By Scott Livengood
If you are an adult with intellectual or developmental disabilities, our state government plays a significant role in where you may choose to live. Many of the choices are far from ideal: state institutions, hospital settings and living with aging parents without support services. There is currently one care model available, supported living, where those with intellectual and developmental disabilities may live in their own home in communities across our state while receiving consistent care from trained providers. The decisions that our state Legislature make in these closing days of the 2023 session will make a significant difference in whether or not we put providing care for some of our most vulnerable citizens on a more sustainable path.
Supported living makes it possible for those with intellectual and developmental disabilities to live in their own homes with a level of care that is often required 24 hours a day, seven days a week. And unlike other models of long-term care, supported living is almost entirely reliant on Medicaid for care providers’ wages, program costs, administration and general operations.
Despite this reliance, our state government has never forged a clear, sustainable plan that would ensure that those who rely on supported living for care can count on consistent support. The state’s Medicaid investment over the years has been inconsistent and is often working hard just to play catch up after years of minimal support, an approach made even more challenging by the stark current economic realities of inflation.
So, while I appreciate that lawmakers have set aside some level of funding in proposed budgets for supported living care this year, there is a longer road ahead to achieve a level of funding that is truly sustainable.
The ongoing housing affordability crisis in our state affects us all. For those with intellectual and developmental disabilities working to live in their own homes, the negative outcomes of the crisis are profound.
There are many adults who would greatly benefit from supported living, but today are waiting for services for no other reason than a lack of an accessible, affordable home in their community.
Programs like the Housing Trust Fund are critical state investments to help lower barriers to housing for many people. That’s why we applaud the Senate and the House for proposing $25 million in this program to help lower these barriers for those with intellectual and developmental disabilities, a five-fold increase over previous years. This investment will create affordable housing options for 100-130 individuals, and I urge lawmakers to advance this investment toward final adoption. It can be easy to get lost in a budget line item, but when we see older adults who have lived in an institution their entire lives sit for the first time on their own back-porch, the case could not be more clear for the human need to live in a community among neighbors.
In any care setting, consistency is paramount. We work hard to train the direct support professionals providing care and to uphold a staffing model that allows for our clients to get to know their caregivers, despite a very challenging staff turnover environment. This need for consistency is another pillar in our work to pursue a more sustainable path for supported living by asking state government to formally forecast the level of need in our state’s population so that everyone in need of care can access it. Currently, the lack of an accurate forecast of demand means that providers can only make an educated guess of the level of need in their respective communities, and the state can also only guess what level of funding would be required to support this care in our state. Sustainable care is not possible until our state reliably measures the need for care.
As the leader of a nonprofit – founded almost 50 years ago by parents – that specializes in supported living, I am just one person among so many in Washington doing their best every day to provide care. Whether I am going from meeting to meeting in our state’s capital or chatting with one of our direct support professionals, I try to always keep an eye on a horizon where a sustainable approach for providing care is possible. I know that our state is more than capable of aligning its values with its investments and I hope that this year we get closer to that better horizon for those in our care.
Scott Livengood, of Woodinville, Washington, serves as the CEO of Alpha Supported Living Services, a nonprofit agency founded in 1974 that provides supported living, group home, community inclusion and other services for adults and children with intellectual and developmental disabilities. The agency has offices in Bothell and Spokane.