Editorial: Limit redundant reviews of those providing care

Published 1:30 am Thursday, February 5, 2026

By The Herald Editorial Board

With the word out that state lawmakers again faced a budget gap this year, groups that make regular — and not unreasonable — requests for funding already knew they would need to lower their expectations.

That’s a concern for groups that provide vital services throughout the state and are dependent on state funding.

Among those serving the state’s most vulnerable are supported living services providers who care for about 4,700 state residents living with significant intellectual and developmental disabilities, clients who are dependent on the care of about 14,000 trained support professionals. Providers of these services include group homes that offer instruction and support in a residential facility of five to 12 adults; supported living services that work with clients in their own homes with up to three roommates; and licensed voluntary placement homes for children.

Supported by a combination of state and federal Medicaid funding, nonprofit service providers last year sought and won a reasonable 2 percent increase in their Medicaid reimbursement rate, necessary to fairly pay, attract and retain employees engaged in demanding work.

This year, service providers went to Olympia with a hand extended, not seeking more funding but instead offering some suggestions to improve efficiency and allow them to use their time more wisely, particularly in client care, said Scott Livengood, chief executive for Alpha Supported Living, a Bothell-based nonprofit that also provides supportive living services for adults and children in Snohomish, King and Spokane counties.

Those service industries, in the interest of providing quality care to vulnerable residents, are required to submit to reviews and audits regarding client finances, the provider’s financial stability, individual service plans, federal compliance requirements, clients’ integration with the community and general quality assurance.

Some of what Livengood and others have seen over the years are an increase in investigations and quality assurance visits as well as an increase in the number of personnel within the Department of Social and Health Services.

Service providers, Livengood said, have seen the number of various audits, reviews, inspections and evaluations increase to as many as 25 within a year, often with a duplication of information requested and overlapping areas of focus, with some site visits lasting up to a week or longer and requiring significant time from providers’ administrative and care staffs as well as interviews of clients.

“Often they are looking for the exact same information that may have been reviewed a few months or even a few weeks ago,” Livengood said during a House early learning and human services committee hearing earlier this month.

Often several departments within DSHS are seeking the same information or certification requested by another.

Livengood, in an interview prior to the start of the legislative session, said he was required to submit to background checks for a children’s program one week, another program a week later and then an adult program in Spokane, each check performed repeatedly by the State Patrol.

And, no, he couldn’t ask each to just check with the State Patrol.

“One world think,” he said. “I even said, ‘I have the tracking number I was supplied a week ago,’ but each had to be separate from the other.”

Along with the cost to the state of $40 to $50 for each background check, that’s a process that demands staff time from the State Patrol and has contributed to a backlog of requests for background checks, said Randy Hauck, executive director of Community Living, which also provides care to those with developmental disabilities and their families throughout the state.

“We’re waiting for other background checks to be expedited because we have staff that need to go out and start working in homes, but the backlog just puts us further behind,” Hauck said.

The concern is the same for other reviews, beyond the background checks, he said.

“Those require hours and hours of our time working with them to pull that information, sort it out, talk about that information, look for any issues that they might have for this concern,” he said. “In some cases, it can take upward of a week or more of dedicated staff time to work with the agency. So it takes a lot of time on that end, and they still have the duties that they need to do on top of that, so often it causes overtime that we’re not reimbursed for.”

Wash, rinse, repeat. Twenty-five times.

Helpfully, two bills with bipartisan support are now moving through each chamber, seeking to cut some of that red tape and aggravation.

Senate Bill 6024 would direct the state’s Department of Social and Health Services to limit investigations of community residential service providers to an annual review, with some exceptions, and consolidate other reviews on a range of subject areas.

House Bill 2230, along with the provisions in the Senate bill, goes further and would require DSHS to adopt rules and policies regarding record sharing among agency divisions for monitoring and oversight of residential and supported living services providers. The House bill also makes an exception for reviews by Adult Protective Services, exempting that agency from limiting its review activity.

“In these times of extreme budget challenges, we need to be as efficient as possible while providing the oversight and the reporting that are absolutely essential,” said Rep. Janice Zahn, D-Bellevue, the House bill’s sponsor. The key, Zahn said, during testimony for a hearing on the bill, is in providing necessary oversight but doing it efficiently through better communication among those agencies and department offices responsible for reviews.

“They’re all doing really important jobs within their departments, but not necessarily coordinating with each other,” Zahn said.

In a year when lawmakers can’t offer much on the funding side, they appear supportive of the legislation, said Melissa Johnson, a lobbyist working with the supported living providers.

“They are looking for things like this bill to help streamline that regulatory process,” she said. “And they see it as something valuable to do for the supported living industry and our staff and our clients when they can’t help us financially.”

Certainly, state agencies and their departments should take seriously their mandate to provide necessary oversight, especially of vulnerable adults and children. But those same offices, as part of that mandate, should be open to opportunities to reduce the workload on the providers they oversee as well as that of their own employees.

Just as certain, there must be far more opportunities throughout all state agencies to reduce such duplication of work and requirements.

It’s the cliched advice of many bosses, but state agencies don’t need to work harder, just smarter.