(1) Hospitals and acute care facilities shall:
(a) Work cooperatively with the department of social and health services, area agencies on aging, and local long-term care information and assistance organizations in the planning and implementation of patient discharges to long-term care services.
(b) Establish and maintain a system for discharge planning and designate a person responsible for system management and implementation.
(c) Establish written policies and procedures to:
(i) Identify patients needing further nursing, therapy, or supportive care following discharge from the hospital;
(ii) Develop a documented discharge plan for each identified patient, including relevant patient history, specific care requirements, and date such follow-up care is to be initiated;
(iii) Coordinate with patient, family, caregiver, and appropriate members of the health care team;
(iv) Provide any patient, regardless of income status, written information and verbal consultation regarding the array of long-term care options available in the community, including the relative cost, eligibility criteria, location, and contact persons;
(v) Promote an informed choice of long-term care services on the part of patients, family members, and legal representatives; and
(vi) Coordinate with the department and specialized case management agencies, including area agencies on aging and other appropriate long-term care providers, as necessary, to ensure timely transition to appropriate home, community residential, or nursing facility care.
(d) Work in cooperation with the department which is responsible for ensuring that patients eligible for medicaid long-term care receive prompt assessment and appropriate service authorization.
(2) In partnership with selected hospitals, the department of social and health services shall develop and implement pilot projects in up to three areas of the state with the goal of providing information about appropriate in-home and community services to individuals and their families early during the individual's hospital stay.
The department shall not delay hospital discharges but shall assist and support the activities of hospital discharge planners. The department also shall coordinate with home health and hospice agencies whenever appropriate. The role of the department is to assist the hospital and to assist patients and their families in making informed choices by providing information regarding home and community options.
In conducting the pilot projects, the department shall:
(a) Assess and offer information regarding appropriate in-home and community services to individuals who are medicaid clients or applicants; and
(b) Offer assessment and information regarding appropriate in-home and community services to individuals who are reasonably expected to become medicaid recipients within one hundred eighty days of admission to a nursing facility.
[1998 c 245 § 127; 1995 1st sp.s. c 18 § 5.]
Notes: Conflict with federal requirements -- Severability -- Effective date -- 1995 1st sp.s. c 18: See notes following RCW 74.39A.030.