How are state DD-specific services funded?

Medicaid is the top funding source 

A participant in Wings for Autism


Medicaid is the single largest funding source for both acute health care and long-term supports and services for people with developmental disabilities. Most of our state funds for developmental disability services are matched by federal Medicaid funding.

Services include:

Home and Community Based Services (HCBS) waivers

These services are based on habilitation - that is, services to help you keep, learn, or improve skills and functioning for daily living. and support to build and maintain abilities that lead to independence.

Waiver services may include assistive technology, skilled nursing, employment support, physical or behavior therapies, or respite for family caregivers. The “waiver” means services are provided in the community instead of an institution, such as a Residential Habilitation Center.


Residential Habilitation Centers (RHCs)

Washington has four state-run, residential institutions that provide habilitation and health-care services. While decades ago they served thousands, today they serve 700 to 800 adults.

Community First Choice

This Medicaid program was created in the Affordable Care Act. It funds services to assist with activities of daily living, such as skills acquisition, personal care, or community transition services.

Other services specific to people with developmental disabilities include case management and early intervention services for children birth to age 3. Residential options, included in the Core waiver, include Supported Living and group homes. Some of these services are provided by counties, such as birth to 3 interventions; behavior supports; school-to-work and employment support; community access and outreach, and crisis respite.

Non-DD specific services

Individuals with developmental disabilities also rely on the foundation of education, health and social services all communities rely on:

  • Early learning, K-12 and post-secondary schools
  • Parks and recreation
  • Financial and economic services
  • Juvenile justice and rehabilitation
  • Aging and long-term support
  • Foster care
  • Behavioral health
  • Housing stability
  • Public transit 
How well programs integrate ꟷ and how accessible they are to people with cognitive and adaptive differences ꟷ affects the success of DD services. For instance, K-12’s role in setting expectations forlearning, or housing’s role in stable living situations.
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