Washington state Developmental Disabilities Administration




*Developmental Disabilities Administration*



*May 16, 2023*







Dear DDA Stakeholder:??

The 2023 regular legislature adjourned on April 23, 2023. Today, Governor Inslee signed the 2023-25 biennial operating budget Engrossed Substitute Senate Bill 5187.? We are delighted to see that the legislature and the governor continue to support clients, families, providers, and the workforce who support our clients.

I am pleased to share the 2023-2025 DDA biennial budget with you. The highlights listed below that also include state-only funding for significant policy bills.

I am delighted to share the budget?s highlights for DDA below:


*
* *House Bill 1128 Personal Needs Allowance:* Funding is provided to increase the personal needs allowance to $100 per month for clients receiving Medicaid and served in licensed residential settings, nursing homes, and state-operated residential habilitation centers. The PNA is the amount of income retained by these clients to pay for their personal items.
* *Engrossed Second Substitute House Bill 1188 Child Welfare Services: *DSHS is funded to seek federal approval to expand the existing Medicaid waivers to dependent children and youth with developmental disabilities.
* *House Bill 1407 Maintaining Service Eligibility: *Funding is provided to update DDA eligibility rules so that clients who are made eligible between age three and 17 do not loose eligibility or need redetermination of eligibility.
* *Second Substitute House Bill 1580 Children in Crisis:* One-time funding is provided to create a Multisystem Care Coordinator within the Office of the Governor and a Rapid Care Team composed of representatives from multiple agencies.
* *Engrossed Second Substitute House Bill 1694 Home Care Worker Shortage:* Modifies training and certification requirements for home care workers. It also directs DDA to conduct a feasibility study for how to pay parent caregivers of children with complex needs.
* *Engrossed Second Substitute Senate Bill 5440 Competency Evaluations and Restoration:* Funding is provided for DSHS to provide housing and wrap around services for individuals found incompetent to stand trial due to an intellectual or developmental disability, traumatic brain injury, or dementia to receive services and supports in community-based settings.
* *Community Supports for Children: *Funding is provided to continue the phase-in of one, three-bed intensive habilitation services facility and six, three-bed enhanced out-of-home services facilities. IHS will provide short-term, up to 90 days, placements for children and youth aged eight to 21. E-OHS will provide long-term services to support youth aged 12 to 21 who have discharged from inpatient care.
* *Expand High School Transition*: Funding is provided to expand the Basic Plus waiver so that, upon high school completion, approximately 598 eligible youth may be phased in to receive supported employment and community inclusion services.
* *Non-citizen Program: *Funding is provided to establish 33 slots at an average rate of $278 per client per day for individuals with intellectual or developmental disabilities who are ineligible for Medicaid due to citizenship status. Priority must be given to clients in acute care hospitals.
* *Complex Needs Enhanced Rate Pilot: *Funding is provided to pilot an enhanced daily rate of $450 per client per day for community residential providers who receive additional training to support individuals with complex physical and behavioral health needs. Funding is sufficient to serve 30 clients.
* *Enhanced Adult Family Homes Specialty Pilot: *Funding is provided to pilot a specialty AFH contract to serve up to 100 individuals with intellectual or developmental disabilities who may also have co-occurring health or behavioral diagnoses.
* *Enhanced Behavior Support Specialty: *Funding is provided to develop a plan for implementing an enhanced behavior support specialty contract to provide intensive behavioral services and supports to adults with intellectual and developmental disabilities in community residential settings.
* *Study to Expand Medicaid Services: *One-time funding is provided to study opportunities to restructure services offered under DDA?s Medicaid waivers.
* *Assessment Tool Study*: Funding is provided for a feasibility study to identify opportunities to improve the Comprehensive Assessment Reporting Evaluation (CARE) system. The feasibility study must include an assessment of the system's questions, processes, workflows, and underlying technology.
* *Continue Klamath Cottage*: One-time funding is provided to operate Klamath Cottage at Rainier School as a short-term transition option for individuals with developmental disabilities who are ready to discharge from an acute care hospital or state hospital and do not have an immediate community placement alternative available.

* *Employment & Community Inclusion Services Rates*: Funding is provided for a 21 percent increase FY 2024 and a one percent increase in FY 2025 for supported employment. A 27 percent increase in FY 2024 and a five percent increase in FY 2025 for community inclusion services.
* *Adult Day Respite Rates: *Funding is provided to increase rates for respite in an adult day center and for a feasibility study that examines resources needed to add adult day services to the Medicaid state plan or as a service within the existing Basic Plus and Core waivers.
* *Community Residential Provider Rates*: Funding is provided to increase community residential services rates, including both individualized support services and administrative components, by 2.5 percent effective January 1, 2024.
* *Adult Family Award/Agreement*: Funding is provided to implement the 2023-25 collective bargaining agreement. Among other provisions, the CBA increases the base daily rate by an average of 24 percent in FY 2024 and by an additional two percent in FY 2025.
* *Assisted Living Facility Rates: *Funding is provided for a 15 percent increase in the base Medicaid daily rates for assisted living facilities, which is sufficient to cover 79 percent of operational costs effective July 1, 2023.
* *Nursing Services Rates: *Funding is provided for a 20 percent rate increase for agency providers of daily skilled nursing services; a 24 percent rate increase for nurse delegation services provided by agency providers; and a two percent rate increase for nurse delegation services provided by individual providers.
* *Consumer Directed Employer Rates & Agency Parity: *
* Funding is provided to implement a new labor rate for the consumer-directed employer contracted individual providers, which was adopted by the rate setting board established in RCW 74.39A.530.
* Funding is provided to increase the administrative rate paid to the consumer-directed employer by 12 cents per hour effective July 1, 2022. This rate increase was adopted by the rate setting board established in RCW 74.39A.530.
* Funding is provided to increase the administrative rate paid to home care agencies by 56 cents per hour effective July 1, 2023. RCW 74.39A.310 requires that home care agency providers shall receive wage and benefit parity with individual providers. Funding is provided for increases in the home care agency rate that corresponds to the new labor rate adopted by the rate setting board established in RCW 74.39A.530.

* *Behavior Stabilization Services & Rates: *Funding is provided to expand mobile diversion services and to add 10 diversion beds. Funding is also provided to increase the daily rates paid to providers who deliver these services by 23 percent.
* *Dan Thompson Memorial Account*: Expenditure authority from the Developmental Disabilities Community Services Account (also known as the Dan Thompson Memorial Account) is shifted from the 2021-23 biennium for projects to enhance and expand Home and Community Based Services for individuals with intellectual and developmental disabilities.

More detail can be found at the?OFM budget website. [ [link removed] ]

Thank you for your partnership as we focus on implementing these items. We will continue to work each day to transform lives by providing support and fostering partnerships that empower people to live the lives they want.

Sincerely,

"Dr. Tonik Joseph"

"Interim Assistant Secretary, Developmental Disabilities Administration"

DSHS:?"Transforming Lives"








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