Dear Interested Stakeholder,

Last week, Governor Inslee released his proposed 2019-21 Biennial budget. We are pleased to see that the Governor has recommended funding to continue transforming the services in Residential Habilitation Centers (RHC) to meet federal requirements. There are also significant rate increases for our community residential providers necessary to provide choices for our clients. And of course, we are pleased to see funding for raises in the collective bargaining proposals for the providers who partner with Developmental Disabilities Administration (DDA) to provide services in the community.

Below are significant items the Governor’s budget proposal included for DDA:

RHC Compliance: Increased direct care and professional staffing is necessary to meet Centers for Medicare and Medicaid Services (CMS) requirements concerning continuous and aggressive active treatment in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) at the RHCs. This includes new RHC nursing facility capacity at Fircrest and Lakeland and additional State Operated Living Alternative (SOLA) capacity to transition ICF/IID clients to more services and supports. ($20.1M GF-S; $40.2M Total Funds; 238 FTE)

Behavioral Health Reform: DDA will continue to play a significant role in transforming the delivery of mental health services in Washington by providing community placements, including 53 additional SOLA placements in the 2019-21 biennium. ($5.3M GF-S; $10.5M Total Funds; 61.8 FTE)

Collective Bargaining Agreements: New collective bargaining agreements that affect DDA providers, including:

• SEIU 1199: State employee nurses ($1.3M GF-S; $2.5M Total Funds)
• SEIU 775 NW: Individual Provider in-home care workers ($23.6M GF-S; $53.6M Total Funds)
• Agency Parity: While not bargained separately, in-home care agencies receive comparable changes to the SEIU775 Individual Provider bargaining agreement. ($12.4M GF-S; $28.3M Total Funds)
• Adult Family Home Council: Owners of Adult Family Homes bargain with the state for daily rates and special programs. ($8.4M GF-S; $18.8M Total Funds)

Vendor Rate Increases: There are several key areas where the Governor made targeted investments for key Medicaid service providers.

• Community Residential (Supported Living): Rates for the community residential providers are increased by ten percent on January 1, 2020, and another ten percent on January 1, 2021. ($59.4 GF-S; $117.6M Total Funds)
• Nursing Services: Rate increases for nursing services to help people stay in the community rather than have to move to more expensive nursing homes with 24/7 nursing care: Private Duty Nursing (approximately 18 percent increase), Nurse Delegation (approximately 22 percent increase) and Skilled Nursing (approximately 82 percent increase). ($3.3M GF-S; $6.8M Total Funds)

Electronic Visit Verification: Homecare agencies receive a rate increase pay for systems to electronically verify and report the delivery of personal care services as required by the federal Centers for Medicare and Medicaid Services. ($932,000 GF-S; $2.1M Total Funds)

Children’s SOLA: Two new children’s SOLA homes will be created in Western Washington where there is a demand for services for children with profound intellectual disabilities accompanied with challenging behaviors aged 20 or younger. Currently there is only one children’s SOLA in Eastern Washington. ($ 2.5M GF-S; $4.8M Total Funds; 34.2 FTE)

High School Transition Students: 915 DDA eligible students who will leave high school are funded to receive employment services. ($5.9M GF-S; $10.6M Total Funds)

Community Respite Beds: Six Overnight Planned Respite Services beds for adults and six Enhanced Respite Services beds for children are created, and the daily rate for existing beds is increased to retain existing providers as the demand is outpacing the available capacity for both settings. ($5.3M GF-S; $6.3M Total Funds; 2.0 FTE)

Supported Living (SL) Investigators: Additional new investigators will be added. The entire SL investigation program in Residential Care Services will change from GF-State and federal match funding to being funded by an annual provider certification fee, which is paid back to the providers in their daily rate over the course of the year, resulting in a GF-State savings in the Aging and Long Term Supports budget. ($0 GF-State; $7.0M Total Funds)

This is only the first step in the biennial budget process. The budget can and will change over time, but we are optimistic and appreciate the Governor’s support. DDA’s specific budget information, general budget information can be found at the OFM budget site.

Thank you for the work you do each day for people with a developmental disability throughout our state. Have a safe and happy holiday season.

Sincerely,

Evelyn Perez

Assistant Secretary, Developmental Disabilities Administration

DSHS: Transforming Lives