By 2003, Washington State’s developmental disabilities system was experiencing growing demand for community-based supports. The state’s Family Support Program waitlist had grown substantially. The families on the waitlist represented individuals who were eligible for services such as respite care and family stabilization supports but were unable to access funded assistance due to limited state resources. This growth reflected a major system shift, as increasing numbers of people with developmental disabilities were living at home and in community settings rather than in institutions.

Following the U.S. Supreme Court’s 1999 Olmstead v. L.C. decision affirming the right to services in integrated community settings, Washington continued expanding community living opportunities throughout the early 2000s. However, funding did not keep pace with eligibility and demand. The need to formally recognize and track individuals who were eligible but not receiving paid services eventually led to the development of what is now known as the No Paid Services (NPS) caseload. The 2003 Family Support waitlist represents an important early indicator of the growing gap between eligibility and funded services in Washington’s modern service system.