Signed by Governor Jay Inslee

Vote Smart's Synopsis:

Vote to concur with senate amendments and pass a bill that establishes a program for long-term services and supports.

Highlights:

• Defines “qualified individual” as an individual who meets the duration of payment requirements as established in the act (Sec. 2).

• Defines “eligible beneficiary” as a qualified individual who is 18 or older, residing in the state of Washington, was not disabled before the age of 18, has been determined to meet the minimum level of assistance with activities of daily living necessary to receive benefits through the trust program, and who has not exhausted the lifetime limit of benefit units (Sec. 2).

• Defines “benefit unit” as an amount of up to $100 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 (Sec. 2).

• Establishes the long-term services and supports trust commission for the purpose of making recommendations and decisions that maintain benefit adequacy, and fund solvency and adequacy (Sec. 4).

• Establishes the long-term services and supports council to determine on an annual basis adjustments to the benefit unit to ensure benefit adequacy and solvency of the long-term services and supports trust account (Sec. 5).

• Requires the health care authority to take the following actions, including (Sec. 3):

• Tracking 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;

• Ensuring 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 compensate for any inappropriate payments;

• Establishing criteria for the payment of benefits to registered long-term services and supports;

• Establishing rules and procedures for benefit coordination when the eligible beneficiary is also funded for Medicaid and other long-term services and supports, including Medicare; and

• Adopting rules and procedures necessary to implement and administer the activities related to the program.

• Requires the employment security department to classify an individual as qualified if the person has paid the long-term services and supports premiums for the equivalent of either (Sec. 6):

• A total of ten years without interruption of five or more consecutive years; or 

• Three years within the last six years. 

• Requires approved services be made available and benefits payable to a registered long-term services and supports provider on behalf of an eligible beneficiary, beginning January 1, 2025 (Sec. 7).

• Requires the employment security department to assess for each employed individual a premium based on the amount of the individual's wages, beginning January 1, 2022 (Sec. 9). 

• Specifies that the initial premium rate is .58 percent of the individual’s wages, and after January 1, 2024, the rate will be set by the pension funding council at a rate no more than 0.58 percent (Sec. 9).

• Requires the pension funding council to set the premium rate at the lowest amount necessary to maintain the actuarial solvency of the long-term services and supports trust account created in this act (Sec. 9).

• Authorizes any self-employed person, including a sole proprietor, independent contractor, partner, or joint venturer, to elect coverage under this act (Sec. 10).

Full Bill Text

Vote Smart's Synopsis:

Vote to pass with amendment a bill that establishes a program for long-term services and supports.

Highlights:

• Defines “qualified individual” as an individual who meets the duration of payment requirements as established in the act (Sec. 2).

• Defines “eligible beneficiary” as a qualified individual who is 18 or older, residing in the state of Washington, was not disabled before the age of 18, has been determined to meet the minimum level of assistance with activities of daily living necessary to receive benefits through the trust program, and who has not exhausted the lifetime limit of benefit units (Sec. 2).

• Defines “benefit unit” as an amount of up to $100 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 (Sec. 2).

• Establishes the long-term services and supports trust commission for the purpose of making recommendations and decisions that maintain benefit adequacy, and fund solvency and adequacy (Sec. 4).

• Establishes the long-term services and supports council to determine on an annual basis adjustments to the benefit unit to ensure benefit adequacy and solvency of the long-term services and supports trust account (Sec. 5).

• Requires the health care authority to take the following actions, including (Sec. 3):

• Tracking 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;

• Ensuring 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 compensate for any inappropriate payments;

• Establishing criteria for the payment of benefits to registered long-term services and supports;

• Establishing rules and procedures for benefit coordination when the eligible beneficiary is also funded for Medicaid and other long-term services and supports, including Medicare; and

• Adopting rules and procedures necessary to implement and administer the activities related to the program.

• Requires the employment security department to classify an individual as qualified if the person has paid the long-term services and supports premiums for the equivalent of either (Sec. 6):

• A total of ten years without interruption of five or more consecutive years; or 

• Three years within the last six years. 

• Requires approved services be made available and benefits payable to a registered long-term services and supports provider on behalf of an eligible beneficiary, beginning January 1, 2025 (Sec. 7).

• Requires the employment security department to assess for each employed individual a premium based on the amount of the individual's wages, beginning January 1, 2022 (Sec. 9). 

• Specifies that the initial premium rate is .58 percent of the individual’s wages, and after January 1, 2024, the rate will be set by the pension funding council at a rate no more than 0.58 percent (Sec. 9).

• Requires the pension funding council to set the premium rate at the lowest amount necessary to maintain the actuarial solvency of the long-term services and supports trust account created in this act (Sec. 9).

• Authorizes any self-employed person, including a sole proprietor, independent contractor, partner, or joint venturer, to elect coverage under this act (Sec. 10).

Full Bill Text