.9
(3) A caregiver providing complex care services who has 10
successfully completed the training may change employers without 11
having to repeat the training course required under subsection (1)(b) 12
of this section. 13
(4) The home health agency that employs the caregiver providing 14
complex care services under subsection (1) of this section must 15
assume all costs of training the caregiver and may not require the 16
caregiver to reimburse the home health agency for the cost of the 17
training. 18
(5) When determining an enrollee's eligibility for complex care 19
services, the authority may only consider the child's income and not 20
the income of any other person living in the household.21
(6) The authority shall seek a state plan amendment or waiver, as 22
applicable, from the federal centers for medicare and medicaid 23
services to implement this section. 24
(7) By September 1, 2029, the authority must submit a report to 25
the governor and the committees of the legislature with jurisdiction 26
over health policy matters. The report must assess the viability of 27
the complex care services payment program established in this 28
section, including data analyzing the effectiveness of the program. 29
The authority must use available data and not require home health 30
agencies to submit data necessary for creating the report.31
(8) For the purposes of this section, "complex care services" 32
means the provision of the care services by the parent, guardian, 33
family member, or other close association that is the equivalent of a 34
family relation of the enrollee to a person under 18 years old who is 35
receiving private duty nursing when provided under the direction of a 36
registered nurse licensed under chapter 18.79 RCW. "Complex care 37
services" may include patient transfer; patient positioning; patient 38
ambulation; patient feeding; personal care; catheter care; medication 39
administration; tracheostomy care; enteral care, therapy, and feeding 40
p. 2 HB 1521
administration; formula preparation; comprehensive respiratory care, 1
chest physiotherapy, and cough assistance; and other tasks approved 2
by the authority. 3
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p. 3 HB 1521