This bill adds a new section to chapter 71A.12 RCW and amends multiple existing sections, creating new statutory requirements and modifying existing law governing services for people with developmental disabilities. It requires the Department of Social and Health Services (DSHS) developmental disabilities administration to contract directly with service providers for delivery of community inclusion services under home and community-based waivers, and it sets standards for those services (including allowing incidental personal care, permitting provider-to-client ratios other than one-to-one, limiting billing for recordkeeping to up to 15 minutes per week per client, and requiring access to services by assessed service hours that may not be reduced when rolled into aggregate services subject to a dollar limit). The bill also amends contracting authority and service-delivery rules in RCW 71A.12.110 and 71A.14.060, requires that clients age 21 and older enrolled in employment services be offered the choice to transition to a community inclusion program after nine months, and updates definitions in RCW 71A.10.020, including a requirement that the administration promulgate rules by June 30, 2025 to define “developmental disability” without using IQ scores. The bill changes certification and training requirements for certain long-term care workers by amending RCW 18.88B.041 to list categories of workers who are exempt from becoming certified home care aides and to allow some exempt individuals to obtain certification by exam without meeting a specific training requirement. Specific exemptions described include individual providers who provide 20 hours or less of nonrespite care to one person in a calendar month, providers who only deliver respite services and work less than 300 hours in a calendar year, workers who provide approved services only for a spouse or registered domestic partner under the state long-term services and supports trust or under certain U.S. Department of Veterans Affairs programs, and workers who provide only the community inclusion services described in the new section. Exempted workers may still enroll in the training under RCW 74.39A.074, and the department is required to adopt rules to implement these exemptions. The extracted text ends mid-sentence in one provision and omits some subsequent language and implementation details, so the remainder of that exemption and any additional provisions are not visible here.

If enacted, the department of social and health services will take on direct contracting and clearer rules for "community inclusion" waiver services, which means providers delivering those services can contract directly with DSHS under new standards (including allowance for provider-to-client ratios other than one-to-one, billing up to 15 minutes per week per client for recordkeeping, and a rule that assessed service hours cannot be reduced when folded into aggregate, dollar-limited services). Counties and developmental disability boards will be able to provide services by rule, and clients age 21 and older in employment programs must be offered the option to transition to community inclusion after nine months, so providers may need to change staffing models, billing practices, and service scheduling while DSHS expands contracting and rulemaking responsibilities. The bill also exempts many categories of long-term care workers from a state certification/training requirement — including qualified nurses and aides, certain individual providers who work only limited hours or only provide respite, spouses or registered domestic partners under some programs, VA-funded caregivers, and people who provide only community inclusion services — and requires the department to adopt rules implementing those exemptions; workers hired before January 7, 2012 who completed training at hire are also noted as exempt. Practically, those workers and their employers will likely face lower training costs and faster ability to be paid for services, but oversight, liability, and the exact scope of exemptions remain partly unclear because the bill text cuts off in places and the department must still issue rules.