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(15) Appropriations provided in this section are sufficient to 1 continue community alternative placement beds that prioritize the 2 transition of clients who are ready for discharge from the state 3 psychiatric hospitals, but who have additional long-term care or 4 developmental disability needs. 5 (a) Community alternative placement beds include enhanced service 6 facility beds, adult family home beds, skilled nursing facility beds, 7 shared supportive housing beds, state operated living alternative 8 beds, assisted living facility beds, adult residential care beds, and 9 specialized dementia beds. 10 (b) Each client must receive an individualized assessment prior 11 to leaving one of the state psychiatric hospitals. The individualized 12 assessment must identify and authorize personal care, nursing care, 13 behavioral health stabilization, physical therapy, or other necessary 14 services to meet the unique needs of each client. It is the 15 expectation that, in most cases, staffing ratios in all community 16 alternative placement options described in (a) of this subsection 17 will need to increase to meet the needs of clients leaving the state 18 psychiatric hospitals. If specialized training is necessary to meet 19 the needs of a client before he or she enters a community placement, 20 then the person centered service plan must also identify and 21 authorize this training. 22 (c) When reviewing placement options, the department must 23 consider the safety of other residents, as well as the safety of 24 staff, in a facility. An initial evaluation of each placement, 25 including any documented safety concerns, must occur within thirty 26 days of a client leaving one of the state psychiatric hospitals and 27 entering one of the community placement options described in (a) of 28 this subsection. At a minimum, the department must perform two 29 additional evaluations of each placement during the first year that a 30 client has lived in the facility. 31 (d) In developing bed capacity, the department shall consider the 32 complex needs of individuals waiting for discharge from the state 33 psychiatric hospitals. 34 (16) No later than December 31, 2021, the department of social 35 and health services and the health care authority shall submit a 36 waiver request to the federal department of health and human services 37 to authorize presumptive medicaid eligibility determinations for 38 clients preparing for acute care hospital discharge who may need 39 long-term services and supports. The department and the authority 40 p. 923 ESSB 5187.SL