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Dear Interested Stakeholder,
Last Friday,
Department of Social and Health Services (DSHS) Secretary Cheryl Strange
announced the submission of the DSHS proposed budget to the Office of Financial
Management (OFM), which included DDA’s budget proposal.
DDA’s mission is
to transform lives by providing support and fostering partnerships that empower
people to live the lives they want. We prioritized our funding requests to
maintain a robust continuum of care. If
enacted, this funding provides additional resources for investigating
complaints of abuse and neglect in homes where supported living services are
provided, additional staff to help the Residential Habilitation Centers (RHC)
meet federal standards of care, and new community State Operated Living
Alternative home options for people currently living in an RHC who have
expressed a desire to live in the community and for people with behavioral
health needs who are currently living in a state hospital.
The agency submitted
two types of proposals for the next biennium’s budget: maintenance level and
policy level requests. Maintenance level reflects the increased or
reduced costs of mandatory caseload changes, inflation, and other costs
mandated under current law that need to be accounted for in the upcoming
budget. Policy level requests include funding or savings for things like
new programs and services or a change in the way existing services are
delivered, some of which may require a change in statue.
Maintenance Level:
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Minimum Wage: Increase community residential provider rates so that they can pay employee wages in compliance with Washington State law I-1433. This law was passed in 2016, creating mandatory increases in the minimum wage. ($75.2M; $35.0GF-State)
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High School Transition Students: Adding Basic Plus waiver capacity in anticipation that 51 percent of the 1,793 eligible high school graduates will seek DDA services in the 2019-21 Biennium. ($10.6M; $5.9 GF-State)
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RHC Compliance: Increase staffing levels at the state’s RHCs necessary to meet federal requirements concerning continuous and aggressive active treatment in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID). This proposal also includes creating four new State Operated Living Alternative (SOLA) homes and new RHC nursing facility capacity to transition some current ICF/IID clients to more appropriate levels of services and supports. ($40.2M; $20.1M; 238 FTE)
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Consumer Directed Employer (CDE) initiative: The legislature enacted ESSB 6199 in the 2018 session, the most significant change to the delivery of in-home services in our state in the last two decades. This funding will continue the implementation of the CDE, which will become the employer for all Individual Providers as of July 2020. ($5.7M total funds; $3.5M GF-State; -5.0 FTE)
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Discharge Placements: Continue creating new community alternative placement beds for clients who are ready for discharge from the state psychiatric hospitals but who have additional long-term or developmental disability needs as required by SSB 5883 (Section 206(17) enacted by the 2017 Legislature. ($10.5M; $5.3M GF-State; 61.8 FTE)
Policy Level:
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Community Residential Rate Increase: Rate increases of 5.0 percent in July and January of
Fiscal Year 2020 followed by another 5.0 percent increase in July and
January of Fiscal Year 2021 will help community residential providers
reach an operating margin that allows them to stay in business and address
an ongoing crisis in the community residential system. ($150.8M; $76.2M GF-State)
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Community Transition Expansion: Expanding capacity in the State Operated Living
Alterative (SOLA) program is necessary to meet the ongoing need for community
placements for Residential Habilitation Centers (RHC) residents seeking
placement in a residential community setting when a contracted community
provider is unable to serve them. ($21.2M; $10.8M; 110.3 FTE)
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Aging Caregivers:
Currently 106 aging adult children (age 60 and older) live with their
elderly parent(s). An estimated 88 percent of these elderly parents will
become incapable of continuing to care for their adult children during the
2019-21 Biennium. ($11.4M; $5.7M
GF-State)
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Children’s SOLA:
Two new SOLA homes would serve six children age 20 and younger on the west
side of the state who are not eligible for RHC admission and are not able
to successfully transition to out-of-home residential placement because
suitable options do not exist. ($4.8M; $2.5M GF-State; 29.0 FTE)
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Targeted Vendor Rate Increase: The proposed increases are Assisted Living Facilities
(ALF), Adult Residential Care Facilities (ARC), and Critical Nursing
Services. ($8.5M; $4.0M GF-State)
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Community Respite Beds: Six new Overnight Planned Respite Services (OPRS)
beds for adults and six new Enhanced Respite Services (ERS) beds for
children will help meet current demand.
In addition rate increases for existing beds effective July 2019 ($374
to $450-$550 for ERS and from $350-$448 to $400-$510 for OPRS) will
encourage qualified providers to offer services. ($6.3M; $5.3M GF-S; 2.0 FTE)
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Supported Living Investigators: The Supported Living investigation workload has
increased without corresponding staff increases, resulting in the
Department struggling to meet its statutory responsibility to investigate
complaints about provider practice by reassigning staff from other
areas. The proposal is to fund 5.4
new investigators (in the Aging and Long-Term Support Administration)
through a certification fee paid be supported living providers. ($7.0M; $0 GF-State)
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Electronic Visit Verification
(EVV): Home
care agency rates are increased to cover the cost of electronically
verifying and reporting the delivery of personal care services as required
under the federal “21st Century Cures Act.” States that fail to implement
an EVV system by January 1, 2020 will be subject to a loss of federal
funding through an escalating reduction in the federal match rate. ($2.1M; $0.9M GF-State)
Please remember that this is just 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. As we move through
this process we will be meeting with stakeholders and will keep you apprised of
the budget status.
Thank you for the work you do each day to provide supports and
foster partnerships that empower people to live the lives they want.
Sincerely,
Evelyn Perez
Assistant Secretary,
Developmental Disabilities Administration
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