Tailored Supports for Older Adults (TSOA)
WA DSHS HCLA
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Tailored Supports for Older Adults (TSOA) is a special Medicaid program for older Washingtonians (55+) who are NOT on Medicaid but who need the kind of help Medicaid long-term care covers. TSOA gives support either directly to the older adult or, more often, to their unpaid family caregiver. The goal is to help the older adult stay independent longer and delay or avoid moving onto the regular Medicaid long-term care program. As of December 1, 2025, TSOA has paused new enrollments and is running a waitlist.
Who qualifies
What it covers
Cost
How to apply
Where to get this in Washington
13 organizations deliver this program. Coverage varies, so check the area each one serves.
East Wenatchee, Adams County
Free public agency that helps older adults and people with disabilities in central Washington find in-home care, caregiver support, nutrition, transportation, and benefits help.
Spokane, Ferry County
AAA for the Spokane region; one number connects callers to information, caregiver support, dementia help, Medicaid in-home care, Medicare counseling, and nutrition.
Yakima, Asotin County
Council-of-governments AAA covering eight southeast Washington counties; one call connects callers to information & referral, case management, nutrition, caregiver support, and Medicaid in-home care.
Vancouver, Clark County
Free public AAA for the Vancouver/Longview area covering five counties; one stop for caregiver assistance, dementia resources, in-home help, kinship care, Medicare counseling, and WA Cares Fund support.
Seattle, King County
Home of the Sunshine Garden Chinese Senior Community Center, with culturally tailored elder programs in Cantonese, Mandarin, Russian, Vietnamese, and more across King County.
Port Orchard, Kitsap County
Kitsap County Human Services division and AAA for Kitsap County. Coordinates information, case management, caregiver support, nutrition, kinship care, and Medicaid in-home services.
Olympia, Lewis County
Three-county AAA for Lewis, Mason, and Thurston counties offering caregiver support, in-home services, nutrition, and the Senior Farmers Market produce benefit.
Bellingham, Island County
AAA for Whatcom, Skagit, Island, and San Juan counties. Helps older adults, adults with disabilities, and family caregivers navigate aging and disability services since 1971.
Aberdeen, Clallam County
AAA covering the Olympic Peninsula and southwest Washington coast; offers information & assistance, caregiver support, nutrition, transportation, and Medicaid case management for seniors and adults with disabilities.
Tacoma, Pierce County
Pierce County's AAA and Aging & Disability Resource Center; coordinates long-term services and supports for older adults, adults with disabilities, and caregivers.
Colville, Adams County
Community Action Agency serving 12+ rural counties in eastern Washington since 1965. Runs the SAILS senior services department covering info & assistance, caregiver support, kinship care, SHIBA, senior nutrition, and tailored supports for older adults.
Seattle, King County
Seattle Human Services division that serves as the AAA for King County. Runs Community Living Connections for aging/disability help and administers caregiver support, healthy aging, and age-friendly programs.
How to apply
TSOA paused new enrollment on December 1, 2025 and opened a statewide waitlist. You can join the waitlist, which is first come, first served by request date. Enrollment reopens when program spending falls below the budget forecast, with no set date. People already enrolled keep their services. American Indian and Alaska Native applicants are not subject to the waitlist.
Call Community Living Connections to join the waitlist
Your place on the waitlist is set by the date you ask, so calling sooner matters even though enrollment is paused.
- Community Living Connections 1-855-567-0252
- Community Living Connections Open
- Form HCA 18-008, the TSOA application Open
- Local Area Agency on Aging or DSHS Home and Community Services office
Documents to gather
- Photo ID
- Proof of gross income
- Bank and asset statements
- Information about daily-living limitations and diagnoses
- Information about the unpaid caregiver
Enrollment is paused, so there is no meaningful decision timeline right now. Any underlying Apple Health application follows the standard 45 day rule, or 60 days if a disability decision is needed.
Worth knowing
TSOA is for people aged 55 and older who are not yet on Medicaid and are at risk of needing long-term care. It is an on-ramp that supports the unpaid family caregiver.
You may hear that TSOA has no asset test. That is only half right. There is a resource limit, but it is far higher than the $2,000 limit elsewhere, and there is no asset-transfer penalty, no home equity test, and no estate recovery. For 2026 the limits are $84,354 for one person and $156,883 where there is a spouse at home.
The income limit is $3,976 a month for 2026, which is 400 percent of the federal benefit rate. It resets every January 1.
Enrollment has been paused with a waitlist since December 1, 2025. People already enrolled keep their services.
See your next step, the documents you will need, and how to apply. Save it to your account to track your progress.
Where to go from here
A Matter of Balance
A Matter of Balance is a structured eight-week class developed at Boston University and managed nationally by MaineHealth. Trained coaches lead small groups through discussion and gentle exercises that help participants reduce fear of falling, set realistic goals for activity, change environments to lower fall risk, and exercise to increase strength and balance. The CDC recognizes it as an evidence-based fall prevention program. In Washington it is hosted by Area Agencies on Aging, senior centers, hospitals, and faith communities.
ACRS Care Transitions
ACRS Care Transitions gives short-term help to adults coming home after a hospital stay. Staff help them follow their discharge plan, manage medications, get to follow-up appointments, and connect with ongoing community resources. It works alongside the ACRS Health Home program, which offers longer-term Medicaid care coordination through a health plan built around each person's needs.
ACRS Case Management for Older Adults
ACRS case managers, who speak many languages, meet with homebound older adults and adults with disabilities to understand their needs and build a full care plan around them. The goal is to help older adults live safely at home with support from their families and caregivers. Staff pay close attention to the language and cultural needs of Asian and Native Hawaiian/Pacific Islander communities.
ACRS Food Bank
The ACRS Food Bank gives out healthy foods that fit people's cultures, including rice, tofu, noodles, and fresh produce, matched to the diets of Asian and Native Hawaiian/Pacific Islander families across King County. Anyone in the community can use it, but the food is chosen for Asian and Pacific Islander cooking that most food banks don't carry.
Not sure this one fits your situation? Your local Area Agency on Aging can check what you qualify for and point you to the right programs, for free. No one will sell your information, and no one will cold-call you.
Source www.dshs.wa.gov/altsa/stakeholders/medicaid-transformation-demonstration
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