The Long-Term Services and Supports Trust Program (Trust Program) provides long-term care benefits to persons who have paid into the Trust Program for a specific period of time and who have been assessed as needing a certain amount of assistance with activities of daily living.? The Trust Program is administered jointly by the Department of Social and Health Services, the Employment Security Department, and the Health Care Authority.

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The Trust Program is funded through a 0.58 percent premium assessment on an employee's wages. ?An employee in Washington may become a qualified individual under the Trust Program if they have paid the premium assessment for either three of the last six or years or a total of ten years with no more than a five-year interruption. ?A qualified individual may be eligible to receive benefits if the person is a Washington resident, is at least 18 years old, and has been assessed as needing assistance with at least three activities of daily living. ?Eligible beneficiaries may receive benefits in the form of benefit units that the Department of Social and Health Services pays to long-term services and support providers. ?The premium assessment began July 1, 2023, and eligible beneficiaries may begin receiving benefits on July 1, 2026.

Out-of-State Participation in the Long-Term Services and Supports Trust Program.
Beginning July 1, 2026, employees or self-employed persons who have moved out of Washington may elect to continue participation in the Long-Term Services and Supports Trust Program (Trust Program). ?The option is available to persons who have been assessed premiums under the Trust Program for at least three years in which they worked at least 500 hours in Washington. ?A person must notify the Employment Security Department (ESD) of the decision to continue coverage within one year of establishing a primary residence outside of Washington.

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Out-of-state participants must report their wages or self-employment earnings and provide documentation to the ESD. ?After age 67, out-of-state participants are no longer required to provide documentation to the ESD, but if they earn wages or self-employment income, they must submit reports of wages or self-employment earnings and remit premiums. ?The coverage may be canceled if the out-of-state participant fails to make payments or submit reports.

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An out-of-state participant may become eligible to receive benefits under the Trust Program beginning January 1, 2030. ?To become an eligible beneficiary, an out-of-state qualified individual must apply to the Department of Social and Health Services (DSHS) and undergo an eligibility determination. ?The eligibility determination must evaluate whether the individual:

1. is unable to perform without substantial assistance, at least two of the following activities of daily living for at least 90 days:? eating, toileting, transferring, bathing, dressing, or continence; or
2. requires substantial supervision to protect the individual from threats to health and safety due to severe cognitive impairments.

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Entities that provide services to out-of-state participants must meet care provision and program administration standards established by the DSHS and be appropriately credentialed in the jurisdiction in which the services are being provided. ?The DSHS must develop criteria to allow family members to provide services to an eligible beneficiary who is residing outside of Washington.

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The ESD must adopt standards for the manner and timing of reporting and document submission for out-of-state participants, collect premiums from out-of-state participants, and verify the wages or self-employment earnings reported by out-of-state participants.

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Prohibition on Discrimination.
Discrimination against persons based upon race, gender, age, or preexisting condition is prohibited under the Trust Program. ?The DSHS must adopt rules to prohibit discrimination in the Trust Program to apply to all state agencies, persons, and entities implementing the chapter. ?These prohibitions apply to both in-state and out-of-state participants as well as entities providing services to eligible beneficiaries outside Washington. ?The prohibitions are additional and supplemental to existing protections against discrimination under federal, state, and local laws.