Nurse Delegation Program

DSHS HCS provides Registered Nurse Delegation Orientation 6-hour classes every other month for Registered Nurses who are interested in a DSHS contract to provide delegation to DSHS Medicaid clients.

This RN Delegation Orientation class is an introduction to nurse delegation in community based residential settings such as Adult Family Homes, In-Home, and Developmental Disabilities Certified Community residential services for Medicaid state clients. If you provide private pay ND or ND in an Assisted Living Facility, this training class is not required. Please see class handout.

How Do I Find DSHS HCLA Classes?

Registered Nurse Delegation Orientation class is provided at no cost every other month in different locations in WA state.  Registration is required and classes fill up fast. We typically have the capacity for 30 people per class. We are unable to accommodate a waiting list. If you are not interested in the contract and want to just take private pay clients, please do not register. There are other options such as the handout and LTC associations.

If there is an open spot the registration link will direct you to the sign-in page and if it does not redirect then the training date is closed. Please do not reach out to us via email or phone to get signed up as we do not have the ability to accommodate a wait list.

If you are an RN providing nursing services for DSHS as an employee, please contact your Human Resources (HR) department regarding other employment. You will not be able to take the training until after contacting HR and letting us know at nursedelegation@dshs.wa.gov

Here is the link to the registration information page: Registered Nurse Delegation Registration

The class training material is available for viewing and downloading for 2026. It is available for any RN that wants to learn about delegation and has resources for more information: Registered Nurse Delegation Orientation Handout

How does an RN Contractor find clients?

DSHS does not automatically provide clients to the delegator; the delegator must market their services for themself. DSHS does distribute the current list of Contracted Nurse Delegators to DSHS Case Managers who authorize Nurse Delegation services for Medicaid clients qualified for services.

How does the Nurse Delegator get paid for delegation services?

The DSHS contracted nurse delegator receives authorization for services for state Medicaid clients from Case Managers in Home and Community Living Administration and Developmental Disabilities Community Services. The contractor submits time through Health Care Authority and ProviderOne for payment of services. 

How Do I Get Nurse Delegation Forms?

You can download all mandatory forms at the Nurse Delegation Forms page. The forms provided are mandatory by contract.

Resources for Current RN Delegation DSHS Contracts

• Billing Tutorial
• Audit
• Find a DSHS Contracted RND
• Nurse Delegation Forms
• Skin Observation Protocol (SOP) Resources
• DSHS Electronic Forms

Nurse Delegation Program Contact

nursedelegation@dshs.wa.gov