BILL REQ. #:  H-2523.3 

Read first time 04/14/11.   Referred to Committee on Ways & Means.

     AN ACT Relating to transition services for people with developmental disabilities; amending RCW 71A.10.020, 71A.20.010, 71A.20.020, 71A.18.040, and 71A.20.080; adding new sections to chapter 71A.20 RCW; creating new sections; providing an effective date; and declaring an emergency.

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

NEW SECTION.  Sec. 1   The legislature finds that:
     (1) A developmental disability is a natural part of human life and the presence of a developmental disability does not diminish a person's rights or the opportunity to participate in the life of the local community;
     (2) In Washington state, people living in residential habilitation centers and their families are satisfied with the services they receive, and deserve to continue receiving services that meet their needs when moving to a community setting;
     (3) People with disabilities, including residential habilitation center residents, should be provided genuine choices as to where they can live, including the most integrated setting possible; and
     (4) In a time of fiscal restraint, the state should consider the needs of all persons with developmental disabilities and spend its limited resources in a manner that serves more people, while not compromising the care people require.

NEW SECTION.  Sec. 2   It is the intent of the legislature that:
     (1) Community-based residential services supporting people with developmental disabilities should be available in the most integrated setting appropriate to individual needs; and
     (2) An extensive transition planning and placement process should be used to ensure that people moving from a residential habilitation center to a community setting have the services and supports needed to meet their assessed health and welfare needs.

Sec. 3   RCW 71A.10.020 and 2010 c 94 s 21 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) "Community residential support services," or "community support services," and "in-home services" means one or more of the services listed in RCW 71A.12.040.
     (2) "Crisis stabilization services" means services provided to persons with developmental disabilities who are experiencing behaviors that jeopardize the safety and stability of their current living situation. Crisis stabilization services include:
     (a) Temporary intensive services and supports, not to exceed sixty days, to prevent psychiatric hospitalization, institutional placement or other out-of-home placement; and
     (b) Services designed to stabilize the person and strengthen their current living situation so the person may continue to safely reside in the community during and beyond the crisis period.
     (3) "Department" means the department of social and health services.
     (((3))) (4) "Developmental disability" means a disability attributable to intellectual disability, cerebral palsy, epilepsy, autism, or another neurological or other condition of an individual found by the secretary to be closely related to an intellectual disability or to require treatment similar to that required for individuals with intellectual disabilities, which disability originates before the individual attains age eighteen, which has continued or can be expected to continue indefinitely, and which constitutes a substantial limitation 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 determinant of these conditions, and notify the legislature of this action.
     (((4))) (5) "Eligible person" means a person who has been found by the secretary under RCW 71A.16.040 to be eligible for services.
     (((5))) (6) "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.
     (((6))) (7) "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.
     (((7))) (8) "Notice" or "notification" of an action of the secretary means notice in compliance with RCW 71A.10.060.
     (((8))) (9) "Residential habilitation center" means a state-operated facility for persons with developmental disabilities governed by chapter 71A.20 RCW.
     (((9))) (10) "Respite services" means relief for families and other caregivers of people with disabilities to include both in-home and out-of-home respite care on an hourly and daily basis, including twenty-four hour care for several consecutive days. Respite care workers provide supervision, companionship, and personal care services temporarily replacing those provided by the primary caregiver of the person with disabilities. Respite care may include other services needed by the client, including medical care which must be provided by a licensed health care practitioner.
     (11) "Secretary" means the secretary of social and health services or the secretary's designee.
     (((10))) (12) "Service" or "services" means services provided by state or local government to carry out this title.
     (((11))) (13) "State-operated living alternative" means community residential services and housing which may include assistance with activities of daily living, behavioral, habilitative, interpersonal, protective, nursing, and mobility supports to individuals who have been assessed by the department as meeting state and federal requirements for eligibility in home and community-based waiver programs for individuals with developmental disabilities. State-operated living alternatives are operated and staffed with state employees in a house owned by or leased to the state.
     (14) "Supported living" means community residential services and housing which may include assistance with activities of daily living, behavioral, habilitative, interpersonal, protective, nursing, and mobility supports provided to individuals with disabilities who have been assessed by the department as meeting state and federal requirements for eligibility in home and community-based waiver programs for individuals with developmental disabilities. Supported living services are provided under contracts with private agencies or with individuals who are not state employees.
     (15) "Vacancy" means an opening at a residential habilitation center, which when filled, would not require the center to exceed its biennially budgeted capacity.

Sec. 4   RCW 71A.20.010 and 1988 c 176 s 701 are each amended to read as follows:
     (1) This chapter covers the operation of residential habilitation centers. The selection of persons to be served at the centers is governed by chapters 71A.16 and 71A.18 RCW. The purposes of this chapter are: To provide for those ((children and adults)) persons who are exceptional in their needs for care, treatment, and education by reason of developmental disabilities, residential care designed to develop their individual capacities to their optimum; to provide for admittance, withdrawal and discharge from state residential habilitation centers upon application; and to insure a comprehensive program for the education, guidance, care, treatment, and rehabilitation of all persons admitted to residential habilitation centers.
     (2) Effective July 1, 2012, no person under the age of twenty-one years may be admitted to receive services at a residential habilitation center, unless such admission is limited to the provision of short-term respite or crisis stabilization services.

Sec. 5   RCW 71A.20.020 and 1994 c 215 s 1 are each amended to read as follows:
     Except as provided in section 6 of this act, the following residential habilitation centers are permanently established to provide services to persons with developmental disabilities: Lakeland Village, located at Medical Lake, Spokane county; Rainier School, located at Buckley, Pierce county; Yakima Valley School, located at Selah, Yakima county; Fircrest School, located at Seattle, King county; and Frances Haddon Morgan Children's Center, located at Bremerton, Kitsap county.

NEW SECTION.  Sec. 6   (1) On December 31, 2011, the department shall begin operation of two houses located on the grounds of the Frances Haddon Morgan center as state-operated living alternatives. On December 30, 2011, Frances Haddon Morgan center shall cease to operate as a residential habilitation center. Placements shall be arranged for current Frances Haddon Morgan center residents as provided in this section and section 7 of this act.
     (2) To assure the successful transition of Frances Haddon Morgan center residents, the department:
     (a) Shall use the person-centered discharge planning approach described in section 7 of this act to assist each person transitioning to another care setting;
     (b) Shall establish additional state-operated living alternatives in other locations if needed to provide community residential services to former residential habilitation center residents who prefer a state-operated living alternative. The department shall offer residential habilitation center employees opportunities to work in state-operated living alternatives as they are established;
     (c) May use existing supported living program capacity in the community for former residential habilitation center residents who prefer a supported living program;
     (d) Shall establish crisis stabilization and respite services for individuals with developmental disabilities requiring such services; and
     (e) May establish regional or mobile specialty services, such as dental care, physical therapy, occupational therapy, and specialized nursing care, which can be made available to former residents of residential habilitation centers, and, with available funds, other individuals with developmental disabilities residing in the community.

NEW SECTION.  Sec. 7   A new section is added to chapter 71A.20 RCW to read as follows:
     The department shall:
     (1) Within sixty days of admission to a residential habilitation center, ensure that each resident's individual habilitation plan includes a plan for discharge to the community;
     (2) Use a person-centered approach in developing the discharge plan to assess the resident's needs and identify services the resident requires to successfully transition to the community, including:
     (a) Engaging families and guardians of residents by offering family-to-family mentoring provided by parents who themselves experienced moving a child with developmental disabilities from an institution to the community. The department shall contract with the developmental disabilities council to provide mentoring services;
     (b) Employees of the residential habilitation centers and the department providing transition planning for residents. To strengthen continuity of care for residents leaving residential habilitation centers, the department shall provide opportunities for residential habilitation center employees to obtain employment in state-operated living alternatives;
     (c) Providing choice of community living options and providers, consistent with federal requirements, including offering to place, with the consent of the resident or his or her guardian, each resident of the residential habilitation center on the appropriate home and community-based waiver, as authorized under 42 U.S.C. Sec. 1396n, and provide continued access to the services that meet his or her assessed needs;
     (d) Providing residents and their families or guardians opportunities to visit state-operated living alternatives and supported living options in the community;
     (e) Offering residents leaving a residential habilitation center a "right to return" to a residential habilitation center during the first year following their move;
     (f) Addressing services in addition to those that will be provided by residential services providers that are necessary to address the resident's assessed needs, including:
     (i) Medical services;
     (ii) Nursing services;
     (iii) Dental care;
     (iv) Behavioral and mental health supports;
     (v) Employment or other day support; and
     (vi) Transportation or other supports needed to assist family and friends in maintaining regular contact with the resident;
     (3) Assure that, prior to discharge from a residential habilitation center, clients continue to be eligible for services for which they have an assessed need;
     (4) Maximize federal funding for transitioning clients through the roads to community living grant;
     (5) Limit the ability of a state-operated living alternative to reject clients;
     (6) Use any savings achieved through efficiencies to extend services, including crisis stabilization and respite services, to people with developmental disabilities currently receiving limited or no services; and
     (7)(a) Employ the quality assurance for people moving process to monitor the adjustment of each resident who leaves a residential habilitation center; and
     (b) Convene a work group to review findings from the quality assurance for people moving process and provide feedback on the transition process. The work group shall include representatives of the developmental disabilities council, disability rights Washington, University of Washington center for human development and disability, providers, and families and advocates of persons with disabilities.

Sec. 8   RCW 71A.18.040 and 1989 c 175 s 142 are each amended to read as follows:
     (1) A person who is receiving a service under this title or the person's legal representative may request the secretary to authorize a service that is available under this title in place of a service that the person is presently receiving.
     (2) The secretary upon receiving a request for change of service shall consult in the manner provided in RCW 71A.10.070 and within ninety days shall determine whether the following criteria are met:
     (a) The alternative plan proposes a less dependent program than the person is participating in under current service;
     (b) The alternative service is appropriate under the goals and objectives of the person's individual service plan;
     (c) The alternative service is not in violation of applicable state and federal law; and
     (d) The service can reasonably be made available.
     (3) If the requested alternative service meets all of the criteria of subsection (2) of this section, the service shall be authorized as soon as reasonable, but not later than one hundred twenty days after completion of the determination process, unless the secretary determines that:
     (a) The alternative plan is more costly than the current plan;
     (b) Current appropriations are not sufficient to implement the alternative service without reducing services to existing clients; or
     (c) Providing alternative service would take precedence over other priorities for delivery of service.
     (4) The secretary shall give notice as provided in RCW 71A.10.060 of the grant of a request for a change of service. The secretary shall give notice as provided in RCW 71A.10.060 of denial of a request for change of service and of the right to an adjudicative proceeding.
     (5) When the secretary has changed service from a residential habilitation center to a setting other than a residential habilitation center, the secretary shall reauthorize service at the residential habilitation center if the secretary in reevaluating the needs of the person finds that the person needs service in a residential habilitation center.
     A person who has moved from a residential habilitation center that has closed to a community-based setting shall be offered a right to return to a residential habilitation center during the first year following their move to the community.
     (6) If the secretary determines that current appropriations are sufficient to deliver additional services without reducing services to persons who are presently receiving services, the secretary is authorized to give persons notice under RCW 71A.10.060 that they may request the services as new services or as changes of services under this section.

Sec. 9   RCW 71A.20.080 and 1989 c 175 s 143 are each amended to read as follows:
     (1) Whenever in the judgment of the secretary, the treatment and training of any resident of a residential habilitation center has progressed to the point that it is deemed advisable to return such resident to the community, the secretary may grant placement on such terms and conditions as the secretary may deem advisable after consultation in the manner provided in RCW 71A.10.070. The secretary shall give written notice of the decision to return a resident to the community as provided in RCW 71A.10.060. The notice must include a statement advising the recipient of the right to an adjudicative proceeding under RCW 71A.10.050 and the time limits for filing an application for an adjudicative proceeding. The notice must also include a statement advising the recipient of the right to judicial review of an adverse adjudicative order as provided in chapter 34.05 RCW.
     (2) A placement decision shall not be implemented at any level during any period during which an appeal can be taken or while an appeal is pending and undecided, unless authorized by court order so long as the appeal is being diligently pursued.
     ((The department of social and health services shall periodically evaluate at reasonable intervals the adjustment of the resident to the specific placement to determine whether the resident should be continued in the placement or returned to the institution or given a different placement.))

NEW SECTION.  Sec. 10   A new section is added to chapter 71A.20 RCW to read as follows:
     Beginning November 1, 2012, and annually thereafter, the department shall submit information to the appropriate committees of the legislature regarding persons who have transitioned from residential habilitation centers to the community, including:
     (1) Progress toward meeting the requirements of this act;
     (2) Client and guardian satisfaction with services;
     (3) Stability of placement and provider turnover, including information on returns to a residential habilitation center under section 7(2)(e) of this act;
     (4) Safety and health outcomes;
     (5) Types of services received by clients transitioned to the community; and
     (6) Continued accessibility of former residents to family.

NEW SECTION.  Sec. 11   If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.

NEW SECTION.  Sec. 12   If any part of this act is found to be in conflict with federal requirements that are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this act is inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and this finding does not affect the operation of the remainder of this act in its application to the agencies concerned. Rules adopted under this act must meet federal requirements that are a necessary condition to the receipt of federal funds by the state.

NEW SECTION.  Sec. 13   Section 7 of this act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect June 30, 2011.