"Sec. 205   2011 2nd sp.s. c 9 s 205 (uncodified) is amended to read as follows:
FOR THE DEPARTMENT OF SOCIAL AND HEALTH SERVICES -- DEVELOPMENTAL DISABILITIES PROGRAM
     (1) COMMUNITY SERVICES
General Fund -- State Appropriation (FY 2012) . . . . . . . . . . . . (($418,815,000))
       $411,247,000
General Fund -- State Appropriation (FY 2013) . . . . . . . . . . . . (($422,854,000))
       $419,814,000
General Fund -- Federal Appropriation . . . . . . . . . . . . (($743,532,000))
       $778,974,000
General Fund--Private/Local Appropriation . . . . . . . . . . . . $184,000
          TOTAL APPROPRIATION . . . . . . . . . . . . (($1,585,385,000))
       $1,610,219,000

     The appropriations in this subsection are subject to the following conditions and limitations:
     (a) Individuals receiving services as supplemental security income (SSI) state supplemental payments shall not become eligible for medical assistance under RCW 74.09.510 due solely to the receipt of SSI state supplemental payments.
     (b) Amounts appropriated in this subsection reflect a reduction to funds appropriated for in-home care. The department shall reduce the number of in-home hours authorized. The reduction shall be scaled based on the acuity level of care recipients. The largest hour reductions shall be to lower acuity patients and the smallest hour reductions shall be to higher acuity patients.
     (c) Amounts appropriated in this subsection are sufficient to develop and implement the use of a consistent, statewide outcome-based vendor contract for employment and day services by July 1, 2012. The rates paid to vendors under this contract shall also be made consistent. In its description of activities the agency shall include activity listings and dollars appropriated for: Employment services, day services, child development services and county administration of services to the developmentally disabled. The department shall begin reporting to the office of financial management on these activities beginning in fiscal year 2010.
     (d) $944,000 of the general fund--state appropriation for fiscal year 2012, $944,000 of the general fund--state appropriation for fiscal year 2013, and $1,888,000 of the general fund--federal appropriation are provided solely for state contributions for individual provider health care benefits. Pursuant to the collective bargaining agreement negotiated with the exclusive bargaining representative of individual providers established under RCW 74.39A.270, the state shall contribute to the multiemployer health benefits trust fund (($1.96)) $2.21 per paid hour worked by individual providers.
     (e) (($1,871,000 of the general fund--state appropriation for fiscal year 2012, $1,995,000 of the general fund--state appropriation for fiscal year 2013, and $3,865,000 of the general fund--federal appropriation are provided solely for home care agencies to purchase health coverage for home care providers. The department shall calculate and distribute payments for health care benefits to home care agencies at $558 per month for each worker who cares for publicly funded clients at 86 hours or more per month. In order to negotiate the most comprehensive health benefits package for its employees, each agency may determine benefit levels according to the hours an employee works providing state-funded personal care. Health benefits shall be offered to all employees who care for publicly funded clients for 86 hours per month or more. At a minimum, employees who care for publicly funded clients at 140 hours a month or greater must receive a comprehensive medical benefit. Benefits shall not be provided to employees who care for publicly funded clients at 85 hours or less per month or as interim respite workers. The department shall not pay an agency for benefits provided to an employee who otherwise receives health care coverage through other family members, other employment-based coverage, or military or veteran's coverage. The department shall require annually, each home care agency to review each of its employee's available health coverage and to provide a written declaration to the department verifying that health benefits purchased with public funds are solely for employees that do not have other available coverage. Home care agencies may determine a reasonable employee co-premium not to exceed 20 percent of the total benefit cost.
     (f))) $1,127,000 of the general fund--state appropriation for fiscal year 2012, $1,199,000 of the general fund--state appropriation for fiscal year 2013, and $2,322,000 of the general fund--federal appropriation are provided solely for the state's contribution to the training partnership, as provided in RCW 74.39A.360, for instructional costs associated with the training of individual providers. House Bill No. 1548 and Senate Bill No. 5473 (long-term care worker requirements) make statutory changes to the increased training requirements and therefore the state shall contribute to the partnership $0.17 per paid hour worked by all home care workers. This amount is pursuant to the collective bargaining agreement negotiated with the exclusive bargaining representative of individual providers established under RCW 74.39A.270. Expenditures for the purposes specified in this subsection shall not exceed the amounts provided in this subsection.
     (((g))) (f)(i) Within the amounts appropriated in this subsection, the department shall revise the current working age adult policy to allow clients to choose between employment and community access activities. Clients age 21 and older who are receiving services through a home- and community-based medicaid waiver shall be offered the choice to transition to a community access program after nine months of enrollment in an employment program, and the option to transition from a community access program to an employment program at any time. The department shall inform clients and their legal representatives of all available options for employment and day services. Information provided to the client and the client's legal representative shall include the types of activities each service option provides, and the amount, scope, and duration of service for which the client would be eligible under each service option. An individual client may be authorized for only one service option, either employment services or community access services. Clients may not participate in more than one of these services at any given time.
     (ii) The department shall work with counties and stakeholders to strengthen and expand the existing community access program. The program must emphasize support for the client so they are able to participate in activities that integrate them into their community and support independent living and skills.
     (iii) The appropriation in this subsection includes funding to provide employment or community access services to 168 medicaid eligible young adults with developmental disabilities living with their families who need employment opportunities and assistance after high school graduation.
     (((h))) (g) $75,000 of the general fund--state appropriation for fiscal year 2012 and $75,000 of the general fund--state appropriation for fiscal year 2013 are provided solely for the restoration of direct support to local organizations that utilize parent-to-parent networks and communication to promote access and quality of care for individuals with developmental disabilities and their families.
     (((i))) (h) In accordance with Engrossed Substitute House Bill No. 1277 (licensed settings for vulnerable adults), adult family home license fees are increased in fiscal years 2012 and 2013 to support the costs of conducting licensure, inspection, and regulatory programs.
     (i) The current annual renewal license fee for adult family homes shall be increased to $100 per bed beginning in fiscal year 2012 and $175 per bed beginning in fiscal year 2013. Adult family homes shall receive a corresponding vendor rate increase per medicaid patient day of $0.22 in fiscal year 2012 and $0.43 in fiscal year 2013 to cover the cost of the license fee increase for publicly funded beds.
     (ii) Beginning in fiscal year 2012, a processing fee of $2,750 shall be charged to each adult family home when the home is initially licensed. This fee is nonrefundable.
     (((j))) (i) Clients with developmental disabilities have demonstrated a need and a desire for a day services program as verified by over 900 clients currently accessing day programs through a long-term care service model. In addition, every individual, to include those with a developmental disability, should have the opportunity for meaningful employment which allows them to contribute to their communities and to become as self-sufficient as possible. Providing choice empowers recipients of publicly funded services and their families by expanding their degree of control over the services and supports they need.
     The department shall work with legislators and stakeholders to develop a new approach to employment and day services. The objective of this plan is to ensure that adults with developmental disabilities have optimum choices, and that employment and day offerings are comprehensive enough to meet the needs of all clients currently served on a home and community based waiver. The proposal shall be submitted to the 2012 legislature for consideration and shall be constructed such that a client ultimately receives employment, community access, or the community day option but not more than one service at a time. The proposal shall include options for program efficiencies within the current employment and day structure and shall provide details on the plan to implement a consistent, statewide outcome-based vendor contract for employment and day services as specified in (c) of this subsection.

     (2) INSTITUTIONAL SERVICES
General Fund -- State Appropriation (FY 2012) . . . . . . . . . . . . (($80,815,000))
       $80,937,000
General Fund -- State Appropriation (FY 2013) . . . . . . . . . . . . (($79,939,000))
       $80,171,000
General Fund -- Federal Appropriation . . . . . . . . . . . . (($154,388,000))
       $154,403,000
General Fund -- Private/Local Appropriation . . . . . . . . . . . . $22,043,000
          TOTAL APPROPRIATION . . . . . . . . . . . . (($337,185,000))
       $337,554,000

     The appropriations in this subsection are subject to the following conditions and limitations:
     (a) Individuals receiving services as supplemental security income (SSI) state supplemental payments shall not become eligible for medical assistance under RCW 74.09.510 due solely to the receipt of SSI state supplemental payments.
     (b) $721,000 of the general fund--state appropriation for fiscal year 2012 and $721,000 of the general fund--state appropriation for fiscal year 2013 are for the department to fulfill its contracts with the school districts under chapter 28A.190 RCW to provide transportation, building space, and other support services as are reasonably necessary to support the educational programs of students living in residential habilitation centers.

     (3) PROGRAM SUPPORT
General Fund -- State Appropriation (FY 2012) . . . . . . . . . . . . (($1,380,000))
       $1,382,000
General Fund -- State Appropriation (FY 2013) . . . . . . . . . . . . (($1,371,000))
       $1,374,000
General Fund -- Federal Appropriation . . . . . . . . . . . . $1,323,000
          TOTAL APPROPRIATION . . . . . . . . . . . . (($4,074,000))
       $4,079,000

     (4) SPECIAL PROJECTS
General Fund--State Appropriation (FY 2012) . . . . . . . . . . . . (($4,648,000))
       $4,658,000
General Fund--State Appropriation (FY 2013) . . . . . . . . . . . . (($4,637,000))
       $4,657,000
General Fund--Federal Appropriation . . . . . . . . . . . . (($9,575,000))
       $9,588,000
General Fund--Private/Local Appropriation . . . . . . . . . . . . $998,000
          TOTAL APPROPRIATION . . . . . . . . . . . . (($19,858,000))
       $19,901,000

     The appropriations in this subsection are subject to the following conditions and limitations:
     Amounts appropriated in this subsection are for the purposes of transitioning clients with developmental disabilities into community settings. The department is authorized as needed to use these funds to either pay for clients residing within a residential habilitation center or for placements in the community. Pursuant to Second Substitute Senate Bill No. 5459 (services for people with developmental disabilities), funding in this subsection must be prioritized for the purpose of facilitating the consolidation and closure of Frances Haddon Morgan Center. The department shall use a person-centered approach in developing the discharge plan to assess each resident's needs and identify services the resident requires to successfully transition to the community or another residential habilitation center. The department is authorized to use any savings from this effort for the purpose of developing community resources to address the needs of clients with developmental disabilities who are in crisis or in need of respite. The department shall track the costs and savings of closing Frances Haddon Morgan Center and any investments into community placements and resources. The department shall provide a fiscal progress report to the legislature by December 5, 2011."

"Sec. 724   2011 1st sp.s. c 50 s 709 (uncodified) is amended to read as follows:
INCENTIVE SAVINGS -- FY 2012
     The sum of ((one hundred twenty-five million)) thirty-nine million three hundred ninety-four thousand dollars or so much thereof as may be available on June 30, 2012, from the total amount of unspent fiscal year 2012 state general fund appropriations, exclusive of amounts expressly placed into unallotted status by this act, is appropriated for the purposes of RCW 43.79.460 in the manner provided in this section.
     (1) Of the total appropriated amount, one-half of that portion that is attributable to incentive savings, not to exceed twenty-five million dollars, is appropriated to the savings incentive account for the purpose of improving the quality, efficiency, and effectiveness of agency services, and credited to the agency that generated the savings.
     (2) The remainder of the total amount, not to exceed one hundred million dollars, is appropriated to the education savings account.

Sec. 725   2011 1st sp.s. c 50 s 710 (uncodified) is amended to read as follows:
INCENTIVE SAVINGS--FY 2013
     The sum of ((one hundred twenty-five million)) thirty-nine million three hundred ninety-four thousand dollars or so much thereof as may be available on June 30, 2013, from the total amount of unspent fiscal year 2013 state general fund appropriations, exclusive of amounts expressly placed into unallotted status by this act, is appropriated for the purposes of RCW 43.79.460 in the manner provided in this section.
     (1) Of the total appropriated amount, one-half of that portion that is attributable to incentive savings, not to exceed twenty-five million dollars, is appropriated to the savings incentive account for the purpose of improving the quality, efficiency, and effectiveness of agency services, and credited to the agency that generated the savings.
     (2) The remainder of the total amount, not to exceed one hundred million dollars, is appropriated to the education savings account."