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(A) Beginning with the governor's budget proposal submitted in 1 December 2022, submit a budget request for expenditures associated 2 with anticipated demand for services under the individual and family 3 services waiver, the basic plus waiver, and the number of individuals 4 who are expected to reside in state-operated living alternatives for 5 consideration by the governor and the legislature for inclusion in 6 maintenance level budgets; 7 (B) Examine the need for community respite beds to serve eligible 8 individuals and stabilization, assessment, and intervention beds to 9 provide crisis stabilization services for individuals with complex 10 behavioral needs. A preliminary report must be submitted no later 11 than October 1, 2022, with a final report submitted no later than 12 October 1, 2023, to the governor and the appropriate committees of 13 the legislature that estimates the number of beds needed in fiscal 14 years 2023 through 2025, recommends geographic locations of these 15 beds, provides options for contracting with community providers for 16 these beds, provides options for utilizing existing intermediate care 17 facilities to meet these needs, and recommends whether or not an 18 increase to respite hours is needed; 19 (C) Contract with a private vendor for a study of medicaid rates 20 for contracted community residential service providers. The study 21 must be submitted to the governor and the appropriate committees of 22 the legislature no later than December 1, 2023, and must include: 23 (I) A recommendation of rates needed for facilities to cover 24 their costs and adequately recruit, train, and retain direct care 25 professionals; 26 (II) Recommendations for an enhanced rate structure, including 27 when and for whom this rate structure would be appropriate; and 28 (III) An assessment of options for an alternative, opt-in rate 29 structure for contracted supported living providers who voluntarily 30 serve individuals with complex behaviors, complete additional 31 training, and submit to additional monitoring; 32 (D) Submit by October 1, 2022, a five-year plan to phase-in the 33 appropriate level of funding and staffing to achieve case management 34 ratios of one case manager to no more than 35 clients. The five-year 35 plan must include: 36 (I) An analysis of current procedures to hire and train new staff 37 within the developmental disabilities administration of the 38 department of social and health services; 39 p. 909 ESSB 5187.SL