The Developmental Disabilities Administration (DDA) is a division of the Department of Social and Health Services (DSHS) that administers a broad range of programs and Medicaid services for eligible individuals with developmental disabilities. These services and programs may include case management, personal care, respite, employment, community engagement, crisis stabilization services, and residential supports. The level of support needed by DDA clients to assist them in their daily lives and help them participate in the community varies by individual.
Functionally and financially eligible individuals may obtain Medicaid paid services in community settings through the Community First Choice Option (CFCO) of the Medicaid State Plan and Home or through Community Based Services (HCBS) waivers. The CFCO is an uncapped entitlement and provides personal care to those who qualify for institutional care but would rather be served in their homes or communities. The five HCBS waivers allow DDA clients who live in community settings to receive optional services at the same level the individual would receive in an institutional setting. Unlike the CFCO, each HCBS waiver has a capacity limit on the number of people who can be served.
Once determined eligible for DDA services, an individual may or may not request services. An individual may initiate the eligibility process without a current need for services to reduce the timeline for accessing future services when needed. A client is put on the no-paid services caseload once determined eligible for DDA services but are not receiving paid services. When the client needs a paid service, they must contact DDA to make a request.
Prior to 2011, the no-paid services caseload was managed by case managers. In 2020, the Legislature directed the DDA to review the no-paid services caseload and update the information to accurately reflect a current count of eligible people and identify the number of people contacted who are currently interested in receiving a paid DDA service. On September 30, 2021, there were 48,181 DDA-eligible individuals. Of these, 12,040 were not receiving any paid services. In December 2021, DDA reported they were able to successfully contact 1,784 individuals and of these, 63 percent of them desired a service. The DDA was allocated two full-time employees to complete this work. Funding for these employees ends on June 30, 2022.
The DSHS must hire two permanent, full-time employees to regularly review and maintain the no-paid services caseload, including updating the caseload to reflect a current count of eligible individuals and identifying the number of individuals contacted who are interested in receiving a DDA paid service now or within the next year. Beginning December 1, 2022, the DSHS must annually report this information to the Governor and the Legislature.
The DDA must provide clients on the no-paid services caseload with case resource management services. The case resource managers are required to contact and respond to the client to discuss the client's service needs and explain the service options available through the DSHS or other community resources.
(In support) When an individual is placed on the no-paid services caseload, they also do not receive any case management. Even having just two case managers assigned to the no-paid caseload would make a difference. Sometimes people are left on the no-paid caseload when they are eligible for services, and they do not even have a case manager or another person to contact. Waiver services are very important for working families and the individuals who need them. The system is too difficult for families to navigate on their own.
(Opposed) None.
A null and void clause is added, making the bill null and void if not funded in the budget.
(In support) None.
(Opposed) None.