New Page 1

Is the downsizing at Fircrest being done without the authority of the Legislature?

Last year the Legislature determined in the 03-05 budget that resources for DD populations could be more effectively used by downsizing Fircrest and moving residents with developmental disabilities to another institution with significant vacancies or into a community or nursing home setting of their choice. The Legislature clearly directs the Department of Social and Health Services to downsize Fircrest. This budget was passed by both chambers of the state Legislature and signed by the Governor.

When will the first individuals be moved from Fircrest?

Twelve residents have already been moved. Ten have chosen to move to Rainier School. One has chosen to live in the community and one has chosen Lakeland Village.

Will the individuals at Fircrest one day be forced to pack their bags and move?

After the Division of Developmental Disabilities (DDD) has thoroughly examined the needs and desires of each individual and his/her family member or guardian, the moves will occur. These individual assessment plans determine what services and supports the individual will need in his/her new home. Once the assessment plan is complete, the individual, his/her guardian and a case manager with DDD will visit each new home option and give the individual an opportunity to provide feedback. Ultimately, where the individual moves is his or her choice and that of his or her guardian.

Will Fircrest residents be forced to move into the community?

No. Individuals and/or guardians are able to choose whether to move to vacancies at another institution, such as Rainier School in Buckley or Lakeland Village near Spokane; or choose to move into a community or nursing home setting depending on the individual’s needs and wants.

Isn’t it true that many people who move from an institution into the community die shortly after moving?

No. In fact, statistics show a substantially lower death rate for people with developmental disabilities living in community settings compared to those in institutions.

Deaths per 1,000 people 2001 2002

People w/ DD in community 5.84 6.03

General population 7.99 7.90

People w/ DD in institutions 12.00 23.00

How will we know if people who move to the community are safe?

This should be the most important consideration of everyone. In fact, there has been close monitoring of the experiences of people who move from an institution into a community program. This has been done both by state government and both public and private protection and advocacy organizations. These monitoring efforts have found that people with disabilities were receiving needed services and living in safe conditions in the community. Importantly, both clients and the families were satisfied with the community programs accessible to the individual and happy with the results of the move.

If Fircrest residents move, are they at risk of losing their funding?

How people receive funding for services in institutions and community settings differ. People currently living at Fircrest receive funding under a federal-state funding arrangement that pays for care in the institution. If the individual chooses to move to another DD institution the same funding source will be used. If the individual chooses to move to a community setting, a different funding source call the Home and Community Based Waiver would be used. The programs under this waiver are governed by federal law and require the state to provide all of the services the client needs as identified in the individual assessment plan.

Why make these vulnerable people move from the only home they’ve known?

Downsizing is really a matter of making limited resources go farther. More than 32,000 individuals with developmental disabilities qualify for services in Washington, yet ¼ of families of individuals in communities are on waiting lists for basic services. Resources for people with developmental disabilities are disproportionately and inefficiently being used in institutions that continue to see decreasing populations and significant vacancies. By downsizing Fircrest, individuals will be able to get the same care at another institution or move to a community home nearby. This in turn could help the state more effectively use resources.

How is an individual who has lived his or her whole life in an institution expected to adapt to community life?

It is important to remember that people must make a choice to be moved to the community. If clients and their families make this choice, the state has more than a 30-year history of assisting people in successfully making this transition. A relatively new program is making further improvements in this process. The Developmental Disabilities Council in 2002 began funding a program that offers people who move an opportunity to connect with a mentor. Under this project, the mentors are fellow self-advocates (people with developmental disabilities themselves) who befriend the mover and help “show the ropes” of living in a local community.

Isn’t the state blocking admission to Fircrest and that’s the real reason for declining populations?

Over the past nine months a stop placement at Fircrest has been in effect because the institution has not met federal health and safety standards as required. Today, people with developmental disabilities are thriving and living productive, full lives in the community. In the 70s more than 4,000 people lived in the state’s five DD institutions; now only 1,000 people remain in an institution, including 250 people at Fircrest. Under a federal law called “Olmstead” the state is required to allow individuals to live in the least restrictive setting. Under Olmstead in 2001 through 2003, 62 people have left the institutions and are living productive, rewarding lives in their local communities.

Has a downsizing of this nature ever happened before in Washington state?

Yes. During the mid 90s, the state closed Interlake School in Eastern Washington. 95 of the 118 Interlake residents moved to another state institution. 23 of the residents chose to move into the community successfully. Ten other states have chosen to close all of their state-operated DD institutions.

Currently, several specialized health care professionals provide care at Fircrest. Will their expertise be lost and how will that affect people who need this specialty care?

The Legislature directed the Department of Social and Health Services to address the issue of deployment of these specialized services. We do not currently know what will happen to the services provided at Fircrest, but our hope is that these services will be more readily available to all people with developmental disabilities who need them. People with developmental disabilities live everywhere in the state. Access to medical and health care is hard to find, especially in rural areas. Because the DD system is managed regionally, it makes sense that these resources be connected to the 6 DD regions so they will be available closer to home for all Washingtonians with developmental disabilities.

What else could be done to ensure specialty health care currently at Fircrest is maintained?

The state could create a toll-free medical consultation line so that local doctors, pharmacists, nurses and others who are providing care for people with developmental disabilities can ask questions of experts who provide this specialty care on a regular basis.