HB 1: "An Act relating to the Department of Health and Social Services; relating to in-home personal care services agencies; establishing the In-Home Personal Care Services Advisory Board; and providing for an effective date."

00 HOUSE BILL NO. 1 01 "An Act relating to the Department of Health and Social Services; relating to in-home 02 personal care services agencies; establishing the In-Home Personal Care Services 03 Advisory Board; and providing for an effective date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 47.32.010(b) is amended to read: 06 (b) This chapter and regulations adopted under this chapter apply to the 07 following entities: 08 (1) ambulatory surgical centers; 09 (2) assisted living homes; 10 (3) child care facilities; 11 (4) child placement agencies; 12 (5) foster homes; 13 (6) free-standing birth centers; 14 (7) home health agencies;

01 (8) hospices, or agencies providing hospice services or operating 02 hospice programs; 03 (9) hospitals; 04 (10) in-home personal care services agencies; 05 (11) intermediate care facilities for individuals with an intellectual 06 disability or related condition; 07 (12) [(11)] maternity homes; 08 (13) [(12)] nursing facilities; 09 (14) [(13)] residential child care facilities; 10 (15) [(14)] residential psychiatric treatment centers; 11 (16) [(15)] runaway shelters; 12 (17) [(16)] rural health clinics. 13 * Sec. 2. AS 47.32.020 is amended by adding a new subsection to read: 14 (d) If an entity is providing personal care services under the medical assistance 15 program or for veterans as authorized by federal law, the entity is exempt from the 16 licensing requirements for in-home personal care services agencies under this chapter 17 and AS 47.34 when operating the program. 18 * Sec. 3. AS 47.32.900(2) is amended to read: 19 (2) "assisted living home" 20 (A) means a residential facility that serves three or more adults 21 who are not related to the owner by blood or marriage, or that receives state or 22 federal payment for services regardless of the number of adults served; the 23 department shall consider a facility to be an assisted living home if the facility 24 (i) provides housing and food services to its residents; 25 (ii) offers to provide or obtain for its residents 26 assistance with activities of daily living; 27 (iii) offers personal assistance as defined in 28 AS 47.33.990; or 29 (iv) provides or offers any combination of these 30 services; 31 (B) does not include

01 (i) a correctional facility; 02 (ii) an emergency shelter; 03 (iii) a program licensed under AS 47.10.310 for 04 runaway minors; 05 (iv) a type of entity listed in AS 47.32.010(b)(5), (8), 06 (9), [(10),] (11), [OR] (12), or (13); 07 * Sec. 4. AS 47.32.900 is amended by adding new paragraphs to read: 08 (22) "in-home personal care services agency" means an entity that 09 provides personal care services, including attendant care, homemaker services, and 10 companion care, for compensation to an individual in the individual's home to enable 11 the individual to remain in the home; "in-home personal care services agency" does 12 not include an entity that exclusively provides house cleaning services or that is a 13 home health agency, hospital, or long-term care facility licensed under this chapter; 14 (23) "personal care services" includes 15 (A) attendant care for assistance with bathing, dressing, 16 ambulation, transfers, toileting, and other activities of daily living for which an 17 individual license is not required; 18 (B) homemaker services for assistance with meal preparation, 19 light housekeeping, shopping, and other household tasks; 20 (C) companionship care for assistance with transportation, 21 companionship, memory, and other related needs. 22 * Sec. 5. AS 47 is amended by adding a new chapter to read: 23 Chapter 34. In-Home Personal Care Services. 24 Sec. 47.34.010. Establishment of advisory board; composition. (a) The 25 In-Home Personal Care Services Advisory Board is established in the department for 26 the purpose of advising the department on the development of regulations for the 27 standards of in-home personal care services agencies. 28 (b) The board consists of five members appointed by the governor as follows: 29 (1) two members of the in-home personal care services industry; 30 (2) two members who represent clients of in-home personal care 31 services agencies; and

01 (3) one member who is employed by the department. 02 (c) Members appointed under (b) of this section 03 (1) serve staggered terms of three years, until reappointed or replaced; 04 (2) serve at the pleasure of the governor; and 05 (3) may be reappointed. 06 (d) If a member appointed under (b) of this section no longer meets the 07 qualifications prescribed in (b) of this section or if a vacancy occurs for any reason 08 other than the expiration of a member's term, the governor shall, within 30 days after 09 the occurrence of the vacancy, make an appointment, effective immediately, for the 10 unexpired portion of the term. A member appointed by the governor under this 11 subsection to fill an unexpired term must meet the requirements of (b) of this section. 12 Sec. 47.34.020. Compensation. Members of the board serve without 13 compensation but are entitled to per diem and travel expenses authorized under 14 AS 39.20.180. 15 Sec. 47.34.030. Duties; meetings. (a) The board shall provide input and 16 recommendations to the department for the development of regulations for the 17 standards for in-home personal care services agencies. 18 (b) The board shall meet at least annually, at the request of the department, at 19 the request of the majority of the members, or at a regularly scheduled time as 20 determined by a majority of the members. 21 (c) The board shall keep a record of its proceedings and issue an annual report 22 to the department on the status of the development and implementation of proposed 23 regulations. 24 Sec. 47.34.040. Practice of in-home personal care services by an agency 25 without a license. A person may not operate an in-home personal care services 26 agency for compensation or advertise as an in-home personal care services agency 27 without being licensed under AS 47.32 or AS 47.34.070. 28 Sec. 47.34.050. Client rights. (a) A client of an in-home personal care services 29 agency has the right to 30 (1) live in a safe and sanitary environment; 31 (2) be free from verbal, physical, and psychological abuse;

01 (3) be treated with consideration and respect for personal dignity, 02 personal property, and the need for privacy, including privacy in 03 (A) a medical examination or health-related consultation; 04 (B) bathing and toileting, except for assistance in those 05 activities that is specified in the client's service plan; and 06 (C) the maintenance of personal possessions; 07 (4) self-administer the client's own medications, unless specifically 08 provided otherwise in the client's service plan; 09 (5) receive the prior notice of the agency's intent to terminate the 10 services contract of the client; 11 (6) present to the agency grievances and recommendations for change 12 in the policies, procedures, or services of the agency; 13 (7) have reasonable access to files relating to the client. 14 (b) An in-home personal care services agency may not establish or apply a 15 policy, procedure, or rule that is inconsistent with or contrary to a right provided by 16 this section or by other law. 17 Sec. 47.34.060. Client grievance procedure. (a) An in-home personal care 18 services agency shall establish a written grievance procedure for handling complaints 19 of clients. At the time an individual begins receiving services from an in-home 20 personal care services agency, the agency shall give a copy of the grievance procedure 21 to the client and the client's representative, if any. 22 (b) The grievance procedure established under this section must provide that a 23 client and the client's representative have the right to 24 (1) present both a written and an oral explanation of the client's 25 grievance; 26 (2) have an advocate of the client's choice and the client's 27 representative, if any, attend meetings concerning the client's grievance; and 28 (3) be notified in writing, within 30 days after the filing of the 29 grievance, of the final decision of the agency regarding the grievance. 30 (c) The agency shall maintain all records related to a grievance and make them 31 available for inspection by the department on request.

01 Sec. 47.34.070. Provisional licenses. (a) If an applicant for licensure has not 02 been previously licensed and the agency is not in operation at the time the application 03 is submitted, the department may issue a provisional license to operate an in-home 04 personal care services agency in this state. 05 (b) A provisional license issued under this section is initially valid for 120 06 consecutive calendar days. Upon request of a licensee, the department shall extend a 07 license issued under this section for 120 calendar days if, before the expiration of the 08 initial 120-day license, the licensee submits to the department a completed application 09 form and the fees required for licensure under AS 47.32, except that the department 10 may refuse to grant a request for an extension for the same reasons the department 11 may revoke a license. Provisional licenses and extensions of licenses issued to a 12 licensee under this section are not valid for more than 240 calendar days during any 13 consecutive 24 months. 14 Sec. 47.34.080. Disclosure. (a) A person who provides in-home personal care 15 services shall disclose that the person's training and practice are in the area of personal 16 care services 17 (1) to each client; and 18 (2) on all material used in the practice of providing in-home personal 19 care services and made available to clients or to the public. 20 (b) A person who provides in-home personal care services without being 21 covered by malpractice insurance shall disclose to each patient that the person does 22 not have malpractice insurance. 23 Sec. 47.34.090. Inspections and investigations. (a) The department may 24 conduct inspections and investigations of in-home personal care services agencies. 25 Inspections and investigations may include direct observation of in-home care if 26 consent is given by the client. 27 (b) An in-home personal care services agency shall investigate complaints 28 made by a client or the client's representative regarding services provided or services 29 that failed to be provided, lack of respect for the client's property by an employee of 30 the in-home personal care services agency, or other client complaints. 31 Sec. 47.34.100. Regulations. The department may adopt regulations to

01 implement in-home personal care services agency requirements under AS 47.32 and 02 this chapter, including regulations establishing 03 (1) standards for the practice of providing in-home personal care 04 services; 05 (2) standards for continuing education and training; 06 (3) a code of ethics for providing in-home personal care services; 07 (4) liability insurance policy requirements for in-home personal care 08 services agencies; 09 (5) reporting requirements for in-home personal care services agencies; 10 (6) employment requirements for in-home care services agencies; and 11 (7) standards of competency in 12 (A) infection mitigation and control; 13 (B) client mobility procedures; 14 (C) client hygiene procedures; 15 (D) client nutrition administration; 16 (E) provision of homemaker services; 17 (F) client services documentation; and 18 (G) emergency procedures. 19 Sec. 47.34.190. Definitions. In this chapter, 20 (1) "agency" or "in-home personal care services agency" has the 21 meaning given to "in-home personal care services agency" in AS 47.32.900; 22 (2) "board" means the In-Home Personal Care Services Advisory 23 Board; 24 (3) "department" means the Department of Health and Social Services; 25 (4) "personal care services" has the meaning given in AS 47.32.900. 26 * Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to 27 read: 28 TRANSITION: REGULATIONS. The Department of Health and Social Services may 29 adopt regulations necessary to implement the changes made by this Act. The regulations take 30 effect under AS 44.62 (Administrative Procedure Act), but not before the effective date of the 31 relevant provision of this Act implemented by the regulation.

01 * Sec. 7. Section 6 of this Act takes effect immediately under AS 01.10.070(c).