The Centers for Medicare and Medicaid Services (CMS) require states to seek public input when submitting an application for renewal or an amended 1915c waiver.
The Health Care Authority (HCA) and Aging and Long-Term Support Administration (ALTSA) intend to submit a waiver amendment application for the Residential Support Waiver to amend the RSW services of Expanded Community Services, Adult Family Home Specialized Behavior Support Services, Community Stability Supports, and Enhanced Residential Services to include the clarification that when a Medicaid Long Term Services and Supports participant is eligible for a service provided under the Medicaid State Plan, they must receive the service through the Medicaid State Plan program, not through a 1915c home and community-based services waiver.
Please note this is not a new requirement. Services under the waiver are limited to services not otherwise covered under the State Plan, or to participants who do not meet eligibility for the State Plan service. The purpose of the 1915(c) waiver is to provide additional services beyond what is available in the State Plan to help an individual avoid institutionalization. Services under this waiver are intended to supplement, and not replace services through the State Plan, including through 1915(i). Clients must meet Medicaid LTSS functional and financial eligibility to be eligible to receive 1915(c) waiver services.
HCA and DSHS also intend to clarify that under the waiver, recreational opportunities are offered by residential providers and may be identified in behavioral support plans.
The effective date of this waiver amendment will be July 1, 2025.
A paper copy of the draft is available upon request by contacting Anne Moua at the address listed below.
The Department of Social and Health Services (DSHS) welcomes all comments on the draft waiver amendment. Comments may be submitted to DSHS through the website address listed above or may be mailed to Anne Moua at the address listed below. DSHS will receive comments through 5:00pm, close of business, on February 28, 2025.
Anne Moua, Home and Community Services Division
Aging and Long-Term Support Administration
P.O. Box 45600
Olympia, WA 98504-5600