State health care officials are working to overcome challenges in establishing housing for Washingtonians with developmental disabilities (DD).
Debbie Roberts, Assistant Secretary for the Washington State Department of Social & Health Services’ Developmental Disabilities Administration (DDA), discussed DDA initiatives during a Joint Legislative Executive Committee on Planning for Aging and Disability Issues meeting on Wednesday.
DDA serves more than 49,000 clients, with 81% receiving in-home, personal care from a parent or relative. Its Adult Family Homes (AFH) program serves about 1,800 clients, Roberts said. Its State-Operated Living Alternative (SOLA) program provides state-operated, supported living services to about 200 DDA clients.
SOLA clients live in their own home and enter lease agreements with landlords to rent a home or apartment with up to 3 other people, Roberts said.
“The clients pay for their own living expenses and state employees go into their home and provide 24-hour instruction and support services in the client’s home,” Roberts said.
There is also a Children’s SOLA program, in which the state acquires housing for kids.
Resident capacity for SOLA programs is based on funding appropriated by the legislature. SOLA supports clients who have medically-complex needs or significant behavioral support needs. In the last 5 years, SOLA has doubled its capacity Roberts said.
“The number of homes supported by SOLA has gone from about 34 to 75 statewide,” Roberts said. “In fiscal year 2022, Children’s SOLA is projected to expand its services to support 15 children and youths. SOLA has experienced some challenges in expanding due to the pandemic, the workforce shortage, and the lack of affordable housing since these are rentals the clients rent themselves.”
AFHs are licensed residential homes that provide care for 2-8 residents. They typically provide a room, meals, laundry, supervision and personal care services, Roberts said. Some offer nursing services or some other type of specialized care.
“Residents pay a provider and receive room, board, and personal care in return,” Roberts said. “For individuals relying on Medicaid for adult family home services, the state pays the AFH rate based on a rate methodology for any services provided after room and board and resident cost of care is accounted for.”
DDA officials face challenges in expanding housing options for DD residents, however, in site requirements and insufficient affordable housing options.
Rep. Steve Tharinger (D-Dungeness) said aging parents in his district who have aging DD children have voiced concerns about finding long-term housing options to him. He said residents who fit into that category represent a significant portion of the state’s population.
“That’s probably about 13-14,000; I think it’s unclear, but it’s probably at least that many across the state that are challenged with this issue,” Tharinger said. “Then there’s also the populations that are being brought to ER rooms and we don’t have a placement for them. ER is definitely not the right place for them. A SOLA or some sort of adult family home probably could handle this population. So I think we’re really behind here on the demands for the capacity. I’m trying to understand what we can do as a committee or legislature to make this process easier and expand this capacity.”
Roberts said she is working with health care officials from other health agencies, including the state Health Care Authority, Behavioral Health, and Department of Children, Youth, and Families to address gaps in care for people with co-occurring disorders of mental health and developmental disabilities.
“We’re all trying to come together and come up with solutions for that,” Roberts said. “I expect that you’ll probably see something come forward for legislation next year. As far as the aging caregivers, we want people to feel comfortable. They’re 70-80 years old. They’ve been working with their child all those years, and they need to have some level of comfort there’s a place to go.”