From the Executive Director - Washington State Residential Care

A Publication of the Washington State Residential Care Council (WSRCC)
For Professional Adult Family Home Providers
www.wsrcc.org
February 2015
From the Executive Director
Hello Adult Family Homes of Washington,
I would like to begin by thanking all of the providers who were able to take the time to come to Olympia earlier this month for the
Adult Family Home Lobby Day. With nearly 90 providers present, we were able to deliver our message to many key
legislators. As I shared with everyone at lobby day, this is not the end of our work, just the beginning. For all of those who
attended, we encourage you to follow up with your legislators. WSRCC’s legislative agenda and a sample letter are included in
this newsletter, you can also find a copies on our website on the members home page. For those who were unable to attend
lobby day, we encourage you to begin a conversation with your legislators. Let them know about the issues that affect you as
AFH providers. Our office can help you identify your legislators if you are unsure. We need to remind all legislators that AFH
providers serve high acuity residents in a home like setting, with staffing ratios of 1:6, and we serve our residents at rates that
save the state hundreds of millions of dollars each year. As the population of people in need of care continues to grow, the state
must invest in AFH providers in order to ensure these resources stay available. The squeaky wheel does indeed get the grease.
Please take the time to invest in the continued development and support of adult family homes.
In January at WSRCC’s Clark and Pierce County chapter meetings, Mr. Carl I. Walters II, Director of Residential Care Services (RCS)
came to present his vision of RCS. He took the time to describe how he wants to ensure that RCS is working with AFH providers in
a manner that promotes partnership and respect. Mr. Walters brought with him his executive leadership team. All of them took
the time to answer questions and hear member’s concerns. Providers who attended these meetings commented that this was
“breath of fresh air” and we believe the beginning of a significant and positive shift in the way AFH providers and RCS interact.
We have four more scheduled opportunities for providers to hear Mr. Walter’s presentation and to ask questions.
The remaining times are:
South King County Chapter Meeting. 2/19/15 11:30 - 2:30
Olympia Chapter Meeting 2/20/15 1:00-3:00
Eastside Chapter Meeting. 3/17/15 12:30 - 3:30
Sno-King Chapter Meeting. 3/25/15 12:30 - 3:30
Meeting locations and details are available on the chapter pages at www.wsrcc.org. If you are unable to attend any of these
meetings, you can also review his presentation here, if you have questions you can submit them to info@wsrcc.org and we will do
our best to include them in the remaining meetings.
As always, please feel free to contact our office with questions, concerns and ideas. The Washington State Residential Care
Council is a member driven, mission focused organization here to serve you.
Sincerely,
John Ficker
Executive Director
www.wsrcc.org
Page 2
WSRCC Lobby Day - Educational for both WSRCC Members & Legislators!
Thank you to those of you who attended WSRCC’s Lobby Day! For those of you who could not make it, there is still
time and opportunities to make your voices heard by your legislators. Follow the link below for WSRCC’s legislative
agenda and a sample letter for you to contact your legislators. Sharing YOUR personal story with YOUR legislators will
offer the greatest impact! https://www.wsrcc.org/wsrcc-members/members-home
If you need assistance you can email Maria Chiechi at maria@wsrcc.org or call the office @ 360-754-3329.
Thank You to Rice Insurance
for their sponsorship of Lobby Day Lunch!
Thank You to Peaks & Plains
for their sponsorship of our Lobby Day
Breakfast!
Roger Chamberlin & Rebecca Sparks
Leigh McNellis
6326 E Trent Avenue #A
Spokane, WA 99212
Leigh@peaks-plains.com
Rebecca - Rebecca@riceinsurance.com
509-922-1572
360-734-1161
PO Box 639, Bellingham, 98227
Roger - roger@riceinsurance.com
www.wsrcc.org
Page 3
Sample Letter to Your Legislators
Dear Senator OR Representative X:
As a constituent, and on behalf of the 2,750 Adult Family Homes (AFH) in the State of Washington , I want to
urge you to support the Washington State Residential Care Council’s agenda to:

Fund the awarded raise to AFH Medicaid rates

Stop the proposed increase to our bed licensing fees

Improve the change of ownership process with HB 1132 & SB 5796

Improve the appeal process with SB 5877.
As you may know, adult family homes are small businesses often family operated, providing personal care for
the most acute clients in any home and community based settings. AFH’s provide this service at an average
rate of $87 per day, in comparison to the more expensive institutional settings at an average rate of $190
per day.
(INSERT PERSONAL STORY OR INFORMATION SPECIFIC TO YOUR ADULT FAMILY HOMES - Sharing YOUR
personal story with YOUR legislators will offer the greatest impact!)
I support the position of the Washington State Residential Care Council, and I am aware of the budget crisis
you are dealing with, that there is much work yet to be done. As you move forward, I hope all adult family
homes in Washington State will continue to be acknowledged as a critical component in the long term care
arena, and you will do everything you can to invest in our states nationally recognized long term care system
in the years to come!
Please contact me to let me know your position on WSRCC’s legislative agenda or with any questions you
might have about adult family homes in your district. I can be reached at [INSERT YOUR CONTACT
INFO]. My representative in Olympia is Maria Chiechi, please feel free to contact her if you have questions as
well @ 360-754-3329 or maria@wsrcc.org.
Sincerely,
www.wsrcc.org
Page 4
Prepare and Protect Washington’s Long Term Care System for the Future
Fund awarded raise to AFH Medicaid rates and Stop increase to Licensing Fees
 Arbitration awarded adult family home (AFH) providers a 5% increase effective 7/1/15 and an additional 5%
increase effective 7/1/16.
 Cost of approximately, $36.4 million state and federal funds or $18.2 million in state funds
 Hold licensing fees at $225 per bed
Why is this needed?
 Current Medicaid rates are built on cost indicators from 2005.
 Since 2005 Medicaid rates have increased by 3.98%, while the CPI has increased 25.5% and starting wage for an in
home care giver has increased 21.8%.
 Since 2008, Medicaid occupancy in AFH’s has increased from 46% to 57% of available beds.
 Increase in demographics of senior citizens (AgeWave) and vulnerable adults
 Decrease in AFH beds/homes licensed. ALTSA is predicting a continued decline.
 AFH providers serve the highest acuity of any home and community based setting at an average of $87 per day.
Loss of AFH beds for high acuity clients increases the likelihood of residents being placed in more restrictive and
more expensive settings like skilled nursing facilities and hospitals at an average of $190 per day.
 Access to services is often limited due to extremely low daily rates, causing longer time in SNF and hospitals.
 Proposed increase to AFH licensing fees since FY09 these fees will increase by 3,900%
House Bill 1132 & Senate Bill 5796 - Improve Change of Ownership (CHOW) Process
House Bill 1132 allows the delay of training requirements and a waiver of the AFH application fee under exceptional
circumstances. Additionally this legislation creates an application fee for CHOW separate from the initial application
fee, making it easier for homes to change business structure or partnerships.
Senate Bill 5877 - Concerning due process for adult family home licensees. SB 5877 ensures that adult family home
providers are entitled to the full due process described in the Administrative Procedures Act RCW 34.05. Specifically,
SB 5877 eliminates administrative code that currently keeps a provider from requesting a stay hearing related to
enforcement actions levied by DSHS. This bill does not change the residents protections or DSHS’s right to enforce
appropriate enforcement actions. This allow a provider to continue to provide care pending a final administrative
decision.
Additional considerations
 MORE AFH beds were identified as a primary need in a 2011 needs assessment conducted by DSHS
 Increase in training requirements are funded by AFH operators and cause challenges in finding staffing.
 The legislature has identified AFH providers as “an important part of the state's long-term care system”
 AFH providers serve the highest acuity of home and community services (See Chart #2)
www.wsrcc.org
ProviderOne Help!
Contact the BASS team
Call: 800-562-3022 (after the introduction, press 5 for Providers, then press 1 for Social Services)
Email: BASS@dshs.wa.gov
Online: www.altsa.dshs.wa.gov/providerone
Page 5
www.wsrcc.org
Page 6
RCS Goal is to Foster a Culture of Dignity and Respect
Confirmed Visits Planned to WSRCC Chapter Meetings by
Mr. Carl I. Walters II, RCS Director
South King County Chapter Meeting. 2/19/15.
11:30-2:30
Olympia/Peninsula Chapter Meeting. 2/20/15.
1:00-3:00
Eastside Chapter Meeting.
12:30-3:30
3/17/15.
Sno-King Chapter Meeting.
3/25/15. 12:30-3:30
Please check WSRCC’s website to find meeting addresses and chapter officers to contact for
questions. Also, watch your email and US postal mail—you should be receiving detailed
meeting announcements for your region! If not, contact the WSRCC to update your contact
information!!
At these meetings, Mr. Carl I. Walters II and his Senior Management Team will be our guests. They will make a presentation
emphasizing the new RCS Director’s goal of “Fostering a Culture of Dignity and Respect” with AFH partners, and will then take
time to hear your concerns through a Q & A Panel. Per Mr. Walters 10/13/14 Dear Provider letter, he “would like to invite you to
help us recalibrate our working relationship with you so we can all better serve the vulnerable adults of our state.”
Some details of Mr. Walters vision: (quoted directly from the DSHS/ALTSA website)

To create a stronger partnership between Residential Care Services and AFH Providers;

To position RCS to operate in a more transparent, respectful and collaborative manner with AFH providers;

To be more open to receiving feedback from AFH
providers regarding steps RCS can/should take to
strengthen the partnership between AFH providers
and RCS;

To offer more consultative guidance and technical
assistance to help AFH providers operate in a more
consistent regulatory manner;
These words may help further explain the purpose of Mr.
Walters outreach to you in these meetings--in the
10/13/14 Dear Provider Letter, he wrote, “I would like to
thank each and every one of you for your hard work and
dedication. I look forward to building a new business
relationship with you that is based not only on
professionalism, but mutual respect for the roles we all
play.”
Please plan to join us and take advantage of this
opportunity to speak directly with Mr. Carl I. Walters II,
and the RCS Senior Management Team. You can be a part
of creating a culture shift between RCS and AFH Providers
across the state!
Susan Zarenski
WSRCC Member Services & Education Specialist
VS Tax and Accounting
We are an Enrolled, IRS Tax Agent, authorized by
the US Treasury, as well as, Business Consultants,
with MBA and PhD. Degrees. We prepare Tax
Returns for Individuals, the Self-Employed and
Corporations.
We specialize in Foster Care Homes
We offer a free ½ hour consultation
We have over 35 years’ experience in taxes,
bookkeeping and payroll preparation. We also
speak Romanian.
Website: vstaxesandaccounting.com;
cell: 503-806-7276
Email address: vioricaconsulting@gmail.com
www.wsrcc.org
Page 7
Let WSRCC help fill your beds with the AFH Home Locator
Does your home have a Website? Pictures? Email Address? Vacancies?
One of the many questions we receive here at the WSRCC is: “Where are the adult
family homes with vacancies?” We would like to add and enhance the adult family
home locator page on WSRCC’s website.
This is where we will need your participation: If you are a current member and
would like to see your home on the locator with a picture, email address, link to your
website and vacancies we need you to send us your information to info@wsrcc.org
License Number:
Sample of current information being displayed on
WSRCC’s AFH Locator.
Name of AFH:
Email address:
Angelwings AFH
Website address:
Contact Person: Amelia Hertog
Vacancies/Type:
Click on this picture to take you to
WSRCC’s current AFH locator.
Contact Email: c.iuhertog@comcast.net
Website: http://angelwingshome.com
Phone: (206) 660-5224
Street: 484 S 190 STREET
City: Seattle
County: King
State: WA
Zip Code: 98148
WSRCC Chapter: South King
www.wsrcc.org
Page 8
New Affiliate Business Partner - Kline Galland
Kline Galland’s Community Based Services are provided in King County and include:
Hospice & Palliative Care Bridge Services, Home Health, and Home Care - Relative to our 100 years
of delivering healthcare, these service lines are relatively new and growing. Patients in our Continuum of
Care may receive multiple services simultaneously. Some may receive individual services at different times
depending on their preferences and care needs. We recognize the importance of integrated care planning
and communication with Adult Family Homes and would like to make our services available to all owners and
employees of these homes. We enjoy providing care while at the same time educating staff, patients, and
families about their care options and empowering with the knowledge needed to make their most informed
decisions.
Hospice & Palliative Care Bridge Services - Hospice is about living better with extra support and care
from a specialized team of healthcare professionals. Our nurses, social workers, home health aides, spiritual
care teams, etc. are experts at supporting people and their family through pain management, disease processes, and caring for their spiritual and cultural wishes.
Hospice is covered by Medicare and other insurances. Our Palliative Care Bridge Services are available to
those who may not be eligible for hospice or are trying to navigate through healthcare decisions. We help
them understand their choices for medical care, identify supportive services that enhance quality of life and
reduce visits to the emergency room and hospital.
Home Health - Home Health Services are one of our most utilized additions to our Continuum of Care. Services include rehabilitative and nursing care in a person’s home environment. Our team of nurses, therapists, social workers and home health aides is committed to helping patients reach their highest level of
health and function.
We are Medicare Certified and CHAP Accredited (Community Health Accreditation Program). Services may
be covered by Medicare Part A and similar insurance plans.
Home Care - Services are intended to provide support for everyday tasks in the comforts of one’s home.
Home includes a private residence, retirement or assisted living apartment, or long term care center. We
provide flexible, personalized and dependable services for short term or ongoing care needs.
Home care is usually paid for privately however some long term insurance plans will provide coverage. Charges are based on the level of caregiving assistance needed and the amount of time scheduled.
http://www.klinegalland.org/
Phone: (206) 725-8800 | Fax: (206) 722-5210
www.wsrcc.org
Free Training Available
Page 9
www.wsrcc.org
Page 10
Trainings Available
DSHS AFH Admin Training (48 hour)
April 13-May 27th Class is on Mon and Tuesdays
with one exception this quarter of the week of
May 25th. That Monday is a holiday so class will
be on Tues and Wed that week.
5:00-8:30 pm
Jennifer Carter
Director for Professional Development and Consulting
South Puget Sound Community College
Corporate & Continuing Education
360-596-5749
Fax: 360-407-0483
Do you participate in your local chapter
meetings?
Do you take part in free local training and networking
opportunities?
Get more information here
Central Washington Chapter
Clark County Chapter
Eastside (Bellevue) Chapter
Fourth Corner AFH Chapter
Kitsap County Chapter
Olympia/Peninsula Chapter
North Central Chapter
Pierce County Chapter
Sno-King Chapter
So East Chapter - Tri-Cities & Surrounding Areas
South King County Chapter
Spokane Regional Chapter
www.wsrcc.org
Page 11
Explanation of the Required Character, Competence, and Suitability (C/C/S) Review
In December 2015, we had many members calling the WSRCC Main Office with some concern due to a sudden Background Check
audit they were being subjected to. Many questioned this audit may not have been legitimate, since this was not part of their
regular DSHS inspection. The WSRCC was asked to find out what was going on, and we did!
Marie Rose, RN, MN, a Nursing Home Surveyor from RCS, was assigned to perform this legitimate Background Check audit of 300
Adult Family Homes and was given a short deadline, so she informed Providers over the phone. Marie also informed the WSRCC
the audit was addressing homes which employ persons with a conviction on their record. DSHS was checking specifically to see
that the proper documentation was done by Providers to complete a Character, Competence, and Suitability Review.
Here is the actual WAC that describes this “C/C/S Review” process must be completed and documented, any time a background
check is not free of findings, but the findings do not automatically disqualify an employee:
WAC 388-76-10181
Background checks—Employment—Nondisqualifying information.
(1) If any background check results show that an employee or prospective employee has a criminal conviction or pending
charge for a crime that is not disqualifying under chapter 388-113 WAC, then the adult family home must:
(a) Determine whether the person has the character, competence and suitability to work with vulnerable adults in long-term
care; and
(b) Document in writing the basis for making the decision, and make it available to the department upon request.
(2) Nothing in this section should be interpreted as requiring the employment of any person against the better judgment of the
adult family home.
Here is more information to help you understand and complete the process:
On the DSHS/ALTSA website, you can find advice from DSHS if you click on this link: https://www.dshs.wa.gov/altsa/fingerprintbackground-checks-interim-result-letter. About halfway down this DSHS page is a section called “Performing a Character,
Competence, and Suitability (C/C/S) review” which explains the purpose, and some important things to consider. You must use
your best judgment as to a person’s suitability to work with vulnerable adults, and you must be able to explain your rationale.
DSHS emphasizes to Providers to be seriously considering all the factors involved in any convictions found, before making a
decision about continued employment.
Within the info written in this section of the DSHS page, you will find a blue link called “C/C/S Review Form.” Use of this particular
form is not required; however, the WSRCC believes this form works well to show your decision and why you made it. Here are 2
things to note: You must have documented in writing the determination you make -- #5 on this form gives a clear place to
document your decision to employ or not employ the person. You must also document in writing the basis for making the decision- #6 of this form gives a place to write your comments and explain your rationale.
The WSRCC has another form that can be a very helpful way for you to gather more information from the staff person who has a
finding on a background check. Use of this form during your C/C/S investigation will create an opportunity for the staff in question
to self-report further details about the background check findings, explain what they did to correct the issue, and any steps they
have taken, or are willing to take, to prevent the situation from happening again. You must be a Member to access this Form from
the WSRCC website’s Forms Library. The helpful form for staff to self-report the circumstances around any convictions is called
“C.C.S Review-STAFF SELF-REPORT-Explanation of Circumstances for Convictions”
Please be aware your state licensors and investigators will be looking for any needed C/C/S Reviews are complete. Hopefully, the
information in this article will provide you with the information and tools you need to complete these accurately.
Susan Zarenski
Member Services/Education Specialist
www.wsrcc.org
Page 12
Adult Family Homes are Residential Properties
Adult Family Homes are defined in
law as a residential setting. RCW
70.128.010 defines an adult family
home as “a residential home in which
a person or persons provide personal
care, special care, room, and board to
more than one but not more than six
adults who are not related by blood
or marriage to the person or persons
providing the services.” Despite the
clarity of the definition, many
providers have been asked by their
cities, counties, home owners
association and other vendors to pay
“business “ or “commercial” rates for
services. Since the definition of an
adult family home in law calls out
that your home is residential, those
rates may not be appropriate. We
encourage providers to review their
billing statements and understand
what definition the vendor is using to
classify your AFH. Some business
rates may apply, but if the vendor
using zoning or property type you
may be entitled under the definition
of the law to residential rates and/or
services. One example was an AFH in
Pierce county who was told he could
not get curbside waste removal
because he operated a business.
However, the WSRCC contacted the
waste management office, clarified
the definition of an adult family home
and the service was restored.
Another provider in east King county
was being charged business rates for
water and utilities, once it was
clarified by law the home was
residential, the rates were lowered.
The WSRCC can provide members
with sample letters and assistance in
correcting these issues.
Your WSRCC Team
Del Miles ~ Board President - w2godiving@charter.net - (509) 728-1484
John Ficker ~ Executive Director - john@wsrcc.org - (360) 754-3329
Maria Chiechi ~ Executive Assistant & Legislative Coordinator - maria@wsrcc.org (360)-754-3329
Susan Zarenski ~ Member Services/Education Specialist-susan@wsrcc.org
(360)754-3329
Bryon Dahl ~ Office Manager - bryon@wsrcc.org - (360)-754-3329
Washington State Residential Care Council
523 Pear Street SE - Olympia, WA 98501
Office - 360-754-3329 * Fax - 360-943-6653
www.wsrcc.org - info@wsrcc.org
www.wsrcc.org
Page 13
www.wsrcc.org
Page 14
To access this Caregiver Alert or any others you may be interested in,
follow the link below:
https://www.dshs.wa.gov/dda/publications/caregiver-alerts-information
www.wsrcc.org
Page 15
Buy * Sell * Trade
WSRCC Members Marketplace Page
Place an ad on this page in our next issue of the VOICE
Looking for AFH to Lease or Buy
Established AFH For Sale in
Ocean Park, WA
Looking for lease or lease with option to
buy an AFH with or without residents.
Location: Kent, Des Moines, Renton,
Kirkland, Bellevue, Redmond,
Sammamish, Issaquah. Call/text, Alla or
Igor: 732-456-3992.
Save the Date for 2015 Fall
Conference!
Not getting WSRCC’s
newsletters in your email
inbox?
OCTOBER 29 & 30
TULALIP RESORT & CASINO
Please let us know and we will
get you started right away!
Register for email newsletters
and alerts by contacting us at
info@wsrcc.org .
To best serve you, please notify us of any changes to your contact information. If you have new telephone number, license
or name changes, emails, additions or closures of homes or
moved from one location to another, please call our office @
360-754-3329 or info@wsrcc.org.
ADULT FAMILY HOME FOR SALE on the
Long Beach peninsula. One mile from the
Pacific Ocean, close to shopping and
hospital.
Large garden area in fenced yard on a
dead end quiet street.
Asking $34,000 for business and lease
the house for 2 years at $2,000 a
month. Or buy house and business for
$224,000. Please, only serious potential
buyers may inquire. Call 360) 665-3223 for
more information
Buy * Sell * Trade
Place a classified ad in our
next Marketplace section
Washington State Residential Care Council
523 Pear Street SE, Olympia WA 98501
1-888-439-8999—360-754-3329 - Fax 360-943-6653 www.wsrcc.org
523 Pear Street SE
Olympia, WA 98501
Save the Date for 2015 Fall Conference!
OCTOBER 29 & 30
Message from WSRCC’s Executive
Director John Ficker
TULALIP RESORT & CASINO
WSRCC’s Sample Letter & Legislative
Agenda
ProviderOne Information
DSHS RCS Director to visit Chapters!
WSRCC’s AFH Locator
New Affiliate Business Partner
Training Opportunities
Character, Competence & Suitability
Review Information
Caregiver Alerts!
AFH for Sale
www.wsrcc.org
Code of Ethics for Adult Family Home Providers
This Code of Ethics for Adult Family Home Providers has been developed as a guide for carrying out provider responsibilities in a manner
consistent with professional values and moral standards which define the essentials of honorable behavior for the Adult Family Home
Provider.
As Adult Family Home Providers we want the public to acknowledge us as professionals. Part of this process is to develop a system of ethical codes of conduct and standards of practice that incorporate our principles and values regarding quality care. We need to have an
open review process that includes substantive critique and modifications to develop our final ethical code. Please participate in this endeavor by reading the following and e-mail your opinions and suggestions to info@wsrcc.org.
1. An Adult Family Home Provider recognizes and respects the dignity of residents without consideration for race, religion, gender, sexual
orientation, social or economic status.
2. An Adult Family Home Provider, while honoring the residents’ rights to self determination, will promote and protect the rights of all
their residents.
3. An Adult Family Home Provider is responsible and accountable for their individual practice and determining how they deliver optimum
care to their residents.
4. An Adult Family Home Provider acknowledges the responsibility to protect their own integrity, maintain competence in their field, and
continue their personal and professional growth.
Through their Associations and working with fellow members Adult Family Home Providers will promote their profession with continued
education and political action in shaping the WACs and rules that govern their profession.