I/DD Waivers in Washington

All states: Medicaid disability services map

Washington I/DD services at a glance

Last verified against state sources: 2026-10-28.

Who runs I/DD services in Washington?

The Developmental Disabilities Administration (DDA) in the Department of Social and Health Services (DSHS) runs Washington's I/DD home and community services day to day. The Health Care Authority (HCA) is the state Medicaid agency, and DDA operates the five I/DD waivers under a written agreement with HCA. DDA case resource managers, who are state staff, assess each person and write their service plan.

• DDA, also called Developmental Disabilities Community Services (DDCS): since May 1, 2025, DDA has been a division of the DSHS Home and Community Living Administration (HCLA), according to a 2025 report to the Legislature. DSHS public pages and brochures still use the DDA name, so this page does too.
• Health Care Authority (HCA): the state Medicaid agency. Washington's Medicaid program is called Apple Health.
• Counties: DDA contracts with counties for supported employment and community inclusion. Counties provide these services or subcontract with local providers.
• Front door: people first apply for DDA eligibility through a DDA regional intake team. Once eligible, they request paid services or a waiver through their case resource manager, an online Service and Information Request form or a regional service request line.

What Medicaid waivers and programs serve people with I/DD in Washington?

Washington has five 1915(c) waivers for people with intellectual and developmental disabilities, all run by DDA. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. Each waiver serves a different group and has a limit on how many people it can enroll. DDA clients can also get personal care through Community First Choice, a state plan benefit.

• Basic Plus Waiver (control number WA.0409): serves DDA clients of all ages who live in their own home, a family home, an adult family home or an adult residential center. Services include respite, supported employment, community inclusion, community engagement, life skills, remote support, staff and family consultation, stabilization services, assistive technology, environmental adaptations, therapies and skilled nursing (21 and up) and transportation. It has an annual aggregate service budget and room for up to 13,400 people. See the Basic Plus waiver document.
• Core Waiver (WA.0410): serves children and adults at immediate risk of institutional placement, or who need residential habilitation that Basic Plus cannot provide. Residential habilitation means support to live in the community, in settings such as supported living, group homes, group training homes, companion homes, alternative living and children's residential settings. Core also covers supported employment, community inclusion, community engagement, respite (for people not in residential habilitation), supported parenting, remote support, stabilization services, specialized equipment and transportation. See the Core waiver document.
• Community Protection Waiver (WA.0411): serves adults 18 and older assessed as at risk of violent, stalking, sexually violent or predatory behavior who need 24-hour on-site staff supervision and agree to follow the Community Protection program. Services include residential habilitation (therapeutic residential supports), supported employment, specialized evaluation and consultation, risk assessment, stabilization services, staff and family consultation, therapies and skilled nursing (21 and up) and transportation.
• Individual and Family Services (IFS) Waiver (WA.1186): serves people of all ages who live in the family home with another family member and need waiver services to stay there. Each person has an annual budget based on assessed need. Services include respite, community engagement, life skills, peer mentoring, person-centered plan facilitation, supported parenting, remote support, assistive technology, home and vehicle modifications, specialized equipment and transportation. It has room for up to 8,000 people.
• Children's Intensive In-Home Behavioral Support (CIIBS) Waiver (WA.40669): serves youth ages 8 to 17 at enrollment (served through age 20) who are at high or severe risk of out-of-home placement because of challenging behaviors and live with a participating family member. Services include intensive wraparound care coordination, respite, life skills, equine and music therapy, peer mentoring, person-centered plan facilitation, staff and family consultation, assistive technology, modifications and transportation. It has room for up to 200 youth.

A related program, Community First Choice (CFC), is a 1915(k) state plan benefit, which means it is part of the regular Medicaid plan rather than a waiver with slots. It pays for personal care, relief care, skills acquisition training, caregiver management training, personal emergency response systems, assistive technology and community transition services for Apple Health clients who meet institutional level of care and live in their own home, an adult family home or an assisted living facility. CFC also serves older adults and people with physical disabilities. Washington's institutional option is four state-run Residential Habilitation Centers, which include Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).

Does Washington pay for I/DD services through managed care?

No. Washington pays I/DD waiver services fee-for-service, meaning the state pays each provider directly for each authorized service. Services are authorized and paid through ProviderOne, the state's Medicaid payment system. No health plan sits between DDA and the provider for waiver services.

• Who coordinates services: DDA case resource managers complete assessments and person-centered service plans and authorize services.
• Who pays claims: providers bill ProviderOne.
• County role: for supported employment and community inclusion, DDA contracts with counties, which contract with and oversee local providers and negotiate their unit rates. DDA directly manages the other parts of the waivers.

Is there a waiting list for I/DD services in Washington?

Yes. Each waiver has a slot limit, and people who request a waiver when no slot is open go on a statewide waiver service request list. The state's Caseload Forecast Council reported 349 people on that list in September 2026. People are enrolled by priority as capacity opens.

• Which waivers are full: the Caseload Forecast Council says all waivers have enough capacity except IFS and CIIBS, and that rising IFS requests drive its forecast growth for 2025 to 2027.
• Priority order: when a slot opens, DDA enrolls from the statewide list by priority. Current waiver participants whose needs call for a different waiver come first, followed by groups such as priority populations funded by the Legislature and people at immediate risk of ICF/IID admission.
• Legislation: a 2026 bill, SB 6163, would have budgeted IFS waiver costs to end the IFS wait list. It did not pass.

To check a person's status on the list, families can ask their DDA case resource manager or their regional service request line.

How do people apply for I/DD services in Washington, and how are budgets set?

A person first applies for DDA eligibility by sending form 14-151 (Request for DDA Eligibility Determination) and form 14-012 (Consent), with records, to their regional intake team. DDA decides within 30 days of receiving the last document. An eligible client then requests a waiver, and the DDA Assessment sets the level of support and, for some services, the budget or hours.

• Regional intake teams: Region 1: DDAR1IE@dshs.wa.gov, (800) 462-0624. Region 2: DDA2IETEAM@dshs.wa.gov, (800) 326-1247. Region 3: DDAR3IE@dshs.wa.gov, (800) 248-0949.
• DDA eligibility: under chapter 388-823 of the Washington Administrative Code (WAC), a qualifying developmental disability that began before age 18, with an adaptive assessment from the past 36 months.
• Waiver eligibility: Social Security disability, long-term care Apple Health with income up to 300 percent of the SSI benefit and resources under $2,000 (or Apple Health for Workers with Disabilities), ICF/IID level of care set in the assessment, and an open waiver slot.
• Assessment: the DDA Assessment is done in the state's CARE system. It uses the Supports Intensity Scale (SIS-A 2nd Edition since January 1, 2025) for ages 16 and up and the Children's Support Assessment for 15 and under, plus a Service Level Assessment. A full SIS is repeated every five years.
• How it sets services: the SIS sets residential support levels, which drive the daily rate for supported living and group homes, and it caps monthly community inclusion hours. Basic Plus has an annual aggregate service budget, and IFS gives each person an annual budget based on assessed need.

What day and residential services can I/DD providers offer in Washington?

Day services in Washington center on supported employment and community inclusion, both delivered through county contracts and billed by the hour. Residential habilitation is offered in the Core and Community Protection waivers in several settings. Supported living, group homes and group training homes are certified by DSHS Residential Care Services.

Day and employment services

• Supported employment (individual and group): in Basic Plus, Core and Community Protection, for ages 21 and up. Ongoing support to get and keep a job in the community, including job development, on-the-job training and retention supports. No license is required; providers contract with counties under DDA county service guidelines. Group supported employment is limited to groups of no more than eight workers with disabilities. Billed hourly.
• Community inclusion: in Basic Plus and Core. Individual community activities to build relationships and skills, for people for whom a job is not right at this time or who have had at least nine months of employment services. Monthly hours are capped by a SIS-based acuity level, from up to 3 to up to 20 hours a month. County-contracted, no license. Billed hourly. The research did not find a published staff ratio.
• Community engagement: in Basic Plus, Core and IFS. Support to go out and take part in the community. We did not find its licensing, ratio or billing unit.

Residential services

• Supported living: instruction, supports and supervision in the person's own rented home, often shared with housemates, paid on a tiered daily rate. Providers are certified (not licensed) as Certified Community Residential Services and Supports (CCRSS) under chapters 388-101 and 388-101D WAC. DSHS also runs its own supported living, called State Operated Living Alternatives (SOLA).
• Group homes and group training homes: agency-run homes for adults, paid on the same tiered daily rate. Adult group care homes are licensed as assisted living facilities (chapter 388-78A WAC) and certified under chapter 388-101 WAC. Group training homes are certified under chapter 388-101 WAC.
• Companion homes: a shared living model where a contracted provider supports one client in the provider's own home, paid a daily rate from the DDA assessment. DDA contract qualifications apply; the waiver lists no facility license.
• Alternative living: hourly individual support for people living on their own, under DDA contract qualifications.
• Children's residential settings: residential habilitation in licensed child foster homes, group care facilities and staffed residential homes, licensed by the Department of Children, Youth, and Families.
• Residential Habilitation Centers: four state-run centers, Lakeland Village and Fircrest School (ICF/IID and nursing facility), Rainier School (ICF/IID) and Yakima Valley School (nursing facility). They serve adults 21 and older, and ages 16 to 20 when community services cannot meet their needs.

How are I/DD provider rates set and how do agencies enroll in Washington?

Washington sets rates differently by service. Supported living, group homes and group training homes are paid one of nine daily rate tiers. Respite and personal care rates follow the union contract and legislative funding, and counties negotiate supported employment and community inclusion rates with their providers. DSHS's rate workbook lists current rates as of July 1, 2026.

• Residential rates: a residential rate assessment built on the SIS places each person in one of nine tiers. Tiers 1 to 8 are standard rates that vary by county group (King County, other metro counties and non-metro counties); tier 9 is set individually. See DSHS's supported living, group training home and group home rate documents. New rate tables for supported living, group homes and companion homes were added for July 1, 2025.
• Other rates: companion homes get a daily rate from the electronic rates system, and alternative living is paid hourly. Individual provider and agency respite and personal care rates follow the collective bargaining agreement with SEIU (the caregivers' union) and legislative funding. Professional services use rate ranges based on federal Bureau of Labor Statistics wage data.
• Rate workbook: the All DDA Rates workbook lists rates as of July 1, 2026. We did not confirm whether the 2026 budget changed residential or county service rates that month.
• Becoming a provider: DDA's provider information page covers enrollment. New supported living, group home and group training home providers request the CCRSS application at ccrssapplicationsrequest@dshs.wa.gov, then contract with DDA and bill through ProviderOne. Supported employment and community inclusion providers contract with their county.
• Individual providers: the Consumer Directed Employer (CDE) has been the legal employer of individual providers of waiver respite and CFC personal care since June 1, 2022. The client chooses and manages the caregiver and acts as co-employer.
• EVV: electronic visit verification is required for Medicaid in-home personal care, respite and home health. For DDA clients this covers CFC personal care, in-home respite and waiver skilled nursing. Washington uses a provider choice model, so home care agencies pick their own EVV system, and ProviderOne collects the data as aggregator. Individual providers employed by the CDE use the CareAttend app.

What is changing next for I/DD services in Washington?

DDA plans to consolidate its five waivers into two under its Waiver Restructure Report. This needs legislative funding and has no effective date. As of October 28, 2026, the plan is a recommendation, not a final decision.

• Waiver restructure: DDA's December 2024 Waiver Restructure Report recommends moving from five waivers to two. DSHS's waiver redesign page says many of the recommendations need funding from the Legislature and would take multiple years. Separately, DSHS aims to improve services on the current waivers by September 2027.
• A Path Forward: a long-term plan for developmental disability services that the Legislature requested, including reducing reliance on large institutions, is due to the Legislature by June 30, 2027. See DSHS's A Path Forward page.
• Flood emergency flexibilities: an Appendix K emergency amendment in effect from December 9, 2025 through November 30, 2026 allows extended aggregate budgets, services in temporary settings and residential habilitation retainer payments of up to 70 percent for up to 30 days. These flexibilities are set to end November 30, 2026.

Recent changes already in place: waiver amendments effective January 1, 2025 added a foster care eligibility group, moved to SIS-A 2nd Edition, renamed Specialized Habilitation to Life Skills and raised Basic Plus capacity to 13,400.

Washington I/DD sources

• DSHS Developmental Disabilities Administration: Home and Community Based Waivers
• DSHS: DDA waiver services brochure (22-605)
• DSHS: Core Waiver (WA.0410, effective January 1, 2025)
• DSHS: How to enroll in DDA
• Caseload Forecast Council: DDD Total Waiver Requests
• Caseload Forecast Council: DDA Waiver Requests handout
• DSHS: SL, GTH and GH rates and reimbursement documents
• DSHS: DDA and counties provider information
• DSHS: Electronic Visit Verification
• DSHS: DDA waiver redesign project overview and updates

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• What is Active Support in Disability Services?
• Outcome Measures in Disability Services: Measuring what matters
• I/DD services in every state (map)
• Washington EVV requirements

Page history

• October 28, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.