Announcements
New Rules effective January 1, 2026, to comply with federal Home and Community Based Settings (HCBS) requirements.
The rules require AFH, ALF, and ESF to have a “residency agreement” with residents who have Medicaid as a payor. The purpose of the agreement is to provide resident protections for eviction and appeals comparable to the Residential Landlord Tenant Act. AFH, ALF, and ESF must also provide written notice to Medicaid residents of their right to legal assistance when issuing a notice of transfer or discharge.
- Find the provider letter, slide deck presentation, Q & A, and FAQ here.
- Optional forms available for use on January 1, 2026:
- HCLA Residency Agreement Language Template (DSHS 16-302).
- Notice of Transfer or Discharge (DSHS 15-458). Distribution of the form to the Long-term Care Ombuds and DSHS case manager is required only for residents with Medicaid:
- DSHS case manager: Send via fax (855) 635-8305 or mail to DMS at PO Box 45826 Olympia, WA 98599-5826
- Long-Term Care Ombuds: email the Notice of Transfer or Discharge to Discharges@mschelps.org or send by e-fax (253) 216-3699.
- The long-term care discharge defense screening line phone number is (888) 437-0017. You must include it in any discharge notice to a resident with Medicaid. This number must also be included in your residency agreement.
- Check for information about other RCS rulemaking projects here ALTSA RCS Rulemaking | DSHS.
AFH License Application process informational slideshow
Reporting Abuse and Neglect in Adult Family Homes Webinar (May 7, 2024 Recording)
AFH online license application note: There are certain symbols that can create errors or prevent submission in the completed application. Do not use the following symbols &, =, +, or #. Instead, use the following terms: (and) (equals) (plus) (number sign), spelling out the words, with parentheses on either side. See the updated Instructions for the license application for details. We are researching a permanent fix to this issue and will advise you of any changes.
Background checks during and after licensure:
If you have any questions regarding the Adult Family Home (AFH) application process, please contact the Business Analysis and Applications Unit at baau@dshs.wa.gov. If you have general questions about opening an AFH, please reach out to Resource Support and Development at resourcedevelopment@dshs.wa.gov.