SB 5428
In CommitteeSenate
Community inclusion services
Improving community inclusion services for individuals with developmental disabilities.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill improves access to and flexibility in community inclusion services for people with developmental disabilities by allowing direct state contracts with providers, updating service delivery standards (e.g., group interactions and billing rules), and expanding client choice in switching between employment and community inclusion programs. It also clarifies definitions and expands exemptions for certain long-term care workers.
- Requires the Department of Social and Health Services (DSHS) to contract directly with service providers for community inclusion services under home and community-based waivers.
- Establishes new service standards for community inclusion services, including allowing incidental personal care, permitting non–one-to-one provider-client ratios, and permitting billing for up to 15 minutes per week of administrative time and reasonable transportation fees.
- Guarantees that assessed service hours for community inclusion services cannot be reduced if those services are bundled into a dollar-based aggregate service limit.
- Expands client choice by allowing individuals to transition freely between employment programs and community inclusion programs after nine months in an employment program—without prior approval—and requires DSHS to inform clients about all available options.
- Exempts long-term care workers who provide only community inclusion services from the requirement to become certified home care aides, though they may still choose to pursue certification.
- Directs DSHS to promulgate rules by June 30, 2025 to define 'developmental disability' without using IQ scores.
Who is affected
- Individuals with developmental disabilities — Individuals with developmental disabilities who receive or may receive community inclusion services, as the bill changes how those services are delivered, structured, and accessed.
- Community service providers — Service providers who contract with the state to deliver community inclusion services, as the bill sets new billing rules, service delivery standards, and provider-client ratio flexibility.
- Families and legal representatives — Families and legal representatives of individuals with developmental disabilities, as the bill requires clearer communication about service options and expands choice in transitioning between service types.
- Department of Social and Health Services (DSHS) and county developmental disability boards — State and county agencies involved in managing and delivering developmental disabilities services, as the bill expands their authority to contract for services and adjust service delivery models.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Requiring DSHS to contract directly with providers eliminates intermediaries (e.g., managed care organizations or county boards acting as fiscal sponsors), which could reduce administrative delays and improve responsiveness to service needs—particularly for clients in rural or under-resourced counties.
Local GovernmentPeopleRef: Sec. 1(1)Defining 'community inclusion services' to emphasize integration, skill development, and relationship-building—rather than segregated settings—strengthens the right to community-based, inclusive living and aligns with federal ADA and Olmstead enforcement priorities.
Rights & LibertiesPeopleRef: Sec. 2(19)Expanding client choice to transition freely between employment and community inclusion programs after nine months—without prior approval—and requiring DSHS to proactively inform clients of all options significantly enhances autonomy and self-determination for individuals with developmental disabilities.
Rights & LibertiesPeopleRef: Sec. 3(1)–(3)Exempting long-term care workers who provide *only* community inclusion services from home care aide certification reduces barriers to workforce entry and retention, especially for individuals with special education credentials who may otherwise be excluded despite relevant training.
Business & EmploymentPeopleRef: Sec. 6Mandating inclusion of incidental personal care in community inclusion services ensures that clients who need assistance with basic self-care (e.g., toileting, dressing, medication reminders) can access those supports in community settings—reducing reliance on institutional care or family caregivers.
HealthcarePeopleRef: Sec. 1(2)(a)
Potential Concerns (3)
Allowing providers to bill up to 15 minutes per week per client for administrative tasks may increase administrative overhead and create complexity in billing compliance, especially for small or under-resourced providers who lack dedicated billing staff.
Business & EmploymentRef: Sec. 1(2)(c)(ii)Permitting non–one-to-one provider-client ratios and group interactions may reduce individualized supervision, potentially increasing risks for clients with high-support needs—particularly those with aggressive behaviors, self-injurious behavior, or severe cognitive impairment—if providers lack adequate training or staffing to manage group dynamics safely.
Public SafetyRef: Sec. 1(2)(b)While the bill prohibits reduction of assessed service hours when services are bundled into a dollar-based aggregate limit, it does not address whether the underlying funding level for those aggregate limits will increase—potentially forcing DSHS to reduce hours elsewhere or cap enrollment, indirectly limiting access for new or existing clients.
FinancialRef: Sec. 1(2)(d)
Who Is Most Affected
Individuals with developmental disabilities—especially those with high support needs—may benefit from increased access to integrated community services and greater autonomy in choosing service types, but could face safety risks if group interactions are not properly staffed or monitored.
Small and mid-sized community providers may benefit from streamlined direct contracting and expanded billing flexibility (e.g., transportation, admin time), but may struggle with compliance burdens if DSHS does not provide robust technical assistance or if staffing exemptions reduce workforce stability.
Families gain stronger rights to be informed about service options and to transition clients without bureaucratic delays, but may face uncertainty if service hours are capped under aggregate dollar limits despite protections against hour reduction.
DSHS gains expanded authority to contract directly and define service standards, improving operational flexibility—but may face fiscal pressure if utilization increases without corresponding funding increases, potentially straining county boards' implementation capacity.