Enhanced Services Facilities

The Washington State Legislature authorized DSHS to develop Enhanced Services Facilities (ESFs) under Chapter 70.97 RCW. This new category of licensed residential facility will provide a community placement option for individuals whose complicated personal care and behavioral challenges do not rise to a level that requires an institutional setting. Rather than extended and unnecessary stays in State Hospitals, patients who are no longer responding to active psychiatric treatment and who have been assessed as stable and ready for discharge can be referred to an ESF.

ESFs use high staffing ratios, behavioral and environmental interventions to serve individuals who are no longer receiving active treatment at a state psychiatric hospital. These facilities offer behavioral health, personal care services and nursing, a combination that is not generally provided in other licensed long-term care settings.

Information and Updates

The Department has released a Request for Information to identify potential providers interested in becoming a licensed Enhanced Services Facility.“

The Department developed rules and policies for the oversight of this new type of licensed facility and is seeking interested and qualified providers. Please see below for the statutory authority, the licensing WACs, and the ESF contract.

How to become a licensed and contracted ESF Provider

  1. Read and understand the licensing regulations, Chapter 388-107 WAC.
  2. Ensure the building meets all requirements in Chapter 388-107 WAC, by working with the Department of Health's Construction Review Services to comply with all building specifications.
  3. Submit the completed ESF license application and the license fee of $1,040 per bed.
  4. Work with Residential Care Services' licensors to comply with all requirements to obtain a license.
  5. Once licensed, submit an ESF contract application (available soon) to provide services to DSHS clients.

Contract Qualifications

In order to receive an ESF Contract to serve DSHS clients, the Contractor must provide evidence of all requirements listed below.

  1. The Contractor must have a current Enhanced Services Facility (ESF) license.
  2. The Contractor must have demonstrated experience and ability providing services and supports in a community based setting to adults with complex behavioral and personal care needs.
  3. The Contractor must have a demonstrated ability to provide (or arrange) for all required staff trainings.
  4. The ESF Contractor shall ensure qualified professionals are available as required the contract to furnish needed services. If the Contractor does not employ the qualified professional, the Contractor must ensure the facility has a written contract with a qualified professional or agency outside the facility to furnish the needed services in compliance with the Subcontracting section and Indemnification and Hold Harmless section, General Terms and Conditions of the contract. Prior written approval to subcontract is required.

Stakeholder Materials

Statute and Draft Regulations

Questions and Comments

For questions about the ESF Program, please contact Sandy Robertson at Sandy.Robertson@dshs.wa.gov

For questions about licensing and the licensing WACs, please contact Penny Rarick at penny.rarick@dshs.wa.gov.