Description: The health care authority (HCA) in conjunction with the aging and long-term support administration (ALTSA) in the department of social and health services (DSHS) previously published their intent to submit medicaid SPA 22-0007 in WSR 22-01-142. This SPA will amend Washington's 1915(i) section of the medicaid state plan for home and community-based service benefits regarding behavioral health personal care (BHPC), in compliance with legislative direction. Currently, BHPC services are offered as nontraditional services through the managed care delivery system and are paid with state-only funds. The previous projected effective date for SPA 22-0007 was July 1, 2022; this has changed and is now anticipated to be effective January 1, 2023.

SPA 22-0007 is expected to increase the annual aggregate cost/payment for community behavioral health support services, which includes protective oversight and supervision and direct skill development or restoration. HCA will set rates to be paid for these new services in both the managed care and fee-for-service delivery models. HCA will utilize its established rate setting methodologies. The costs/payments associated with these new services will increase because HCA forecasts an increase in the number of clients eligible for these services; see below (note - this information is unchanged from the previous notice):

SPA 21-0007 is in the development process. A copy will be available for review on February 10, 2022, on HCA's website. HCA and ALTSA would appreciate any input or concerns regarding this SPA. To request a copy when it becomes available or to submit comments, please contact the person named below (please note that all comments are subject to public review and disclosure, as are the names of those who comment).

Interested parties may submit comments and concerns about the rates or the effects the changes may have on beneficiary access to care or continued service access. Please submit comments and concerns to the person named below by February 24, 2022. Please note that all comments are subject to public review and disclosure, as are the names of those who comment.

CONTACT: Rebecca Carrell, Medicaid Programs Division, 805 Plum Street, Olympia, WA 98501, phone 360-972-0347, TRS 711, email rebecca.carrell@hca.wa.gov, website hca.wa.gov.

Fiscal Year	State Costs	Federal Match	Total Cost
2022	$20,097,792.00	$25,579,008.00	$45,676,800.00
2023	$22,509,527.04	$28,648,488.96	$51,158,016.00