State Seeking Global Waiver Project Proposals

December 17, 2015

Date:             December 17, 2015

To:                 CEOs, CMOs, and Government Affairs staff

From:            Chelene Whiteaker, Policy Director
Claudia Sanders, Senior Vice President

Contact:        Chelene Whiteaker at or 206-216-2545


The purpose of this bulletin is to make you aware that the state is soliciting local and statewide projects for exploration and selection in the state’s global waiver negotiations with the Centers for Medicare & Medicaid Services for Medicaid. Project proposals are due January 15, 2016 to the state Health Care Authority (HCA).

In August 2015, the HCA submitted a global waiver application for Washington State to CMS. The state’s application focuses on transforming Medicaid by: (1) implementing selected projects through the Accountable Communities of Health; (2) broadening and redefining long-term services and supports; (3) providing targeted housing and employment supports for at-risk populations. HCA is broadly soliciting project proposals to be considered under criteria 1 of the application.

WSHA Board Direction on Project Submission
Last week, the WSHA board directed the staff to develop a global waiver project proposal that contains improvements for behavioral health care. WSHA staff are exploring projects, including targeting patients with behavioral health needs who are considered high-utilizers of emergency department with care connectors or navigators to educate and connect patients with primary or behavioral health care. This project would build on the work of the successful “ER is for Emergencies” program.

If you are interested in participating in a call to discuss this proposal, please e-mail Chelene Whiteaker at, and we will send you an appointment to discuss.


  • Project proposals. Review the requirements to submit a proposal. If your organization is planning to propose a project, please let Chelene know the type of project you plan to submit.
  • Linking of similar projects across hospitals. WSHA has been asked by members to assist in linking projects that have similar scopes and goals. If you are interested in WSHA reviewing and connecting your proposal with other similar projects (if applicable), please share your draft proposal by January 7, 2016.
  • Participate on WSHA call to discuss the proposal targeting ERs. (See the comment above under WSHA Board section of the bulletin.)

Project Scope and Materials
Any organization can submit a project(s). The HCA has developed some basic criteria for projects, including projected costs and return on investments for Medicaid enrollees. Projects must have a clear benefit to Medicaid enrollees. Any project submitted will be available to the public and will go through a vetting process. The HCA has indicated they will reduce the number of projects to a list that will be discussed with CMS for approval. CMS will have a say in the final approved project list.

The HCA has released detailed information on its website including the application, an informational webinar, and a guide for developing project proposals.

According to the HCA, for favorable review projects should be:

  • Designed to promote the integrity and objectives of the state’s Medicaid program;
  • Designed to positively impact a substantial number of Medicaid enrollees;
  • Transformative and explicitly support the goals of the waiver;
  • Evidence-based or promising practices with strong potential for measurable return on investment over the course of the waiver (within 5 years if possible);
  • Substantially different than other CMS-funded initiatives (in other words, they are new and innovative, or they augment or leverage current initiatives); and
  • Designed to address significant community health needs in the Accountable Community of Health region or statewide, with evidence of collaboration in project planning.

Next Steps
In 2016, WSHA will share the narrowed project list and timeline for negotiations with CMS when more information becomes available.


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