BP BHEAD INT S

AN ACT Relating to support programs for families of individuals with developmental disabilities; amending RCW 71A.10.015, 71A.10.020, 71A.12.010, and 71A.18.010; adding a new chapter to Title 71A RCW; and creating a new section.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1. RCW 71A.10.015 and 1988 c 176 s 101 are each amended to read as follows:

The legislature recognizes the capacity of all persons, including those with developmental disabilities, to be personally and socially productive. The legislature further recognizes the state's obligation to provide aid to persons with developmental disabilities through a uniform, coordinated system of services to enable them to achieve a greater measure of independence and fulfillment and to enjoy all rights and privileges under the Constitution and laws of the United States and the state of Washington.

The legislature also recognizes the benefits of supporting families who provide appropriate levels of care to their family members with developmental disabilities. The legislature declares that the family, which is the fundamental resource of American life, should be nurtured. The legislature declares that it is in the best interest of the state to preserve, strengthen, and maintain the family units caring for persons with developmental disabilities. Individuals with developmental disabilities have a right to and need enduring family relationships with caring people in a nurturing home environment. The legislature further finds that a growing number of families are searching for ways to maintain family members with developmental disabilities in home and community settings. Families are also selecting out-of-home placement as members with developmental disabilities reach adulthood, but continuing to provide some support to the members with developmental disabilities outside the home. Public policy encourages the family to seek out-of-home living and treats the adult member as a separate individual, interdependent on the family and appropriate services. The legislature finds that if families and friends in ongoing relationships with individuals with developmental disabilities provide support, augmented by family support and community-based services, the cost of long-term care may decrease.

Sec. 2. RCW 71A.10.020 and 1988 c 176 s 102 are each amended to read as follows:

As used in this title, the following terms have the meanings indicated unless the context clearly requires otherwise.

(1) "Case management" includes, but is not limited to those services that assist eligible families to gain access to social, medical, legal, educational, and other services and includes:

(a) Services that assure, through a continuing relationship between an agency or provider and a family, that the changing needs of the family are recognized and appropriately met;

(b) Coordinating and monitoring services provided to families by two or more persons, organizations, or agencies; and

(c) Providing information to families about the availability of services and assisting them in obtaining appropriate services.

(2) "Community supports" means formal programs and informal associations designed to promote independence, productivity, and integration for individuals with developmental disabilities and their families.

(3) "Department" means the department of social and health services.

((~~(2)~~)) (4) "Developmental disability" means a disability attributable to mental retardation, cerebral palsy, epilepsy, autism, or another neurological or other condition of an individual found by the secretary to be closely related to mental retardation or to require treatment similar to that required for individuals with mental retardation, which disability originates before the individual attains age eighteen, which has continued or can be expected to continue indefinitely, and which constitutes a substantial handicap to the individual. ((By January 1, 1989, the department shall promulgate rules which define neurological or other conditions in a way that is not limited to intelligence quotient scores as the sole determinate [determinant] of these conditions, and notify the legislature of this action.

~~(3)~~)) (5) "Eligible person" means a person who has been found by the secretary under RCW 71A.16.040 to be eligible for services.

(((4) "Habilitative services" means those services provided by program personnel to assist persons in acquiring and maintaining life skills and to raise their levels of physical, mental, social, and vocational functioning. Habilitative services include education, training for employment, and therapy.

~~(5)~~)) (6) "Family" means the unit that consists of an individual member with a developmental disability and one or more natural, adoptive, or foster parents, or siblings, or grandparents, regardless of where each member resides.

(7) "Family support" means support services authorized by this chapter.

(8) "Habilitation" means the process by which an individual with a developmental disability is assisted to acquire and maintain those skills that enable the individual to cope more effectively with the demands of the person's conditions and environment and to raise the level of the individual's physical, mental, and social efficiency. Services that achieve habilitation include but are not limited to family support services, vocational training, and education programs.

(9) "Independence and interdependence" means the extent to which individuals with developmental disabilities and their families exert control and choice over their own lives.

(10) "Integration" and "inclusion" mean (a) the use by individuals with developmental disabilities and their families of the same community resources that are used by and are available to other individuals; (b) the participation by persons with developmental disabilities and their families in the same community activities in which individuals without developmental disabilities participate, together with regular contact with individuals without developmental disabilities; and (c) the residing in homes or in homelike settings by individuals with developmental disabilities.

(11) "Legal representative" means a parent of a person who is under eighteen years of age, a person's legal guardian, a person's limited guardian when the subject matter is within the scope of the limited guardianship, a person's attorney at law, a person's attorney in fact, or any other person who is authorized by law to act for another person.

((~~(6)~~)) (12) "Notice" or "notification" of an action of the secretary means notice in compliance with RCW 71A.10.060.

((~~(7)~~)) (13) "Productivity and contribution" means engagement by an individual with developmental disabilities in income-producing work that is measured through improvements in wages and benefits, employment status, or job advancement, or engagement by an individual with a developmental disability in work contributing to household or community.

(14) "Residential habilitation center" means a state-operated facility for persons with developmental disabilities governed by chapter 71A.20 RCW.

((~~(8)~~)) (15) "Secretary" means the secretary of social and health services or the secretary's designee.

((~~(9)~~)) (16) "Service" or "services" means services provided by state or local government to carry out this title.

(17) "Therapeutic services" means occupational, physical, communication, respiratory, vision, behavior management, and other therapies to increase, maintain, or improve the functional capacities of individuals with developmental disabilities.

Sec. 3. RCW 71A.12.010 and 1988 c 176 s 201 are each amended to read as follows:

(1) It is declared to be the policy of the state to authorize the secretary to develop and coordinate state services for persons with developmental disabilities; to encourage research and staff training for state and local personnel working with persons with developmental disabilities; and to cooperate with communities to encourage the establishment and development of services to persons with developmental disabilities through locally administered and locally controlled programs.

(2) The complexities of developmental disabilities require the services of many state departments as well as those of the community. Services should be planned and provided as a part of a continuum. A pattern of facilities and services should be established, within appropriations designated for this purpose, which is sufficiently complete to meet the needs of each person with a developmental disability regardless of age or degree of handicap, and at each stage of the person's development.

(3) The department shall coordinate and assist in coordinating efforts by public and private agencies to provide services for individuals with developmental disabilities and their families. The department shall apply the principles of coordination in chapter 198, Laws of 1992, to this chapter.

Coordination efforts shall include, but not be limited to:

(a) Identifying services provided by different agencies to eliminate duplication;

(b) Designating areas of responsibility for services, identifying existing gaps in services, and assigning responsibility for providing the missing services; and

(c) Coordinating planning among and implementation by agencies and consumer groups to ensure that interagency programs receive approval from individuals with developmental disabilities and their families.

Sec. 4. RCW 71A.18.010 and 1988 c 176 s 501 are each amended to read as follows:

((~~The secretary may produce and maintain an individual service plan for each eligible person.~~)) The secretary shall assist each eligible individual and his or her family, if applicable, to develop an individual service plan, which shall include family support services unless it is inappropriate to do so. An individual service plan is a plan that identifies the needs of a person for services and determines what services will be in the best interests of the person and will meet the person's needs.

NEW SECTION. Sec. 5. FAMILY SUPPORT PROGRAM. (1) To carry out the intent of the 1993 amendments to RCW 71A.10.015, 71A.10.020, 71A.12.010, and 71A.18.010 contained in chapter ..., Laws of 1993 (this act), the family support program is established and shall have the following family-focused principles:

(a) To empower families of individuals with developmental disabilities to determine their own needs and choices and to meet those unique needs and choices with individualized flexible services designed to increase the integration, contribution, productivity, and inclusion in the community of the individual with developmental disabilities at all stages of his or her life without overly intruding.

(b) To provide a systematic process for access to and participation in the family support program and other programs that help families identify and satisfy their health, education, social service, and other needs and choices.

(2) The state policy principles declared in RCW 74.14A.025 apply to families with members with developmental disabilities seeking services from state and local, private, and public agencies.

(3) To carry out the intent of the 1993 amendments to RCW 71A.10.015, 71A.10.020, 71A.12.010, and 71A.18.010 contained in chapter ..., Laws of 1993 (this act), the family support program shall have the following system-wide principles and goals:

(a) To provide services in settings that are close to the patterns and norms of society and sensitive to regional, cultural, and ethnic characteristics of families and communities.

(b) To promote the return of individuals with developmental disabilities where appropriate from out-of-home placement.

(c) To promote the appropriate placement, with family support, in independent and interdependent residential living settings by providing home and community-based services to families in the least restrictive appropriate setting.

(d) To provide services for families as close to their home communities as possible and to promote integration of individuals with developmental disabilities and their families into their communities.

(e) To be sensitive to the differing capacities of local communities and to complement existing public and private community resources, including natural and informal supports provided by family and friends.

(f) To give priority to planning, developing, implementing, and evaluating family support programs that prevent, ameliorate, or reduce the impact of developmental disabilities on families.

NEW SECTION. Sec. 6. Every two years, the department shall prepare, adopt, review, solicit public input in the preparation of, and, as appropriate, revise a state family support plan and budget for submittal by the governor to the legislature that shall:

(1) Assess needs, establish goals, and set priorities for the provision of family support services to families of individuals with developmental disabilities;

(2) Provide for coordinated delivery of family support services and establish comprehensive services, resources, and programs for families;

(3) Review and comment on plans and services provided by departmental divisions and other state agencies that affect the state plan; and

(4) Be implemented by a fair, swift, and convenient process.

NEW SECTION. Sec. 7. The department shall implement the state plan by requiring that providers of family support services, as applicable:

(1) Identify and coordinate all available resources, both formal, and informal, public and private, so that the family's identified needs can be met and their strengths applied;

(2) Include participation of families with members with developmental disabilities in all phases of planning, developing, implementing, and evaluating the programs that affect them;

(3) Be staffed by qualified staff who are trained in the principles of the family support program;

(4) Be flexible, so that families will have power to decide what services to use, how to use them, and how often to use them, unless the law requires otherwise on behalf of the individual with developmental disabilities;

(5) Apply the family-focused principles approach identified in section 5(1) of this act;

(6) Disseminate information so that eligible families will know of the availability of services; and

(7) Avoid discrimination on the basis of race, sex, religion, ethnicity, national origin, or disabling condition in the employment of individuals in the program.

NEW SECTION. Sec. 8. (1) The department shall use funds allocated for the family support program to purchase a broad range of goods and services within the following categories to support the family. Services authorized by the family support program shall include, but not be limited to:

(a) Case management and service coordination that includes individualized planning;

(b) Specialized diagnosis and evaluation;

(d) Respite care for families;

(e) Personal assistance services;

(f) Homemaker services;

(g) Home health services;

(h) Therapeutic and nursing services not otherwise covered;

(i) Home and vehicle modifications;

(j) Equipment and supplies;

(k) Transportation;

(l) Recreation and social services;

(m) Specialized nutrition and clothing;

(n) Counseling services;

(o) Parent education and training;

(p) Communication services;

(q) Crisis intervention;

(r) Vocational and employment supports;

(s) Day care;

(t) Specialized utility costs;

(u) Self-advocacy training; and

(v) Estate and transition planning.

(2) The department may use funds allocated for the family support program, including cash subsidies and grants, to meet the special needs of each eligible family.

(3) Funds distributed under this chapter on behalf of the family may be used only to provide those goods and services necessary to meet the family's unmet needs as determined in the assessment and the individual service plan.

(4) Families receiving cash subsidies under the family support program shall have the authority to decide how the services will be used, subject to the following conditions:

(a) The family shall annually prepare a report in the way that the family is best able stating how the cash subsidy was used to meet the special needs of the family.

(b) The family shall promptly report to the department any event or condition affecting eligibility for services, including but not limited to:

(i) Death of the family member with developmental disabilities;

(ii) Death of the responsible adult in the eligible family to whom the cash subsidy or services were being provided;

(iii) Placement outside the home of the member with developmental disabilities;

(iv) Change of state of residence of the eligible family; and

(v) Any other change in need for services or eligibility for any assistance programs from other agencies.

(5) Family support cash subsidy payments shall not be alienable by assignment, sale, garnishment, execution, or otherwise and in the event of family bankruptcy shall not pass to or through a trustee or any other person acting on behalf of the creditors.

NEW SECTION. Sec. 9. (1) The family support program may assist in developing community-based services by:

(a) Establishing a program of grants to regional and local agencies and providers, both public and private, and to consumer groups to establish or develop family support services;

(b) Contracting directly with providers, both public and private, including consumer groups, to establish services in regions of the state where services are not readily available;

(d) Using available state, regional, and local parent-to-parent programs to support outreach to families so that families may become aware of available family support services.

(2) The family support program may provide technical assistance to public and private agencies and consumer groups that are developing or offering family support services to provide appropriate, flexible, and cost-effective home and community-based services for families in order to prevent and ameliorate the impact of developmental disabilities on families.

NEW SECTION. Sec. 10. FAMILY SUPPORT SERVICES PLAN. (1) For eligible individuals whose individual service plan as provided for under RCW 71A.18.010 calls for family support as a needed service, the department shall immediately assist the family to develop a family support services plan. In developing the plan the department shall conduct an assessment in the following manner:

(a) Ensure that the family participates in the assessment to the greatest extent possible;

(b) With the permission of the family, involve other persons who are knowledgeable about the member with developmental disabilities' needs and who can identify and assist the family in assessing the social, psychological, and medical needs of all family members;

(c) Identify services and goods that the family is currently receiving, other services and goods available to the family through public and private agencies, friends, and relatives and services and goods that the family is not currently receiving and that the family needs to maintain the family member with developmental disabilities at home;

(d) Identify the services and goods needed by the family that are available from sources other than public or private sources, including friends and family;

(e) Identify the services and goods needed by the family that are available for funding through the program;

(f) Where possible the assessment shall take place in the home of a family member unless the family chooses another setting; and

(g) During the assessment process the member with developmental disabilities shall be included to the greatest extent possible by the person or persons conducting the assessment.

(2) The plan shall include, but not be limited to:

(a) Documentation of the individual and family's need for service and identification of the individual or family's strengths and resources that the plan may supplement or support to meet the family's needs;

(b) Notice of the specific programs, subsidies, or services for which the individual or family is eligible;

(c) A clear explanation of the way in which the programs, subsidies, or services will be provided to the individual or family;

(d) A statement of the specific goals of the services and the methods to be used in achieving the goals and the measures for success;

(e) A projected timetable for obtaining goals.

(3) Each service plan shall include all of the following:

(a) A list of services and goods that will be funded through the family support program, the estimated costs of each and an estimate of the length of time each will need to be funded through the program; and

(b) For families receiving vouchers, a written participation agreement, which shall be signed by a parent and the department, governing expenditure of program funds by or on behalf of the family.

(4) An annual review shall be made by the department of each family participating in the family support program. The review shall include a review of the needs of the family for family support services, including an assessment prepared by the family and the department of whether there is cooperation and active participation by the family in the planning and whether the needs and the goals of the individual service plan are being met.

The family may at any time request a review of their needs and the services to meet those needs.

NEW SECTION. Sec. 11. The governor shall appoint an advisory council to make recommendations on the operation and implementation of the family support program and advocate for the family support program before the legislature, the public, and the governor. The advisory council shall advise the governor, the department, the legislature, and all concerned state and local agencies on issues affecting individuals with developmental disabilities and their families; and its members shall serve as ombudsmen for complaints by consumers of family support services. The advisory council shall review the state family support plan and make appropriate recommendations.

NEW SECTION. Sec. 12. The developmental disabilities planning council shall evaluate the family support program and annually submit to the governor and the legislature and the advisory council an evaluation report that includes but is not limited to the following:

(1) Information on the impact of the family support program on families, including sample case studies on families who chose to participate in the program, families who chose not to participate, and families who participated but whose eligibility terminated;

(2) Information on the types of services used by families;

(3) Information on family satisfaction with the family support program, including sample case studies of the adequacy of the services, and on the need for services not available;

(4) With confidentiality protected, sample decisions on appeals from the denial or termination of eligibility for the family support program, together with statistics on the actual number of appeals, the outcome of those appeals, and changes in the family support program made as a result of the appeals;

(5) Information on efforts to reach families who may be eligible for the family support program;

(6) Information on efforts to return family members with developmental disabilities from state or private institutions or foster care that can be attributed to the alternative services offered by the family support program;

(7) Information on programs that can be attributed to the family support program to ameliorate the impact of developmental disabilities on families; and

(8) Information on family satisfaction with the family support program and their willingness to continue providing total or partial care to their family member with developmental disabilities.

The department shall assist families in determining whether other sources of governmental funds can appropriately address the needs and choices of the family and the member with developmental disabilities before using family support funds.

NEW SECTION. Sec. 13. The department shall adopt rules necessary and appropriate to fully administer and implement the provisions of this chapter.

The department shall adopt rules including but not limited to:

(1) Procedures and guidelines for determining need and choice priorities and other criteria for selecting families to participate in the family support program;

(2) Procedures and guidelines for coordinating other sources of support for families;

(3) Procedures for reviewing, at least annually, the eligibility of each family receiving a cash subsidy or services from the family support program and of the progress toward the goals set by the individual service plan;

(4) Standards and procedures for making grants and contracting with public and private entities and vendors and families, including procedures for quality assurance; and

(5) Procedures to provide accountability for the family support program through a fair process of determining family eligibility, including due process hearings and an independent evaluation, including an assessment of consumer satisfaction.

NEW SECTION. Sec. 14. It is intended by this chapter that the activities authorized and operated pursuant to it shall (1) comply with all relevant federal laws and regulations; and (2) supplement, rather than supplant, any existing rights, entitlement, or services for which families and individuals with developmental disabilities may be eligible under any other state or federal law or regulation.

NEW SECTION. Sec. 15. Sections 5 through 14 of this act shall constitute a new chapter in Title 71A RCW.

NEW SECTION. Sec. 16. Captions as used in this act constitute no part of the law.