Changes to Medicaid LTSS Eligibility from HR 1 (Non-citizen impacts), Residential Providers
Event Information
DSHS is planning a webinar for adult family homes and other long-term care facilities around these changes. The session is anticipated to include program information and an opportunity for providers to ask questions. We encourage AFHs to register and join.
For long-term services and supports residential providers, skilled nursing facilities and hospital. Presentation on DSHS HCLA implementation work related to HR 1 and opportunity for Q&A.
Registration not required.
Non-Citizens in Adult Family Homes: What AFH Providers Need to Know
Beginning October 1, 2026, federal changes under H.R. 1 will restrict access to federally funded Apple Health Medicaid long-term services and supports (LTSS) for some non-citizen residents.
Residents who may be affected include individuals with refugee, asylee, trafficking-survivor, Ukrainian humanitarian parolee, or certain other humanitarian-protection statuses. DSHS has advised that affected residents will receive information about these changes and should report any change in immigration or citizenship status to DSHS.
State-Funded Services for AFH Residents
AFHC requested additional clarification from DSHS regarding the impact of H.R. 1 on residents living in adult family homes.
DSHS has advised that affected AFH residents who are currently receiving Medicaid-funded long-term services and supports will continue to receive services through available state funding when the federal changes take effect.
The agency is still working through the operational details of the state-funded model. As soon as we know more, we will provide that information.
Funding and Implementation
The Legislature appropriated funding to address a portion of impact of non-citizen residents in long-term care facilities. DSHS has explained that the available funding is limited and that the long-term availability of state-funded services remains uncertain.
The state is developing an emergency rule for implementation by October 1, 2026, and expects to begin permanent rulemaking shortly thereafter. From our understanding, there should not be proposed changes to AFH reimbursement, service limits, provider documentation, training, or other administrative requirements once the state funding gets rolled out.
AFHC will continue to monitor the rulemaking process, implementation details, and funding developments and will advocate for clear communication and continuity of services for affected AFH residents.