BILL REQ. #:  S-2822.3 

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 intends that:
     (1) Out-of-the-family home residential services supporting individuals with developmental disabilities should be available in the most integrated setting appropriate to individual needs; and
     (2) A person with a developmental disability moving from an institution to a community setting should have the services and support arrangements needed to meet the person's assessed health and welfare needs.

Sec. 2   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 persons with developmental disabilities who demonstrate behaviors that jeopardize the safety or stability of their current living situation. Crisis stabilization services include:
     (a) Temporary intensive services and supports, typically not to exceed sixty days, to prevent psychiatric hospitalization or 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 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 short-term services provided to people with disabilities unable to care for themselves because of the absence of or need for relief by caregivers usually providing the care. "Respite services" includes both in-home and out-of-home 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 that may include assistance with activities of daily living, behavioral, habilitative, interpersonal, protective, medical, 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 staffed with state employees.
     (14) "Supported living" means community residential services that may include assistance with activities of daily living, behavioral, habilitative, interpersonal, protective, medical, 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. 3   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 no later than 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. 4   RCW 71A.20.020 and 1994 c 215 s 1 are each amended to read as follows:
     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; and Fircrest School, located at Seattle((, King county; and Frances Haddon Morgan Children's Center, located at Bremerton, Kitsap county)).

NEW SECTION.  Sec. 5   A new section is added to chapter 71A.20 RCW to read as follows:
     (1) By December 31, 2011, the department shall close Frances Haddon Morgan residential rehabilitation center and relocate current residents consistent with the requirements of section 6 of this act.
     (2) By June 30, 2014, the department shall close the Rainier school and relocate current residents consistent with the requirements of section 6 of this act.
     (3) To assure the successful implementation of these closures, the department, within available funds:
     (a) May offer a nonprofit entity or entities the opportunity to purchase one or more houses located on the grounds of a closing facility for the purpose of conversion to state-operated living alternatives. Before commencing any sale of property, the department shall first determine the fair market value of the property as well as estimated costs associated with subdividing lots for the purpose of determining the cost-effectiveness and viability of any transaction under this section. For houses located at Frances Haddon Morgan Center, a nonprofit entity must submit a letter to the department by September 30, 2011, stating the intent to purchase the house or houses for conversion to state-operated living alternatives by December 31, 2011;
     (b) Shall establish state-operated living alternatives to provide community residential services to residential habilitation center residents transitioning to the community under this chapter 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 or establish new supported living program capacity in the community for former residential habilitation center residents who prefer a supported living program;
     (d) Shall establish community-based crisis stabilization and respite services for individuals with developmental disabilities requiring such services;
     (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, within available funds, other individuals with developmental disabilities residing in the community; and
     (f) Provide opportunities for employees of the residential habilitation centers to compete for employment in state-operated living alternatives.

NEW SECTION.  Sec. 6   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 by assessing the resident's needs and specifying services and supports in the plan to enable the resident to successfully transition to the community, including:
     (a) Engaging families and guardians of residents by offering family-to-family mentoring provided by family members who themselves experienced moving a family member with developmental disabilities from an institution to the community. The department may contract with the developmental disabilities council to provide mentoring services;
     (b) Providing residents and their families or guardians opportunities to visit state-operated living alternatives and supported living options in the community;
     (c) Informing residents leaving a residential habilitation center that they have a "right to return" to a residential habilitation center during the first year following their move;
     (d) 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 all authorized waiver services that meet his or her assessed needs;
     (e) Providing choice of community living options and providers, consistent with federal requirements and prioritizing community placement in close proximity to the resident's family, where possible;
     (3) Maximize federal funding for transitioning clients, including the roads to community living grant; and
     (4) Limit the ability of state-operated living alternatives to reject clients.

Sec. 7   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 to a community-based setting shall be offered a right to return to a residential habilitation center during the first year following his or her 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. 8   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. 9   A new section is added to chapter 71A.20 RCW to read as follows:
     Beginning November 1, 2012, and annually thereafter through 2015, the department shall submit information to the appropriate committees of the legislature regarding persons who have transitioned from residential habilitation centers to the community under this chapter, including:
     (1) Number of residential habilitation residents moved from each facility and the type of facility or community placement the resident was moved to;
     (2) Client and guardian satisfaction with services;
     (3) Stability of placement and provider turnover, including information on individuals who have returned to a residential habilitation center;
     (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. 10   A new section is added to chapter 71A.20 RCW to read as follows:
     There is established in the state treasury the community residential investment account. Moneys in the account may be spent only after appropriation. Any savings achieved through the consolidation or closure of a residential habilitation center may be deposited into the community residential investment account. Expenditures from the account may only be used to extend service to people with developmental disabilities currently receiving limited or no services or to enhance rates paid to community residential service businesses.

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 6 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.