DDA Waiver Changes and State Plan Services

Dear Staffed Residential Program Administrator,

Effective September 1, 2017, the DDA Home and Community-Based Service waivers' five-year renewals were approved by the Centers for Medicare and Medicaid Services (CMS). This applies to the Basic Plus, Core, Community Protection, and the Children’s Intensive In-home Behavioral Supports waiver.

CMS now requires that the state plan and other informal resources be used first. This applies to all of the services available under the Medicaid state plan and private insurance, such as:

  • Skilled nursing,
  • Positive behavior support and consultation,
  • Staff/family consultation and training,
  • Behavioral health stabilization services, and
  • Peer mentoring.

Clients requesting a waiver may be asked by a case resource manager for documentation showing the client used their state plan or private insurance benefits first.

 Youth age 20 and younger on Medicaid are covered under Early and Periodic Screening, Diagnosis and Treatment benefits. These benefits requires state-plan insurance providers to produce all medically-necessary state-plan benefits such as Applied Behavioral Analysis (ABA) or other behavioral health services, nursing, etc. without limits.

DDA received a transition period for youth on one or more ABA waitlists. This allows the administration to offer short-term supports to youth while they wait for state plan services.

If your agency is currently working with a behavior support provider that is interested in continuing to provide ABA or other behavioral health services to DDA clients, contact Provider Enrollment at the Health Care Authority or call 1-800-562-3022 ext.16137.

Summaries of the changes in the waiver renewals and amendment are available on the DDA internet site.

I appreciate the services and supports you provide to children and families approved for Voluntary Placement Services.  If you have questions, please feel free to contact your VPS Resource Manager or Coordinator.

Nichole Jensen / Voluntary Placement Services Program Manager

Developmental Disabilities Administration

Washington State Department of Social and Health Services

(O) 425.977.6631 / (F) 360.407.0955

Nichole.Jensen@dshs.wa.gov