Legislation directed the Health Care Authority (HCA) to create a new Medicaid benefit to better assist providers in supporting individuals with complex behavioral needs in long-term care settings. Currently, many individuals receive additional supports at your facilities through exceptional rates paid by Managed Care Organizations (MCO) and authorized through the Aging and Long-Term Support Administration (ALTSA). In response to the legislation, a 1915(i) State Plan Amendment was submitted for a new service called Community Behavioral Health Support Services. Starting 7/1/2023 the payor for these additional support services will be changing to the Managed Care Organizations (MCO) and the Health Care Authority (HCA). (Note: These new interventions are not related to the provision of personal care. These new services will be provided concurrently with personal care. You will continue to contract with DSHS/ALTSA for the personal care services and rate.)

On March 16, 2023, HCA, in partnership with ALTSA, held a Kick-off Webinar to discuss the changes and how it would impact service providers, including Assisted Living Facilities (ALF) and Enhanced Services Facilities (ESF). We will be posting the PowerPoint slides on HCA’s website. This will help explain the transition process and how it may impact your organization.

Beginning July 1, 2023, ALFs and ESFs who would like to offer this new service will need to contract with HCA and MCOs. A Core Provider Agreement (CPA) is necessary to contract with HCA and the Managed Care Organizations. In order to prepare:

1. Facilities will need to complete the CPA application with HCA prior to contracting the MCOs.
2. A webinar has been scheduled to provide instruction on how to complete the CPA. You only need to attend one webinar.  
   1. Join us on April 20 or April 27 at 2 p.m. for a one-hour webinar to help you complete the CPA: https://us02web.zoom.us/j/87029752267
3. Office Hours are also available for individualized assistance.
   1. Office Hours are scheduled every day from 2-3 p.m. Click here to join the meeting or call 1-564-999-2000, conference ID: 365 922 13#. There are no office hours on April 27.

Over the next few months, HCA and the MCOs will be inviting you to participate in webinars and symposiums to support the transition. We appreciate your wiliness to continue to serve our clients and look forward to working with you during this transition.

To stay up to date, 
sign up for notifications or contact us at HCA1915iservices@hca.wa.gov

Questions?

Contact:

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