Community inclusion services

AN ACT Relating to improving community inclusion services for 1
individuals with developmental disabilities; amending RCW 71A.10.020, 2
71A.12.110, 71A.12.290, 71A.14.060, and 18.88B.041; and adding a new 3
section to chapter 71A.12 RCW. 4
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:5
NEW SECTION. Sec. 1. A new section is added to chapter 71A.12 6
RCW to read as follows: 7
(1) The department shall enter into contracts directly with 8
service providers for the delivery of community inclusion services 9
under home and community-based waivers. 10
(2) Administrative rules and provider contracts must align with 11
the following standards for community inclusion services:12
(a) Community inclusion services must include the provision of 13
incidental personal care as needed by the client; 14
(b) Provider-client ratios may not be restricted to a one-to-one 15
ratio, and the service must provide opportunities for peer group 16
interaction; 17
(c) Providers may only bill for direct client services with the 18
following exceptions: 19
(i) Reasonable fees may be billed for transportation to and from 20
community inclusion services and between service settings; and21
H-0376.1
HOUSE BILL 1158
State of Washington 69th Legislature 2025 Regular Session
By Representatives Leavitt, Eslick, Taylor, Barkis, Ryu, Jacobsen,
Macri, Obras, Callan, Bronoske, Simmons, Gregerson, Goodman, Wylie,
Caldier, Rule, Kloba, Ormsby, and Hill
Prefiled 01/03/25. Read first time 01/13/25. Referred to Committee
on Early Learning & Human Services.
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(ii) Up to 15 minutes per week may be billed per client for 1
recordkeeping and other administrative tasks; 2
(d) Access to community inclusion services must be in the form of 3
assessed service hours. Assessed community inclusion service hours 4
may not be reduced in the event that community inclusion services are 5
integrated into aggregate services that are subject to a specified 6
dollar limit. 7
Sec. 2. RCW 71A.10.020 and 2022 c 277 s 2 are each amended to 8
read as follows: 9
As used in this title, the following terms have the meanings 10
indicated unless the context clearly requires otherwise.11
(1) "Administration" means the department of social and health 12
services developmental disabilities administration.13
(2) "Assessment" means an evaluation is provided by the 14
department to determine: 15
(a) If the individual meets functional and financial criteria for 16
medicaid services; and 17
(b) The individual's support needs for service determination.18
(3) "Community residential support services," or "community 19
support services," and "in-home services" means one or more of the 20
services listed in RCW 71A.12.040. 21
(4) "Crisis stabilization services" means services provided to 22
persons with developmental disabilities who are experiencing 23
behaviors that jeopardize the safety and stability of their current 24
living situation. Crisis stabilization services include:25
(a) Temporary intensive services and supports, typically not to 26
exceed ((sixty)) 60 days, to prevent psychiatric hospitalization, 27
institutional placement, or other out-of-home placement; and28
(b) Services designed to stabilize the person and strengthen 29
their current living situation so the person may continue to safely 30
reside in the community during and beyond the crisis period.31
(5) "Department" means the department of social and health 32
services. 33
(6) "Developmental disability" means a disability attributable to 34
intellectual disability, cerebral palsy, epilepsy, autism, or another 35
neurological or other condition of an individual found by the 36
secretary to be closely related to an intellectual disability or to 37
require treatment similar to that required for individuals with 38
intellectual disabilities, which disability originates before the 39
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individual attains age ((eighteen)) 18, which has continued or can be 1
expected to continue indefinitely, and which constitutes a 2
substantial limitation to the individual. By June 30, 2025, the 3
administration shall promulgate rules to further define developmental 4
disability without the use of intelligence quotient scores.5
(7) "Eligible person" means a person who has been found by the 6
secretary under RCW 71A.16.040 to be eligible for services.7
(8) "Habilitative services" means those services provided by 8
program personnel to assist persons in acquiring and maintaining life 9
skills and to raise their levels of physical, mental, social, and 10
vocational functioning. Habilitative services include education, 11
training for employment, and therapy. 12
(9) "Legal representative" means a parent of a person who is 13
under ((eighteen)) 18 years of age, a person's legal guardian, a 14
person's limited guardian when the subject matter is within the scope 15
of the limited guardianship, a person's attorney -at-law, a person's 16
attorney-in-fact, or any other person who is authorized by law to act 17
for another person. 18
(10) "Notice" or "notification" of an action of the secretary 19
means notice in compliance with RCW 71A.10.060. 20
(11) "Residential habilitation center" means a state-operated 21
facility for persons with developmental disabilities governed by 22
chapter 71A.20 RCW. 23
(12) "Respite services" means relief for families and other 24
caregivers of people with disabilities, typically not to exceed 25
((ninety)) 90 days, to include both in-home and out-of-home respite 26
care on an hourly and daily basis, including ((twenty-four)) 24 hour 27
care for several consecutive days. Respite care workers provide 28
supervision, companionship, and personal care services temporarily 29
replacing those provided by the primary caregiver of the person with 30
disabilities. Respite care may include other services needed by the 31
client, including medical care which must be provided by a licensed 32
health care practitioner. 33
(13) "Secretary" means the secretary of social and health 34
services or the secretary's designee. 35
(14) "Service" or "services" means services provided by state or 36
local government to carry out this title. 37
(15) "Service request list" means a list of eligible persons who 38
have received an assessment for service determination and their 39
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assessment shows that they meet the eligibility requirements for the 1
requested service but were denied access due to funding limits.2
(16) "State-operated living alternative" means programs for 3
community residential services which may include assistance with 4
activities of daily living, behavioral, habilitative, interpersonal, 5
protective, medical, nursing, and mobility supports to individuals 6
who have been assessed by the department as meeting state and federal 7
requirements for eligibility in home and community-based waiver 8
programs for individuals with developmental disabilities. State-9
operated living alternatives are operated and staffed with state 10
employees. 11
(17) "Supported living" means community residential services and 12
housing which may include assistance with activities of daily living, 13
behavioral, habilitative, interpersonal, protective, medical, 14
nursing, and mobility supports provided to individuals with 15
disabilities who have been assessed by the department as meeting 16
state and federal requirements for eligibility in home and community-17
based waiver programs for individuals with developmental 18
disabilities. Supported living services are provided under contracts 19
with private agencies or with individuals who are not state 20
employees. 21
(18) "Vacancy" means an opening at a residential habilitation 22
center, which when filled, would not require the center to exceed its 23
biennially budgeted capacity. 24
(19) "Community inclusion services" means services provided to 25
individuals with developmental disabilities that:26
(a) Are provided in typical, integrated community settings;27
(b) Are individualized;28
(c) Promote skill development, independent living, and community 29
integration to assist participants in learning how to actively and 30
independently engage in their community; and31
(d) Provide opportunities for participants to develop 32
relationships and increase independence.33
Sec. 3. RCW 71A.12.110 and 1988 c 176 s 211 are each amended to 34
read as follows: 35
(1) The secretary may enter into agreements with any person, 36
corporation, or governmental entity to pay the contracting party to 37
perform services that the secretary is authorized to provide under 38
this title, except for ((operation)):39
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(a) Operation of residential habilitation centers under chapter 1
71A.20 RCW; and2
(b) As provided in section 1 of this act. 3
(2) The secretary by contract or by rule may impose standards for 4
services contracted for by the secretary. 5
Sec. 4. RCW 71A.12.290 and 2022 c 142 s 2 are each amended to 6
read as follows: 7
(1) Clients age 21 and older who are receiving employment 8
services must be offered the choice to transition to a community 9
((access)) inclusion program after nine months of enrollment in an 10
employment program, and the option to transition from a community 11
((access)) inclusion program to an employment program at any time. 12
Enrollment in an employment program begins at the time the client is 13
authorized to receive employment. 14
(2) Prior approval by the department shall not be required to 15
effectuate the client's choice to transition from an employment 16
program to community ((access)) inclusion services after verifying 17
nine months of participation in employment-related services.18
(3) The department shall inform clients and their legal 19
representatives of all available options for employment and day 20
services, including the opportunity to request an exception from 21
enrollment in an employment program. Information provided to the 22
client and the client's legal representative must include the types 23
of activities each service option provides, and the amount, scope, 24
and duration of service for which the client would be eligible under 25
each service option. 26
(4) The department shall work with counties and stakeholders to 27
strengthen and expand the existing community ((access)) inclusion 28
program, including the consideration of options that allow for 29
alternative service settings outside of the client's residence. The 30
program should emphasize support for the clients so that they are 31
able to participate in activities that integrate them into their 32
community and support independent living and skills.33
(5) The department shall develop rules to allow for an exception 34
to the requirement that a client participate in an employment program 35
for nine months prior to transitioning to a community ((access)) 36
inclusion program. 37
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Sec. 5. RCW 71A.14.060 and 1988 c 176 s 306 are each amended to 1
read as follows: 2
The secretary by rule may authorize the county and the 3
developmental disability board to provide any service for persons 4
with developmental disabilities that the department is authorized to 5
provide, except for ((operating)):6
(1) Operating residential habilitation centers under chapter 7
71A.20 RCW; and8
(2) As provided in section 1 of this act. 9
Sec. 6. RCW 18.88B.041 and 2024 c 322 s 1 are each amended to 10
read as follows: 11
(1) The following long-term care workers are not required to 12
become a certified home care aide pursuant to this chapter:13
(a)(i)(A) Registered nurses, licensed practical nurses, certified 14
nursing assistants or persons who are in an approved training program 15
for certified nursing assistants under chapter 18.88A RCW, medicare-16
certified home health aides, or other persons who hold a similar 17
health credential, as determined by the secretary, or persons with 18
special education training and an endorsement granted by the 19
superintendent of public instruction, as described in RCW 20
28A.300.010, if the secretary determines that the circumstances do 21
not require certification. 22
(B) A person who was initially hired as a long -term care worker 23
prior to January 7, 2012, and who completes all of the training 24
requirements in effect as of the date the person was hired.25
(ii) Individuals exempted by (a)(i) of this subsection may obtain 26
certification as a home care aide without fulfilling the training 27
requirements in RCW 74.39A.074(1)(d)(ii) but must successfully 28
complete a certification examination pursuant to RCW 18.88B.031.29
(b) All long-term care workers employed by community residential 30
service businesses. 31
(c)(i) An individual provider caring only for the individual 32
provider's child or parent, including when related by marriage or 33
domestic partnership; and 34
(ii) An individual provider caring only for the individual 35
provider's sibling, aunt, uncle, cousin, niece, nephew, grandparent, 36
or grandchild, including when related by marriage or domestic 37
partnership. 38
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(d) A person working as an individual provider who provides 20 1
hours or less of nonrespite care for one person in any calendar 2
month. 3
(e) A person working as an individual provider who only provides 4
respite services and works less than 300 hours in any calendar year.5
(f) A long-term care worker providing approved services only for 6
a spouse or registered domestic partner, pursuant to the long-term 7
services and supports trust program established in chapter 50B.04 8
RCW. 9
(g) A long-term care worker providing approved services only for 10
a spouse or registered domestic partner and funded through the United 11
States department of veterans affairs home and community-based 12
programs. 13
(h) A long-term care worker providing only community inclusion 14
services as described in section 1 of this act.15
(2) A long-term care worker exempted by this section from the 16
training requirements contained in RCW 74.39A.074 may not be 17
prohibited from enrolling in training pursuant to that section.18
(3) The department shall adopt rules to implement this section.19
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