Description
HCA is amending WAC 182-501-0213, Case management services, and writing new rules under new Chapter 182-563 WAC to provide limited coverage for certain services for incarcerated individuals up to 90 days before their expected release date. This rulemaking aligns with Washington’s Medicaid Transformation Project 2.0, in accordance with Section 1115(a) of the Social Security Act and the Consolidated Appropriations Act (CAA).

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

  • WSR 25-08-063
  • Hearing Date: 5/6/2025
  • Registration is required to attend the public hearing.
    View the rulemaking's CR102 for the registration link.
  • Comments due by 5/6/2025

Permanent Adoption (CR103P)

Description
The agency is amending these rules to allow for the payment of services under the Apple Health program by certified anesthesiologist assistants (CAA), as established in Chapter 18.71D RCW and adds other clarification about providers of anesthesia services.
The proposed rules:
• Add qualified dentists or oral surgeons and certified anesthesiologist assistants to the list of qualified anesthesiologist providers eligible for reimbursement
• Replace the “department” with “medicaid agency” or “agency”
• Relocate anesthesia reimbursement provisions from section 182-551-0300 to section 182-551-0350
• Update the source of the base anesthesia units (BAU) values
• Include the calculation of allowed anesthesia charges for more than one procedure and for add-on procedures
• Clarify that the agency does not reimburse attending surgeon for anesthesia services
• Describe reimbursement for multiple anesthesia providers present on a case and for anesthesia provided by a team

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

  • WSR 25-07-047
  • Hearing Date: 4/22/2025
  • Registration is required to attend the public hearing.
    View the rulemaking's CR102 for the registration link.
  • Comments due by 4/22/2025

Withdrawal (CR102)

Proposal (CR102)

  • WSR 25-09-089
  • Hearing Date: 5/27/2025
  • Registration is required to attend the public hearing.
    View the rulemaking's CR102 for the registration link.
  • Comments due by 5/27/2025

Permanent Adoption (CR103P)

Supported employment

Supported employment is one branch of the Foundational Community Supports (FCS) program. It is an effective approach centered on assisting individuals in securing competitive employment within the community, while also providing the necessary support to ensure their success in the workplace. Meaningful employment contributes to a more fulfilling life for many adults and youth in transition, aiding them in achieving their career and educational objectives, and promoting recovery for those facing behavioral health challenges.

Overview

Supported employment extends beyond mere job placement; it mitigates the risks of homelessness and incarceration while empowering individuals to escape cycles of poverty. By emphasizing personal choice and support, it enables participants to flourish in their roles, enhance their lives, and become contributing members of their communities. This model is utilized in various environments, including community mental health centers and rehabilitation programs, and is adaptable to different geographic contexts and job markets.

Central to our initiative is the Individual Placement and Support (IPS) model, an evidence-based strategy designed to assist individuals in obtaining meaningful employment. This model prioritizes individual preferences, boosts self-esteem, and ultimately improves quality of life, financial stability, and mental health in Washington State.

Unemployment has a significant impact on overall well-being, often leading to reduced life expectancy, particularly among those with behavioral health issues or prior involvement in the justice system. Moreover, systemic barriers frequently hinder individuals from returning to work by diminishing public benefits, and there is a notable shortage of resources for benefit planning to facilitate transitions from public assistance to earned income. IPS programs demonstrate a high rate of successful implementation and sustainability over time.

Resources

Supportive housing

Supportive housing is one branch of the Foundational Community Supports (FCS) program. It provides a holistic and intensive case management approach aimed at assisting individuals in securing and maintaining safe, affordable housing. It also integrates critical support services related to behavioral health care, employment, public benefits, physical health care, and more.

Want to become a supportive housing provider? Learn how.

Overview

The primary goal of supportive housing services is to empower individuals seeking housing to achieve stable and independent living by recognizing the various life factors that contribute to housing instability and tailoring coordinated support to meet their unique needs and objectives. Additionally, our program strives to reduce homelessness in Washington State and lower the costs associated with accessing high-quality behavioral health care, ultimately leading to healthier lives for our participants.

Supportive housing services are grounded in evidence-based practices derived from the Substance Abuse and Mental Health Services Administration's (SAMHSA) principles of Permanent Supportive Housing (PSH) model. This model is founded on seven core principles that research has shown to yield the most effective long-term housing stability outcomes for those receiving housing support services:

  • Choice of housing
  • Separation of housing and services
  • Decent, safe, and affordable options
  • Housing integration
  • Rights of tenancy
  • Access to housing
  • Flexible, voluntary services

Other FCS opportunities

Supportive housing case management services provide essential resources for those seeking assistance in achieving housing stability. These services can be particularly effective when combined with additional programs such as mental and physical health care, substance use disorder services, public benefits, housing subsidies, voucher programs, and more.

The Foundational Community Supports (FCS) program offers additional opportunities for individuals enrolled in supportive housing that eligible participants may consider alongside these case management services including:

  • Supported employment
  • Transition Assistance Program (TAP)
  • Apple Health and Homes (AHAH) housing
  • AHAH Rental Assistance Program (AHAH-RAP)
Transition Assistance Program (TAP)

Unemployment, job insecurity, homelessness, and unstable housing contribute to poor health. Homelessness is traumatic and cyclical, putting people at greater risk for developing physical and mental health conditions, including substance use disorders.

Enrollees of FCS supportive housing services often face financial obstacles to obtaining and maintaining safe, quality, affordable places to call home-especially when transitioning out of inpatient settings

Program goals

  • Support supportive housing enrollees as they take steps to achieve their personalized housing goals.
  • Lower barriers to securing housing stability by covering fees including but not limited to IDs, application fees, move-in costs, and more.

Eligibility criteria

Individuals are eligible to access TAP funding, so long as they:

  • Are receiving FCS-eligible Medicaid
  • Are authorized for Supportive Housing services
  • Are seeking to transition into the housing of their choice
  • Identify as having a behavioral health treatment need

TAP resources

Contact

Maureen Maples, FCS housing subsidies program manager for TAP

Apple Health and Homes

Apple Health and Homes (AHAH) is a multiagency effort that pairs health care services with housing resources for some of the state’s most vulnerable residents. AHAH aligns housing resources (capital financing and rental/operations assistance) with supportive services through the FCS program.

HCA has contracted with Wellpoint to be the coordinating entity that confirms eligibility for participants in conjunction with local FCS providers across the state.

HCA’s role is:

  • Administration of eligibility determinations for services
  • Enrollment in AHAH's CSS benefit
  • Coordination of permanent supportive housing units for eligible individuals

Eligibility

FCS is a targeted Medicaid benefit designed to meet the needs of individuals with significant barriers to finding stable housing and employment.

Participants must be:

  • Medicaid-eligible
  • Meet certain age requirements
  • Meet specific medical risk factors including chronic homelessness, complex behavioral health and co-occurring substance use needs among others, as well as a disability or other long-term care needs.

FCS does not pay for rent, rental subsidies, wages, or wage enhancements.

AHAH eligibility uses a subset of existing eligibility criteria used by Supportive Housing benefit. Enrollment in Supportive Housing requires individuals to meet several risk factors and medical necessity requirements.

While AHAH uses the Supportive Housing program’s eligibility criteria as a blueprint, AHAH’s eligibility criteria are more restrictive, based on two risk factors: frequent turnover of in-home caregivers, and individuals who have a predictive risk score of 1.5 or higher.

Resources

Contact

Elizabeth Pitts, AHAH program manager

Apple Health and Homes rental assistance

The AHAH Rental Assistance Program provides project- or tenant-based rental subsidies. The legislature appropriated funds to provide rental assistance for persons enrolled in the AHAH program.

The Department of Commerce will pay rent each month on behalf of AHAH program participants deemed eligible for the program. Referrals will be received from Wellpoint, the program’s coordinating entity, signaling that the participant has located housing with the assistance of the local Supportive Housing service provider.

Prior to payment of rent, landlords will be contacted for confirmation and to gather information necessary to pay rents each month. The Department of Commerce is developing a data platform that will track real-time allocations of rent funds to each of the state’s ten behavioral health regions, the amounts spent in each region, and the amount of uncommitted funds in each region.

Resources

Foundational Community Supports

Foundational Community Supports (FCS) provides supportive housing and supported employment services to our most vulnerable Medicaid beneficiaries. These services are designed to promote self-sufficiency and recovery by helping participants find and maintain stable housing and employment.

About FCS

What is supportive housing and supported employment?

  • Supportive housing helps individuals get and keep community housing.
  • Supported employment helps individuals with barriers to employment get and keep a job.

Who's eligible?

FCS is a targeted Apple Health (Medicaid) benefit designed to meet the needs of individuals with significant barriers to finding stable housing and employment.

Participants must be:

  • Apple Health (Medicaid)-eligible
  • Meet certain age requirements
  • Meet specific medical risk factors including:
    • Chronic homelessness
    • Complex behavioral health needs
    • Co-occurring substance use needs
    • A disability or other long-term care needs

Learn more about FCS eligibility with our quick reference guide.

How can someone be referred to FCS?

Providers can refer clients who need supportive housing and supported employment to Wellpoint, the third-party administrator of FCS.

What isn't covered?

FCS does not pay rent, rental subsidies, wages, or wage enhancements.

Provider enrollment and resources

How does provider enrollment work?

To begin the process, please complete the FCS New Provider Inquiry Form and the FCS Provider Application. Then, submit both documents via email to the HCA FCS inbox.

Provider enrollment is based on a variety of factors, including regional service gaps and enrollee demand. Enrollment is not guaranteed for applying providers. To provide FCS services, organizations must hold an active contract with our third-party administrator (TPA), Wellpoint.

Provider resources

FCS training

Contact information for HCA's Supportive Housing Program Manager:

Contact information for HCA's Supported Employment Program Manager:

Foundations newsletters

Sign up to receive FCS emails and the Foundations monthly newsletter. See an archive of past editions below.

2026
Date Title
February Foundations newsletter
January Foundations newsletter
2025
2024
Date Title
December 1 Foundations
November 7 Foundations
October 11 Foundations
September 10 Foundations
August 6 Foundations
July 5 Foundations
June 6 Foundations
May 6 Foundations
April 1 Foundations
March 5 Foundations
February 6 Foundations
January 9 Foundations
2023
Date Title
December 1 Foundations
November 1 Foundations
October 3 Foundations
September 5 Foundations
July 6 Foundations
June 1 Foundations
May 5 Foundations
April 11 Foundations
March 2 Foundations
February 6 Foundations
January 4 Foundations

FCS reports

Washington State Health Care Authority (HCA) and Department of Social and Health Services (DSHS) Research and Data Analysis (RDA) generate monthly reports to analyze access and engagement in the Foundational Community Supports program. These reports review historical enrollment information to verify data accuracy and completeness.

FCS supportive housing reports

2026

2025

2024

2023

2022

FCS supported employment reports

2026

2025

2024

2023

2022

Description
The agency is amending WAC 182-543-2000 to amend the medical equipment and supplies provider requirements.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

  • WSR 25-04-044
  • Hearing Date: 3/11/2025
  • Registration is required to attend the public hearing.
    View the rulemaking's CR102 for the registration link.
  • Comments due by 3/11/2025

Permanent Adoption (CR103P)