PO Box 40124
Olympia, WA 98504-0124
The Social and Health Olympia Division (SHO) is comprised of 44 attorneys and 33 professional staff. The largest client agency of the division is the Department of Social and Health Services (DSHS). DSHS administers a variety of federally- and state-funded programs to protect the general public and assist those who are unable to provide for themselves. Programs include income assistance, children’s services, child support, behavioral health and recovery services, developmental disabilities, juvenile rehabilitation, alcohol and drug rehabilitation, vocational rehabilitation, nursing home regulation, adult protective services, home and community care services, and other related social service programs. Legal services provided to these programs include client advice as well as representation of the programs in legal challenges.
Another major client agency of the division is the Health Care Authority (HCA). The Washington State Health Care Authority has a key role in health care purchasing and the delivery of health care services in Washington state. The HCA oversees nine health care programs, the largest of which is Medicaid. The Medicaid program covers approximately 1.2 million low income Washington residents including two out of every five kids and just over 50% of all births in the state . In addition, the HCA administers employee benefits for more than 330,000 state employees, retirees and dependents. The agency coordinates and implements state-wide health care policy initiatives designed to improve health care quality, access and affordability. The agency is implementing chronic care management, medical homes, and other care coordination strategies as well as evidence-based purchasing for all state agencies through its Health Technology Assessment and Prescription Drug programs.
In addition to representing DSHS and HCA, the Social and Health Olympia Division also provides legal support to two other small state agencies: the Department of Veterans Affairs and Department of Services for the Blind.
Major DSHS Program Areas
- Children’s Services: The division provides headquarters legal support to the DSHS Children’s Administration, including legal advice to administrators and managers and representation in major legal challenges. The division also provides representation in child abuse and neglect cases in Thurston, Lewis and Mason counties.
- Economic Services: The Economic Services Administration (ESA) administers public assistance programs, including Temporary Assistance to Needy Families (TANF), food benefits, Disability Lifeline Program (general assistance), telephone assistance, and refugee assistance. The division handles litigation ranging from individual appeals of reductions to or denials of benefits to class action lawsuits challenging program implementation. Other significant issues include the development of agreements with Indian tribes for the delivery of TANF and WorkFirst services on the reservations, confidentiality of client records, electronic application for and delivery of public assistance benefits, and ongoing advice on legislation and administrative regulations on both the state and federal levels. ESA also administers the child support program, though county prosecutors generally handle litigation relating to individual child support orders.
- Medical Assistance: DSHS is responsible for administering federal and state programs that provide medical services to low-income individuals. Legal services related to medical assistance programs include client advice and representation before federal and state tribunals on issues concerning compliance with the federal Medicaid laws, payment rates paid to hospitals and other medical providers, scope of medical services provided, contract disputes with medical providers (including contractual agreements with managed care plans), and Medicaid eligibility issues.
- Aging Services: The DSHS Aging and Disability Services Administration administers programs that provide services to elderly and vulnerable adults in the state, including residential care services (nursing homes, adult family homes, boarding homes, and the resident protection program); home and community long-term care services (Medicaid Personal Care, COPES, Chore, and Adult Protective Services); developmental disability services (as further described below); and management services. Attorneys provide legal advice on the interpretation of state and federal Medicaid laws that govern DSHS programs and represent the agency in litigation, including provider appeals of licensing actions, challenges to reimbursement rates paid to providers, and challenges to the availability and scope of services provided to recipients.
- Developmental Disabilities: DSHS operates five residential habilitation centers for the developmentally disabled and contracts with counties and private providers for home and community-based residential and day programs. The Social and Health Olympia Division provides advice on such issues as eligibility for services, federal reimbursement, program certification, contracts, civil rights and right to treatment issues, public disclosure, and adoption of administrative rules and policies. Litigation issues include eligibility and access to services, access to clients and client records by the Washington Protection and Advocacy System, standards of care in institutions and state mental hospitals, right to community placement under the Americans with Disabilities Act (ADA), and medical decision making.
- Behavioral Health and Recovery: DSHS operates the two state mental hospitals and the Child Study and Treatment Center. It also contracts with Regional Support Networks to provide Medicaid and state-funded community mental health services. This division provides legal advice to the state hospitals on issues ranging from patient health care and confidentiality to contracts for educational services for minor patients at the children’s facility to questions concerning the forensic services unit. It provides advice to DSHS on such issues as Medicaid and Medicare financing, licensing, and contracts with the Regional Support Networks, as well as issues related to DSHS’ substance abuse programs, including certification of treatment programs. This division also represents the hospitals in all civil commitment hearings and jury trials, as well as in civil rights litigation concerning patients’ rights to various types of treatment and services. Attorneys also represent DSHS in litigation concerning disbursement of Medicaid funds and reimbursement of community mental health providers.
- Special Commitment Center: The Special Commitment Center (SCC) houses the DSHS program for the involuntary treatment of sexually violent predators. Litigation often involves civil rights challenges by program residents against all aspects of the program. This division also defends individual SCC and DSHS employees in civil rights or torts actions brought in federal court by residents of the SCC.
- Juvenile Rehabilitation: The Juvenile Rehabilitation Administration (JRA) provides for the care, custody, rehabilitation, and community supervision of court-committed juvenile offenders. JRA operates six institutions, one basic training camp and seven state-operated group homes. It also contracts out for additional community residential placements. The division provides legal advice to JRA on a variety of issues, including terms and conditions of confinement, right to treatment, conditions of parole, public disclosure, and community protection requirements.
- Vocational Rehabilitation: The Division of Vocational Rehabilitation (DVR) assists people with disabilities to gain, maintain, and advance in employment. Specifically, DVR provides individualized employment services and counseling to people with disabilities, and technical assistance and training to employers about the employment of people with disabilities. The division provides legal advice on a variety of issues, and occasionally represents DVR in some of the complex administrative hearings.
- Office of Deaf and Hard of Hearing Services: This DSHS program provides telecommunications access to individuals who are hearing or speech impaired. It provides telecommunications equipment to eligible persons and contracts out for a telecommunications relay service that provides telephone access to the hearing impaired. This division advises on issues such as eligibility, contract formulation and administration and interpretation of statutes and regulations.
- Office of Financial Recovery: The Office of Financial Recovery (OFR) is responsible for collecting money that is owed to various DSHS programs such as the Medicaid Drug Rebate Program, Medical Assistance Long-term Care Services, Western and Eastern State Hospitals, and Working Child Care Connections. The division advises and represents OFR on judicial review of administrative decisions, enforcement of creditor’s claims in probate, termination of special needs trusts, other types of enforcement actions, and foreclosures.
Other Client Agencies
- Department of Veterans Affairs: The Department of Veterans Affairs (DVA) provides residential, financial and advocacy services to qualified veterans who are state residents and to veterans’ families and survivors. The division advises DVA on a number of matters including eligibility for services, rights of veterans, veterans’ home policies and regulations, nature and scope of DVA’s fiduciary authority, and federal Medicaid requirements for nursing facilities.
- Department of Services for the Blind: The Department of Services for the Blind provides a range of services to visually impaired individuals to assist them in establishing or maintaining their productivity, employability and independence. The division provides advice on such issues as eligibility for services, interpretation of applicable statutes and regulations and various other matters.