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Initiative 2: long-term services and supports

Washington has achieved a rebalanced system where individuals have a community care entitlement for Long-Term Services and Supports (LTSS). Our LTSS system has earned the ranking of first in the nation by the American Association of Retired Persons (AARP) for its excellence in supporting seniors, adults with disabilities, and their family caregivers. Washington is building on the successes of our current system and creating a “next generation” system of care focused on outcomes, supporting families in caring for loved ones, delaying or avoiding the need for more intensive Medicaid-funded care where possible, creating better linkages to a reformed health care system, and continuing its commitment to a robust Medicaid LTSS system for those who need it.

How will long-term care system transform?

The state will create a system of care that will:

  • Provide additional options for people with long-term care needs that do not require them to impoverish themselves, or lose their estates.
  • Increase access to services for people on the cusp of poverty, which may slow their functional decline or need to seek out-of-home  placement, as well as slow their spend down of resources.
  • Slow the growth trend of traditional Medicaid caseload (such as Community First Choice or COPES).
  • Provide family caregivers with supports and knowledge to continue providing unpaid care while also taking care of themselves.
  • Assist individuals to remain in the setting of their choice for as long as possible.
  • Support individuals using person-centered options counseling to utilize their limited resources to maintain independent living without Medicaid LTSS.

What are the new programs?

  • Medicaid Alternative Care (MAC): a benefit package for individuals who are eligible for Medicaid but choose not to  access traditional Medicaid-funded long-term services and supports (LTSS)
  • Tailored Supports for Older Adults (TSOA): a new eligibility category and benefit package for individuals at risk of future need for Medicaid LTSS but who currently do not meet Medicaid financial eligibility criteria

What are the benefits under these programs?

  • Caregiver Assistance Services: services that take the place of those typically performed by unpaid caregiver (dyads only)
  • Training and Education: assist caregivers with gaining skills and knowledge to care for and assist care receivers to maintain their independent living as long as possible
  • Specialized Medical Equipment & Supplies: goods and supplies needed by the caregiver and/or care receiver
  • Health Maintenance & Therapies: clinical or therapeutic services for caregivers to remain in role or care receiver to remain at home
  • Personal Assistance Services: services involving the labor of another person to help care receiver complete everyday activities in order to remain in their home (TSOA individual without a caregiver only)

How do I make a referral?

For practical caregiving information, and help finding local resources/services, call your local Community Living Connections/Area Agency on Aging or Home and Community Services Office.