Changes To Residential Support Waiver (RSW)
DSHS recently released a Dear Provider letter outlining changes to the Residential Support Waiver (RSW) scheduled to start July 1, 2025. Services under RSW include Expanded Community Support (ECS) and Specialized Behavior Support (SBS). The state is shifting how it pays for behavioral health support to leverage better federal participation and reduce state costs. This means that SBS and ECS will no longer be the primary program for serving residents needing behavioral or mental health support. Community Behavioral Health Supports Services (CBHS) program, administered by the Health Care Authority (HCA) under a 1915(i) State Plan Authority will become the primary program.
Providers serving this population may already have clients converting to the CHBS services. If you are a home serving this population and you have not yet had a client convert to CBHS, you may want to review the process for starting that contracting available here: Community Behavioral Health Support (CBHS) services | Washington State Health Care Authority.
We have heard from many members already engaged in the CBHS program about reductions in rates, delays in payments, loss of support, contracting challenges, and additional administrative burdens presented by this change in program. The Adult Family Home Council has filed multiple unfair labor practices against HCA and DSHS based on the state’s failure to appropriately engage us in the negotiation of these changes. We are currently bargaining over the impact of these services. Unfortunately, the state has not been transparent in their plans to implement CBHS and modify RSW services. For example, the Council was specifically told that current RSW clients would remain on RSW, and only new residents would begin CBHS— but this letter states they intend to begin converting all eligible residents now.
As we continue to learn and negotiate the impact of this change, please ask us questions, and share your challenges. We need your input to ensure you have the tools you need and our residents still receive appropriate benefits that allow you to support them in your homes.
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