Below are a few articles about people with intellectual and developmental disabilities being stuck in hospitals. There are many more articles, I will spare you! Most, (if not all) of these individuals are autistic and very limited communication proficiency.

• Stuck in the emergency room because there's nowhere else to go
• After 5 months stuck in hospital, autistic Washington teen sent to facility 2,700 miles from home
• He’s 13-years-old, autistic and stuck in the hospital for the holidays. He’s not the only one
• Why Washington Is Shipping More Disabled Students Out Of State, Splitting Up Families And Costing Taxpayers Millions
• Patients With Developmental Disabilities Stuck In Washington Psychiatric Hospitals
• Contempt orders, fines as developmentally disabled patients languish in local hospitals

As a brief background, the level of stabilization and ongoing behavior & psychiatric support our population of interest needs is not in existence out in the community and outside of Residential Habilitation Centers. Since 2012, children and adults have not been admitted to ICF's even if they are eligible for ICF level of care. Here's the DSHS/DDA Policy that outlines this: "No one under the age of 21 may be admitted to receive services at an ICF/IID or SONF “unless no service options are available in the community” and that “such admission is limited to the provision of short-term respite or crisis stabilization services.”

We know from personal experience of the families that we work with that the equivalent is not in existence in the community. ICF facilities are the only placements in the state of Washington that offer active treatment and wraparound care coordination, day habilitation, vocational training and recreation for those with complex support needs.

We also know that “Unnecessary institutionalization of people with disabilities is discrimination under the Americans with Disabilities Act”. These few words summarized the opinion of the U.S. Supreme Court when it handed down its decision in the case of Olmstead v. L.C. on June 22, 1999. The Supreme Court further stated that people with disabilities have the right to receive services in the “most integrated setting”, a provision of the ADA known as the “inclusion mandate”.

Washington Autism Alliance (WAA) has proposed a solution is to add Enhanced Behavior Support Homes that provide the same level of services as ICF's in the community and in an integrated setting (SB 5506 / HB 1654), modeled after a California model. We are grateful for the incremental successes in the past session. Specifically in the 2023 legislative session funded directives to Developmental Disabilities Administration(DDA) included:: 

•  6 full time employees (FTE) to increase capacity of direct support providers for those with complex support needs, reduce unnecessary hospitalizations of children and adults ($13.17 M total)
• 2 FTE to expand capacity of diversion beds, mobile diversion services and behavior stabilization services as well as increase rates to behavior support service providers ($10.96 M total)
• And the legislature directed the DDA to develop a plan for implementing an enhanced behavior support home, including a detailed description of the design of the enhanced behavior support specialty contract and setting, including a description of and the rationale for the number of staff required within each behavior support specialty setting and the necessary qualifications of these staff.

While these are excellent outcomes, practical outcomes of the above are 30 slots for enhanced behavior support beds, a rate study and a report due to the legislature in 2 years. We need your support in order to dramatically increase access to community based behavior support and psychoactive medications in a timely manner, including the appropriate workforce development serving older adolescents and adults across all systems (Residential, Vocational, Day Habilitation and Recreation).

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