The Developmental Disability Administration (DDA) within the Department of Social and Health Services (DSHS) serves people with developmental and intellectual disabilities. DDA provides employment services, assistance providing personal care, respite services, environmental modification, and housing.
Respite care is short-term intermittent care to provide relief for a person who lives with the client, is the client's primary care provider, and is:
Home and community based services (HCBS) waivers are services approved by the Centers for Medicare and Medicaid Services (CMS) under section 1915(c) of the Social Security Act as an alternative to intermediate care facility for individuals with intellectual disabilities (ICF/IID). Certain federal regulations are waived enabling the provision of services in the home and community to individuals who would otherwise require the services provided in an ICF/IID. Each waiver has a capacity limit on the number of people who can be served in a waiver year. DDA has the authority to limit capacity based on availability of funding for new waiver participants.
A number of services are available under the basic plus waiver including aggregate services. Aggregate services include assistive technology, extermination of bedbugs, community engagement, environmental adaptations, occupational therapy, physical therapy, remote support, skilled nursing, specialized equipment and supplies, specialized habilitation, speech, hearing, and language services, staff and family consultation, transportation, and wellness education. Total costs must not exceed $6,192 per year per participant.
A number of services are available under the children's intensive in-home behavioral support (CIIBS) waiver, including aggregate services. Aggregate services include assistive technology, environmental adaptations, nurse delegation, specialized clothing, specialized equipment and supplies, specialized habilitation, staff and family consultation, transportation, and vehicle modifications the total costs of which may not exceed $15,000 per year in any combination.
Respite care is available in the basic plus and CIIBS waiver, as well as other waivers. Respite care limits are determined by a DDA assessment and are not part of aggregate services.
DDA is to provide respite care as part of aggregate services available under both the basic plus waiver and the CIIBS waiver.
By September 1, 2024, DDA is to submit a waiver amendment to CMS and upon approval, DDA has 30 days to update the basic plus and CIIBS waivers to allow respite care as aggregate services.