Aging and Long-Term Support Administration

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Blake Office Park Employee Emergency Line: 360-725-2301
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The 2022 Long-Term Services and Supports (LTSS) Accomplishments Report (PDF) provides an overview of the significant policy and operational elements that keep Washington’s LTSS system strong. We encourage you to read more about how the Aging and Long-Term Support Administration provides a framework for over four decades of community-based services. In addition to the Older American’s Act services that reach over 170,000 individuals and 13,000 unpaid family caregivers annually, Washington has a strong Medicaid long0term care network. As of October 2022, Washington serves a monthly caseload of nearly 67,000 individuals in Medicaid home and community-based (HCBS) long-term care. Another 7,600 receive monthly services in skilled nursing facilities. Of the Medicaid HCBS individuals, over 48,500 receive services in-home and are offered care planning and case management through Washington’s 13 Are Agencies on Aging (AAA).


ALTSA's Derrick Ross receives the Reverend Dr. Martin Luther King Jr. DSHS "Beloved Community" Award! The Beloved Community Award honored an employee, a community partner and a business that have made significant contributions in the areas of service to the community, social justice/human rights, and/or racial equity, anti-racism and the empowerment of Black, Indigenous and People of Color communities. Read more on the DSHS Medium page.


DSHS has maintained Apple Health Medicaid Coverage for the Aged, Blind or Disabled population during the Public Health Emergency, and will continue into the future, however beginning April 1, 2023 customers must complete a renewal in order to keep your coverage.

You will receive a letter in the mail when it is time for your renewal. Make sure your address and phone number with Washington Connection is up to date so you can stay enrolled. Report a change.

What We Do

The Aging and Long-Term Support Administration (ALTSA) promotes choice, independence, and safety through innovative services and partnerships with tribes, advocates, providers and caregivers to support seniors and people with disabilities so they can live with good health, independence, dignity and control over decisions that affect their lives.


Adult Protective Services (APS) investigates reports of abuse, neglect, and exploitation of vulnerable adults.

Home and Community Services (HCS) provides and administers long-term care services to eligible individuals and collaborates with Area Agencies on Aging to share community service options. 

Residential Care Services (RCS) provides licensing, certification, and regulatory oversight to long-term care facilities including:

  • Nursing Homes
  • Assisted Living Facilities
  • Adult Family Homes
  • Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID)
  • Supported Living; and
  • Enhanced Services Facilities

The Office of the Deaf and Hard of Hearing (ODHH) provides service to individuals who are deaf, hard of hearing, deaf-blind and speech-disabled facing communication barriers. Services include telecommunications, reasonable accommodations and client services.

The Management Services Division (MSD) supports the operations of the Aging and Long-Term Support Administration providing rates management, administrative support services, information technology, fiscal and contract management, and personnel operations.