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 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 the 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. The client capacity for community residential services is determined by legislative appropriation.

Community Residential Rates.  A tiered methodology is used to determine the rates for community residential services providers. Nine tiers are used to match individual clients, whose residential support needs are identified through a DDA assessment process, with associated payment brackets based on cost of service. Actual rates paid to providers will vary based on the identified characteristics of each individual client and the county of residence. 

The county classifications currently used by the DDA for community residential rates are King County, Metropolitan Statistical Area (MSA) counties, and non-MSA counties. The MSA classification represents a relatively free-standing metropolitan area that is not closely associated with other metropolitan areas. The federal Office of Management and Budget considers King, Pierce, and Snohomish counties as the Seattle-Tacoma-Bellevue MSA.

For the purpose of community residential rates, the DDA classifies Snohomish County as its own MSA County, along with Asotin, Benton, Chelan, Clark, Cowlitz, Douglas, Franklin, Island, Kitsap, Mason, Pierce, Skagit, Spokane, Thurston, Whatcom, and Yakima counties. All other counties are considered non-MSA areas.

DSHS must use the King County classification for determining the provider rate in Snohomish County for community residential service businesses.

The provider rate is defined as the rate for each tier that is specific to county categories. The act is null and void if specific funding is not provided in the omnibus appropriations act by June 30, 2023.

None.