Aging and Long Term Supports Administration - ALTSA administers Medicaid state plan and 1915(c) waivers, and the 1115 Medicaid Transformation Demonstration - MTD waiver that provide an array of long term services and supports to adults with unmet needs for assistance with activities of daily living due to functional impairments caused by age, physical disability or cognitive impairment as well as services and supports to their unpaid family caregivers.
ALTSA contracts with 13 Area Agencies on Aging - AAA to develop maintain and ensure a quality statewide Medicaid provider network to serve clients who are eligible for Medicaid long term services and supports. All applicants must meet the minimum qualifications to provide services. A Medicaid contract does not guarantee referrals.
Eligible clients may choose to receive services from any qualified provider of a particular service. Providers do not determine eligibility for services. All state plan and 1915(c) waiver services are authorized by DSHS Home and Community Services and Area Agency on Aging staff. MTD services are authorized by Area Agency on Aging staff. Providers must have adequate cash flow to provide services in advance of reimbursement.
Service authorizations and payment for claims are completed through the Health Care Authority’s ProviderOne payment system. Applicants who receive a Medicaid contract will be mailed a ProviderOne Enrollment Packet from the Health Care Authority. Additional training and resources for ProviderOne can be found at training. DSHS determines Home and Community Services Medicaid rates, which are posted here.
Application materials for a Home and Community Services Medicaid contract are submitted directly to the Area Agency on Aging. Contract templates provided in the links below are examples that are used for most businesses structures. Additional templates are available that may be more appropriate for some applicants (e.g., county governments, tribal nations, quasi-governments). Applicants who receive a contract will be monitored by the Area Agency on Aging.
If you are considering submitting an application or have questions about any of these contracts, please reach out to Resource Support and Development at resourcedevelopment@dshs.wa.gov.
Medicaid Services are as follows. Click on the link to get to the Provider Application Form:
- Adult Day Care
- Adult Day Health
- Caregiver and Client Support
- Client Training
- Community Choice Guiding
- Community Transition or Sustainability Services (CTSS)
- Environmental Modifications
- Home Care Agencies
- Home Delivered Meals
- House work and Errands
- Personal Emergency Response Systems
- Behavior Support Service
- Skilled Nursing
- Transportation Services
- Wellness Programs and Activity
- Yardwork and Snow Removal
Steps to apply:
- Click on the appropriate Medicaid Service listed above and follow the instructions specified on the Provider Application Form.
- Gather appropriate documentation to show you meet qualifications to provide services under the contract.
- If you are interested in providing one of the following services you may need an National Provider Identifier - NPI and a Medical Providers HCA CPA Packet.
- Behavior support providers, including:
- MH Agency
- Counselor
- Marriage and Family Therapist
- Psychologist
- Social Worker
- Social Worker, Clinical
- Chemical Dependency Counselor
- Certified Dietician/Nutritionist
- Occupational Therapist
- Physical Therapist
- Pharmacist
- Nurses
- Registered Nurse, Agency
- Registered Nurse, Individual
- Licensed Practical Nurse
- Adult Day Health Provider
- Home Health Agency
- Speech/Hearing/Communication Pathologist
- Durable Medical Equipment
- Behavior support providers, including:
- After reviewing specific Medicaid Service requirements and instructions, submit all required documents to the appropriate Area Agency on Aging Intake Contact. If interested in contracting with more than one AAA, all documents must be submitted to each AAA Contact.
Some Provider Application Forms are still under development. If there is no link to the Medicaid Service for which you wish to apply, please complete the contractor intake form and submit to the Area Agency on Aging Intake Contact, who will provide you with the next steps.
ALTSA directly contracts for the Medicaid services listed below. Therefore, do not contact the Area Agency on Aging for these contracts. Instead, see the links referenced below if you are seeking one of the following contracts:
- Personal Care delivered by Licensed Adult Family Homes—please see https://www.dshs.wa.gov/altsa/residential-care-services/residential-care-services for information regarding the licensing and contracting process
- Personal Care delivered by Licensed Assisted Living Facilities—please see https://www.dshs.wa.gov/altsa/residential-care-services/residential-care-services for information regarding the licensing and contracting process
- Nurse Delegation—please see https://www.dshs.wa.gov/altsa/residential-care-services/nurse-delegation-program for information regarding the contracting process
- Private Duty Nursing—please contact privatedutynursing@dshs.wa.gov.
- Specialized Equipment and Supplies (SES) — please contact adshqcontracts@dshs.wa.gov
- Assistive Technology (AT) – please review the Medicaid Provider Application Form – Assistive Technology for information regarding the AT contract and eligibility. If you meet eligibility, please complete the application process
- Wellness Education
If you are considering submitting an application or have questions about any of these contracts, please reach out to Resource Support and Development at resourcedevelopment@dshs.wa.gov.