Washington Medicaid Resources:

• State Medicaid Website: Washington
• Washington State Developmental Disabilities Council Website
• The Arc of Washington

Washington Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 173,700 people with disabilities who are covered by Medicaid in Washington. Washington spent $12,999 for each Medicaid recipient with a disability in 2007.

15% of all people covered by Medicaid in Washington have a disability, which is the same as the national percentage of Medicaid recipients with a disability.

Washington spends 42% of all the money it spends on Medicaid on services for people with disabilities, which is also the same as the national percentage of spending on these services.

Integrated Mental Health Services Program:

This program provides mental health services to adults and children with disabilities who need mental health care. You may not always get to choose your service provider under this plan.

• Health: crisis management, inpatient and outpatient treatment, rehabilitation
• Social Services: case management

Chronic Care Management Plan:

This program provides disease management services to adults with disabilities and other chronic health conditions. Children and people also eligible for Medicare are not eligible for health care through this program.

• Community: education about health care
• Social Services: coordination with other services

Washington Medicaid Integration Partnership:

This program covers adults with disabilities and children with “special needs” as defined by the state of Washington and the BBA (this will include most children with disabilities). It provides coverage to people who are also eligible for Medicare.

• Health: disease management, durable medical equipment, family planning, hearing, hospice, immunization, hospitalization, mental health, substance abuse treatment, laboratory, long-term care, occupational therapy, pharmacy, physical therapy, physician services, podiatry, speech therapy, vision, x-ray
• Home: home health care

Program of All-Inclusive Care for the Elderly (PACE):

PACE programs are designed for people 55 and older who need nursing care, which includes many people with disabilities. These programs provide integrated care and support including a high level of preventive care. PACE programs must provide all services otherwise included in a person’s Medicaid or Medicare benefit, as well as all other services deemed medically necessary.

Ages: 55 and older

Level of Care: nursing

Restrictions: You must live close enough to a PACE center to be eligible.

• Community: day care, health-related transportation
• Health: primary and specialty care, nursing, physical therapy, occupational therapy, speech therapy, recreation therapy, prescription drugs,
• Home: home health care, home and environmental modifications
• Social Services: social services

COPES (Community Options Program Entry System) waiver:

This waiver serves older adults and people with disabilities of all ages. This waiver helps pay for these services to be delivered in the community so that people can live in their own homes and not have to live in institutions.

Level of Care: nursing

• Health: personal emergency response systems
• Home: personal care, assisted living, adult home family care

Medically Needy In-Home waiver:

This waiver supports people with disabilities of all ages. This waiver provides services in people’s homes so that they can keep living independently.

• Community: transportation
• Health: personal emergency response systems, skilled nursing
• Home: personal care, home delivered meals, home health aide

Children’s Intensive In-Home Behavioral Support (CIBS):

This waiver is intended to serve children with Autism Spectrum Disorder, other developmental disabilities, and children who are at risk of an out-of-home placement because of very challenging behaviors. It was created because of an increase in requests for long-term institutional placement for children under 18.

Ages: children applying for this waiver must be between 8 and 17, but once enrolled they can be served until they are 21.

• Community: transportation
• Health: behavioral support, therapeutic equipment and supplies, assistive technology, nutrition counseling, specialized clothing, specialized medical equipment and supplies, psychiatric services, sexual deviancy evaluations, nurse delegation, occupational therapy, physical therapy, communication therapy
• Home: planned respite, staff and family training, personal vehicle modification, personal care, environmental accessibility modifications

New Freedom waiver:

This waiver serves older adults and adults who have disabilities. It is designed to provide home and community based options for people who do not want to move into institutional living arrangements.

Ages: 65 and older for people with or without disabilities, 18 and older for people with disabilities

Option for Self-Direction: This program has options for people with disabilities to direct their own services.

• Community: training and educational supports
• Health: treatment and health maintenance
• Home: personal assistance, environmental and vehicle modifications