New supports are coming beginning July 2023 for individuals in your setting with complex behavioral health needs.

Get additional information from the Health Care Authority (HCA) by signing up for notifications.

Currently, many individuals are provided additional support through exceptional rates paid by the MCOs but authorized through the Aging and Long-Term Support Administration (ALTSA). Changes are coming that will shift the payment for these additional support services to be paid directly by the Managed Care Organizations (MCOs) and HCA.

About CBHS services

Legislation directed HCA, in partnership with ALTSA, to create an Apple Health (Medicaid) benefit. The benefit in intended to better support providers in assisting individuals with complex behavioral health needs in long-term care settings. In response, HCA has submitted a 1915(i) State Plan Home and Community-Based Services application to Centers for Medicare and Medicaid Services (CMS). Services will begin on July 1, 2023 and be phased in over time.

The new benefit is called Community Behavioral Health Support (CBHS) Services and includes two services: 1) Supportive Supervision and Oversight, and 2) Skills Development and Restoration.

Supportive supervision and oversight

This service is provided in the residential setting that the client is residing in, such as an Adult Family Home, Assisted Living Facility or Enhanced Services Facility.

• This service provides additional staffing support to help the resident retain and/or improve community living, including direct monitoring, redirection, diversion, and cueing of the resident to prevent at risk behavior.
• This service will be paid based on a per diem rate and tiered according to acuity of the resident.
• These interventions are not related to the provision of personal care. These services will be provided concurrently with personal care.

Skills development and restoration

This service is provided by local behavioral health agencies to help clients living in a long-term care setting:

• Learn or restore life skills to gain independence.
• Build or maintain natural supports and independent living skills.
• Learn to engage with local resources, such as how to arrange or take transportation.

What this means for you

• If you provide exceptional care in your facility that is funded by an MCO, the process for ongoing payment of this care is changing, beginning in July 2023. You will need to contract directly with MCOs and/or HCA to provide these services. HCA and the MCOs will be available to help with this.
• You will continue to contract with DSHS/ALTSA for the personal care services and rate.
• If you are not currently receiving funding for care from the MCO, you may also be interested in contracting with MCO or HCA to provide this new service.

What’s next

Sign up for GovDelivery notifications to receive Community Behavioral Health Support (CBHS)-Supportive Supervision updates.

HCA in partnership with the MCOs will be hosting meetings and trainings to provide more information about the services and requirements. These dates will be forthcoming and shared through GovDelivery. 

Contact Email: hca1915iservices@hca.wa.gov

Questions?

Contact:

Laura Hofmann, MSN, RN – Director of Clinical and Nursing Facility Regulatory Services
c: 425-231-4804