DDA No Paid Services Washington — How to Get Off the NPS Caseload

The Scale of the Problem

As of December 2024, Washington's Developmental Disabilities Administration reported 20,231 eligible clients receiving no paid DDA services — roughly 29% of all DDA-enrolled individuals. These are people who passed the eligibility screening, received a DDA case number, and then... nothing. No DDA-funded personal care hours. No DDA-funded respite. No DDA-funded employment supports. No waiver funding.

The remaining 71% are on "paid services" — actively receiving funding through an HCBS waiver or the Community First Choice entitlement. The gap between these two groups isn't a waitlist in the traditional sense. It's a system design issue.

Why Families End Up on the NPS Caseload

The most common reason is deceptively simple: the family never formally requested a specific funded service. DDA eligibility opens a file and assigns a Case Resource Manager (CRM), but it does not automatically trigger a service authorization. Many families assume that becoming eligible means they're "in the system" and that services will come to them. They don't.

Other common reasons:

• Waiver slot caps: HCBS waivers have legislatively capped enrollment. When all slots are filled, new requests go on a request list. The Basic Plus waiver has 13,400 slots statewide — the largest — but demand exceeds capacity.
• Incomplete CARE assessments: without a completed functional assessment, DDA can't authorize services. If the family doesn't respond to assessment scheduling, the case stalls.
• SB 5394 limitations: enacted in 2025, this legislation authorized DDA to provide limited case resource management to NPS clients, but prohibited case management for "inactive" clients who don't engage with the agency. If you don't reach out, DDA won't reach out to you.

How to Move Off the List

Step 1: Contact Your Case Resource Manager

Call or email your assigned CRM directly. If you don't know who your CRM is, contact your regional DDA office. Make the request explicit: "I am requesting paid services for [client name]. Please schedule a CARE functional assessment and add us to the waiver request list."

Put it in writing. An email or a submitted Service and Information Request form creates a dated record that you made the request.

Step 2: Request a CARE Assessment

The CARE assessment is the gateway to funded services. Without it, DDA has no documented basis to authorize hours or waiver enrollment. Request the assessment even if you think your child's needs are modest — the assessment may reveal eligibility for services you didn't know existed.

Step 3: Ask About Community First Choice

Community First Choice (CFC) is the fastest path off the NPS caseload. Unlike the HCBS waivers, CFC is a Medicaid State Plan entitlement — meaning there's no waitlist and no slot cap. If your child has Apple Health coverage and meets the functional criteria for an institutional level of care (as determined by the CARE assessment), they're entitled to CFC services by federal law.

CFC provides personal care assistance (help with bathing, dressing, eating), assistive technology, personal emergency response systems, and transition services. It won't cover everything a waiver does — no residential services or supported employment through CFC — but it does not require a waiver slot.

Step 4: Request Waiver Enrollment

Simultaneously, ask to be placed on the request list for the appropriate HCBS waiver:

• Individual and Family Services (IFS): for individuals living with family, capped annual allocation ($1,560–$4,680/year)
• Basic Plus: broader services for individuals in family homes, up to $6,192 annually plus emergency funding
• Core: comprehensive 24/7 residential and support services for individuals at risk of institutional placement

If a waiver slot isn't available, ask DDA how the request list is handled and keep your service request current while you wait.

What Your CRM Can and Cannot Do

Your Case Resource Manager can help you identify community resources, connect with service providers, navigate the waiver request process, and schedule assessments. They cannot override waiver slot caps, guarantee a specific timeline, or authorize services without a completed CARE assessment.

Under SB 5394's restrictions, your CRM is only required to provide case resource management if you're actively engaged. Responding to calls, attending scheduled meetings, and following through on documentation requests keeps your case active.

Our Washington SSI at 18 & Adult Disability Benefits Guide includes the full NPS-to-funded-services strategy — from the initial service request through CARE assessment preparation and waiver request submission — mapped to the age-18 transition timeline.

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