How Washington pays for disability services

Waiver inventory

All five 1915(c) waivers carry an effective date of 8/2025. Total waiver enrollment across the five waivers was 24,990 in FY2025, up from 21,049 in FY2021. Washington has no 1915(i) DD state plan option.

State-only funded programs

DDA classifies its state-only bucket as roughly 2 percent of the budget, comprising Child Development Services and State Supplemental Payments. dshs.wa.gov

State Supplementary Payments in lieu of the IFS Waiver. Monthly cash payments to families of people with developmental disabilities who are not enrolled in the IFS waiver. FY2025: 991 people received payments; amounts are based on assessed need and range from $100 to $300 per month. Administered by DSHS DDA. Service codes SA611 through SA615 and SA619 in the rate workbook. dshs.wa.gov

Child Development Services. County-delivered early intervention and family support for young children, reported by county in the DDA caseload report. Appropriation not broken out separately in the 2025-27 budget table. dshs.wa.gov

Dan Thompson Memorial Community Services Account. Competitive grants run in partnership with the Washington State Developmental Disabilities Council. Round 3 covers July 2025 through June 2027 with $1.5 million in grant awards; 150-plus applications produced 13 awardees across nine counties. Focus areas are recreation, transportation and technology. Awardees include Auburn Parks Arts & Recreation, Bridge of Promise, Kitsap Public Health District, PROVAIL, South Sound Parent to Parent and Walla Walla Valley Disability Network. dshs.wa.gov

State-only residential and staffing supplements appear on the fee schedule as distinct state-funded codes: Staff Add On-State-Supported Living, Group Home and Foster Care Agency (SA719 U1/U2/U3) at $25.00 to $40.00 per hour, and Cost of Care Adjustment-State (SA720) at $0.01 to $1,000 per day, paralleling federally matched equivalents SA725 and SA726. dshs.wa.gov

County / regional / local funding

Mandatory county property tax levy. RCW 71.20.110 requires the governing authority of every county to levy annually a tax equal to 2.5 cents per $1,000 of assessed value against taxable property in the county, to be used for coordination and provision of community services for people with developmental disabilities or for mental health services. The levy may be imposed as a separate levy or folded into the county's regular levy under RCW 84.52.043(1)(b). All or part of the proceeds may be transferred to DSHS to draw federal match, in which case the state must grant the money plus the federal match back to service-providing community agencies or community boards in the transferring county. app.leg.wa.gov

County developmental disability boards and county contracts. Chapter 71A.14 RCW ("Local Services") establishes county developmental disability boards, sets county eligibility for state funds (RCW 71A.14.030 and .040), authorizes local authority to provide services, to receive and spend funds, and to participate in federal programs, and confirms that counties may use RCW 71.20.110 levy proceeds for these activities (RCW 71A.14.100). app.leg.wa.gov

Counties contract with DDA to deliver adult employment and day program services (Group Supported Employment, Individual Employment, Community Inclusion), child development services, and high school transition support. The DDA caseload report tabulates all three by county for all 39 counties. County administrative and infrastructure costs are reimbursed through dedicated service codes SA920 through SA926 (County Admin Costs, Staff Training, Board Training, Info and Education, Infrastructure, Start Up, Partnership), all at contracted rates. dshs.wa.gov and dshs.wa.gov

Scale of county levy collections statewide: not found in the sources retrieved.

Funding scale

• 2025-27 DSHS Developmental Disabilities Community Services operating budget: $5.276 billion total, of which General Fund-State is $2.589 billion (49.1 percent) and federal/other funds are $2.687 billion (50.9 percent). dshs.wa.gov
• 2025-27 state funds by category (millions, GF-State): In-Home Services and Supports $1,203.6 serving 27,728 clients; Community Residential $1,147.6 serving 4,643 clients; Field Services $171.6 with 1,145.5 FTE; Other Community and Professional Services $59.0; Central Office Program Support $7.6 with 23.7 FTE. Total $2,589.4 million, 1,169.2 FTE, 32,371 clients.
• Budget growth: total funds by biennium were $3.02B (2017-19), $3.96B (2019-21), $4.62B (2021-23), $5.47B (2023-25), $5.28B (2025-27). GF-State: $1.53B, $2.20B, $2.70B, $2.77B, $2.69B.
• FMAP: 50 percent for FY2026 (KFF). Roads to Community Living carries an enhanced 75 percent federal match for the first 12 months after a person moves out of an institution. kff.org
• Average monthly cost per client, FY2025 (total funds): Core Waiver Residential $18,571 (3,936 average monthly caseload); Core Waiver Non-Residential $11,505 (557); CFC plus Medicaid and CHIP Personal Care $4,517 (17,176); CIIBS $2,772 (111); Basic Plus $1,096 (10,271); IFS $143 (4,844).
• Residential Habilitation Centers (ICF/IID and nursing facility campuses): census fell from 592 in FY2021 to 431 in FY2025, while average cost per resident day rose from $1,169 in FY2021 to $1,770 in FY2025.
• People served: total DDA eligible caseload 67,594 as of July 2025, up from 49,512 in FY2021, a 6.6 percent five-year average annual growth rate. Growth is concentrated in children ages 3 to 17 at 13.7 percent annually.
• Eligibility volume: 12,775 initial determinations in FY2025, 91.2 percent found eligible; 16,663 total determinations including reviews and reapplications, 88.8 percent eligible, up 15.7 percent from FY2024. Autism accounted for 8.5 percent and developmental delay 78.8 percent of FY2025 eligibility determinations by condition.
• Waiting list: Washington does not operate a conventional DD waiver waiting list. The analog is the "no-paid services" caseload: 22,964 people were enrolled with DDA but receiving no paid services as of July 2025 (point in time), concentrated in King (6,503), Pierce (3,363), Snohomish (3,395), Spokane (1,411) and Clark (1,132). DDA reported to the legislature in 2025 on this population. app.leg.wa.gov
• Waivers are capped by CMS-approved capacity rather than by a waitlist: combined approved capacity across the five waivers is 27,806 against 24,990 enrolled in FY2025.
• Children's out-of-home residential services: 117 children in FY2025, up from 85 in FY2024.
• PASRR specialized services expenditures grew from $1,135,900 in FY2021 to $6,335,576 in FY2025, a 58 percent average annual increase; 2,619 screenings and assessments completed in FY2025.

Residential funding detail

Washington's community residential system is contract-based and cost-settled, not a published per-service fee. DDA sets standard rates by cost center; providers submit annual cost reports; DDA's Rates Unit verifies costs and determines whether a settlement is owed back to the state. Current rates live in Exhibit C of each provider's Community Residential Services contract. dshs.wa.gov

Rate mechanics (Policy 6.02, last revised 06/2026). A WAC 388-828-9500 through 9530 assessment algorithm produces a residential support score, then identifies how much support can be shared among housemates, then assigns one of nine tiers. Tiers 1 through 8 use a standardized methodology, each linked to a daily rate. Tier 9 is a client-specific exception rate set through the rate assessment process, effective no more than 12 months and reassessed annually. Every tier's daily rate is stratified by county category: King County, MSA county, and Non-MSA county. The daily rate has three or four components: instruction and support services (ISS), an administrative/non-ISS rate that varies by service type, county and incremental daily ISS, a certification rate covering the DSHS certification fee under chapter 71A.12 RCW, and where applicable transportation and residential professional services. Rates are prospective and subject to legislative appropriation. dshs.wa.gov

Settings funded: - Supported living (Core and Community Protection waivers), contracted, tiered ISS plus a supported living administrative/non-ISS rate. - Group homes, contracted, tiered ISS plus a group home administrative rate with separate wheelchair and non-wheelchair schedules. - Group training homes, contracted, tiered ISS plus a group training home administrative rate that includes a $2.40 statewide certification component, with wheelchair and non-wheelchair schedules. - Companion homes (host home model), acuity-scaled daily rates on a 0 to 19 scale. - Licensed staffed residential homes (SRH), an administrative rate table keyed to ISS hour bands from 0 to 15-plus hours, with a direct staff benchmark rate ($29.57 Non-MSA, $30.08 MSA, $31.02 King), program manager rate ($42.58 / $43.30 / $44.73), staff add-on rates ($34.37 / $35.72 / $37.13), a community inclusion rate of $189.68 per month, a consultant fee of $109.52 per hour, client transition hours at $43.81, and damage reimbursement at $6.34 per day. - Adult family homes and adult residential care, per diem by CARE classification and service area. - State Operated Living Alternatives (SOLA), state-operated community homes in Kent, Shoreline, Snohomish, Kitsap, Pierce, East Pierce, Thurston, Spokane, Spokane 2, Yakima, plus a children's SOLA. - Residential Habilitation Centers, the state ICF/IID and nursing facility campuses at Fircrest School, Lakeland Village, Rainier School and Yakima Valley School.

Room and board. Client financial responsibility (participation) in a group home or group training home is determined under WAC 182-515-1514. Providers must accept the DDA rate as full compensation for contracted residential services and cannot require additional payment from or on behalf of a client except as allowed in Policy 6.02. For people in their own homes under supported living, room and board is paid from the person's own income, principally SSI, with the State Supplementary Payment adding $100 to $300 per month for eligible people. dshs.wa.gov

Rate structure link: dshs.wa.gov and dshs.wa.gov

Comparable service rates

From the All DDA Rates workbook. Residential tables are the "SL & GH July 2025" tab (2.2 percent increase to ISS only, administrative and certification rates unchanged); non-residential service codes are the "DDA Services July 1, 2026" tab. Unit key: OF and 1/4 HR = 15 minutes, DL = daily, HR = hourly, MN = monthly, EA = each.

Other published rates worth noting: Residential Provider Training Wages (SA534) $17.62 to $25.00 per hour, Alternative Living Provider Training Wages (SA534 U1) $30.08 per hour, DDA Residential Provider Training Tuition (SA538) $310.00, RN Delegation per 15 min $12.86 individual / $15.43 agency, Private Duty Nursing RN $14.15 individual / $16.97 agency per 15 min, Skilled Nursing RN $14.15 / $16.97 and LPN $11.62 / $13.95 per 15 min, mileage $0.73 per mile, Peer Mentoring $5.50 per 15 min, Wellness Education $4.15 per month, Assistive Technology CFC up to $10,000, Environmental Adaptations In-Home up to $60,000.

Average daily rate by residential setting is charted for FY2025 in the caseload report (Adult Family Homes $180.68 and Assisted Living $173.44 are the two clearly labeled values; the remaining SOLA, RHC, supported living, group training home and staffed residential values are plotted without one-to-one label alignment in the extractable text, so they are not reproduced here).

Official rate schedule links

• All DDA Rates workbook (includes DDA Services January 1, 2026 and July 1, 2026 tabs, SL & GH July 2025, CH Rates July 2025, SRH Rates July 2025, Community Rates January and July 2026, Bridge Rates, Bed Hold Calculator, Track Change Log): dshs.wa.gov
• Supported living, group training home and group home rates and reimbursement documents: dshs.wa.gov
• DDA Policy 6.02, Rates and Other Covered Costs for Supported Living, Group Training Homes, and Group Homes (rev. 06/2026): dshs.wa.gov
• DDA Policy 6.04, Billing, Payment, and Cost Reporting (rev. 07/2026): dshs.wa.gov
• 2025 DDCS Caseload and Cost Report: dshs.wa.gov
• Current DDA 1915(c) HCBS Medicaid Waivers summary: dshs.wa.gov
• ALTSA Office of Rates Management: dshs.wa.gov
• A Guide to Residential Service Levels of Support (DSHS 22-1184): dshs.wa.gov

Notable features and flags

• August 2025: All five 1915(c) waivers carry an effective date of 8/2025 with capacities of 13,400 (Basic Plus), 8,000 (IFS), 5,702 (Core), 504 (Community Protection) and 200 (CIIBS). dshs.wa.gov
• July 1, 2025: A 2.2 percent increase applied to the instruction and support services component of supported living, group home and group training home rates. Administrative, non-ISS and certification rates were unchanged. Companion home base rates also rose 2.2 percent. dshs.wa.gov
• December 1, 2024 into 2029-2030: DDA delivered a Waiver Restructure Report to the legislature recommending consolidation from five waivers to two, with service options aligned across both and waiver assignment driven by where a person lives and what they need. The full transition is estimated at 4 to 5.5 years, with CARE tool changes taking 3 to 4 years after service design, and a move to two waivers "no earlier than 2029-2030." DDA is pursuing interim improvements to the current waivers by September 2027, and has held over 50 community collaborator meetings, with monthly 2025 topics covering waiver names, incidental personal care, access and adaptation, social engagement, and goods and services. dshs.wa.gov and dshs.wa.gov
• July 2025: 22,964 people enrolled with DDA were receiving no paid services. DDA states it "has received funding to hire case managers for almost every person enrolled with DDA," which would extend paid case management to much of that group. informingfamilies.org
• FY2021 to FY2025: Community Protection waiver enrollment fell steadily from 401 to 301 while Basic Plus grew from 9,750 to 12,490 and IFS from 6,246 to 7,208. Residential Habilitation Center census fell from 592 to 431 while average daily cost rose from $1,169 to $1,770, a widening institutional cost gap. dshs.wa.gov
• Self-direction: Washington uses a Consumer Directed Employer model (taxonomy 253Z00CDEL) that pays $9.91 per 15 minutes for personal care and respite, alongside individual provider reimbursement and supplemental payment codes (SA603, SA604). Client and IFS reimbursement codes (SA605, SA606) allow direct purchase up to $5,000 and $10,000.
• October 1, 2025: S5125 U1 AFH Medical Escort at $6.01 replaced T1019 U6 for that purpose; September 2025 rate workbook change log entry. dshs.wa.gov

Confidence

Solid: the 2025-27 budget totals and state/federal split, waiver enrollment by year FY2021 through FY2025, waiver capacities and August 2025 effective dates, the no-paid-services caseload, average monthly cost per client by program, RHC census and cost trend, the full tiered ISS and administrative rate tables, the fee schedule for non-residential services with its change log, the county levy statute and chapter 71A.14 RCW structure, and the Dan Thompson account Round 3 award total. Estimated: the exact composition of paid versus no-paid within the 67,594 total eligible caseload, since the caseload report presents budget client counts (32,371 unduplicated in paid fund categories) and point-in-time county paid/no-paid counts on different bases. Could not find: statewide county levy collections or county general revenue contributions, the state total for adult employment and day program services across counties (the report tabulates by county in a graphic that does not extract cleanly), an authoritative one-to-one mapping of the FY2025 average daily rate by residential setting chart, and the DDCS county contract templates, which sit behind a page that timed out repeatedly. Supported living, group home and group training home rates are contracted per provider in Exhibit C and are therefore reported here as the underlying tier tables rather than as a single published rate.