Home and Community Based Waivers (HCBS)

Waiver Overview

The Developmental Disabilities Administration (DDA) offers five Home and Community Based Services (HCBS) Waivers:

  • Basic Plus
  • Children's Intensive In-home Behavioral Supports (CIIBS)
  • Community Protection         
  • Core
  • Individual and Family Services (IFS). 

Each of the five waivers provides an array of services tailored to the specific populations they serve. Waiver services provide additional support when Medicaid state plan services and other supports are not sufficient.  For more information about the waiver program, go to the Services and Information Request form, contact your Case Resource Manager, Social Worker, or regional DDA office.

For detailed information about all DDA services, please visit the Informing Families Website.

DDA received approval from the Centers for Medicare and Medicaid Services (CMS) for the 5 year renewals of the following 4 waivers:  Basic Plus, Core, Community Protection (CP) and Children’s Intensive In-home Behavioral Support (CIIBS).  DDA also received approval of the Individual and Family Services (IFS) waiver amendment. 

Current Approved Waivers

Waiver Amendments

Draft waiver amendments for the Individual and Family Service, Basic Plus, Core, Community Protection and Children’s Intensive In-Home Behavioral Support (CIIBS) Waivers are available for public comment January 16, 2019, through February 16, 2019:

Proposed Changes to the IFS, Basic Plus, Core, Community Protection and Children’s Intensive In-Home Behavioral Support waivers effective July 1, 2019:

  • Add the following new services:
    • Specialized Habilitation, which are support services for clients to learn or maintain a range of life skills, to the IFS, Basic Plus and CIIBS waivers;
    • Complementary Therapies, Music Therapy and Equine Therapy, to the CIIBS waiver;
    • Person-Centered Plan Facilitation to the CIIBS waiver;
    • Community Engagement to the Basic Plus, CIIBS and Core waivers;
    • Specialized Evaluation and Treatment – Sex Offender Treatment Provider Therapy to IFS, Basic Plus, Core and CIIBS waivers; and
    • Stabilization Services – Crisis Diversion Beds to the IFS waiver.
  • Revise service options into new categories in the CIIBS waiver:
    • $8,000 per waiver year for any combination of Assistive technology, Environmental adaptations, Nurse delegation, Specialized habilitation, Specialize clothing, Specialized medical equipment and supplies, Specialized evaluation and treatment – sex offender treatment provider therapy, Staff/family consultation and training, Therapeutic equipment and supplies, Transportation and Vehicle modifications;
    • 125 hours of service per waiver year for any combination of Person-centered plan facilitation, music therapy, equine therapy and community engagement.
  • Redefine Stabilization Services in all five waivers to include:
    • Staff/Family Consultation and Training (existing service);
    • Specialized Habilitation (new service); and
    • Crisis Diversion Bed Services (existing service);
  • Reorganize the following supports to be included in a new service called Specialized Evaluation and Treatment Services:
    • Risk Assessment (including polygraph and plethysmograph);
    • Sex Offender Treatment Program Therapies; and
    • Community Protection Program Treatment
  • Revise the following service:
    • Chemical Extermination of Bed Bugs to become Extermination of Bed Bugs; and
    • Respite definition to include: personal care is incidental to the delivery of this service.
    • Exit process for Positive Behavior Support
  • Add provider types to the following services:
    • Enhanced Adult Residential Care to Respite
    • Teacher to Staff/Family Consultation and Training
  • Remove the following services:
    • Community Guide from Basic Plus and Core waivers (replaced by Community Engagement);
    • Specialized Psychiatric Services from all waivers; and
    • Pre-vocational Services from the Basic Plus, Core and Community Protection waivers.

All participants who are currently receiving services proposed to be removed will be transitioned to appropriate Medicaid state plan or other waiver services during their plan year 2018-2019. We believe these proposed changes will have minimal impact on current or future DDA waiver participants.

To view a draft amendment, click on the bolded name of the waiver amendment above.

Send your comments to DDAWaiverAmendments@dshs.wa.gov during the comment period.

DDA Waiver Amendment Stakeholder Summary

In June, 2018 DDA representatives met with stakeholders across Washington State to discuss amendments to DDAs five HCBS waiver programs.  The amendments would help redefine DDA services to make the pathway to access between AppleHealth behavioral health and DDA waiver services more transparent and easier for a waiver participant to navigate. Stakeholder feedback summary

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Resources