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People with developmental disabilities
JANUARY 2010 DSHS | One Department, One Vision, One Mission, One Core Set of Values
PLANNING, PERFORMANCE AND ACCOUNTABILITY | RESEARCH AND DATA ANALYSIS DIVISION | OLYMPIA, WASHINGTON
Percent of clients receiving this DSHS service 40,637 of 2,177,023 TOTAL, SFY 2008
2%DSHS clients
receiving services for a
developmental disability
DSHS clients NOT receiving services for a
developmental disability 98%
Supporting the potential of people
with developmental disabilities 2008 CLIENT SERVICE COUNTS
DEVELOPMENTAL DISABILITY SERVICES: DSHS provides support services and opportunities for the personal growth and development of persons with developmental disabilities resulting from mental retardation, epilepsy, cerebral palsy, autism, or another neurological or other condition closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation. Clients' disabilities are lifelong and constitute a substantial handicap to everyday functioning. Children under age 6 may receive services if they have Down Syndrome or developmental delays of 25 percent or more below children of the same age.1 In State Fiscal Year (SFY) 2008, 40,637 clients received the services described below from the Aging and Adult Services Administration, Division of Developmental Disabilities (ADSA|DDD). The average cost per client was $19,793.
CASE MANAGEMENT Case managers perform intake, eligibility determinations, and reviews, and provide information and referral services to applicants and eligible clients. Case managers also help eligible clients and families assess needs; develop individual service plans; authorize service provision; link clients with needed medical, social, educational, or other services, and provide support and assistance in handling life crises. Case management services are not provided to clients living in state institutions. Habilitation Plan Administrators at institutions monitor these clients. 40,138 clients, average client cost = $1,054
COMMUNITY RESIDENTIAL SERVICES Clients with developmental disabilities who require assistance with daily living may receive services in their own homes or in live-in facilities. For clients living in their own homes, either alone or with a roommate, contracted agencies provide the necessary support. These non-facility based services include Alternative Living, Companion Homes, Medical/Dental services (for clients who are not Medicaid-eligible), Supported Living and State Operated Living Alternatives (SOLAs). Additionally, other residential support may include summer recreational activities, specialized aids or equipment purchases, reimbursement for activity fees, client transportation, interpreters, and other community supports such as client allowances. Staff provide support and training for clients living in Community Intermediate Care Facilities for the Mentally Retarded, Adult Residential Centers, Group Homes, and Adult Family Homes. 5,433 clients, average client cost = $55,266
Number of clients receiving
developmental disability services
SFY 2008
Total Clients = 40,637
DSHS Client Services Database
NOTE: Since most clients receive more than one service, the sum of the
categories shown at right will exceed the total
number of clients served by the program.
40,138
13,610
12,893
6,891
5,858
5,433
1,019
270
Case Management
County Services
Personal Care Services
Individual and Family Services
Community Residential Services
Professional Support Services
RHCs and Nursing Facilities
Voluntary Placement-Children
Developmental disability client trend
34
,79
7
35
,53
0
37
,60
9
39
,42
3
40
,63
7
2004 2005 2006 2007 2008
0
Clients need many services In SFY 2008, percent using developmental disability services and . . .
21%
29%32%
18%
1 other type of DSHS service
2 other types of DSHS
services
3 or more other
types of DSHS
services
No other DSHS service
PROGRAM CONTACT Doug Washburn, 360.725.3452
RDA CONTACT (CSDB) Maija Sandberg, 360.902.0749
BUDGET CONTACT Marcia Wendling, 360.902.7769
www1.dshs.wa.gov/rda/
Report Number 11.146.040
NOTE: CSDB identifies service use information and expenditures specific to each DSHS client. Costs that cannot be assigned to individual clients are not included—such as facilities, licensing, admin, outreach, prevention, fraud investigation, community block grants, and cost recoveries.
2 ● SFY 2008 | DEVELOPMENTAL DISABILITIES CLIENTS DSHS | RDA
Comparing FTEs and caseload 1999-01 to 2007-09 Biennium
99-01 01-03 03-05 05-07 07-09
FTEs
Caseload
3,800
3,000
38,000
30,000
Case
s FTEs
31,741
37,400
3,455
3,521
COUNTY SERVICES DSHS contracts with county governments to provide services to both adults and infants with developmental disabilities. Adult-oriented services include Individual Supported Employment that helps clients find and keep jobs in the community, Group Supported Employment that enables clients to work in groups or enclaves at local businesses, Prevocational Employment/Specialized Industries that provide employment in training centers, , Community Access, , and Person-to-Person services which are a part of an individual's pathway to Individual Employment. A client in Person to Person is not yet stable in employment. Through county contracts, DSHS also funds Child Development services which involve specialized therapeutic or educational services for infants, toddlers, and their families to maximize the child's development and enhance parental support.2 13,610 clients, average client cost = $3,989
INDIVIDUAL AND FAMILY SERVICES The purpose of the Individual and Family Services Program is to partner with families as care providers for children with developmental disabilities and adults who choose to live in the family home. To the maximum extent possible, individuals and families must be given choice of services and exercise control over the resources available to them. The Individual and Family Services (IFS) Program allows participants to use their award to pay for services related to, and resulting from, their disability and identified and agreed to in your DDD Assessment Individual Support Plan (ISP) such as respite, Therapies, equipment and supplies. 6,891 clients, average client cost = $2,996
PERSONAL CARE SERVICES DSHS provides Personal Care Services to Medicaid-eligible children and adults with developmental disabilities. The major difference between children’s and adult’s Personal Care is in the age appropriate level of need for specific Personal Care tasks. This service enables eligible individuals to remain in their community residences through the provision of semi-skilled maintenance or supportive services. These services can be provided in the person's own home, a licensed Adult Family Home, or an Adult Residential Center. 12,893 clients, average client cost = $14,160
PROFESSIONAL SUPPORT SERVICES DSHS funds Professional Support Services for adults with developmental disabilities supported by Community Residential Services providers and for those who live with their families.3 These include medical and dental services for clients Medicaid-eligible, psychological services provided to determine eligibility, professional evaluations , counseling, nursing care, specialized equipment, environmental adaptations, occupational, physical, instructional, communication, behavioral and other therapies approved by exception. 5,858 clients, average client cost = $223
RHCS AND NURSING FACILITIES State Residential Habilitation Centers provide residential and habilitation services to persons with developmental disabilities either under Intermediate Care Facilities for the Mentally Retarded (ICF/MR) or Nursing Facility regulations. Rainier School and the Frances Haddon Morgan Center have only ICF/MR beds; Fircrest and Lakeland Village have both ICF/MR and nursing facility beds. Yakima Valley has only nursing facility beds. 1,019 clients, average client cost = $186,807
VOLUNTARY PLACEMENT-CHILDREN A family may ask for out-of-home placement for their child under 18 due solely to the child's disability. Under certain circumstances, the child may be placed in licensed out-of-home care. 270 clients, average client cost = $46,682
1CSDB obtains service and expenditure information for some clients who do not appear in ADSA|DDD information systems due to the inclusion of additional source information systems (for example, the Medicaid Management Information System). ADSA|DDD also typically reports point in time counts rather than annual counts. For these reasons, CSDB client counts and dollar sums may differ from those reported by DDD. 2For county services, expenditures for county administration are not included. 3CSDB counts for Medical/Dental services include only clients whose treatment was paid for by DDD. Clients whose treatment was paid for by Medical Assistance are included in MA counts.
Not in this report: Training, payments for ADSA|DDD Group Home vacancies, and employment and day service authorizations.
Trends in institutional care Since 1980
1980 1990 2000 2008
993
1,702
1,139
986
0
Living in communities SFY 2008
Community97%
n = 36,800
Non-Community
3%n = 986
Total clients = 37,786
Balancing adult and child care FY 2008
Children49%
n = 19,220
Adults51%n = 18,566
Total clients = 37,786
Client age distribution SFY 2008
0-17 18-64 65+
0
Age Age Age
Children and Youth
n = 20,000
Working Age
Adults
n = 19,726
Seniors
49% 49%
2%n = 903
