Washington Medicaid Waiver Guide

Washington's Developmental Disabilities Administration, part of DSHS, runs five Medicaid waivers serving different situations rather than different diagnoses. The order of operations matters: DDA eligibility comes first and is a separate determination, and only after you are an eligible DDA client can you request a specific waiver. Your Case Resource Manager is the person who makes that request happen. The Individual and Family Services waiver is aimed specifically at people living with family where the caregiver's ability to continue may be at risk but can be sustained with added support.

You must first be determined an eligible DDA client under RCW 71A.10.020(5) — this is a distinct step, with its own paperwork, that precedes any waiver request. Once you have DDA eligibility, waiver enrollment depends on which waiver fits your circumstances, on meeting Medicaid financial rules, and on available capacity. If you do not have a Case Resource Manager yet, use DDA's Service Referral and Information Request page to get connected.

DDA eligibility does not by itself provide paid services — many Washington residents are DDA-eligible without a waiver. Waiver enrollment depends on capacity in the specific waiver that fits your circumstances, and requests are made through your Case Resource Manager. That is why establishing DDA eligibility early matters even if services are not needed yet.

Type

Capacity-limited per waiver, requested through your CRM

Typical timeline

Washington does not publish a single statewide wait figure. Because waivers are capacity-limited and organized by situation, the practical questions for your CRM are which waiver matches your circumstances, whether capacity exists, and what would change if your situation changed.

How to check status

Ask your Case Resource Manager directly. If you do not have one, use DDA's Service Referral and Information Request page to get connected to the right regional office.

1. Apply for DDA eligibility first

   Submit the eligibility paperwork through DDA's eligibility process to be determined an eligible client under RCW 71A.10.020(5). Nothing else can proceed until this is done, and it is worth doing even before services are needed.

   Open link
2. Get a Case Resource Manager

   Waiver requests go through a CRM. If you do not have one, use DDA's Service Referral and Information Request page to be connected.

3. Work out which waiver matches your circumstances

   IFS serves people living in the family home where the caregiver's capacity may be at risk. Core covers residential and more intensive needs. Basic Plus covers a defined set of community supports. CIIBS serves children with significant behavioral needs, and Community Protection has its own criteria.

   Open link
4. Establish Medicaid

   Waiver services are Medicaid-funded, so get Medicaid eligibility settled alongside the DDA determination rather than after.

5. Tell your CRM when the caregiving situation changes

   The IFS waiver is explicitly built around families whose ability to keep caring for someone may be at risk but can be sustained with added services. If that describes your household, say so plainly — it is the situation the waiver exists to address.

• The person's age, diagnosis, and county of residence.
• Medicaid status or whether you still need to apply.
• Current supports, urgent needs, and living situation.
• School, medical, evaluation, or eligibility documents.
• Questions about waitlists, timelines, and next steps.

Exact covered services depend on the waiver, assessed need, Medicaid rules, funding, and state program requirements. Confirm services, availability, and payment acceptance with the state, support coordinator, and provider.

Washington offers individual provider arrangements, letting participants hire and direct their own workers rather than using only agency providers. Ask your Case Resource Manager how individual providers work in your waiver and what employer responsibilities come with the choice.

1. Early childhood

   Washington's early intervention system serves infants and toddlers. Establishing DDA eligibility early is worthwhile even if no waiver is needed yet.

2. Childhood — CIIBS and IFS

   The Children's Intensive In-Home Behavioral Support waiver serves children with significant behavioral needs, and IFS supports children living in the family home. Ask which fits.

3. When caregiving becomes precarious

   IFS exists specifically for families whose ability to continue caring may be at risk but can be sustained with added services. That is a description of a situation, not a diagnosis — if it fits your household, raise it directly with your CRM.

4. Adulthood

   Some IFS services, including occupational, physical, and speech therapy, are specified for ages 21 and older. Core and Basic Plus cover adult residential and community supports. Discuss the shift with your CRM before it arrives.

If DDA eligibility or a waiver service is denied, reduced, or ended, you have the right to appeal within the deadline printed on your notice. Disability Rights Washington is the state's protection and advocacy agency — note that it does not respond to voicemails or emails requesting assistance, so you must go through its formal intake process.

DDA

Developmental Disabilities Administration, within Washington DSHS — determines eligibility and administers the waivers.

DDA eligibility

A determination under RCW 71A.10.020(5) that must come before any waiver request. Being eligible is not the same as receiving paid services.

CRM

Case Resource Manager — the DDA staff member who submits waiver requests and coordinates services.

IFS Waiver

Individual and Family Services Waiver — for people living in the family home where the caregiver's ability to continue may be at risk.

CIIBS

Children's Intensive In-Home Behavioral Support Waiver — for children with significant behavioral support needs at home.

Apple Health

The name of Washington's Medicaid program.

Individual provider

A worker you hire and direct yourself, as an alternative to agency-provided services.