Subject: Medicaid State Plan Amendments (SPAs) 24-0001, 24-0002, 24-0003, and a 1915(i) Waiver Amendment to Add Community Behavioral Health Support Services (CBHS).

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) intend to submit three SPAs and a 1915i waiver amendment to add CBHS services. CBHS services will include two services intended to better support the needs of individuals with complex behavioral health needs in long-term settings: Skills development and restoration and supportive supervision and oversight.

CBHS will begin replacing the majority of behavioral health personal care (BHPC) services in July 2024. Currently, BHPC services are offered as nontraditional services through managed care and are paid for with state-only funds. The new services will be available through both fee-for-service and managed care.

Collectively, these SPAs are expected to increase the annual aggregate cost/payment for CBHS. HCA will utilize its established rate setting methodologies to set rates to be paid for these new services in both the managed care and fee-for-service delivery models. The costs/payments associated with these new services will increase because HCA forecasts an increase in the number of clients eligible for these services. However, specific data are not currently available.

A copy of SPA 24-0001 is available for review. HCA and DSHS would appreciate any input or concerns regarding this SPA. SPAs 24-0002 and 24-0003 and the 1915(i) waiver amendment are under development. To request a copy of SPA 24-0001 or submit comments, or request a copy of SPAs 24-0002, 24-0003, or the waiver amendment when they become available, 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.


•	Submit SPA 24-0001 to add CBHS to the medicaid state plan via a 1915i application.
•	Submit SPA 24-0002 to update the medicaid state plan managed care table so CBHS services can be provided either FFS or within managed care.
•	Submit SPA 24-0003 to adjust the income rules to expand eligibility for CBHS in the medicaid state plan.
•	Submit an amendment to the 1915(b) waiver to adjust the projected rates to include the cost of implementing the 1915(i) CBHS benefit.

CONTACT: Jessica Diaz, Medicaid Program Division, 626 8th Street S.E., Mailstop 45530, Olympia, WA 98501, phone 360-725-1177, TRS 711, email jessica.diaz@hca.wa.gov, website https://hca.wa.gov.