Advocacy

During our first year in existence, WACCRA successfully advocated for the first Washington State CCRC law, RCW18.390.

Washington CCRC residents were concerned that existing state law did not address their needs. Legislation was pursued, and a new law (titled “Continuing Care Retirement Communities”) was signed by Governor Inslee on April 1, 2016. The law went into effect July 1, 2017. Among the provisions of this law, a CCRC is defined; CCRCs are mandated to register with the state; and certain financial disclosures to residents are required.

1. Why is the law important?

It is the only law enacted by the Washington State legislature that directly addresses the interests of residents of Continuing Care Retirement Communities (CCRCs) and of the managers who are responsible for operating them.

2. Why did the legislature enact this law?

Independent living residents of CCRCs in Washington were concerned that they were not sufficiently protected by existing laws. The new law was enacted because the providers and the residents worked with each other and with key legislators to get it enacted promptly. From start to finish, the entire legislative process was accomplished in a remarkably short period of time. 

3. What are some key provisions of the law?

The new law defines a CCRC as “an entity that agrees to provide continuing care to a resident under a residency agreement” (Section 010(4)).

The law establishes two registration requirements: an entity must be registered with the state in order to do business as a CCRC (Section 020); and an entity cannot represent itself as a CCRC unless it is registered with the state (Section 050). The registration is valid for two years (Section 060(4)). 

The law lists several important disclosures that CCRCs must make to prospective residents. For example, it requires “An explanation of all types of fees charged by the [CCRC], how each type of fee is determined, current ranges for each type of fee, and refund policies for each type of fee.” It also requires the CCRC to disclose its policies for placing residents who need specialized services in off-site locations (Section 060(1) (f)).

The law provides for inspection of CCRC facilities by prospective residents (Section 070(1)). It also identifies specific expectations for all residents of CCRCs in independent living units. Section 070(2) describes the expectations this way: 

• (a) Transparency regarding the financial stability of the provider operating the facility;
• (b) Timely notifications of developments affecting the facility…;
• (c) Reasonable accommodations for persons with disabilities;
• (d) The opportunity to participate freely in the operation of independent resident organizations and associations;
• (e) The opportunity to seek independent counsel review of all contracts, including residency agreements, prior to executing the residency agreement; and
• (f) The assurance that all requests for donations, contributions, and gifts, when made by residents to the continuing care retirement community, are voluntary and may not be used as a condition of residency.

The continuing care retirement community is required to provide a copy of these to each prospective resident prior to signing a residency agreement. Also, copies of the expectations must be publicly available in areas of the CCRC accessible to the independent-living residents and visitors.

The law declares that state of Washington’s Consumer Protection Act (Chapter 19.86 RCW) applies to CCRCs (Section 080(1)). It instructs the Attorney General to investigate complaints that may represent a violation of the Consumer Protection Act (Section 080(2)). 

The law also makes clear that nothing in it affects any of the requirements and standards associated with a license to operate an assisted living facility or a nursing home as provided for under other provisions of state law (Section 090).

4. How is the law administered?

The Department of Social and Health Services (DSHS) has the responsibility to administer the registration requirements (Section 010(5) and Section 04). The law contains detailed information about what is required in the application to register with DSHS (Section 030), and what are the duties of DSHS to administer the registration requirements (Section 040).

DSHS registration duties include reviewing an application for completeness. The review for completeness does not signify that DSHS has otherwise issued a certification or license to that CCRC or any of its component parts (Section 040(2)).

5. Do providers and residents always have the same opinions about the operation and management of CCRCs?

Providers and residents have a strong community of interests in the operation and management of CCRCs. It is also true, however, that sometimes residents and management may have differing views on how best to address opportunities or challenges that arise from time to time. 

For example, as the owners and operators of CCRCs, providers’ perspectives are informed by the responsibility to successfully manage and sustain a complex business activity in order to provide a very high level of present services to residents while at the same time planning for the future to assure a high level of services is sustainable.

On the other hand, the residents have very little direct control over how the CCRC will use the funds they contribute at the time of entry and while they are living at the community. Indeed, residents make significant financial commitments to provide the money that makes CCRCs possible. People who pay a substantial non-refundable entrance fee and become residents may no longer have any easy choices should they decide they want to leave the CCRC. Accordingly, the residents have a very strong and personal interest in operational and management issues. 

The fact that there is a strong and continuing public interest in CCRCs means that the state legislature is an appropriate forum for the residents and providers to look to regarding policies affecting CCRCs. Since adoption of Chapter 18.390 RCW, state legislators have continued to pay attention to the operation and management of CCRCs.