SB 5504 — Supporting caregivers who provide complex care services to children with heightened medical needs.

S-1784.1S-0685.1 SUBSTITUTE SENATE BILL 5504 State of Washington 69th Legislature 2025 Regular Session By Senate Health & Long-Term Care (originally sponsored by Senators Chapman, Harris, Cortes, Saldaña, Trudeau, and Valdez)Valdez READRead FIRSTfirst TIMEtime 02/21/25.01/27/25.

Referred to Committee on Health & Long- Term Care.

creatingand adding a new section;section to chapter 74.09 RCW.

and providing an expiration date.

(1)A Bynew Decembersection 1,is 2025,added theto healthchapter care74.09 authorityRCW shall seek consultation from the federal centers for medicare and medicaid services for an approval of a state plan amendment to provideread payment to a home health agency for complex care services as afollows: component of the private duty nursing benefit when provided to an enrollee under 18 years old receiving private duty nursing in a medical assistance program under chapter 74.09 RCW when:

(1) Beginning September 1, 2026, the authority shall require or provide payment to a home health agency for complex care services as a component of the private duty nursing benefit when provided to an enrollee under 18 years old receiving private duty nursing in a medical assistance program under this chapter when:

(b) The caregiver has successfully completed at least 75 total hours of instruction offered by a home healthcare agency that is accredited by an organization recognized by the healthauthority careunder authoritysubsection (2) of this section and has been determined to be competent to provide complex care services;

p.(c) The complex care services are provided by the caregiver as delegated by a registered nurse licensed under chapter 18.79 RCW;

1 SSB 5504 (c) The caregiver is educated and trainedp. by a registered nurse licensed under chapter 18.79 RCW to provide complex care services to the patient;

and1 SB 5504 (d) The caregiver providing the complex care services is employed by a home health agency licensed under chapter 70.126 RCW with a provider agreement with the health care authority or a managed care organization.

(2) ByThe Januaryauthority 1,shall 2026,recognize theaccrediting healthorganizations carethat authorityit shalldetermines submithave astandards statusthat reportallow home health agencies to theproperly appropriatetrain policycaregivers andunder fiscalsubsection committees(1)(b) of thethis legislaturesection detailingto thesafely feasibilityprovide ofcomplex ancare approvalservices forin aaccordance statewith planthe amendmentnursing asaide outlinedtraining inand subsectioncompetency (1)evaluation ofprogram thisstandards section.established under 42 C.F.R.

(3)Secs. This section expires December 31, 2026.

483.151 through 154 and 42 C.F.R.

Sec.

484.80.

(3) A caregiver providing complex care services who has successfully completed the training may change employers without having to repeat the training course required under subsection (1)(b) of this section.

(4) The home health agency that employs the caregiver providing complex care services under subsection (1) of this section must assume all costs of training the caregiver and may not require the caregiver to reimburse the home health agency for the cost of the training.

(5) When determining an enrollee's eligibility for complex care services, the authority may only consider the child's income and not the income of any other person living in the household.

(6) The authority shall seek a state plan amendment or waiver, as applicable, from the federal centers for medicare and medicaid services to implement this section.

(7) By September 1, 2029, the authority must submit a report to the governor and the committees of the legislature with jurisdiction over health policy matters.

The report must assess the viability of the complex care services payment program established in this section, including data analyzing the effectiveness of the program.

The authority must use available data and not require home health agencies to submit data necessary for creating the report.

(8) For the purposes of this section, "complex care services" means the provision of the care services by the parent, guardian, family member, or other close association that is the equivalent of a family relation of the enrollee to a person under 18 years old who is receiving private duty nursing when provided under the direction of a registered nurse licensed under chapter 18.79 RCW.

"Complex care services" may include patient transfer;

patient positioning;

patient ambulation;

patient feeding;

personal care;

catheter care;

medication administration;

tracheostomy care;

enteral care, therapy, and feeding p.

2 SB 5504 administration;

formula preparation;

comprehensive respiratory care, chest physiotherapy, and cough assistance;

and other tasks approved by the authority.

23 SSBSB 5504