Enhanced Behavior Support Homes (EBSH): A New Support Tier for Individuals with Developmental Disabilities and Significant Challenging Behaviors
Background: Washington State Developmental Disabilities Administration (DDA) has a stated commitment to support individuals with Intellectual and Developmental Disorders (IDD) to live in the community. For those with significant behavioral challenges, there are frequently no appropriate placements available. This is a growing crisis due to the huge wave of individuals with severe Autism and/or IDD reaching adulthood. Many aging parents fear the future, because their adult children cannot access safe and appropriate community living options. Some IDD individuals with behavior challenges leaving institutional care have struggled to find appropriate supportive care, leading to housing instability for these vulnerable persons.
The Problem: Supported Living, the current housing model, often fails those with IDD who have significant behavioral challenges by refusing to take them as clients. Supported Living provides personal care, but not positive behavioral supports (PBS). Without PBS, some clients develop or intensify aggressive, destructive, or self-injurious behavior. Supported Living providers have terminated clients with significant behavioral challenges and abandoned them at hospitals. These vulnerable individuals, often a danger to themselves and others, then bounce between their family home (if they have one), temporary respite placements, hospital boarding, jail, or homelessness at great expense to our state, medical and mental health systems. The DD Ombudsman's “Stuck in the Hospital” report details this crisis, which is a direct result of the lack of behavioral expertise in Supported Living for these vulnerable persons.
In Summary: Washington State has an expensive gap in the Medicaid Home and Community Based Services Waiver programs and frequently fails to adequately support individuals with IDD and/or ASD who have significant behavior support needs to live in the community.
The Goal: To establish an EBSH model in Washington State to fill this gap and successfully place some individuals leaving institutions and others who have failed or been refused Supported Living placements.
Future Outcomes: Chapter 70.97 RCW authorized this type of support for the elderly and those with psychiatric issues, creating DSHS Enhanced Services Facilities. DSHS/DDA should also provide a similar level of care to individuals with IDD who require intensive support.
California's Enhanced Behavior Support Homes provide 24-hour positive behavior support, staffed by behavior technicians, and overseen by behavior specialists and psychiatric providers. This service tier supports IDD persons with significant behavioral challenges to live safely in the community. Legislation creating this model in Washington will save taxpayer dollars and support our vulnerable IDD residents with safe and stable homes.
About Us: We are a group of parents, family members, and professionals. Some of our adult children have failed or are failing in the current system or have been sent out of state for appropriate services. We see that many DDA clients are in crisis and cannot access community living because of the current gap in service.
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