Washington Medicaid Home and Community-Based Waivers

Managed Care 1915(b) and/or Home and Community-Based 1915(c) Waivers for Respite Support

Medicaid is a program in every state that pays for medical assistance for certain individuals and families with low incomes and resources. It is the largest source of funding for medical and health-related services for America’s poorest people. Because Medicaid is funded jointly by the federal and state governments, the services paid for vary from state to state. In addition to medical services, Medicaid will pay for home and community-based services (HCBS) through the state plan as well as through Medicaid waivers that offer services as a lower-cost alternative to treatment in a medical or long-term care facility, such as a nursing home. Respite is usually paid for through one or more of the following types of waivers: research and demonstration (1115), managed care (1915b) and HCBS (1915c) waiver programs. This state’s Medicaid waivers that include respite are: 

 Washington has introduced an 1115 demonstration called the Medicaid Transformation Project in efforts to improve its healthcare delivery system. The waiver operates through ACHs, which are composed of managed care, provider, and many other community organizations and are focused on improving health and transforming care delivery for the populations that live within their region. The Individual and Family Services 1915(c) waiver operates concurrently with the demonstration. The following 1915(c) waivers with respite will continue to operate and there are currently no plans to incorporate them into the 1115 demonstration.