What is a department contracted/licensed alternate living facility?

Department contracted facility means a licensed facility such as an adult family home or assisted living facility that is contracted with DSHS to provide services such as Medicaid Personal Care (MPC) or Developmental Disabilities Community Services (DDA) or Home and Community Services (HCS) Waiver services. It also applies to facilities that are contracted with the behavioral health organization (BHO) to provide services. The BHO provides Mental Health services. If the facility does not accept an individual with the BHO, DDA, or HCS services it is not considered a department contracted facility. A facility can be licensed, but not contracted with DSHS or mental health. Eligibility for individual's living in a licensed but not contracted facility is done as if the individual is in their own home. Facility rates can vary from one facility to another. The facility rate must be updated in ACES at each eligibility review and documented as to how the rate was verified.

The state rate is used for CN eligibility.

The private rate is used for MN eligibility.

The state and private rate could be the same, or the private rate could be lower than the state rate based on providing an individual with personal care services.

Some facilities that hold a contract with the department also have private-pay beds. Individuals not eligible for Medicaid or state payment for the cost of care in a department-contracted facility pay the private rate established by the facility. These individuals may still be eligible for noninstitutional medical assistance using the rules for the G03 program.

Locate an adult family home or boarding home contracted with DSHS . The list on the locator indicates if the facility is not contracted for Medicaid or mental health.