The bill adds a new section to chapter 71A.12 RCW that amends the basic plus waiver by adding respite care to the list of aggregate services. It requires the (unnamed) department to submit a waiver amendment to the Centers for Medicare and Medicaid Services (CMS) by September 1, 2025, and to immediately update the basic plus waiver to include respite care upon CMS approval. The department is authorized to adopt rules necessary to implement these changes. The bill establishes programmatic and fiscal rules: no more than 30 percent of the total aggregate services budget may be used for respite care, and aggregate funds may be accessed for respite care without prior administrative approval once a beneficiary’s annual assessed hours have been exhausted. The provision is targeted at persons with intellectual or developmental disabilities and their main caregivers and involves the basic plus waiver process with CMS. Uncertainties in the provided text include which state department is referred to, the specific new RCW section number, and formal definitions for terms used such as “respite care,” “basic plus waiver,” “aggregate services,” and “annual assessed hours.” The text does not provide details about the existing basic plus waiver structure or current annual assessed hours.

If enacted, people with intellectual or developmental disabilities and their main caregivers will likely see more access to paid respite services through the basic plus waiver once the federal waiver change is approved — respite can draw from the program’s pooled (aggregate) service dollars and, after a person uses up their annual assessed hours, those aggregate dollars can be tapped for respite without waiting for extra administrative approval. Because no more than 30 percent of the total aggregate services budget can be used for respite, programs that currently rely on aggregate funds may have less money available for other services, so the mix of supports offered through the waiver could shift toward supporting short-term caregiver relief. The state department named in the bill must submit the waiver amendment to CMS by September 1, 2025, and will need to adopt any rules required to implement the change once CMS approves it, creating administrative and planning work for that agency. Key details are unclear from the provided text — the specific department is not named, terms like “respite,” “annual assessed hours,” and the existing design of the basic plus waiver are not defined — so how large the change will be for individual beneficiaries, and which services will be reduced to accommodate the 30 percent cap, cannot be determined from these facts alone.