PERSONAL CARE SERVICES PROVIDER IN WASHINGTON

Fatumata Kaba
36 minutes ago
3 min read

SUPPORTING INDIVIDUALS WITH DAILY LIVING TASKS TO PROMOTE DIGNITY, SAFETY, AND INDEPENDENCE AT HOME

Personal Care Services in Washington provide non-medical assistance with daily activities for individuals who need help due to age, illness, disability, or chronic conditions. These services allow people to remain in their homes and communities while receiving the essential support they need.

Personal Care is covered under Washington’s Apple Health (Medicaid) State Plan and through various Home and Community-Based Services (HCBS) waivers, such as the Community First Choice (CFC) Option, COPES, and New Freedom Waiver. Oversight is provided by the Washington State Health Care Authority (HCA) and the Department of Social and Health Services (DSHS) via the Aging and Long-Term Support Administration (ALTSA).

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1. GOVERNING AGENCIES

Agency: Washington State Health Care Authority (HCA)

Role: Administers Apple Health (Medicaid) and ensures medical necessity and reimbursement processes for personal care services.

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

Role: Oversees long-term care and waiver-based personal care services; manages contracts and provider qualifications.

Agency: Developmental Disabilities Administration (DDA)

Role: Coordinates personal care for individuals with developmental or intellectual disabilities under specific HCBS waivers.

2. PERSONAL CARE SERVICES OVERVIEW

Personal Care Services support individuals in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), based on an authorized Person-Centered Service Plan (PCSP).

Covered services include:

Bathing, dressing, grooming, and hygiene
Mobility and transfers
Toileting and incontinence care
Meal preparation and eating assistance
Light housekeeping and laundry
Medication reminders (non-nursing)
Community access and safety monitoring

Services can be agency-based or consumer-directed (Individual Provider Program), depending on the participant's preference and waiver eligibility.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Washington Secretary of State
Obtain an EIN and Type 2 NPI
Apply for a Home Care Agency License through the Washington State Department of Health (DOH)
Complete the DSHS contract process to serve Medicaid clients
Enroll as a provider with HCA’s ProviderOne system
Develop a Personal Care Policy & Procedure Manual per state standards

4. WASHINGTON PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN and NPI

Step 2: Apply for Home Care Agency License via DOH

Step 3: Complete DSHS Medicaid provider contracting

Step 4: Enroll in ProviderOne for Medicaid billing

Step 5: Hire and train certified home care aides (HCAs)

Step 6: Begin service delivery once participant’s PCSP is authorized

5. REQUIRED DOCUMENTATION

Secretary of State registration, EIN, and NPI
DOH Home Care Agency license
Medicaid provider approval from DSHS
Personal Care Policy & Procedure Manual including:
- ADL/IADL task protocols
- Service documentation and time tracking
- Medication assistance guidelines
- Client rights and grievance procedures
- Staff orientation, training logs, and supervision plans
- Incident reporting and infection control
- HIPAA and abuse prevention measures

6. STAFFING REQUIREMENTS

Role: Home Care Aide (HCA)

Requirements:

Certified by DOH as a Home Care Aide
Must complete 75-hour training and pass the state exam
CPR/First Aid certification
Background checks via DSHS

Role: Nurse Delegator (if applicable)

Responsibilities:

Delegates and supervises certain nursing tasks to HCAs (e.g., insulin injections, catheter care)

All staff must complete:

Mandatory reporter and abuse prevention training
HIPAA and confidentiality modules
Infection control and emergency preparedness
Annual continuing education (CE)

7. MEDICAID WAIVER PROGRAMS & OPTIONS

Personal Care Services are provided under:

Community First Choice (CFC) – State Plan benefit for individuals eligible for Apple Health and needing ADL/IADL support
COPES Waiver – For individuals requiring a nursing facility level of care but preferring to stay at home
New Freedom Waiver – Offers self-directed personal care services with individualized budgets
Basic Plus and Core Waivers (via DDA) – For clients with developmental disabilities

All services require authorization via a Person-Centered Service Plan developed by a DSHS case manager or DDA representative.

8. TIMELINE TO LAUNCH

Phase: Business Registration & HCA Licensing Prep

Timeline: 3–5 weeks

Phase: DOH Licensing & DSHS Contracting

Timeline: 2–3 months

Phase: ProviderOne Enrollment & Staff Hiring

Timeline: 4–6 weeks

Phase: Service Launch

Timeline: Begins after staff are certified and participant plans are authorized

9. CONTACT INFORMATION

Washington State Department of Health (DOH) – Home Care Agency Licensing

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

Washington State Health Care Authority (HCA)

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

ProviderOne Enrollment Portal

Website: https://www.waproviderone.org

Department of Social and Health Services (DSHS) – ALTSA

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

Developmental Disabilities Administration (DDA)

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

PERSONAL CARE SERVICES PROVIDER IN WASHINGTON

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — WASHINGTON PERSONAL CARE PROVIDER

WCG assists agencies in navigating Washington’s multi-agency system, from licensing and Medicaid approval to staffing and documentation for compliant, high-quality personal care delivery.

Scope of Work: