Who Provides IBSS Services in Washington State?

When families or Adult Family Home (AFH) providers hear about Individualized Behavioral Support Services (IBSS), the first question is often: “Who actually provides these services, and does my client qualify?” At Precision Assess, we work closely with caregivers, families, and facilities across Washington to make these answers clear.

What is IBSS?

IBSS is a Medicaid-funded program in Washington that supports clients with high behavioral needs who may require 1:1 supervision. These services are critical in Adult Family Homes, assisted living, and other long-term care settings where safety, structure, and individualized interventions are essential.

Who Provides IBSS in Washington?

In Washington State, IBSS services are only available through Apple Health (Medicaid). Clients must be enrolled with a Medicaid Managed Care Organization (MCO) to access these supports. According to Washington’s Home and Community Services (HCS) guidance, IBSS is administered by four MCOs:

1. Community Health Plan of Washington (CHPW)

2. Molina Healthcare of Washington

3. UnitedHealthcare Community Plan

4. Wellpoint Washington (formerly Amerigroup)

If a client is not enrolled in one of these Medicaid MCOs, they do not qualify for IBSS services. This often surprises families who may have private insurance like Premera, Regence, Kaiser, or Medicare-only coverage. Unfortunately, those plans do not cover IBSS hours.

Special Exceptions

There are a couple of important exceptions to remember:

• Apple Health Behavioral Health Only Plan → Even without full MCO enrollment, clients on this plan can still qualify for IBSS.

• Dual Eligible Clients (Medicare + Medicaid) → These clients may still receive IBSS through the Medicaid side of their coverage.

Families who do not meet these criteria may need to:

• Pay out-of-pocket for 1:1 supervision, or

• Explore other waiver-based supports, such as Developmental Disabilities Administration (DDA) services.

Why This Matters for AFH Providers and Families

Understanding who provides IBSS ensures providers don’t waste valuable time submitting requests for clients who won’t qualify. It also helps families plan realistically for care and support costs.

At Precision Assess, we specialize in guiding Adult Family Homes and caregivers through these complexities. Alongside IBSS education, we also provide:

• Nurse delegation services Washington State – ensuring caregivers are trained and delegated safely under RN supervision.

• Placement assessment for adult family homes – compliant, timely assessments to support new residents.

• Nursing care plan services Bothell WA – locally tailored care planning to meet both resident and facility needs.

• Caregiver care plan Washington – structured plans to help caregivers respond effectively to challenging behaviors.

• Initial health assessments for elderly care – comprehensive evaluations via telephonic, virtual, or in-home visits.

The Bottom Line

IBSS in Washington is only provided through Medicaid’s managed care system. If your client is not enrolled with one of the four Apple Health MCOs, they do not qualify for IBSS hours.

At Precision Assess, we help families and AFH providers understand the system and prepare the right documentation to support their residents.

✅ Next Blog in the Series: We’ll cover “Who Qualifies for IBSS and What Services It Provides.”

Ready for Support?

If you are a caregiver, AFH owner, or family member looking for guidance on IBSS eligibility, assessments, or care planning, Precision Assess is here to help.📍 Based in Bothell, WA, we proudly serve Adult Family Homes, caregivers, and families across Washington State.

👉 Visit us at www.precisionassess.com