Description
Engrossed Substitute Senate Bill 5291 (Chapter 380, Laws of 2025) was signed into law on May 20, 2025. The bill created a new chapter 212 under Title 48 RCW concerning supplemental long-term care insurance. Supplemental long-term care insurance is a new product designed to provide coverage once WA Cares benefits under chapter 50B.04 RCW have been exhausted. The Office of the Insurance Commissioner (OIC) added a new chapter 212 to Title 284 WAC (WSR 26-05-001) to implement the new law and to ensure all affected parties understand their rights and obligations. The Health Care Authority is amending its long-term care partnership rules to add a cross-reference to the new OIC rules.

Agency contacts

Rulemaking contact

Brian Jensen

Program contact

Paige Lewis

Rulemaking status history

Expedited Adoption (CR105)

Permanent Adoption (CR103P)

988 Suicide & Crisis Lifeline

The 988 Suicide & Crisis Lifeline is confidential, free, and available 24/7/365, connecting those experiencing a mental health, substance use, or suicidal crisis with trained crisis counselors.

If you are supporting a patient who is in crisis, refer them to 988 for help.

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As a crisis center or 988 contact hub, are you looking for guidance?

View Washington's 988 best practices guidelines

What to know

  • Access is available in the U.S. through every:
    • Landline
    • Cellphone
    • Voice-over internet device
  • Services are available in English and Spanish and use Language Line Solutions to provide translation services in over 250 additional languages.
  • Text and chat functions are currently available in English only.

How to access

To access the lifeline for all Washington residents, dial 988.

Native and Strong Lifeline

If you are a Tribal provider, refer your patients to the Native and Strong Lifeline. This service is dedicated to American Indian and Alaska Native people. Calls are answered by Native crisis counselors who are tribal members and descendants closely tied to their communities.

To access the Native and Strong Lifeline:

  • Dial 988 and press 4.
  • Text “N8V” to 988.
  • Chat online: 988lifeline.org

988-related websites

What happens when someone calls

Washington has three 988 Lifeline crisis centers that answer calls from around the state. Calls are directed to one of these crisis call centers based on location. Calls are routed by area code.

  • Volunteers of America of Western Washington
  • Frontier Behavioral Health
  • Crisis Connections

People contacting 988 are not required to provide any personal data to receive services. Calls may be monitored or recorded for quality assurance or training purposes. The network system has several safeguards to address concerns about privacy.

  • Callers are connected to a 988 Lifeline crisis call center.
  • They can call, text, or chat 988 on a cellphone, landline, or voice-over internet device.
  • The 988 Lifeline crisis centers operate according to national standards and connect with 911 services and regional crisis services.

Crisis response teams

There are no changes to dispatch for designated crisis responders (DCRs) and mobile crisis response teams (MCRTs) or the functions of any other regional crisis service.

Provider resources

The following handouts are available for you to share with your patients or clients.

Best practices guidelines

HCA and the Washington State Department of Health (DOH) collaborated to create the Washington 988 Lifeline Crisis Center Best Practices Guidelines.

Contact hubs will assist people who contact 988 by minimizing the use of emergency room services or law enforcement for people in crisis. We received feedback from both community partners and recommendations from the Crisis Response Improvement Strategy (CRIS) Committee to create the guidelines.

*These best practice guidelines do not override any statutes or rules and are not meant to override any agency policies or clinical judgment. These best practice guidelines apply only to 988 Lifeline crisis centers contracted by the Department of Health (DOH) and Regional Crisis Lines contracted by Behavioral Health Administrative Service Organizations (BH-ASOs).

Mobile crisis response

SAMHSA national guidance on transforming behavioral health crisis care is built on three foundational elements that are essential within an integrated crisis care system with the goal that everyone should have access to:

  • Someone to contact: Services like the 988 Lifeline and other behavioral health hotlines provide immediate, accessible support.
  • Someone to respond: Services like mobile crisis teams that deliver rapid, onsite interventions to deescalate crises and connect individuals to care as well as crisis outreach teams that provide complementary crisis prevention and postvention; and
  • A safe place for help: A wide array of stabilization services for behavioral health crisis and emergencies where people can receive immediate treatment and support as well as services that can aid in crisis prevention and postvention.

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Goals and overview: someone to respond

A behavioral health crisis can be devastating, and even traumatic, for individuals, families, and communities. Although we cannot know when a crisis may occur, we can create a system that is agile and responsive when the need arises. We imagine a crisis system in Washington state that minimizes delays, reduces the use of law enforcement and emergency departments, and only looks to the most restrictive responses when no other safe resolution exists.

A key component of our state’s crisis system must include mobile crisis response (MCR) teams that can be rapidly deployed to the location of the crisis and provide crisis assessment and stabilization services to anyone, anywhere, and at any time.

Program guide

The Mobile Crisis Response program guide was developed using SAMHSA’s best practice toolkit. The guide was created to standardize mobile crisis response programs while still giving regions the ability to make teams work for their unique areas and serves as the first step in standardizing mobile crisis response in the state. It serves as a clinical and operational guide for new and existing teams. Best practices direct teams to improving services and moving practices toward implementing SAMHSA’s best practices in Washington’s crisis system enhancements.

View the program guide.

Mobile crisis teams: future work and expansion

HCA is working to expand the crisis system to respond to an increase in calls to 988 in alignment with SAMSHA's best practices for crisis response. SAMHSA’s vision for comprehensive crisis care that is for anyone, anytime, anywhere and comprised of three key components; someone to contact, someone to respond, and somewhere to go.

HCA continues to work with Behavioral health administrative service organizations (BH-ASOs), managed care organizations (MCOs), the Crisis Response Improvement (CRIS) committee and subcommittees, providers and stakeholders on the crisis system expansion to ensure adequate coverage for an equitable response statewide as calls to 988 increase. Building mobile crisis response teams to capacity in alignment with SAMHSA’s vision will reduce response times, reduce the likelihood of unnecessary contact with law enforcement or continued reliance on emergency responders like fire and EMS for behavioral health needs.

Adult mobile crisis response

Mobile crisis response (MCR) services offer voluntary community-based interventions to individuals in need wherever they are including at home, work, school, courts, or anywhere else in the community where the person is experiencing a crisis. The caller, not the provider, defines the crisis. These services are provided by two-person teams that include a behavioral health clinician and a certified peer counselor.

Key components of quality MCR services include:

  • Triage/screening, including explicit screening for suicidality and risk of harm to others
  • Responding without law enforcement accompaniment, unless special circumstances warrant inclusion, to support true justice system diversion
  • Reducing the use of emergency departments
  • Assessing for risk and opportunities to resolve the crisis in the least restrictive setting
  • Developmentally appropriate de-escalation/resolution
  • Peer support; including family peers or youth peers
  • Coordination with medical and behavioral health services
  • Crisis planning and follow up

Mobile response and stabilization services (MRSS) for youth and families

MRSS is a child and family specific intervention that recognizes the unique developmental needs of youth. Caregivers and youth are interconnected so when a youth is in crisis, the caregiver’s ability to respond to the crisis can be impacted. Supporting the caregiver’s response to the behavioral health need decreases the likelihood of calling 911, juvenile justice or child welfare involvement.

MRSS removes the word crisis, because in this comprehensive crisis continuum, youth can be screened during a crisis event and stabilized and connected to resources and supports after stabilization. This reduces barriers to ongoing clinical care, prevents return to the crisis phase, and improves outcomes.

In addition to the goals for all MCR services, MRSS is unique in the following areas:

  • There is an initial response for 72 hours, and a separate stabilization phase for up to 14 days
  • The crisis is defined by the youth, young adult, parent, or caregiver
  • The team responds in person with peers within two hours and without law enforcement
  • The team works with the youth and caregivers to reduce admissions to emergency departments (EDs) or adolescent inpatient units, and prevent unnecessary contact with law enforcement or child welfare
  • Support and maintain youth in their living and community environment, reducing out of home placements
  • Promote and support safe behavior in the home, schools, and community
  • Ensure staff are trained in culturally responsive, developmentally appropriate trauma-informed care, de-escalation, safety planning for youth and families, and harm reduction
  • Assist youth and families in identifying, accessing, and linking to natural and clinical supports
  • Teams should provide robust outreach and engagement with youth system of care partners

HCA's crisis systems team (CST) is working to expand dedicated youth teams statewide and implement MRSS expansion through the ongoing work of HB 1477 and the CRIS committees.

Mobile crisis response endorsement program

The goal of the Mobile crisis response endorsement program is to enhance the statewide behavioral health crisis response system and ensure individuals experiencing a crisis have access to help easily in their regions. Endorsed teams meet standards for staffing, training, and transportation ensuring they maintain the capacity to respond quickly and effectively to the most acute calls received by 988 Suicide & Crisis Lifeline.

Learn more about the mobile crisis response endorsement program.

Can being approved for PFML or FMLA impact an employee's eligibility for PEBB benefits?

Employers need to determine eligibility for PEBB benefits without considering whether an employee will or will not take leave that is protected under state and/or federal laws. Working hours that contribute to the minimum necessary for eligibility are not “reduced” by anticipated OR taken PFML or FMLA time. If an employee is already determined to be benefits eligible when they go on PFML or FMLA, those benefits must be maintained during PFML or FMLA.

What happens when an employee returns from approved PFML or FMLA?

When the employee returns from approved PFML or FMLA, the following WACs apply:

  • Maintaining eligibility for SEBB benefits (WAC 182-31-040 (4) (d)): A school employee who returns from approved leave without pay will maintain or establish eligibility for the employer contribution toward SEBB benefits if their work schedule, had it been in effect at the start of the school year, would have resulted in the school employee being anticipated to work the minimum hours to meet SEBB eligibility for the employer contribution in the school year. A school employee who regains eligibility under this subsection, establishes eligibility for the employer contribution toward SEBB benefits as of the date they returned from approved leave without pay.
  • Eligibility for SEBB benefits ends (WAC 182-31-050 (1) (d)): The school employee who returns from approved leave without pay, who maintained or established eligibility as described in WAC 182-31-040 (4) (d), and who subsequently has a change in work pattern that, had the work pattern been in effect at the start of the school year, would not have resulted in the school employee being anticipated to work the minimum hours to meet SEBB eligibility for the employer contribution in the school year. In this case, eligibility for the employer contribution ends as of the last day of the month in which the change is effective.
Can being approved for PFML or FMLA impact an employee’s eligibility for SEBB benefits?

Employers need to determine eligibility for SEBB benefits without considering whether a school employee will or will not take leave that is protected under state and/or federal laws. Working hours that contribute to the minimum necessary for eligibility are not “reduced” by anticipated OR taken PFML or FMLA time. If an employee is already determined to be benefits eligible when they go on PFML or FMLA, those benefits must be maintained during PFML or FMLA.

00463: Apple Health (Medicaid): Provider Alert Attention Nursing Facility providers:
Discovery log number
00463
Discovery description

Effective for claims with dates of service in January 2026, the Health Care Authority (HCA) experienced a system error with patient participation causing HCA to put a temporary hold on all nursing home claims.

Unfortunately, approximately 20 claims were denied before HCA realized the system error and halted all remaining claims.

The larger system error has been resolved and all held claims have been released and scheduled to be paid this week.

The remaining 20 claims that were denied will be reprocessed by HCA with payment expected to occur next week.

 

If you have any questions or concerns, contact the Medical Assistance Customer Service Center (MACSC) at 1-800-562-3022.

Date reported
ETA
Provider impact
All Providers
Workaround
None

Home modifications services

Under the Medicaid Transformation Project (MTP 2.0), the Health Care Authority (HCA) has been approved by the Centers for Medicare & Medicaid Services (CMS) to provide home modifications services. These services promote the health, welfare, and safety of an individual by providing accessibility modifications, remediations, and adaptations to their home.

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Why are home modifications services important?

Home modifications increase the independence, safety, and health of the individual living in the home. Home modifications can support people as their mobility needs change, eliminate environmental hazards, and prevent moves to institutional settings. Home modifications make a home more livable and help an individual remain in their setting of choice.

There are three main services under this program:

  • Home accessibility modifications: Services that improve access, increase safety, or reduce health safety risks by improving the home with a reasonable modification.
  • Remediation services: Services that address identified safety risks of a home by providing a remediation that will improve the health and safety of an individual in their home.
  • Adaptation home devices: Services that supply, deliver, and install a home device to treat or prevent a medical need.

Who is eligible for the home modifications services?

Individuals must meet specific criteria to be eligible for home modifications services. Individuals must:

  • Be enrolled in Apple Health (Medicaid).
  • Meet certain social and clinical risk factors that require the use of accessibility home modifications, remediation services, or adaptation home devices.

Individuals must also qualify and be served by one or more of the following programs:

Individuals may also qualify if they are:

  • Transitioning from a hospital stay.
  • Recently released from incarceration.

Additional eligibility information will be available in the HRSN Billing Guide.

Service information

Home modifications services are set to launch in 2026 through HCA's partnership with the Department of Social and Health Services (DSHS). Currently, home modifications services are available for clients served by:

For questions on eligibility or whether you or someone you are working with is a current client, contact your local HCS or DDCS office.

Resources

Nutrition supports

Under the Medicaid Transformation Project (MTP 2.0), the Health Care Authority (HCA) has been approved by the Centers for Medicare & Medicaid Services (CMS) to provide nutrition supports services. These services aim to improve an individual's overall health by increasing food security and access to nutrition.

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Why are nutrition support services important?

The lack of consistent access to a healthy, safe, and affordable diet is known as nutrition insecurity. Nutrition insecurity is a major contributor to poor health outcomes, including a greater risk of diet-related diseases such as diabetes, cardiovascular diseases, and high-risk pregnancies. Nutrition supports is a health-related social needs (HRSN) service that offers opportunities to improve health outcomes and reduce health disparities. 

What do nutrition support services include?

The HRSN nutrition support services included under this program are:

  • Nutrition counseling and education: Provides an individual with educational strategies to make their own healthy food choices.  
  • Medically tailored meals: Provides an individual with a health condition with nutritious meals tailored to improve their health outcomes. 
  • Pantry stocking: Allows an individual to purchase a variety of foods that promote better nutrition.
  • Fruit and vegetables prescriptions: Allows an individual to purchase fruits and vegetables from participating food retailers and farms.
  • Short-term grocery provision: Allows an individual to purchase a variety of foods that promote better nutrition (only available to individuals enrolled in long-term services and supports).

Who is eligible for HRSN nutrition supports services?

Individuals must meet multiple criteria to be eligible for nutrition supports services. Individuals must:

Individuals must also qualify and be served by one or more of the following programs:  

Individuals may also qualify if they are:

  • Transitioning from a hospital stay.
  • Recently released from incarceration.

Certain nutrition support programs have additional requirements and are available to individuals with chronic health conditions.

  • To receive medically tailored meals, clients must have been discharged from institutional care, a hospital, or congregate settings within the past six months.
  • To receive short-term grocery provisions, clients must also be enrolled in long term services and supports (LTSS) and have been discharged from a hospital or skilled nursing facility within six months, or be at high risk of hospitalization or nursing facility placement.
  • To receive meals and pantry stocking, clients must be children under the age of 21 or pregnant individuals.

Additional eligibility information will be available in the HRSN Billing Guide.

Provider service information

Nutrition support services are set to launch in 2026 through HCA's partnership with the Department of Social and Health Services (DSHS). Currently, nutrition support services are available for clients served by:

For questions on eligibility or whether you or someone you are working with is a current client, contact your local HCS or DDCS office.

Resources

Melissa Sarikaya

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