Background:

Community Residential Service Businesses.

The Department of Social and Health Services (DSHS) Developmental Disabilities Administration (DDA) provides contracted community residential services for clients who meet Medicaid functional and financial eligibility requirements. A "community residential service business" means a business that is certified by and contracted with DSHS DDA to provide instruction and support to DDA clients, and includes the following:

supported living, which serves up to four clients living in homes that are owned, rented, or leased by the clients or their legal representatives;
group homes, which are facility-based and serve two or more clients;
group training homes, which are facilities equipped, supervised, managed, and operated on a full-time basis by any person, association, or corporation on a nonprofit basis for the full-time care, treatment, training, and maintenance of persons with developmental disabilities; and
licensed staffed residential homes, which care for up to six child residents who are clients of DDA, may employ staff, and may be a family residence.

Community residential services may include assistance with activities of daily living (such as bathing, dressing, and eating), instrumental activities of daily living (such as meal preparation and ordinary housework), and habilitation services. Depending on client need, services can range from a few hours per month to 24 hours per day. Clients receive services through a Medicaid waiver, or in some cases, state-only funding. The client capacity for community residential services is determined by legislative appropriation.

Community Residential Rates.

Community residential service businesses are paid an hourly rate that is primarily based on the Instruction and Support Services (ISS) cost center. The ISS cost center is intended to reimburse community residential service providers for the costs of employees whose primary job function is the provision of instruction and support services to clients. The ISS hours are paid at the legislatively-determined benchmark rate for the county type of the client's residence. The three county types are King County, Metropolitan Statistical Area (MSA) counties, and non-MSA counties. The MSA county type represents counties with a large population nucleus together with adjacent communities that have a high degree of economic and social integration with that nucleus.

Community residential service providers receive the hourly rate for each individual client for the number of direct care staff hours per day that are necessary to meet the client's needs. The number of hours per day per client are determined by a DDA assessment.

For the purpose of community residential rates, Snohomish County is recognized as an MSA county. Asotin, Benton, Chelan, Clark, Cowlitz, Douglas, Franklin, Island, Kitsap, Mason, Pierce, Skagit, Spokane, Thurston, Whatcom, and Yakima counties are also recognized as MSA counties for the purpose of community residential rates.

Group Homes and Licensure.

Group homes are one type of community residential service business, as listed above. The term "group homes" is not defined in statute and there is no specific group home license type. Group homes may be licensed as either an assisted living facility or an adult family home, as defined below:

An "assisted living facility" means any home or other institution that provides housing, basic services, and assumes general responsibility for up to seven residents. Assisted living facilities may provide domiciliary care, which means assistance with activities of daily living, health support services, and intermittent nursing services.
An "adult family home" means a residential home in which a person or persons provide personal care, special care, room, and board to one to six adults who are not related by blood or marriage to the person or persons providing services.