This bill creates a new DSHS pilot program (a new statutory section) that allows certain people with developmental disabilities who live in community settings to receive dental services at residential habilitation centers. The pilot permits short-term admissions for dental visits of up to 24 hours, and participants may use authorized respite hours under their homeand community-based services waiver. DSHS must work with the Health Care Authority to enroll residential habilitation center dental clinics as Medicaid fee-for-service providers for the pilot; any federal Medicaid matching funds for services provided under the pilot are to be deposited into the state general fund. The pilot must conclude by July 1, 2028, the pilot section expires July 1, 2029, and DSHS must report to the Legislature by October 1, 2028 on outcomes, numbers served, obstacles, and administrative or billing issues. Eligibility for the pilot is limited to people eligible for DSHS developmental disabilities services who meet one of three criteria: assessed high behavior or medical acuity, a documented history requiring general anesthesia or deep sedation for routine care, or a case manager certification that community dental care is unavailable due to the person’s specific medical or behavioral profile. The bill also amends RCW 71A.20.191 to add admissions and transition rules for the Rainier school (Buckley, Pierce County). It limits new long-term admissions as of July 27, 2025 (with certain exceptions), prohibits any kind of admission there as of June 30, 2027 except as provided, and specifies that Rainier will continue operating as a residential habilitation center until its long-term resident census reaches zero. Former long-term Rainier residents who move to community settings after July 27, 2025, are offered a one-time right to return during the first year after their move; further returns after a second move require department review and approval by the secretary based on a multidisciplinary care team recommendation. The act defines “closure” for chapter 410, Laws of 2025 as the prohibition on new admissions described, requires sufficient funding to be appropriated to DSHS for transition requirements, and references RCW reporting and other statutory sections. This is a procedural and programmatic change—creating a new pilot program and amending admission and transition procedures in existing law—rather than a criminal or penalty change. The text provided does not include the full prior language of RCW 71A.20.191 or the full content of chapter 410, Laws of 2025; it also lacks specific funding amounts, the number or locations of participating residential habilitation centers, detailed operational or billing procedures, and a clear identification of which agency “secretary” is meant.

If enacted, the Department of Social and Health Services will run a time-limited pilot letting certain people with developmental disabilities who live in the community get dental care at residential habilitation centers, including brief admissions up to 24 hours and use of authorized respite hours. Practically this means DSHS must work with the Health Care Authority to enroll those centers as Medicaid fee-for-service providers, which will change billing and administrative work for the department and the centers, could increase short-term clinical demand at those facilities, and may shift some community dental care back into residential settings for people with high medical or behavioral needs. The pilot must end by July 1, 2028, produce a report by October 1, 2028, and any federal matching funds claimed will go to the state general fund, which could alter how much Medicaid reimbursement is available to support the services. The bill also tightens admissions at the Rainier school: no new long-term admissions after July 27, 2025 and no admissions at all after June 30, 2027 except narrow exceptions, requires transition supports for residents and choices about returning (one guaranteed return within a year after moving, further returns require review and approval), and obligates adequate funding for those transitions. This will most affect DSHS staff who must plan and pay for transitions, Rainier employees facing changing resident counts and roles, and case managers and multidisciplinary teams who must certify eligibility and recommend return approvals. Important implementation details are missing here—specific funding amounts, how many centers will participate, operational billing procedures, and which agency secretary must approve returns—so the exact scale of costs and administrative burden is unclear.