COMMUNITY TRANSITION SERVICES PROVIDER IN WASHINGTON

Fatumata Kaba
4 hours ago
3 min read

SUPPORTING INDIVIDUALS AS THEY MOVE FROM INSTITUTIONAL SETTINGS INTO SAFE, STABLE, AND INDEPENDENT COMMUNITY LIVING ARRANGEMENTS

Community Transition Services in Washington help individuals transition from nursing facilities, intermediate care facilities, or institutional settings into home and community-based environments. These services cover the essential non-recurring expenses associated with setting up a household, enabling individuals to live independently with dignity and support.

These services are authorized under several Home and Community-Based Services (HCBS) Waivers, including the Basic Plus Waiver, Core Waiver, and Community Options Program Entry System (COPES). Oversight is provided by the Department of Social and Health Services (DSHS) through the Aging and Long-Term Support Administration (ALTSA) and the Developmental Disabilities Administration (DDA), with Medicaid funding from the Health Care Authority (HCA).

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1. GOVERNING AGENCIES

Agency: Department of Social and Health Services (DSHS) – ALTSA

Role: Manages community transition under long-term care waivers for aging adults and physically disabled individuals.

Agency: Developmental Disabilities Administration (DDA)

Role: Oversees transitions for individuals with intellectual and developmental disabilities through DDA waivers.

Agency: Health Care Authority (HCA)

Role: Provides Medicaid funding under Apple Health and manages program compliance.

2. COMMUNITY TRANSITION SERVICES OVERVIEW

Community Transition Services cover one-time, setup-related costs to help individuals successfully move into a home in the community.

Examples of allowable transition expenses:

Security deposits and initial rent
Utility deposits (electric, gas, water, phone)
Essential furnishings and household items
Moving expenses and initial food supplies
Setup of basic appliances (if not provided in the home)
Health and safety items (e.g., locks, fire extinguishers, shower chairs)

All purchases must be pre-approved and listed in the participant’s Person-Centered Service Plan (PCSP).

3. PROVIDER APPROVAL & LICENSING REQUIREMENTS

Prerequisites:

Register business with the Washington Secretary of State
Obtain an EIN and Type 2 NPI
Qualify as a DDA or ALTSA Community Transition Provider
Enroll in Medicaid through the ProviderOne Portal
Maintain liability insurance and submit to background checks
Develop a Transition Services Policy & Procedure Manual

Providers may be case managers, coordinators, or agencies experienced in housing, social work, or care transitions.

4. WASHINGTON PROVIDER ENROLLMENT PROCESS

Step 1: Register the business and obtain EIN and NPI

Step 2: Apply with DSHS/DDA as a Community Transition Provider

Step 3: Enroll in ProviderOne as a Medicaid billing provider

Step 4: Submit policy manual, service outlines, and staff credentials

Step 5: Coordinate with case managers to receive referrals

Step 6: Conduct home setup assessments and provide pre-approved goods or services

5. REQUIRED DOCUMENTATION

DSHS or DDA provider approval
ProviderOne enrollment confirmation
Policy & Procedure Manual including:
- Intake and home readiness checklists
- Transition planning forms
- Purchase approval, invoicing, and receipts protocol
- Staff background checks and training logs
- Participant rights, HIPAA policies, and incident response
- Sample documentation logs for reimbursements

6. STAFFING REQUIREMENTS

Role: Transition Coordinator / Specialist

Requirements:

Background in housing, case management, or disability services
Strong knowledge of home setup standards, Medicaid compliance, and local housing laws
Must pass background checks and be HIPAA trained

Role: Administrative/Logistics Support (Optional)

Responsibilities:

Track expenses, gather receipts, schedule vendors, and maintain documentation

All staff must complete:

HIPAA and client confidentiality training
Person-centered planning and abuse prevention
Financial tracking and fraud prevention training

7. MEDICAID PROGRAMS THAT COVER COMMUNITY TRANSITION

Community Transition Services are available under:

Basic Plus Waiver – For DDA clients moving to supported living or family homes
Core Waiver – For individuals transitioning from ICF/ID or intensive residential care
COPES Program – For older adults or physically disabled individuals leaving nursing homes
Roads to Community Living (RCL) – Time-limited demonstration project for nursing facility transitions
Foundational Community Supports (FCS) – May be paired with transition services for housing support

Each program has maximum allowable spending limits, usually capped at $850–$2,000, depending on waiver rules.

8. TIMELINE TO LAUNCH

Phase: Business Formation & NPI Registration

Timeline: 1–2 weeks

Phase: Provider Qualification (DSHS/DDA) & Medicaid Enrollment

Timeline: 1–2 months

Phase: Staff Onboarding & Policy Manual Finalization

Timeline: 2–3 weeks

Phase: Referrals & Service Delivery

Timeline: Begins upon participant approval and service plan authorization

9. CONTACT INFORMATION

DSHS – Aging and Long-Term Support Administration (ALTSA)

Website: https://www.dshs.wa.gov/altsa

Developmental Disabilities Administration (DDA)

Website: https://www.dshs.wa.gov/dda

Health Care Authority (HCA)

Website: https://www.hca.wa.gov

ProviderOne Portal (Billing)

Website: https://www.waproviderone.org

COMMUNITY TRANSITION SERVICES PROVIDER IN WASHINGTON

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — WASHINGTON TRANSITION SERVICES PROVIDER

WCG helps housing-focused organizations and care professionals launch compliant transition support programs to assist individuals in safely returning to the community.

Scope of Work: