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Caregiver support · state

Tailored Supports for Older Adults (TSOA)

WA DSHS HCLA

Tailored Supports for Older Adults (TSOA) is a Medicaid Transformation Demonstration program for older Washingtonians (55+) who are NOT on Medicaid but who would functionally qualify for Medicaid long-term services and supports. TSOA provides supports either directly to the older adult or, more often, to their unpaid family caregiver, with the goal of delaying or preventing entry onto the formal Medicaid LTSS rolls. As of December 1, 2025, TSOA has paused new enrollments and is operating a waitlist.

Who qualifies

Adults age 55+ in Washington who (a) are not currently receiving Medicaid-funded long-term services and supports, (b) would be functionally eligible for such services, and (c) meet TSOA-specific financial criteria (more generous than full Medicaid). Either the older adult or their unpaid family caregiver may receive TSOA services.

What it covers

Services for the older adult or their unpaid caregiver: caregiver assistance, training, respite, specialized medical equipment and supplies, personal assistance services, and other supports designed to help the older adult remain at home.

Cost

No premium for participants. Eligibility is more generous than full Medicaid LTSS, designed for older adults who are NOT on Medicaid. As of 12/01/2025, new enrollment is paused; applicants are placed on a waitlist.

How to apply

Through DSHS/HCLA Home and Community Services or a contracted Area Agency on Aging. As of December 1, 2025, new enrollment is paused and a waitlist is in effect, see the MAC and TSOA Waitlist FAQ.

Where to get this in Washington

13 organizations deliver this program. Coverage varies, so check the area each one serves.

Source www.dshs.wa.gov/altsa/stakeholders/medicaid-transformation-demonstration