Monitoring Residential Habilitation Centers

DRW has monitored Washington State facilities serving people with developmental disabilities since the 1970s. As the designated protection and advocacy system for Washington State, federal law provides DRW authority to conduct unannounced visits, meet privately with residents, and review otherwise confidential information to ensure the rights of people being served in these settings are fully protected. DRW reviews the conditions in which people live and compares the services being provided to state and federal requirements. DRW also leads public policy efforts, so individuals who want to move into their own home can do so when possible, with dignity, autonomy and the right supports.

Institutions: Downsize, Consolidate and Close

Washington State still has four state-run institutions for people with developmental disabilities. At one point, six of these residential habilitation centers, or RHCs, housed 4,000 people. Today, less than 900 live in four facilities. Other states have closed all of their institutions, and while Washington State has reduced its institutional footprint amid a hotly contested debate, it is still behind the curve on this important civil rights issue.

Research shows the community offers more autonomy, more highly-tailored services, and more choice for people with disabilities. People with the most complex health needs can be, and already are, served in community settings.

"There is no statistical difference in assessment scores of our highest medical and behavioral residents residing in the community, or in our RHCs," said Secretary Susan Dreyfus, of the Department of Social and Health Services (DSHS), in a legislative testimony. "In fact, the persons with the highest scores for medical and behavioral needs are actually residing in the community, not in our RHCs. It's very important to keep that in mind."

DRW supports the responsible consolidation of residential habilitation centers, and the right of individuals with disabilities to live in the least restrictive setting. As individuals move from RHCs into communities, it is imperative the right supports and services are available and carefully constructed to coordinate successful transitions.

Summary of work: 

Lakeland Village’s Nursing Facility

DRW used this access authority and experience to review the services provided to people with developmental disabilities served by the DSHS staff at Lakeland Village’s Nursing Facility. What DRW found over the last several years is troubling. Even more troubling is that serious problems continue to be found. Below is a collection of documents that show the results of recent surveys as well as a letter from DRW to the Centers for Medicare & Medicaid Services (CMS) which summarizes problems that have been identified by Residential Care Services (RCS), CMS, and DRW over the last several years.

Milestone: March 5, 2015

CMS threatens to take all money from nursing facility in a letter to the Developmental Disabilities Administration (DDA) [PDF].

Milestone: March 4, 2015

DRW releases a one-page summary of RCS violation [PDF].

Milestone: January 22, 2015

RCS violation surveys released.

Milestone: January 16, 2015

Letter summarizing problems from the last several years: DRW sent a detailed letter to CMS [PDF] signed by DRW, the Washington State Long Term Care Ombuds, the Washington State Developmental Disabilities Council, Self Advocates of Washington, People First of Washington, Self Advocates in Leadership, and the Arc of Washington. Exhibits to that letter (exhibits 1-6) [PDF], (exhibit 7) [PDF], (exhibits 8 - 18) [PDF], include documents supporting DRW’s analysis well as the actual CMS and RCS surveys with their findings.

Milestone: November 2014

DRW releases a one-page summary of earlier CMS and RCS findings [PDF].

Milestone: November 7, 2013

CMS sends letter to DSHS re: 40,000 violations [PDF].