About HB 1472 & institutions: We have challenges. Fearmongering doesn’t help

Testimony and comments spread misinformation and divert from meaningful improvement

• You can email your legislators here

HB 1472 is a straightforward bill: it consolidates institutional settings for people with intellectual and other developmental disabilities (IDD) from four sites to two. It was requested by the state Office of Financial Managment and is a part of a decades-long effort to reduce our institutional footprint while expanding care options for all.

• It does not take away services.
• It does not end institutional care for people with IDD.
• The type of services affected would continue at Fircrest near Seattle, and Lakeland Village near Spokane, and they have capacity.
• It also does not remove overnight respite options.

It consolidates one intermediate care facility and one nursing home into existing ones in Fircrest near Seattle and Lakeland Village near Spokane. The two remaining institutions would each offer both types of facilities. All residents at Rainier and Yakima Village would have a choice to continue with institutional care or move to a community setting.

And yes – the state and IDD community DO have quite of bit of experience helping people transition out of institutions, safely.

Community options for IDD services need more support. We all know this. But the fixes are achievable IF legislators choose to support them.

Fearmongering

In testimony and legislative debate, we have heard several points that are not substantiated by facts and that ignore the transformation of service delivery since the 1970s.

The most alarming is that people will die – one legislator suggested hundreds, even though only about 100 people will be affected by the consolidation.

Another suggested we have no community infrastructure to support people with IDD and that we have no plan or way to transition people to other settings, even similar ones.

THE TRUTH: People have been moving out of our state institutions for decades, safely. We have downsized successfully - we did it gradually over decades.

Since the 1970s, we successfully shifted from serving 4,000 to 5,000 adults and children in institutional settings, to serving 65,000 in the community.

For people requiring residential care, our statewide system of Supported Living providers serves 4,500 adults. Hundreds of others live in adult family homes, companion homes, and assisted living facilities. Even more live with family members.

Challenges

Do we need to better invest and refine some community services? Absolutely.

There is a pilot program for Supported Living community residential that combines training in behavior support with additional pay that has resulted in safe placements for people with complex behavior.

Another program improved community connection for people living in adult family homes.

Families have championed community day respite for years – and plead for more access.

THE TRUTH: People speaking out against HB 1472 are not suggesting expanding on success. They are not talking about serving more people, or all folks better. Or addressing the issues that prevent people from fully accessing support.

They are saying people with IDD living in institutions cannot leave without jeopardizing their health. Once in, you can’t check out.

And that is a dangerous lie.

Today, people with IDD live longer, healthier lives BECAUSE they are able access care and services in their communities. All relevant research supports the fact that community settings result in improved quality of life in areas of integration, social participation, employment, choice-making and self-determination, quality and duration of services, contact with friends and relatives, and other indicators.

This bill does not require anyone to move into the community. And it doesn't shift large numbers into the other institutions, also called residential habilitation centers, or RHCs for short. Based on past consolidations and waiting lists of people who have already requested community care, DSHS expects half of the 120 or so to move to community settings and half to move to either Fircrest or Lakeland Village. 

Fundamentally, the question is: Do we still need four institutions?

From 1,900 residents to 71

At Rainier School, one of the sites that would close, enrollment declined from a peak of 1,900 in the late 1950s, to 318 in 2018, to 71 today.

Rainier opened in 1939 and operates something called an intermediate care facility for people with intellectual disabilities (ICF/ID). These are transitional programs where adults with cognitive disabilities that started in childhood go to receive “active treatment” in adaptive skill development.

Yakima Valley, the other site subject to closure, opened in the 1950s and began as an institution for children with intellectual disabilities. After public schools were required to serve children with IDD, Yakima converted to a nursing home. Today, about 30 adults with IDD live in an aging facility built to serve hundreds.

If HB 1472 passes, residents at Rainer and Yakima Valley retain the right of choice.

The 71 residents at Rainier will be able to choose a community residential option – such as Supported Living and related services – or transfer to an ICF/ID at either Fircrest or Lakeland Village.

The 30 residents at Yakima Valley can choose a community option, such as an adult family home or assisted living facility, or one of the IDD nursing facilities at Fircrest or Lakeland Village.

The overnight, short-term respite at Yakima would continue. Those services are available for up to 30 days for eligible DDA clients.

Transition support – and years of practice

People opposed to the bill have also suggested that folks would be left adrift – cut off from service or care. Or that the state lacked ability or structure to help with transitions.

THE TRUTH: When people with IDD transition to community services, they have extensive, individualized support from family mentors  who explain options, assist with decision-making, and ensure everything is in place before a move. Their work is personal, hands-on, and rooted in lived experience. You can read some of their success stories here.

Individuals moving have access to the PATH Program of peer mentors.

Roads to Community Living covers the first year of transition to the community, and involves careful, individualized planning and person-centered coordination to ensure success. That program has been around since 2007.

DSHS also has years of experience to draw from, including four times when dozens at a time needed support moving to new care facilities or community placements. The most recent was in 2022. The moves:

1994 - Interlake School in Medical Lake closed. It served 150 people with IDD who were considered medically fragile. All transitioned to community settings or another institution.

2002 - After the Olmstead decision affirmed the right to community services, the state budgeted to assist 80 people to transition out of institutions; 61 took up the offer and successfully moved out – including people with high support needs and complex behavior.

2011 - The Frances Haddon Morgan Center closed, prompting transitions for 52 residents. In the months before closure, 2 suspicious deaths were investigated at the facility. After leaving, one person died after drinking laundry detergent, but multiple investigations determined the move was not directly responsible. The state did a follow-up report a year later and found all other former residents were stable in their new settings. Some insights from that report:

• Anxiety resolved most quickly for those who chose Supported Living community residential.
• Challenging behaviors for most improved or stayed the same.
• Those who chose community settings were more likely to have friends, visit people they cared about, and have friends visit them.
• A year in, all families and guardians said they were confident the participant was safe in their new home.
• Numerous families “noticed their family members seem to be happier.”

2022 – Most recently, the state closed part of Rainier School after it was de-certified and federal funds were pulled. From 2022 to 2023, 57 residents transitioned out. Again, they were given the choice of a community placement or transfer to another institutional setting, and support during and after the transition.

This isn't to say transitions are easy. But we do have experience. In 2022, DSHS developed a process guide, quality framework, a heightened review protocol, and a transition stabilization protocol. During the transition, staff continued to be available to spend time in the new resident’s home after the move, and family mentors with lived experience continued to offer crucial resources to families and guardians of those leaving, including helping them understand the process and learn about community supports available.

Stability is a critical care component for many – whether they live and receive support in an institution or in a community setting. But we can mitigate, we can plan, and we can pace the transition.

Build the future

The Arc supports community. This is no secret. We are driven by the fundamental belief that everyone deserves to write their own life story. That means:

• Real access to education
• Meaningful employment
• Quality healthcare
• Genuine community connections

Some comments heard in hearings, executive sessions, and floor speeches disregard the tremendous work of thousands of people with IDD, their family members, and professionals to make community inclusive.

We DO have a network of community services, and we need legislators to learn about it, invest in it, and help us address and improve the gaps.

This quote from a 2003 state report stands out:

“At this point it is generally accepted that with very few exceptions, any person who lives in an RHC can live safely and well in the community, given the funding necessary to provide the supports needed.”

That same report found that the main barriers to phasing out institutions are NOT that people are too fragile to leave.

The barriers are:

• Lack of affordable and accessible housing for people with extremely low, fixed incomes
• Limited services available to people with challenging support needs or complex health

Those are solvable. Legislators have responded to the first, and we need them to engage - with urgency - on the second.

In the last two years they have put close to $50 million into IDD housing. In the next two-year capital budget, they are proposing up to $55 million for IDD housing. This can be used for new construction or renovation. 

For the second challenge, legislators need to stay focused, invest strategically, and keep the promise: Improve and expand community options so we can all thrive.

- Written by Ramona Hattendorf, Director of Public Policy and Civic Engagement at The Arc of King County

Isolation and retraint bills are a mixed bag

They don't end isolation. But they could help some children

A proposal to reduce isolation and restraint in Washington public schools that passed the House last year is being heard this week in both House and Senate committees.

It is a mixed bag. The Arc of King County supports the proposal overall, especially aspects that lift up effective, trauma informed practices and phase out isolation of our youngest learners. We are grateful to the bill sponsors and their dedication to ending these practices in our schools.

But we have concerns, and some of them are significant - namely a work-around that would allow isolation to continue as an aversive psychological or behavioral treatment in school.

OUR RECOMMENDATIONS

We want a bill that acknowledges the harm these practices cause to students and staff and reflects urgency in ending them. We want legislation that:

• Continues the demonstration sites and makes recommended training easy to access
• Phases out isolation at all schools, starting with grades preK-5, but continuing for older students
• Limits exemptions to ending isolation and makes the time frame shorter 
• Help schools collect and use data to inform staff training, improve student support and recovery, and guard against racial discrimination

Our analysis of the bill is below, followed by an outline of what the bill includes.

WHY WE OPPOSE ISOLATION

Isolation is harmful, causing suicidal ideation, trauma, and complex PTSD. It is often used with restraint to contain and then force children into isolation rooms. There is no evidence of educational, behavioral, or therapeutic value. Going back 15 years, the US Department of Education identified it as posing significant physical and psychological harm to children.

Isolation and restraint trigger cycles of escalating dysregulation, and are used disproportionately on students who are most vulnerable:

• Students in foster care
• Students who are homeless
• Students with disabilities who need effective support to resolve problems and support communication

Data also shows isolation and restraint are used disproportionately on students who are Black/African American.

Isolation and restraint are expensive. Insurance, worker compensation, and legal costs all go down, and staff retention improves, at sites that have ended the practices.

Isolation involves placing children who are in distress into spaces alone, from which they cannot leave. It prevents or delays co-regulation with a trusted adult.

We are not talking about quiet spaces where students can choose to go to de-stress/re-regulate, and from which they can freely leave.

We agree educators need strategies to work with children with big, complex behavior. But relying on isolation and restraint isn’t the fix. They make things worse.

We want the state to stop sanctioning practices that don’t work, are expensive, and are dangerous for children and staff. We want our public schools to pivot – with urgency – to preventive, trauma-informed practices that HELP. 

All schools should be safe and free from harm.

You can read the bills here:

• HB 1795 & SB 5654 - Addressing restraint or isolation of students in public schools and educational programs. Our outline of what is in the proposal follows our analysis, below.
  
  
• Disability Rights Washington also has a great webpage with links to various reports and resources. We recommend reading the report they completed 2 years ago that reviewed our state’s data and included information pulled from site visits and interviews.

OUR ANALYSIS

What we like about HB 1795 & SB 5654 (some with concern)

PHASE OUT FOR YOUNGEST & TECHNICAL SUPPORT: We like that the companion bills phase out isolation for young students, and that the demonstration sites will continue. Those were set up under the Reducing Restraint & Eliminating Isolation (RREI) Project, a win from last year.

We want to know when isolation will end for older students, as well.

CONTRAINDICATE: We like that isolation and restraint cannot be used when they harm a student because of a documented condition. Essentially, families could get a doctor’s note.

We appreciate that since 8 out of 10 times isolation and restraint are used on young, disabled children, this “out” for families could theoretically prevent many instances. If we can’t get a clean bill that prohibits isolation, giving families a way to opt out their children is a good thing.

But … we worry students who are not already identified as disabled or health-impaired would be exposed to harm, and families will be unnecessarily burdened. Getting a doctor’s note telling educators NOT to use a psychologically harmful practice on their child shouldn’t be on the kindergarten parent’s to-do list.

We would prefer a ban on isolation, just like we have a ban on corporal punishment.

PHASING OUT ISOLATION ROOMS: We want to see the padded cells removed from schools, and we appreciate that the bill attempts to address this. But as written, the bills allow schools to continue to build cells indefinitely “just in case” someone requests isolation as an aversive treatment. We want language that closes or repurposes all isolation rooms in public schools, by a given date.

OVERSIGHT: We appreciate the compliance and training in these bills. Schools are not given a simple pass to use these practices.

What we do NOT support:

ALLOWING ISOLATION ON REQUEST: We do not support allowing isolation to be used as an aversive intervention if a parent requests it. We appreciate the guardrails put on that (2 recommendations are needed), but we know parents are pressured to allow it as an aversive intervention. There is no evidence to support isolation as an educational, therapeutic, or behavioral intervention. There are effective, trauma-informed alternatives, backed by research.

EXTENDING EXEMPTIONS: In the bill, schools can continue to isolate young children for 6 years if they apply for an exemption. We can support time-limited exemptions IF it means schools are actively creating a plan, implementing crisis prevention strategies, and reducing isolation and restraint during that time.

We do not support extending exemptions beyond 2031. We prefer shorter exemptions of 2 to 3 years.

A note on the definition of isolation: This proposal changes the definition to add “involuntary separation.” When we talk about isolation, we often stress that it is involuntary to distinguish it from a student’s voluntary use of quiet space, from which they are free to leave. Some attorneys are concerned that schools could argue a student AGREED to enter a room from which they could not leave. They are asking that “involuntary” not be used in the legal definition. 

 

BILL OUTLINE

What HB 1795 and SB 5654 DO

Training & technical support

The bill extends demonstration projects, with the goal of eliminating student isolation and reducing student restraint (subject to funding)

• Adds sites in central or eastern WA (subject to funding)
• Requires sites to showcase certain practices, including:

o   behavior management

o   crisis de-escalation strategies

o   needs assessments

o   use of regulation spaces

o   reduced use of student isolation and restraint

o   inclusionary practices

o   incident data collection and reporting

• Sites must build systems that incorporate positive, trauma-informed behavior support to prevent crisis escalation
  
• Sites must improve data collection and reporting systems
• Requires a report to the legislature by November 15, 2026
  
  

Restrictions on restraint

Restraint done to prevent imminent harm – such as stopping a child from running into traffic – is still allowable. But some types of restraint would be banned, including:

• Chemical restraint by school staff

o   Chemical restraint is using medications to control behavior. Medications can only be given as prescribed

• Mechanical restraint by school staff

o   Mechanical restraint includes handcuffs and zip ties

• Physical restraint/escort that is life-threatening, restricts breathing, or restricts blood flow to the brain, including prone, supine, and wall restraint.

o   These types of restraint can be fatal.

• Physical restraint when it is harmful to the student’s health due to their disability, health care needs, or medical or psychiatric condition

o   Must be documented in a health plan; behavior intervention plan; IEP; or 504 plan

• Use of noxious sprays by school staff

 

Changes to isolation (also known as seclusion)

• The bill would prohibit isolation when it is harmful to the student’s health due to their disability, health care needs, or medical or psychiatric condition.

o   Must be documented in a health plan; behavior intervention plan; IEP; or 504 plan

• Parents or guardians may not consent, nor be asked to consent, to the use of isolation or restraint that is prohibited

•  Isolation can be used when requested by a student’s parent or guardian and authorized by 2 licensed health officials

This is a major area of concern. Research shows long-term harm, including suicidal ideation, trauma, and complex PTSD. There is no evidence that using isolation/seclusion is effective in reducing complex behaviors.

• Isolation of children in preschool and grades K-5 would be prohibited, starting in the 2027 school year, unless:

• The school had an exemption
• Parents gave written permission, and 2 qualified licensed health professionals recommended isolation and provided instructions to staff on when to isolate

This is a major area of concern. Research shows long-term harm, including suicidal ideation, trauma, and complex PTSD. There is no evidence that using isolation/seclusion is effective in reducing complex behaviors.

 Isolation would be allowable when:

• Less restrictive interventions would be ineffective in stopping the imminent likelihood of serious harm to the student or to others
  
  
• The least amount of force necessary is used to protect the student or another person from an imminent likelihood of serious harm to the student or to others
  
  
• During the isolation, the student is under the constant visual supervision of the staff
  
  
• The isolation of the student ends immediately upon the cessation of the imminent
  likelihood of serious harm to the student or to others; and
  
  
• Beginning August 1, 2030, the staff isolating the student has received intensive crisis prevention and response training through an OSPI-approved program.

  Isolation for older students would not be phased out.

Continuing to allow isolation for older students is a major area of concern. Research shows long-term harm, including suicidal ideation, trauma, and complex PTSD. Data shows it is used disproportionately on youth in the foster care system; homeless youth; and Black/African American youth.

 

School exemptions

Schools that get an exemption can continue isolating young students. However, they must:

• Engage in technical assistance
• Provide training for staff
• Request exemption by August 1, 2027

Exemptions expire on July 31, 2031, unless they are extended by OSPI. Extensions are granted until staff have received student behavior management and intensive crisis prevention and response training as described in the staff training plan.

Extending exemptions is a major concern. By 2031, schools will have had 6 years to create a plan and train key staff. We must consider the harm children are exposed to by allowing these practices to continue.

 

Follow-up procedures

• Staff must notify the principal “as soon as practicable”
• Principal must notify parents within 24 hours
• Written documentation must be sent to parents within 3 business days

If an incident of prohibited restraint or isolation occurred:

• The principal must notify the school district superintendent or chief administrator of the education provider
• Notify OSPI within 3 business days
• If services are being provided under contract, the party to the contract must be notified within 3 days

Behavior intervention plans (BIP)

• As soon as practical, a functional behavior assessment must be done for the student, if one has not already been done
• BIPs must be developed or modified

Incident reviews

• The principal must review the incident with the student and parents and inform them of BIP requirements within 1 week of submitting the incident report
• The student must be given an opportunity to meet with a counselor, nurse, psychologist, or social worker.
• The staff team must review the incident and identify needed training, coaching, or assistance for staff who used, or directed the use of, isolation, restraint, or room clear
• No less than monthly, the principal must submit a summary of the outcomes of team incident reviews to the district superintendent

Incident reports

• The principal must work with staff to prepare a daily incident report.
• At least annually, a summary of incident reports must be prepared that is disaggregated to look for trends. Summaries must be submitted to OSPI

Policies and procedures

• Policies must be revised with input from specified groups

• If district policy allows isolation of children in grades 6 to 12, policies and procedures must be submitted to OSPI annually

• School boards must monitor the impact of policies, do trend analysis, and review the staff training plan

Training:

• School board must undergo training every 4 years (developed by OSPI and available to school districts at no cost)
  
• By Oct. 1, 2026, OSPI must develop a model training plan that covers student behavior management and OSPI-approved intensive crisis prevention and response
• Educator preparation programs must include student behavior management

 

Compliance and technical assistance

OSPI must monitor and support compliance of school districts and education providers

Technical assistance must include:

• Publishing guidance on best practice
• Publishing a list of approved intensive crisis prevention and response training programs that are evidence-based, trauma-informed, student-centered, and proactive.
• If funded, OSPI must distribute funds to educational service districts for regional coaches

School districts must make progress toward goals, or they may be put on a plan of improvement that includes targeted technical assistance and site visits

By Dec. 2025, OSPI, PESB and Paraeducator Board must submit to the legislature a joint plan for integrating into educator preparation programs and paraeducator standards of practice the elements of student behavior management.

Beginning December 2025, OSPI must add to its annual report on placements of students with disabilities at authorized entities: (1) the number of students with disabilities in authorized entities within the state and outside the state; and (2) an analysis of whether placement decisions are influenced by requirements related to student isolation and restraint.

By September 1, 2026, the OSPI must submit to the Legislature the report of a research entity contracted to analyze the impacts of room clears on students and to summarize best practices on the use of room clears.