[{"_1":2,"_124":-5,"_125":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100,112],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6177416,"mediaKeyId","5338462-ca6f539f924860dfa4079e309875ac5f","parentId",5338462,"title","Advocates say people with developmental disabilities remain stuck in hospitals; call for better behavioral‑health training and supports","audioSeconds",162,"startMs",2644000,"endMs",2806000,"viewUrl","/Search/View?dp=1&key=5338462-ca6f539f924860dfa4079e309875ac5f&start=2644&end=2806","thumbnailUrl","https://assets.pipeline.soar.com/5338462-ca6f539f924860dfa4079e309875ac5f/thumbnail_2644000.jpg","articleUrl","/articles/6177416/Washington/Advocates-say-people-with-developmental-disabilities-remain-stuck-in-hospitals-call-for-better-behavioralhealth-training-and-supports","mediaUrl","https://secure.pipeline.soar.com/6177416-65dc6c59984bcaa7bb7fddf5d39bbf41/orig.mp4?Expires=1770437791&Signature=Yg3r4Ksx6DQPeD1DvgONHblGmUev-veSJQ-V83SAXRA-E9yH6wgd2lk8oVOIcq-pHor8O2h48f8w~q-ZArSd9ND-FC4HLJhkS3KcSRxFNu6V5FGIqhOFPNbtzpZAlkeKRjFM03XyNvyYpe8A02vRjBdgNeuYBk-jK1nCvem~mxzYjZI8QGdKPhJXiVI08mIyU4T6E3NPzV3rQoiX7wksV6X7lzTbqugJXhajFVRZdOZ7fYtkx2ByLJLyUxcyU9j8FvYi2miKheYMAc44Z9BgGw9n00rwJ3hTuc2OjSXIU2EGa~j7mHF2HY2LK6HF8SjG9I0ojWQq1Cm~3Tidbb6N~Q__&Key-Pair-Id=KUT5TJCACFTXG","author","Joint Legislative Executive Committee on Planning for Aging and Disability Issues","date","2025-06-18T00:00:00Z","article","Advocates and ombudsmen told the Joint Legislative Executive Committee on Planning for Aging and Disability Issues that people with developmental disabilities can face prolonged hospital stays because of gaps in community services and behavioral‑health expertise.

Betty Schwiederman, director of the Office of Developmental Disability Ombuds, said the office has tracked cases of children and adults who remain hospitalized without a medical need because appropriate community services and placements are unavailable. She said the legislature and agencies have funded transition case managers and pilot programs, but long waits persist; she cited individual examples of 200 days, 102 days and 87 days awaiting discharge in a snapshot of current cases.

Why it matters: Long hospital stays are harmful to patients and consume scarce hospital beds, leading to system strain for people with acute medical needs. Schwiederman and others urged better cross‑system collaboration to prevent unnecessary hospitalization and to improve discharge planning and community supports.

Supporting details: Schwiederman called for more behavioral‑health providers trained to serve people with developmental disabilities, improved training relevance for home‑care workers, dual‑training for community‑engagement and supported‑employment staff to deliver personal care, and continued work to improve transitions for youth and nonspeaking autistic adults at risk of hospitalization.

Discussion vs. next steps: The ombuds office said data collection on individuals stuck in hospitals has improved and that more resources are needed to scale transition and complex‑case supports. Committee members asked for follow‑up data; DSHS staff agreed to provide counts and trend figures after the meeting.

Ending note: Advocates thanked JLAC for raising the profile of developmental‑disability discharge issues and encouraged continued attention to workforce training and cross‑system coordination.","mediaType","Video","parentTitle","Joint Legislative Executive Committee on Planning for Aging and Disability Issues - 6/18/2025 10:00 AM","oneSentenceSummary","Developmental‑disability ombuds and advocates told JLAC that people with developmental disabilities continue to experience long hospital stays while awaiting discharge and urged better behavioral‑health integration and workforce training.","taxTitle","Joint Legislative Executive Committee on Planning for Aging and Disability Issues, Joint, Work Groups & Task Forces, Legislative Sessions, Washington","taxId",77555,"location","Washington","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6177423,"State long‑term care ombudsman warns of understaffing, surveillance questions and private‑equity risks",511,2063000,2574000,"/Search/View?dp=1&key=5338462-ca6f539f924860dfa4079e309875ac5f&start=2063&end=2574","https://assets.pipeline.soar.com/5338462-ca6f539f924860dfa4079e309875ac5f/thumbnail_2063000.jpg","/articles/6177423/Washington/State-longterm-care-ombudsman-warns-of-understaffing-surveillance-questions-and-privateequity-risks","https://secure.pipeline.soar.com/6177423-67b24ca8e99f0f8411b33a3e6f0acf5d/orig.mp4?Expires=1770437791&Signature=iHuA5ih~wzHBAGOwhDGvazk9FfXbzCdZELcoyUVYFbPsHx~r7Qv7d9DG8HubgoLDAy2Y~cYiReF5P~-SV7XTlfS5gqGcXSOdlEzc78XK4iJpOdTMq5bVtSdSY99Yz0iBYIiTh0~bhy9Tz2wxb-QCKJzKfXWfnyKI1tULPSDQxf1r3aIuBfi8mQzAC~LUT-sUj3L~cCYinqWyVuqkTFPgDInh5vgeVEuTb~W7-fRxDauWnjEEtVfnn13Wo7zDi7BZsAHWYiuN8CnyB-3BKBB-CIiFkfyNDZYBB2iAsJr~sZpKPlGL7c5gFfiRPohimqB7qhCGE8wHO2p5v6ftxtA1Qg__&Key-Pair-Id=KUT5TJCACFTXG","Patricia Hunter, Washington State Long‑Term Care Ombudsman, told the Joint Legislative Executive Committee on Planning for Aging and Disability Issues that staffing shortages and the growth of complex resident needs are creating harm in licensed care homes.

Hunter, who leads a certified ombudsman program operated by the MultiService Center, said the state has nearly 89,000 licensed resident beds and that adult family homes have grown rapidly during her tenure. She said ombudsmen are seeing rising resident complexity, increasing turnover and persistent understaffing that “is a real problem where lives are harmed and some lost.”

Why it matters: The ombudsman described multiple trends that affect resident safety and access to care: underqualified staffing or high turnover; increased family use of monitoring technology after COVID with unclear data ownership and security; and the expansion of private‑equity and real‑estate investment trust ownership of facilities, which the ombudsman and advocates say can siphon funds away from care and staffing.

Supporting details: Hunter said staff shortages affect kitchen and housekeeping roles as well as direct care and urged wages and training improvements. She described the post‑COVID rise in family monitoring—“nanny cams, Alexa, and other devices”—and asked who owns and secures such data and whether residents on Medicaid have equal access to supportive technology.

On ownership, Hunter said critics report that some corporate owners “siphon public funds through related party structures” and that profit pressures can lower food, maintenance and staffing budgets while corporations expand acquisitions. She also raised concerns about illegal or unsafe discharges and hospital use to bypass legal discharge processes. Hunter highlighted a recent partial funding award to the Office of Civil Legal Aid for legal counsel to residents facing eviction; private‑pay residents still must pay their own legal costs.

Discussion vs. next steps: Hunter said the ombudsman office will continue to work with DSHS in current rulemaking and urged legislators to consider protections around technology, ownership transparency and resident legal supports.

Ending note: Hunter thanked JLAC for its education and advocacy role; she flagged privacy, training, wages and corporate ownership as ongoing priorities for long‑term care oversight.","The state long‑term care ombudsman told JLAC that understaffing in licensed care homes remains severe, that family use of surveillance devices raises privacy and equity questions, and that private equity ownership can weaken facility finances and staffing.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6177427,"DSHS outlines 1115 waiver services: caregiver supports, presumptive eligibility and social needs benefits",475,1219000,1694000,"/Search/View?dp=1&key=5338462-ca6f539f924860dfa4079e309875ac5f&start=1219&end=1694","https://assets.pipeline.soar.com/5338462-ca6f539f924860dfa4079e309875ac5f/thumbnail_1219000.jpg","/articles/6177427/Washington/DSHS-outlines-1115-waiver-services-caregiver-supports-presumptive-eligibility-and-social-needs-benefits","https://secure.pipeline.soar.com/6177427-7dfb066e40916abd9ecfb873bdeca4e8/orig.mp4?Expires=1770437791&Signature=XR40P~w60x6DD3Ehtp2Zr-kFon6ZRIU4My~HyRVGS9NLC9w-x0nFVtAVpbHNmVcZC1Ro6fEz6CRUNodFLslRKzU~78lcqQOY9-dlng4gzdaXWCCrPepa2cfCSzGsggv5pN-59xHLR6VWJSvim2XpCZQSBDQDUuClwZJhDITkY~IjfnBgkSBnA7hoKMOr7juJ9-9WA3~Jer5JlE8osiLmOLdsZh6vGHm~ULK0g9rJk66BgD9WAsLzwsSByhz-l2VW6ckcRBeoWTX7epadJ~oZrKYQl16nkFSzOk9fXkrEFIyRKRrNA6u1-pvA95deIi~ydZGOfvMkeCF09jT3B75MnQ__&Key-Pair-Id=KUT5TJCACFTXG","The Department of Social and Health Services summarized components of Washington’s Medicaid 1115 demonstration waiver that expand long‑term services and supports, speed access to services and add health‑related social needs benefits.

Kathy Kinnaman, Director of Homeless Community Services at DSHS, described two waiver‑funded programs that target people not yet eligible for full Medicaid: Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA). Kinnaman said both programs “target pre‑Medicaid clients by supporting unpaid family caregivers and their care recipients” and use non‑general‑fund dollars matched by federal Medicaid payments.

Why it matters: DSHS said supporting unpaid caregivers is less expensive than institutional care and can delay Medicaid spend‑down. Kinnaman showed 2024 data comparing average monthly spending: about $600 per month in the unpaid family caregiver program versus roughly $4,600 per month for in‑home community residential care and nearly $11,000 per month for nursing‑home care. She said the unpaid caregiver benefit can help a person avoid spending down to Medicaid asset limits.

Key operational changes: The waiver also authorized presumptive eligibility, which lets certain clients receive a limited package of services quickly after an abbreviated assessment and then submit a Washington Apple Health application within 10 days. Phase 1 (December 2023) targeted people discharging from acute and community psychiatric hospitals; Phase 2 testing for statewide in‑home eligibility began in October 2024 in Region 1 with a planned statewide rollout in fall 2025. DSHS reported about 72% of presumptive applicants are found eligible and about 85% of those go on to traditional services.

Health‑related social needs (HRSN): The 1115 renewal that CMS approved in June 2023 added HRSN benefits DSHS can now bill under Medicaid—examples include rental assistance for up to six months, nutrition support, home modification and caregiver respite. DSHS said CMS approved protocols and rate methodology in January 2025, enabling initial implementation and pilots with Area Agencies on Aging.

Discussion vs. decisions: Committee members asked whether federal budget moves could jeopardize the waiver; DSHS said the existing waiver is likely secure until renewal (currently scheduled for 2028). Committee staff requested more granular data on how many people had been served under Phase 1; DSHS said it will provide that information after the meeting.

Ending note: DSHS told the committee it is piloting new processes and working with AAAs and managed‑care organizations to expand timely access to community supports and to use rental assistance to keep people housed and delay costlier institutional care.","DSHS briefed JLAC on services added under Washington’s Medicaid 1115 (\"11‑15\") demonstration waiver, including caregiver supports, presumptive eligibility pilots and health‑related social needs benefits such as short‑term rental assistance.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6177432,"State dementia plan update aims to expand diagnosis, training and community‑level supports",458,687000,1145000,"/Search/View?dp=1&key=5338462-ca6f539f924860dfa4079e309875ac5f&start=687&end=1145","https://assets.pipeline.soar.com/5338462-ca6f539f924860dfa4079e309875ac5f/thumbnail_687000.jpg","/articles/6177432/Washington/State-dementia-plan-update-aims-to-expand-diagnosis-training-and-communitylevel-supports","https://secure.pipeline.soar.com/6177432-6b591f25ba8b5171ccd823fd7c279cb6/orig.mp4?Expires=1770437791&Signature=hfiCxaWmlTOJqOd65qrPpGQi-LYO3qDh8Eo1bnAprWGnKF2KcNLvX0rOVNQWcPBWRZb641l-03PXSfN2UeEPSSkqRpWz-FrZUcPxWwj9cCXYBC0ihUYLdNUVGzL8qxi6XTQL2Wy2ZF5PNC7UfnXIwIrR6j0uS1R4jIF8~2R3sPlEkAOplnCmKezBDtVg8F9bnzBX4Nvo1El6sjkz-~4CNOq8z4H8HrM-T1gR2TeFTuMfoDIWUSQIlLfFUuysQKlv5GM8bmJVKd1Xfmy1a9szEIHBzBLyTMyUPfYOlwoSI~sAdjoMNPyrAJn-qyo88CeoNHPqeGgNb2rYYek7No-yLA__&Key-Pair-Id=KUT5TJCACFTXG","Washington State officials and partners told the Joint Legislative Executive Committee the Dementia Action Collaborative (DAC) continues to implement the Washington State Plan to Address Alzheimer’s and Other Dementia and is focusing on early detection, provider training and local supports.

Lynn Corte, Dementia Care Program and Policy Manager for the Home and Community Living Administration, said the DAC supports implementation of the state dementia plan and is co‑led by the administration’s assistant secretary and an Alzheimer’s Association representative. Corte said the DAC’s membership includes state agencies, academic partners and people living with dementia and their caregivers.

Why it matters: The DAC update stresses early detection and community‑based supports to reduce preventable hospitalizations and to give families time for legal, financial and advance‑care planning. Corte said the number of people with dementia in Washington “will have more than doubled between 2020 and 2040” and that dementia care costs are substantially higher than for people without dementia.

Supporting details: The DAC expanded Project ECHO dementia training at the University of Washington to mentor primary‑care providers statewide and operates three Area Agency on Aging pilots that employ “dementia resource catalysts” to expand local partnerships and services. Corte said preliminary survey results showed about 85% of family caregivers in the pilot reported services helped the person with dementia stay at home.

Discussion vs. next steps: Corte said legislation in 2022 refreshed the DAC roster and that the DAC intends to continue working after the committee’s planned sunset. The DAC is directing work to promote brain health across the lifespan, improve early diagnosis and broaden local access to dementia services through AAAs. Corte noted the DAC’s statutory authority will expire in February 2028 but that the administration and partners plan to continue implementation.

Ending note: Committee members acknowledged the DAC’s role in training, in issuing a “roadmap” for early‑onset cases and in producing widely distributed public materials; DSHS staff said they have distributed more than 100,000 copies of the roadmap statewide.","State Dementia Plan managers told the JLAC that the Dementia Action Collaborative is expanding provider training, piloting community dementia resources and emphasizing early detection to lower avoidable hospital care.",{"_33":113,"_35":36,"_37":38,"_39":114,"_41":115,"_43":116,"_45":117,"_47":118,"_49":119,"_51":120,"_53":121,"_55":56,"_57":58,"_59":122,"_61":62,"_63":64,"_65":123,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6177438,"State officials say WA Cares benefits will launch next summer; private supplemental market created",329,195000,524000,"/Search/View?dp=1&key=5338462-ca6f539f924860dfa4079e309875ac5f&start=195&end=524","https://assets.pipeline.soar.com/5338462-ca6f539f924860dfa4079e309875ac5f/thumbnail_195000.jpg","/articles/6177438/Washington/State-officials-say-WA-Cares-benefits-will-launch-next-summer-private-supplemental-market-created","https://secure.pipeline.soar.com/6177438-082a0442a77e9f4b7653b69e73b80a64/orig.mp4?Expires=1770437791&Signature=T46Wp4spCJxyeu04uD4irPlTYT1bdLDchCV1ceGdxkkZH1-Ox6vnwXDDHEbc3enrX7d3uxjQUVLG84XxkTPrSAQL6RL~tl3Fxp84tyCemfWq3~WpnRMPSjkpAE6IAjdmxbzkAFHdrnnKIdAPWlMIQcCOhHVS5SnHthsgDi2vzEiHOxUoJ6GOvNiTa1l~6yJnmcOBLotc7wNQKJAhHGkJAlG9iJ3RVTyWAjHBlGkV3DhZ~xJY0I4likcRtMosoi3syALObPLv~-8fQMSFONlUbJ7Ms2whYsMBzWNyQbe7Ty2PyMbuRoUt2wA5Su6lf2-qM5lgnknV7U1Y~m3-6MAaLQ__&Key-Pair-Id=KUT5TJCACFTXG","The Department of Social and Health Services told the Joint Legislative Executive Committee on Planning for Aging and Disability Issues that the WA Cares Fund will begin full benefits next July and that the agency is piloting eligibility and payment systems ahead of the launch.

The WA Cares Fund is the state’s public long‑term care benefit. Ben Vechte, director of the WA Cares Fund at DSHS, told the committee the program began premium collection in 2023 and “Workers pay 0.58% of their wages.” He said individuals who become fully eligible can receive benefits “up to $36,500 to use towards long term services and supports of their choice.”

The program started as committee research and was enacted in 2019, Vechte said. He described later adjustments: a pathway for near‑retirees to earn partial benefits, portability rules to preserve benefits for workers who leave Washington, and a 2025 statutory change to allow people who previously opted out a chance to join until 2028. Vechte told the committee DSHS has received about 6,000 inquiries from Washingtonians interested in rescinding prior exemptions.

Why it matters: WA Cares establishes a state‑level baseline long‑term care benefit and, by creating a statutory framework for a supplemental private market, aims to let private insurers sell coverage that layers on top of the public benefit. Vechte compared the structure to Social Security and Medicare, saying the public program will act as a foundation and private plans will offer higher coverage for those who want it.

Supporting details: DSHS plans an IT pilot starting next January with up to 400 applicants; staff expect 150–200 of those to be found eligible and are contracting with local Area Agencies on Aging to recruit participants and test eligibility, provider payments and educational materials. Vechte said the 2025 law also created a framework for a private supplemental market that treats WA Cares as a deductible, letting private coverage be priced assuming the public benefit as a base.

Discussion vs. next steps: Vechte told the committee he expects “further tweaks over time” but said the program is largely “designed according to best practices” and is ready to go. Committee members asked whether additional legislative changes will be needed; Vechte said he did not anticipate major changes but expected ongoing feedback through the LTSS Trust Commission oversight process.

What the committee will see next: DSHS will run the pilot this winter and report back on eligibility determinations, materials and provider‑payment operations. The statute also allows people who bought private long‑term care insurance before November 2021 to retain grandfathered exemptions and lets some other narrow categories remain exempt.

Ending note: Committee members praised the program as an example other states watch closely, and DSHS reiterated that operational testing and stakeholder feedback will guide minor future adjustments.","DSHS officials updated the Joint Legislative Executive Committee on Planning for Aging and Disability Issues on the WA Cares Fund rollout, pilot tests and a new framework to allow private supplemental long‑term care insurance to work with the public benefit.","actionData","errors"]

Article not found

Advocates say people with developmental disabilities remain stuck in hospitals; call for better behavioral‑health training and supports

State long‑term care ombudsman warns of understaffing, surveillance questions and private‑equity risks

DSHS outlines 1115 waiver services: caregiver supports, presumptive eligibility and social needs benefits

State dementia plan update aims to expand diagnosis, training and community‑level supports

State officials say WA Cares benefits will launch next summer; private supplemental market created