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Feds threaten to pull $1 million a month from Rainier School

This is the first time Medicaid officials are planning to withhold funding to provide services for current residents as well as new admissions at the school for people with developmental disabilities.
The Rainier School in Buckley is one of four institutions in the state for people with developmental disabilities.

Federal officials have notified the state Department of Social and Health Services that the Rainier School in Buckley, one of four institutions for people with developmental disabilities in the state, is grossly out of compliance.

An April 12 inspection found 23 violations of federal regulations in a portion of the facility that houses 85 residents.

Violations noted included failure to keep clients safe and failure to report allegations of abuse and neglect. The same area of Rainer was found out of compliance following an inspection in 2017. At that time inspectors found violations stemming from staff not having a proper medical plan for a client who died after a simple surgery for a bunion.

“During this survey, an IJ 'Immediate Jeopardy' (status) was identified… when the facility failed to have a system in place to ensure appropriate follow up medical care… putting clients at risk of harm and may have potentially contributed to client death,” wrote the investigators.

If this section of Rainier is decertified, the state would lose $1 million a month in federal funding. That financial hit would be devastating and would most likely lead to the state shutting down that portion of Rainier.

“We will appeal the decertification,” wrote Don Clintsman, a DSHS Deputy Assistant Secretary in a letter to lawmakers dated April 24. “(But) our current thinking is to pursue the approach that will increase community residential options that allow residents to transition of out of (that section of Rainier).

The state has a history of failing federal inspections at its institutions. In those instances, federal money has been withheld for new admissions until the facilities come into compliance. This is the first time Medicaid officials are planning to withhold funding to provide services for current residents as well as new admissions.

In a 2016 KING 5 investigation, Last of the Institutions, reporters found Washington is an outlier in the country in operating four large institutions for people with disabilities such as Down syndrome, autism, and cerebral palsy. Many other states, including Oregon, Idaho and California have closed their institutions altogether or have plans to do so.

Civil rights advocates, including the Department of Justice, have concluded institutionalization is a form of discrimination and is a violation of the residents’ civil rights. For decades, advocates have lobbied the legislature to stop funding the large facilities and instead invest in housing in regular neighborhoods where those with even the most severe disabilities could be served with proper supports.

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