Developmental Disabilities in Washington:

Increasing Access and Equality

Presenting to the Joint Legislative Audit and Review CommitteeAugust 14, 2013

David Dean, Deputy Director of Performance AuditShauna Good, Senior Performance Auditor

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Does Washington’s Developmental Disabilities Program provide effective services for people with developmental disabilities? • Most people who do receive services pleased with results• However, many eligible applicants receive no services• Widely varying costs to serve people with similar support

needs

What steps can Washington take to improve its Developmental Disabilities Program? • Recommendations aimed toward increasing access and

equality

Overview

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Integrated services are those that allow clients the greatest opportunities to interact with people who do not have

developmental disabilities.

Integrated Services

IntegratedSegregated

Home

Job

Home

Job

Job

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Employment First has made Washington a national leader

Washington provides integrated employment to more of its clients than comparable statesInstitute on Community Inclusion, 2012

25%

5%

28%

89%

United States average = 20% Washington outcomes vary by county

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Overall, clients are satisfied with their services

Choice is an important indicator of satisfactionNational Core Indicators consumer survey, 2009-2010

53%45%

56%40%

87%

85%

86%

64%

89%

63%

79%

60%

74%

58%

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Access to services is Washington’s greatest challenge

Of the 35,150 people who have applied and are eligible for services…

12,250 peoplereceive full

services

15,100 peopleare on the

waitlist7,800 people

receive partialservices

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Washington serves fewer people than other states

Per 100,000

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Washington serves more people in state operated facilities

United States average = 10.1

Per 100,000

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Most people with complex needs are supported in the community

Most clients with the highest support needs live with parents or relatives

Parent/family home60.2%

Parent/family home60.2%

Supportedliving12.9%

Community/residential

10.2%

RHCs10.2%

Ownhome6.6%

Parent/family home60.2%

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Supporting clients in RHCs is more expensive

798 clients with the most complex support needs live in all residential settings, where they receive varying levels of state support and care

$40,104$52,818

$102,058

Parent/family home

Own home Community residential

Supported living

RHCs

$37,660

$193,042

Annual cost per person

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Washington relies on RHCs for crisis stabilization services

How Washington uses its RHCs

Washington United States

Respite18% Respite

4%

Long-termcare74%

Long-termcare94%

Evaluation7%

Crisishousing

1%Crisis housing

0.2%

Evaluation2%

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The Administration give counties financial incentives to equalize access to integrated, individual employment

The Legislature set policy to reduce the number of eligible people awaiting services:

• Set targets and deadlines for increasing the number of people served

• Direct the Administration to develop strategies and a budget proposal that will allow it to prioritize the waitlist by clients’ needs.

The Legislature set policy to maximize cost-effective service options. Strategies may include:

• Reducing the number of Residential Habilitation Centers (RHCs)

• Expanding crisis stabilization and emergency respite services in the community

• Providing resources to build community peer support networks

Recommendations

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Contact Information

Shauna GoodSenior Performance Auditor

(360) 725-9724 Shauna.Good@sao.wa.gov

Website: www.sao.wa.gov