Potential government shutdown

In the event of a federal government shutdown, individuals enrolled in Apple Health (Medicaid), Public Employees Benefits Board, and School Employees Benefits Board coverage—and those accessing behavioral health services—will not experience a disruption in care. In addition, health care providers will continue to be paid for the services they provide.

If a shutdown occurs, we will share more information at that time.

Initiative 2: long-term services and supports

Initiative 2 supports Washington’s aging population and family caregivers who provide care for their loved ones. This initiative is made up of two programs, Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA), both of which:

  • Expand care options for people, ages 55 and older, so they can stay at home and delay or avoid more intensive services, such as moving to a nursing facility.
  • Provide assistance to unpaid family caregivers, ages 18 or older, who provide care for their loved ones.


Under the Medicaid Transformation Project (MTP), this initiative is changing the Medicaid health care delivery system by:

  • Providing additional options for people with long-term care needs.
  • Increasing access to services for people on the cusp of poverty to reduce:
    • A potential health decline.
    • The need to move out of home.
    • The spending-down of limited resources.
  • Slowing the growth trend of traditional Medicaid-funded services, including Medicaid long-term services and supports.
  • Providing unpaid family caregivers with supports and knowledge to continue providing care while also taking care of themselves.
  • Helping people remain at home for as long as possible, and to maintain independent living.


MAC provides support for unpaid family caregivers caring for Medicaid-eligible people who are not currently accessing Medicaid long-term services and supports. MAC helps unpaid family caregivers provide high-quality care for their loved ones, while also tending to their own health and well-being.

TSOA establishes a new eligibility category and benefit package for people who may need Medicaid long-term services and supports in the future. TSOA helps people and families avoid or delay impoverishment and the future need for Medicaid-funded services. TSOA also provides support to unpaid family caregivers.

Benefits of MAC and TSOA

Under Initiative 2, MAC and TSOA provide a variety of services that support the unpaid family caregiver and the person who is receiving care.  

  • Caregiver assistance services support the unpaid family caregiver and include services, such as respite care, housekeeping and errands, adult day care, and home-delivered meals.
  • Training and education helps caregivers gain skills and knowledge to care for their loved one and help them maintain independent living as long as possible.
  • Specialized medical equipment and supplies, such as bath benches, sock aides, personal emergency response systems, and incontinence supplies, are available for family caregivers and those receiving care.
  • Health maintenance and therapies include massage therapy and caregiving counseling, and help caregivers remain a caregiver or help a loved one remain at home.
  • Personal assistance services help an individual complete everyday activities to remain in their home. These services are only available to an individual enrolled in TSOA who doesn’t have a caregiver. Examples of personal assistance services include personal care services, home-delivered meals, and personal emergency response systems.

Benefits for caregivers

Under both MAC and TSOA programs, unpaid family caregivers can receive and have access to number of services, such as:

  • Training
  • Support groups
  • Respite services
  • Help with housework
  • Errands
  • Home-delivered meals

Contacts and resources

Visit the Aging and Long-Term Support Administration’s (ALTSA’s) website for a list of contacts and resources by county. This includes information for a local Area Agency on Aging, Home & Community Services, Residential Care Services, and much more.

To learn if you or a loved one is eligible for MAC or TSOA services, contact your local Community Living Connections office or call 1-855-567-0252.

Visit ALTSA’s website to read more about their Long-Term Care Services.