Bill Summary – FastDemocracy

Z-0418.1
                               SENATE BILL 5611
     State of Washington       67th Legislature       2022 Regular Session
     By Senators Mullet, King, Gildon, Lovick, Padden, Randall, Rolfes,
     Short, and L. Wilson; by request of Secretary of State
     Prefiled 12/29/21. Read first time 01/10/22.    Referred to Committee
     on Health & Long Term Care.
     AN ACT Relating to providing an exemption to long-term care
 insurance for retired veterans and retirement eligible veterans; and
 amending RCW 50B.04.010, 50B.04.020, and 50B.04.085.
 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
     Sec. 1.   RCW 50B.04.010 and 2021 c 113 s 1 are each amended to
 read as follows:
     The definitions in this section apply throughout this chapter
 unless the context clearly requires otherwise.
     (1) "Account" means the long-term services and supports trust
 account created in RCW 50B.04.100.
     (2) "Approved service" means long-term services and supports
 including, but not limited to:
     (a) Adult day services;
     (b) Care transition coordination;
     (c) Memory care;
     (d) Adaptive equipment and technology;
     (e) Environmental modification;
     (f) Personal emergency response system;
     (g) Home safety evaluation;
     (h) Respite for family caregivers;
     (i) Home delivered meals;
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     (j) Transportation;
     (k) Dementia supports;
     (l) Education and consultation;
     (m) Eligible relative care;
     (n) Professional services;
     (o) Services that assist paid and unpaid family members caring
 for   eligible  individuals,   including  training  for  individuals
 providing care who are not otherwise employed as long-term care
 workers under RCW 74.39A.074;
     (p) In-home personal care;
     (q) Assisted living services;
     (r) Adult family home services; and
     (s) Nursing home services.
     (3) "Benefit unit" means up to one hundred dollars paid by the
 department of social and health services to a long-term services and
 supports provider as reimbursement for approved services provided to
 an eligible beneficiary on a specific date. The benefit unit must be
 adjusted annually at a rate no greater than the Washington state
 consumer price index, as determined solely by the council. Any
 changes adopted by the council shall be subject to revision by the
 legislature.
     (4) "Commission" means the long-term services and supports trust
 commission established in RCW 50B.04.030.
     (5) "Council" means the long-term services and supports trust
 council established in RCW 50B.04.040.
     (6) "Eligible beneficiary" means a qualified individual who is
 age eighteen or older, residing in the state of Washington, has been
 determined to meet the minimum level of assistance with activities of
 daily living necessary to receive benefits through the trust program,
 as established in this chapter, and has not exhausted the lifetime
 limit of benefit units.
     (7) "Employee" has the meaning provided in RCW 50A.05.010.
     (8) "Employer" has the meaning provided in RCW 50A.05.010.
     (9) "Employment" has the meaning provided in RCW 50A.05.010.
     (10) "Exempt employee" means a person who has been granted a
 premium assessment exemption by the employment security department.
     (11) "Long-term services and supports provider" means an entity
 that meets the qualifications applicable in law to the approved
 service they provide, including a qualified or certified home care
 aide, licensed assisted living facility, licensed adult family home,
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 licensed nursing home, licensed in-home services agency, adult day
 services program, vendor, instructor, qualified family member, or
 other entities as registered by the department of social and health
 services.
     (12) "Premium" or "premiums" means the payments required by RCW
 50B.04.080 and paid to the employment security department for deposit
 in the account created in RCW 50B.04.100.
     (13) "Program" means the long-term services and supports trust
 program established in this chapter.
     (14) "Qualified family member" means a relative of an eligible
 beneficiary qualified to meet requirements established in state law
 for the approved service they provide that would be required of any
 other long-term services and supports provider to receive payments
 from the state.
     (15) "Qualified individual" means an individual who meets the
 duration of payment requirements, as established in this chapter.
     (16) "Retired veteran and retirement eligible veteran" means a
 person who has served in the armed service of the United States and
 is eligible for retirement or has retired from the armed service
 either after a duration of service necessary to qualify for veterans
 benefits or due to disability qualification for veterans benefits.
     (17) "State actuary" means the office of the state actuary
 created in RCW 44.44.010.
     (((17))) (18) "Wage or wages" means all remuneration paid by an
 employer to an employee. Remuneration has the meaning provided in RCW
 50A.05.010. All wages are subject to a premium assessment and not
 limited by the commissioner of the employment security department, as
 provided under RCW 50A.10.030(4).
     Sec. 2.   RCW 50B.04.020 and 2021 c 113 s 2 are each amended to
 read as follows:
     (1) The health care authority, the department of social and
 health services, the office of the state actuary, and the employment
 security department each have distinct responsibilities in the
 implementation and administration of the program. In the performance
 of their activities, they shall actively collaborate to realize
 program efficiencies and provide persons served by the program with a
 well-coordinated experience.
     (2) The health care authority shall:
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     (a) Track the use of lifetime benefit units to verify the
 individual's status as an eligible beneficiary as determined by the
 department of social and health services;
     (b) Ensure approved services are provided through audits or
 service verification processes within the service provider payment
 system for registered long-term services and supports providers and
 recoup any inappropriate payments;
     (c) Establish criteria for the payment of benefits to registered
 long-term services and supports providers under RCW 50B.04.070;
     (d) Establish rules and procedures for benefit coordination when
 the eligible beneficiary is also funded for medicaid and other long-
 term services and supports, including medicare, coverage through the
 department of labor and industries, and private long-term care
 coverage; and
     (e) Adopt rules and procedures necessary to implement and
 administer the activities specified in this section related to the
 program.
     (3) The department of social and health services shall:
     (a) Make determinations regarding an individual's status as an
 eligible beneficiary under RCW 50B.04.060;
     (b) Approve long-term services and supports eligible for payment
 as approved services under the program, as informed by the
 commission;
     (c) Register long-term services and supports providers that meet
 minimum qualifications;
     (d) Discontinue the registration of long-term services and
 supports providers that: (i) Fail to meet the minimum qualifications
 applicable in law to the approved service that they provide; or (ii)
 violate the operational standards of the program;
     (e) Disburse payments of benefits to registered long-term
 services and supports providers, utilizing and leveraging existing
 payment systems for the provision of approved services to eligible
 beneficiaries under RCW 50B.04.070;
     (f) Prepare and distribute written or electronic materials to
 qualified individuals, eligible beneficiaries, and the public as
 deemed necessary by the commission to inform them of program design
 and updates;
     (g)   Provide  customer   service   and  address   questions and
 complaints, including referring individuals to other appropriate
 agencies;
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     (h) Provide administrative and operational support to the
 commission;
     (i) Track data useful in monitoring and informing the program, as
 identified by the commission; and
     (j) Adopt rules and procedures necessary to implement and
 administer the activities specified in this section related to the
 program.
     (4) The employment security department shall:
     (a) Collect and assess employee premiums as provided in RCW
 50B.04.080;
     (b) Assist the commission, council, and state actuary in
 monitoring the solvency and financial status of the program;
     (c) Perform investigations to determine the compliance of premium
 payments in RCW 50B.04.080 and 50B.04.090 in coordination with the
 same activities conducted under the family and medical leave act,
 Title 50A RCW, to the extent possible;
     (d) Make determinations regarding an individual's status as a
 qualified individual under RCW 50B.04.050; and
     (e) Adopt rules and procedures necessary to implement and
 administer the activities specified in this section related to the
 program.
     (5) The office of the state actuary shall:
     (a) Beginning January 1, 2024, and biennially thereafter, perform
 an actuarial audit and valuation of the long-term services and
 supports trust fund. Additional or more frequent actuarial audits and
 valuations may be performed at the request of the council;
     (b) Make recommendations to the council and the legislature on
 actions necessary to maintain trust solvency. The recommendations
 must include options to redesign or reduce benefit units, approved
 services, or both, to prevent or eliminate any unfunded actuarially
 accrued liability in the trust or to maintain solvency; and
     (c) Select and contract for such actuarial, research, technical,
 and other consultants as the actuary deems necessary to perform its
 duties under chapter 363, Laws of 2019.
     (6) By October 1, 2021, the employment security department and
 the department of social and health services shall jointly conduct
 outreach to provide employers with educational materials to ensure
 employees are aware of the program and that the premium assessments
 will begin on January 1, 2022. In conducting the outreach, the
 employment security department and the department of social and
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 health services shall provide on a public website information that
 explains the program and premium assessment in an easy to understand
 format. Outreach information must be available in English and other
 primary languages as defined in RCW 74.04.025.
     (7) By July 1, 2022, the employment security department and the
 department of social and health services shall jointly conduct
 outreach to retired veterans and retirement eligible veterans living
 in the state and provide employers with educational materials to
 ensure employees are aware of the option available to retired
 veterans to exempt themselves from the program. In conducting the
 outreach, the employment security department and the department of
 social and health services shall provide on a public website
 information that explains the program and premium assessment in an
 easy to understand format, and the procedure for a retired veteran
 and retirement eligible veterans to exempt themselves from the
 program. Outreach information must be available in English and other
 primary languages as defined in RCW 74.04.025.
     Sec. 3.   RCW 50B.04.085 and 2021 c 113 s 5 are each amended to
 read as follows:
     (1)(a) An employee who attests that the employee has long-term
 care insurance purchased before November 1, 2021, may apply for an
 exemption from the premium assessment under RCW 50B.04.080.
     (b) A retired veteran or retirement eligible veteran may request
 exemption from the premium assessment under RCW 50B.04.080 by
 attesting to their service and eligibility for veterans benefits.
     (c) An exempt employee may not become a qualified individual or
 eligible beneficiary and is permanently ineligible for coverage under
 this title.
     (2) The employment security department must accept applications
 for exemptions for retired veterans and retirement eligible veterans
 at any time.
     (3) The employment security department is not required to verify
 the attestation of an employee that the employee is a retired veteran
 or a retirement eligible veteran.
     (4)(a)   The   employment   security    department   must   accept
 applications for exemptions only from October 1, 2021, through
 December 31, 2022.
     (b) Only employees who are eighteen years of age or older may
 apply for an exemption.
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     (((3))) (5) The employment security department is not required to
 verify the attestation of an employee that the employee has long-term
 care insurance.
     (((4))) (6) Approved exemptions will take effect on the first day
 of the quarter immediately following the approval of the exemption.
     (((5))) (7) Exempt employees are not entitled to a refund of any
 premium deductions made before the effective date of an approved
 exemption.
     (((6))) (8) An exempt employee must provide written notification
 to all current and future employers of an approved exemption.
     (((7))) (9) If an exempt employee fails to notify an employer of
 an exemption, the exempt employee is not entitled to a refund of any
 premium deductions made before notification is provided.
     (((8))) (10) Employers must not deduct premiums after being
 notified by an employee of an approved exemption.
     (a) Employers must retain written notifications of exemptions
 received from employees.
     (b) An employer who deducts premiums after being notified by the
 employee of an exemption is solely responsible for refunding to the
 employee any premiums deducted after the notification.
     (c) The employer is not entitled to a refund from the employment
 security department for any premiums remitted to the employment
 security department that were deducted from exempt employees.
     (((9))) (11) The department must adopt rules necessary to
 implement and administer the activities specified in this section
 related to the program, including rules on the submission and
 processing of applications under this section.
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Statutes affected: 
Original Bill: 50B.04.010, 50B.04.020, 74.04.025