HOUSE BILL REPORT

HB 1226

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.

As Reported by House Committee On:

Human Services

Title: An act relating to intensive behavior support services for children with developmental disabilities.

Brief Description: Establishing intensive behavior support services.

Sponsors: Representatives Dickerson, Roberts, Walsh, Kagi and Kenney; by request of Department of Social and Health Services.

Brief History:

Committee Activity:

Human Services: 1/29/09, 2/2/09 [DPS].

Brief Summary of Substitute Bill

  • Creates a program to provide services for children with developmental disabilities who exhibit intense behaviors.

HOUSE COMMITTEE ON HUMAN SERVICES

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 8 members: Representatives Dickerson, Chair; Orwall, Vice Chair; Dammeier, Ranking Minority Member; Green, Klippert, Morrell, O'Brien and Walsh.

Staff: Linda Merelle (786-7092)

Background:

The Division of Developmental Disabilities (DDD) offers several programs and services for children with developmental disabilities and their families. Some examples include the Individual and Family Services Program which supports families while they are caring for a family member with a developmental disability in their home. The program provides families with some of the support services necessary to keep eligible children at home with parents or relatives, including:

Residential services are insufficient for children with the most extreme behaviors. Families who no longer have the ability to care for children with developmental disabilities and such behavior increasingly seek to place such children in a facility outside of the home.

The 2008 Legislature authorized a new waiver to be administered by the DDD, directing the Department of Health and Social Services (DSHS) to submit a waiver application and to implement a program for services. This authorization was made in the form of a budget proviso, rather than a bill.

Under the federal Medicaid statute, Title XIX, a person with a developmental disability has an entitlement to be placed in a Residential Habilitation Center (RHC). A person with a developmental disability, or their representative, may waive the right to be placed in an RHC and choose to receive services in the community instead. Washington has four waiver programs to provide services for individuals in the community: (1) Basic, (2) Basic Plus, (3) Core, and (4) Community Protection. The new waiver for intensive behavior services has been applied for, but has not yet been approved by the federal government.

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Summary of Substitute Bill:

The Intensive Behavior Support Program (Program), previously authorized by the 2008 Legislature, is codified into statute. To the extent that funding is appropriated, intensive behavior support services may be provided by the DSHS directly or by contract to children who have developmental disabilities and their families. The DSHS shall be the lead administrative agency for children's intensive behavior support services and shall:

Eligibility.

A person is eligible for intensive behavior support services if:

Services Provided.

The intensive behavior support services shall be designed to enhance the child's and parent's skills to manage behaviors, increase family and person self-sufficiency, improve functioning of the family, reduce stress on children and families, and assist the family in locating and using other community services. These services are required to be provided through a core team of highly trained individuals, either directly or by contract. The core team shall have the following characteristics and responsibilities:

The Intensive Behavior Support Program would provide the following services:

Substitute Bill Compared to Original Bill:

Out-of-home services as well as in-home services may be provided on the intensive behaviors waiver. A child or family acuity score need only be "high enough" rather than "substantially high enough." A family need only agree to participate in the waiver services rather than "demonstrate an ability and willingness to fully participate." The core team must have both the ability to authorize and coordinate services in the home and other environments rather than have the ability to do one or the other. Therapy, equipment, and supplies are included in the services under this program rather than "therapy equipment." Personal care is allowed regardless of whether it is in-home or out-of-home.

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Appropriation: None.

Fiscal Note: Available.

Effective Date of Substitute Bill: The bill takes effect 90 days after adjournment of the session in which the bill is passed.

Staff Summary of Public Testimony:

(In support) There are five or six states that have waivers for children with developmental disabilities who have behavioral needs. Most families want to take care of their own children in their home. This bill puts something in place that has not been there. In some circumstances, because of behaviors, the child is no longer in the home, not because the parents don't want him or her there but because the parents can no longer have the child at home.

(Opposed) None.

Persons Testifying: Representative Dickerson, prime sponsor; Linda Rolfe, Division of Developmental Disabilities, Department of Social and Health Services; Donna Patrick, Developmental Disabilities Council; Seth Dawson, Little Red Schoolhouse, Rehabilitation Enterprises of Washington, and Partnership 2020; and Dawn Sidell.

Persons Signed In To Testify But Not Testifying: None.