House of Representatives
Office of Program Research
Early Learning & Human Services Committee
This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.
Brief Description: Concerning long-term planning for developmental disabilities services.
Sponsors: Representatives Green, Walsh, Kagi, Zeiger, Farrell, Freeman, Jinkins, Tarleton, Roberts, Bergquist, Buys, Sawyer, Morrell, Tharinger, Senn and Santos.
Hearing Date: 1/30/14
Staff: Luke Wickham (786-7146).
There are a number of services available to individuals with developmental disabilities in Washington. The Developmental Disability Administration (DDA) provides services such as housing, medical care, personal care, and job training. Some individuals receive care in Residential Habitation Centers (RHCs) and others receive services in community living situations or their own homes. There are four RHCs in Washington including Lakeland Village, Yakima Valley School, Fircrest School, and Rainer School. The Medicaid waiver for Home and Community Based Services includes a range of services depending on an individual's living situation and needs. Waivers will pay for community residential services, personal care, respite, supported employment, behavioral management, equipment and supplies, therapies, and skilled nursing. However, waivers are not an entitlement and slots are limited to available funding.
State Auditor's Developmental Disability Program Evaluation.
The State Auditor released a Developmental Disabilities Program Evaluation (Evaluation) on July 31, 2013. This Evaluation reported that of the 35,150 people who have applied and are eligible for services, 15,100 people are on the waitlist, 7,800 people receive partial services, and 12,500 people receive full services. Those on the waitlist have been waiting an average of three and a half years. The report found that supporting a client in an RHC incurs twice the average cost of the most expensive community-based residential service option. It found that there are virtually no crisis stabilization programs at the community care level near the majority of clients. It also found that the opportunities for integrated employment depend largely on where a person lives.
The Evaluation also made recommendations that the Legislature set policy that directs the DDA to develop strategies to maximize cost-effective service options and set policy to reduce the number of eligible people awaiting services. It also recommended that the DDA should provide financial incentives to counties to encourage equal access to integrated, individual employment for clients regardless of where they live in the state.
Summary of Bill:
The DDA shall identify stakeholders to participate in work groups, at their own expense, to report to the appropriate committees of the Legislature by January 1, 2015, on issues raised in the Evaluation. This report must include:
providing community funding scenarios to phase in the 15,000 people who are on the no paid services waitlist;
expanding data gathered during the initial developmental disabilities application process to improve waitlist management;
streamlining the eligibility and assessment processes;
providing options for more community crisis and respite support;
expanding community peer support networks;
reviewing how other states use shared support hours for community living;
identifying additional community residential options;
strategies to increase employment hours and wages;
reviewing community access rules;
retaining an adequate workforce;
streamlining the developmental disabilities system;
mechanisms for improved contract monitoring;
researching and analyzing moving the developmental disabilities system to a managed care approach; and
identifying Medicaid waiver and state plan options that could make better use of state funds while making the service delivery system more accessible to people in need of the service.
Fiscal Note: Available.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.