SENATE BILL REPORT

SB 6462

BYSenators Smith, Bauer, McDonald, Nelson, Lee, Niemi, Anderson, Wojahn, Cantu, Smitherman, Rasmussen, Craswell and Sutherland

Revising provisions for residential services for developmental disabilities clients.

Senate Committee on Children & Family Services

Senate Hearing Date(s):January 23, 1990; January 25, 1990; February 1, 1990

Majority Report:  That Substitute Senate Bill No. 6462 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.

      Signed by Senators Smith, Chairman; Craswell, Vice Chairman; Bailey, Stratton.

Senate Staff:Jan Sharar (786-7747)

                  February 6, 1990

Senate Committee on Ways & Means

Senate Hearing Date(s):February 15, 1990

Senate Staff:Susanne Windels (786-7715)

                  February 16, 1990

AS REPORTED BY COMMITTEE ON CHILDREN & FAMILY SERVICES, FEBRUARY 1, 1990

BACKGROUND:

The Department of Social and Health Services (DSHS) operates several Residential Habilitation Centers (RHCs) for the developmentally disabled including Fircrest School, Rainier School, Lakeland Village, Interlake School, Yakima Valley School, and Francis Haddon Morgan Children's Center.  The RHCs currently house some 1800 residents and receive about one half of their funding under the federal Medicaid program.

In recent years, Medicaid surveyors have repeatedly found staffing and other deficiencies in audits of the RHCs.  Under a recent agreement, DSHS must reduce the resident population at RHCs by several hundred without reducing current staffing levels to meet federal requirements for higher staff to resident ratios in a controversial policy known as "downsizing." 

DSHS has begun the downsizing effort by moving 24 Fircrest School residents to community placements.  Under the plan, 12 residents will be housed in community contract facilities and 12 will be housed in state operated programs.  DSHS reports that the total number of community contracted placements and the total number of state operated placements will depend on "family choice;" that is the type of facility a family member chooses for a child they agree to have moved out of an RHC as part of the downsizing effort.

The DSHS decision to use state employees to directly operate community residential services has met with sharp criticism by community parents, program operators, and county administrators.  These groups cite 50 percent higher staffing costs, competition for trained personnel, potential loss of a sense of community "ownership" of programs and other problems with state operated community facilities.

DSHS and some parents of children in RHCs and state union representatives feel that state operated community facilities are needed because some parents view them as more stable, safe and of higher quality than community operated facilities.

SUMMARY:

The Legislature intends to expand and support the choices for families of developmentally disabled people eligible for state services.  The Legislature recognizes that community programs offer greater opportunities for participation and presence in community life, which contributes to quality of life for the developmentally disabled.

The Legislature recognizes that some families are interested in having state operated community facilities available.  Since this is a major policy change, the Legislature intends that DSHS experiment carefully with this option to determine its relative benefits in terms of cost, safety, and quality, including opportunities for participation in community life.

Whenever the department places a developmentally disabled client from an RHC into a community placement, the department must notify county developmental disabilities boards who, within three months may submit placement proposals for the client.  If more than one board responds, preference must be given to the proposal from the client's county of most recent residence.  The cost of placement may not exceed the cost of care at the RHC.  If no county submits a proposal, DSHS may place the client in a state staffed facility however, not more than 12 clients may be placed in such facilities.

The Legislative Budget Committee must develop a plan and contract for an independent evaluation of the act, within funds provided for the purpose.  A final report must be completed by December 1, 1991.  DSHS must designate six regional parent choice districts within the state using the boundaries of community service office regions.  The department shall request that the county with the highest population within each region prepare and update a directory of all services available within the region for the developmentally disabled.  The directory must be mailed annually to the parent or guardian of every developmentally disabled person in an institution whose parent or guardian resides in the region.

An emergency is declared and the act takes effect immediately.

EFFECT OF PROPOSED SUBSTITUTE:

The Legislature intends to continue to support parental choice for care at the residential habilitation centers.  The department may not operate community programs until existing facilities meet federal certification standards.  Notice requirements are modified to be compatible with existing procedures.  The word "program" is added where the word "facility" occurs to apply to all community services.  Placement of an institutional client in a community program may not occur until services are in place.  First priority for location of a community placement is to be based on the preference of the client, client's parent or guardian rather than where an individual resides.  The department is required to accept a community operated residential proposal unless the proposal does not meet the needs of the client.  The department is directed to use private vendor provided services whenever possible and may only use state-operated community based services after certain conditions are met.  The department must report to the appropriate legislative committees on the results of institutional client placement efforts during the interim.  Additional requirements are added to the required study.  An appropriation section is included.

Appropriation:    $5,490,300 of the state general fund and $3,660,200 of the federal general fund

Revenue:    none

Fiscal Note:      available

Effective Date:The bill contains an emergency clause and takes effect immediately.

Senate Committee - Testified: CHILDREN & FAMILY SERVICES:  FOR:  Marti Johnson, Community Residential Services Coalition; Michael Doctor, Rehabilitation Enterprises of Washington; Kurt Sharar, Washington State Association of Counties; Jane Boone, County Human Services Association; Mike Manby, King County; Sylvia Ferstenberg, Don Armstrong and Cindy Starkey, DDRSA; Margaret Cornish, Community Living; Stephen Start, CRSC; Carolyn Trublood, county board and parent; Willa Johns, ARC Spokane. Against: Philip R. Scheier, Friends of Residential Centers for the Ret arded; Lois Odd, guardian; Gary Moore, Washington Federation of State Employees; Chere Hazen, Friends of Fircrest; Eugene G. and Margaret A. Ollenburger, parents. Neutral: Thelma Struck and Sue Elliott, DSHS

Senate Committee - Testified: WAYS & MEANS:  Sally McQuown, WA Assembly for Citizens With Disabilities (pro); Tom Dean, Friends of Rainier (con); Kurt Sharar, WA State Association of Counties (pro); Thelma Struck, Sue Elliott, DSHS; Sharon Versteey, DSHS (pro); Gary Moore, WFSE (con)