Washington's Developmental Disabilities Administration has offered state budget writers an option that would make it harder to qualify for developmental disability services, cutting off an estimated 2,655 current clients. The idea is in a decision package the Department of Social and Health Services filed with the Office of Financial Management for the 2027-29 budget. The Washington State Standard first reported it on Oct. 7, 2026.
The package raises the bar for functional eligibility, the level of care a person must show to get Medicaid-funded DDA services. Disability status and financial eligibility rules would not change. The department says the people affected would be those with lighter care needs and no significant behavioral or physical health support needs, and the package assumes no exemptions for people already being served.
What would change
DDA uses the ICF/IID level of care standard for people on its home and community-based Medicaid waivers, and some personal care clients qualify through that standard or the nursing facility one. Under the option:
| Who | Current threshold | Proposed threshold |
|---|---|---|
| Children from birth through age 5 | Level of care score of 5 or more | Score of 8 or more, for birth through age 6 |
| Children ages 6 through 15 | Score of 7 or more | Score of 9 or more, for ages 7 through 15 |
| People 16 and older (Supports Intensity Scale, adult version) | One route to eligibility: some physical help with 1 of 17 activities of daily living | Help needed in 6 areas |
The department lists bathing, dressing, hygiene, eating, toileting, taking medication and walking as examples of daily living activities.
Who would lose services
DDA's count of the 2,655 clients, by service. The categories overlap, so they add up to more than the total.
| Service | Clients affected |
|---|---|
| Supported employment and community inclusion | 1,170 |
| Individual and Family Services waiver (people living with family) | 874 |
| Personal care | 471 |
| Out-of-home respite | 325 |
| Community residential, including State Operated Living Alternatives | 195 |
The package warns that people in residential settings face the most serious consequence, because their housing depends on eligibility. It says people with no home to return to, no family or informal caregiver and too little income to keep housing could face housing insecurity. Children under 21 who lose DDA eligibility could turn to the Health Care Authority for medically necessary services under Medicaid's early and periodic screening benefit. The department also says it has not yet had a chance to consult the communities the change would affect.
The money
As of Oct. 7, 2026, the package projects savings of $13,388,000 in the 2027-29 biennium, $6,100,000 of it from the state general fund, all in fiscal year 2029. Savings would grow to $60,726,000 a year in fiscal 2030 and 2031, $28,417,000 of it state funds, with 51.7 fewer state staff positions. The rest of each figure is lost federal Medicaid matching money. The Standard rounded the first-biennium figure to $13.3 million.
What happens next
The option is one of the agency's budget requests, not a decision. Agency spokesperson Jessica Nelson told the Standard it is a "first step in the budgeting process." Gov. Bob Ferguson will release his proposed 2027-29 budget in December, ahead of a legislative session in which lawmakers expect a multibillion-dollar shortfall. The Standard reported that Ferguson included a similar idea in his proposal for the current budget and lawmakers decided against it.
If it is adopted, the department expects federal approval of the waiver and state plan amendments to take 9 to 12 months, followed by changes to chapters 388-106 and 388-828 of the Washington Administrative Code. No change in state law would be needed. People would be rescreened at their regular reassessments, so the change would phase in over time. Each termination would come with advance written notice and hearing rights. The budget would cover July 1, 2027, to June 30, 2029.
The package lists seven groups it expects to oppose the change, including SEIU 775, the Adult Family Home Council, the Developmental Disabilities Council, People First and The Arc of Washington State. The Arc's executive director, Stacy Dym, told the Standard the proposal calls Washington's commitment to community services into question and that cutting them would cost the state more in the end.
Why this matters for providers and DSPs
The biggest single group at risk is people in supported employment and community inclusion, followed by families on the Individual and Family Services waiver, so employment and respite providers would feel the change first. Because terminations would come at reassessment, agencies would lose clients gradually, and DDA expects a short-term jump in hearings and in workload for its case managers. For direct support professionals, fewer authorized clients could mean fewer hours. People supported in residential settings who lose eligibility could also lose their homes. Nothing changes unless the governor and Legislature adopt the option and CMS approves it, and the earliest savings in the package fall in fiscal 2029, which starts July 1, 2028.