A Major Organizational Change
Simplify Your Home Care Operations
CareCade helps DDA and HCBS providers manage scheduling, EVV, and billing in one platform.
In May 2025, the Washington State Department of Social and Health Services (DSHS) announced a significant restructuring creating two new administrations:
- Behavioral Health and Habilitation Administration: For clients receiving residential habilitation and behavioral health services in state-operated facilities
- Home and Community Living Administration (HCLA): For clients receiving home and community-based services through contracted providers
For home care providers—especially those serving individuals with developmental disabilities through DDCS—the creation of HCLA represents the most significant organizational change in years.
What Changed
The Merger
HCLA brings together:
| Previous Structure | New Structure |
|---|---|
| Developmental Disabilities Administration (DDA) - Community Services | Home and Community Living Administration (HCLA) |
| Aging and Long-Term Support Administration (ALTSA) | Home and Community Living Administration (HCLA) |
The community-based services that were split across two administrations are now unified under one leadership structure.
New Names
Along with the organizational change came naming updates:
- Developmental Disabilities Community Services (DDCS): The new name for community services for children and adults with developmental disabilities (effective May 1, 2025)
- HCLA Policy Manual: Replacing separate DDA and ALTSA manuals for community services
Leadership
The Home and Community Living Administration is led by Assistant Secretary Bea Rector, who now oversees both the aging/long-term care and developmental disabilities community service portfolios.
Why the Restructuring?
According to DSHS communications, the "Reimagine DSHS" initiative aims to:
Break Down Silos
Previously, individuals transitioning between systems faced administrative barriers:
- Aging individuals with developmental disabilities navigated two systems
- Families with multiple service needs dealt with separate bureaucracies
- Providers serving diverse populations managed different requirements
Unifying community-based services under HCLA is intended to reduce these fragmentation issues.
Improve Access
A stated goal is "improving access to services by identifying and removing barriers while adapting quickly to public policy shifts and ongoing fiscal uncertainty."
With Medicaid funding under pressure, operating more efficiently becomes essential.
Enable Self-Direction
The restructuring emphasizes "self-direction and person-centered care"—aligning with national trends toward consumer control over service delivery.
Resource Efficiency
Combining administrative functions may enable:
- Shared policy development
- Unified training programs
- Consolidated technology systems
- Streamlined compliance processes
What's Changing for Providers
Website Updates
DSHS is reorganizing its website to reflect the new structure:
"They are reorganizing the website to reflect the new administrations, with goals to make it easier to find information, access services, and stay informed. The website updates are expected to be complete by summer 2026."
During the transition, some information may be in different locations than expected. Bookmark key resources and check for updated URLs.
New Forms
Optional forms available for use beginning January 1, 2026:
- HCLA Residency Agreement Language Template (DSHS 16-302)
- Notice of Transfer or Discharge (DSHS 15-458)
These forms will be available starting December 22, 2025.
Discharge Defense Screening
A new Long-Term Care Discharge Defense Screening Line launches:
- Phone: (888) 437-0017
- Active: January 5, 2026
- Required: Must be included in discharge notices to Medicaid residents beginning January 1, 2026
- Required: Must also be included in residency agreements
Policy Manual Updates
The HCLA Policy Manual is being updated to reflect the new structure. Key chapters are being revised with effective dates throughout 2025 and 2026.
What's NOT Changing
Core Service Delivery
The services themselves remain the same:
- Personal care services
- Community engagement (formerly community inclusion)
- Respite care
- Supported living
- Employment services
- Other waiver services
Provider Contracts
Existing contracts remain in effect. The organizational restructuring doesn't automatically change contractual relationships.
Eligibility Criteria
Who qualifies for services hasn't changed. Eligibility determination processes continue under the same criteria.
Case Management
Case Resource Managers continue their roles, though some may report through different organizational channels.
Concerns and Opportunities
What Advocates Are Watching
The Arc of Washington expressed cautious optimism:
"As advocates for people with intellectual and developmental disabilities, we are excited for the possibilities that will emerge from the creation of a new state agency called The Home and Community Living Administration."
But advocates are also monitoring:
- Whether DD-specific expertise is maintained
- How resources are allocated across populations
- Whether aging-focused priorities overshadow DD needs
- Implementation of promised improvements
Provider Concerns
Providers should watch for:
- Changes to reporting requirements or systems
- Training or certification updates
- Contract modifications
- Communication channel changes
Opportunities
The restructuring may create opportunities:
- Serving broader populations through unified contracts
- Reduced administrative duplication
- Improved technology and systems
- Clearer policy guidance
Practical Steps for Providers
Stay Connected
- Subscribe to DSHS bulletins and newsletters
- Join provider association communications
- Monitor the DSHS website for updates
- Attend stakeholder meetings and webinars
Update Your Records
- Note new office names and contact information
- Update form libraries with new versions
- Revise internal documentation referencing DDA or ALTSA
- Communicate changes to staff
Ask Questions
If you're uncertain about how changes affect your operations:
- Contact your regional DDCS office
- Reach out to DSHS at reimagine@dshs.wa.gov
- Consult with your provider association
- Connect with peer providers facing similar questions
Document Everything
During transitions, documentation becomes even more important:
- Keep records of guidance received
- Document any service disruptions
- Track compliance questions and answers
- Maintain audit-ready files
How CareCade Helps
CareCade supports providers through organizational transitions by maintaining compliance-ready documentation and efficient operations.
Adaptable Documentation
When forms and requirements change:
- Configurable workflows: Adjust to new documentation requirements
- AI session notes: Generate compliant documentation regardless of format changes
- Audit history: Complete records for any review period
Compliance Continuity
Requirements may shift, but compliance expectations don't disappear:
- EVV compliance: Washington requirements remain
- DSHS reporting: Continued documentation needs
- Billing accuracy: Correct claims regardless of organizational changes
Efficient Operations
During transitions, efficiency matters more:
- Smart scheduling: Maintain service delivery through changes
- Mobile tools: Caregivers have what they need regardless of back-office changes
- Digital onboarding: Continue bringing on staff efficiently
Communication Tools
Keep everyone informed:
- Team messaging: Share updates with staff
- Family portal: Transparency through transitions
- Announcements: Broadcast important information
The Bigger Picture
The DSHS restructuring reflects broader trends in how states organize long-term services and supports:
- Integration: Breaking down silos between disability and aging services
- Community focus: Emphasizing home-based over institutional care
- Person-centered: Organizing around individuals rather than programs
- Efficiency: Doing more with constrained resources
For providers, the key is maintaining excellent service delivery while adapting to organizational changes. The individuals you serve care about the quality of their support—not which administration's letterhead appears on correspondence.