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 and Adult Family Homes.
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 are equivalent to supported living but are staffed by state employees rather than contracted providers.
Adult family homes are 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.
By June 30, 2027, the Department of Social and Health Services (DSHS) must close Rainier School residential habilitation center (RHC) and relocate current residents. The DSHS may not permit any new admissions to Rainier School as of the effective date of the bill.
Subject to the availability of amounts appropriated for this specific purpose, the DSHS must provide state-operated living alternatives (SOLAs) to residents transitioning to the community as a result of the closure who prefer a state-operated community residential service, and must use supported living program capacity and adult family home capacity in the community for former residents who prefer and choose those settings. The DSHS must provide space at other RHCs to those who prefer to live in an RHC.
The DSHS must also offer RHC employees opportunities to work in SOLAs and other state facilities and programs, subject to appropriated amounts.
(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.