Home and Community Based Waivers (HCBS)

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. 

Current Approved Waivers

The Centers for Medicare and Medicaid Services have approved DDA’s five HCBS Waiver Appendix K applications.  Appendix K provide the state flexibility in existing waiver programs.

Waiver Amendments

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Draft Waiver Amendments

Draft waiver amendments for the Basic Plus, Core, Community Protection and Children’s Intensive In-Home Behavioral Support (CIIBS) Waivers are available for public comment January 20, 2021, through February 20, 2021:

Proposed Changes to the Basic Plus, Core, Community Protection and Children’s Intensive In-Home Behavioral Support waivers effective September 1, 2020:

Add approved common reporting language that was removed from the waiver applications in error during the waiver renewal process in 2017. This common reporting language describes how the Developmental Disabilities Administration monitors and remediates waiver service performance issues using a common set of performance measures, reports and monitoring tools across all of the Administration’s waivers. 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.

Developmental Disabilities Administration (DDA) has received approval for amendments for five waivers funded by the Centers for Medicare and Medicaid Services (CMS). Affected waivers include:

  • Individual and Family Services (IFS)
  • Basic Plus
  • Core
  • Community Protection
  • Children’s Intensive In-Home Behavioral Support (CIIBS)

DSHS and Health Care Authority amended the waivers with a revised effective date of October 1, 2020. The amendments changes include:

  • Adding the following new services:
    • Specialized Habilitation; Support services for clients to learn or maintain a range of life skills, to the IFS, Basic Plus, non-residential Core and CIIBS waivers
    • Music Therapy and Equine Therapy, to the CIIBS waiver
    • Community Engagement to the Basic Plus and Core waivers and
    • Therapeutic Adaptations to the IFS, Basic Plus and CIIBS waivers
  • Renaming and redefining Behavioral Health Stabilization Services in all waivers to include:
    • Stabilization Services – Staff/family consultation services (existing service)
    • Stabilization Services – Specialized habilitation (new service)
    • Stabilization Services – Crisis diversion bed (existing service)
  • Revising the following service in the Basic Plus, Core and Community Protection waivers:
    • Chemical extermination of bed bugs to become Extermination of bed bugs
  • Closing new enrollment for youth age 20 and younger and phasing out Positive behavior support and consultation from Basic Plus, Core, Individual and Family Services and Children’s Intensive In-Home Behavioral Support waivers for adult clients age 21 and older. The replacement service is Specialized habilitation, in addition to Medicaid state plan behavioral support services through Managed care organizations (MCOs) or Medicaid fee-for-service)
  • Revising the service provider requirements for:
    • Group training homes
  • Restructuring CIIBS waiver fund categories for improved budget tracking
  • Removing the following services:
    • Community guide from Basic Plus and Core waivers (replaced by Community engagement)
    • Specialized psychiatric services from all waivers (service is available under the Medicaid State Plan)
    • Skilled nursing (except nurse delegation) for youth age 20 and younger from all waivers (service is available under the Medicaid state plan)
    • Personal care from Basic Plus waiver (service is available on the Community First Choice program)
    • Prevocational services from the Basic Plus, Core and Community Protection waivers (all clients previously receiving services have already transitioned to other services)
    • Behavioral health stabilization services – positive behavior support and consultation (replacement services include Stabilization services – specialized habilitation and Stabilization services – staff/family consultation services)
    • Behavioral health stabilization services – specialized psychiatric services (service is available under the Medicaid state plan)
  • Adjusting technical language
  • Revising performance measures
  • Revising estimates for state plan utilization and expenditures
  • Revising estimates for waiver service utilization and expenditures
  • Revising post-eligibility treatment of income language for CIIBS waiver.

All affected waiver participants currently receiving services that will be removed or phased out, will be transitioned to an appropriate Medicaid state plan or other waiver services during a transition process.

  • Individuals currently receiving community guide will be auto enrolled to community engagement with the same provider and same number of service hours
  • Specialized psychiatric services and behavioral health stabilization services- specialized psychiatric & positive behavior support will end on September 30th
  • Clients receiving behavioral health stabilization services- specialized psychiatric & positive behavior support will transition to state-only funding supports during a 3-month transition period.

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