Developmental Disabilities Administration.
The Developmental Disabilities Administration (DDA) is a division of the Department of Social and Health Services (DSHS) that assists individuals with intellectual and developmental disabilities and their families with obtaining services and supports based on individual preferences, capabilities, and needs. Clients of the DDA may live in the community or in an institutional setting such as a residential habilitation center (RHC).
Residential Habilitation Centers.
The DDA operates four RHCs that provide clients with residential, habilitative support in an institutional setting. The RHCs generally only serve clients age 21 and older, though clients 16 and older may be served on a short-term basis for respite or crisis stabilization services when no appropriate service options are available in the community. The RHCs are federally certified by the Centers for Medicare and Medicaid Services (CMS) as either an intermediate care facility (ICF) that provides individualized habilitative services, a nursing facility that is capable of caring for clients with unique medical needs, or both.
The four RHCs are:
Rainier School provides 24-hour residential care and teaching in the areas of work or vocational training, leisure activities, social relationships, and everyday life tasks. Between 2019 and 2023, two of Rainier School's three program areas were closed following CMS findings of noncompliance with federal requirements, and residents were relocated. The one remaining program area is CMS certified and is currently serving 58 long-term clients and 13 short-term clients. The Rainier School also operates Klamath Cottage, which was opened in 2020 at the direction of the Governor to move medically stable clients out of acute hospital beds to ensure hospital capacity was available during the pandemic surge, and which provides transitional services while long-term community-based options are pending. Klamath Cottage operates as a non-ICF program with state funds, and currently supports eight individuals. Funding for Klamath Cottage expires in June 2025.
Supported Living Services.
Supported living services support clients living in their own home in the community with support services provided by a DDA contracted agency. Individuals typically live with up to three roommates and receive staffed support based on needs, ranging from a few hours per month to 24 hours per day. Clients pay for their own rent, food, and other personal expenses.
State-Operated Living Alternatives.
State-operated living alternatives (SOLAs) offer a residential model equivalent to supported living services but are staffed and operated directly by DSHS employees rather than contracted providers. Clients live in their own homes in the community, often with up to three roommates, and receive individualized support based on their assessed needs.
Adult Family Homes.
Adult family homes are licensed residential homes operated by a licensed provider that provides personal care, special care, room, and board for up to six adults, or up to eight adults upon approval from the DSHS.
Operations at Rainier School are phased down by prohibiting new long-term admissions as of the effective date of the bill and prohibiting all admissions as of June 30, 2027. Rainier School will continue to operate until there are no remaining residents.
Former long-term residents who transition to a community setting may return to Rainier School once within one year of their transition and subsequent return requests must be reviewed by the DSHS and approved by the Secretary of DSHS based on a multi-disciplinary team recommendation.
The DSHS must provide individualized transition plans and offer residential options including SOLAs, supported living, adult family homes, and other residential habilitation centers based on resident preference.
The DSHS must offer Rainier School employees opportunities for employment in SOLAs and other state operated programs, subject to available appropriation.
The DSHS must submit reports to the Legislature through 2030 on residential capacity, resident transitions, deaths of former residents, geographic distribution of placements, and workforce impacts. The Office of the Developmental Disability Ombuds must report to the Legislature on resident and family feedback regarding transitions. The DSHS must conduct a 90-day public comment period to gather feedback on mitigating impacts of closure.
(In support) Residential habilitation centers (RHCs) have documented cases of abuse, neglect, unsafe conditions, and limited oversight. Many individuals have shown improved health, independence, and quality of life after moving to community settings. Community care supports employment and relationships, and can offer greater dignity. The RHCs cost up to $600,000 per person annually. Community services reach more people at a lower cost. The Americans with Disabilities Act and Olmstead decisions require states to provide community-based care when appropriate. Institutionalization is considered segregation. Washington has decades of experience transitioning people out of institutions. At least 17 other states have closed their RHCs. Guardianship often limits personal choice, and people with disabilities should have control over their own lives.
(Opposed) Individuals with severe intellectual and developmental disabilities have needs that community settings often cannot meet. Community services lack sufficient capacity, especially for crisis and respite care. Deaths and hospitalizations have followed premature or unsupported transitions. The RHCs provide necessary services, trained staff, and consistent care not available elsewhere. Many residents have failed in the community and improved only after returning to RHCs. Policy decisions are being driven by ideology, not resident needs. The bill includes no clear transition plan since a promised state-operated living alternative facility was canceled due to budget cuts. Staff have strong bonds and commitments to residents. Cost savings from closures are doubtful due to the expense of replicating services. Investment is needed in both RHCs and community-based services.
(In support) John Lemus, AtWork, Advocacy Manager; Chloe Merino, Disability Rights Washington; Stacy Dym, The Arc of Washington State; Shawn Latham, Self Advocates in Leadership (SAIL); Scott Livengood, Alpha Supported Living Services; Cathy Murahashi, The Arc of Washington; Taylor Crisp, Self Advocate Panel; Eric Matthes; David Wilder, Chinook Enterprises; Alex Motteler, Trillium; Blake Duarte; Craig Sicilia; Robert Wardell; Krista Milhofer, People First of Washington; Kari Cunningham-Rosvik; and Rusty Allphin, People First.