Medical Respite Funding

Overview 

SWACH is issuing this Request for Proposals (RFP) to support the development and expansion of medical respite care infrastructure in Southwest Washington. This funding opportunity aligns with Washington State’s Medicaid Transformation Project 2.0 (MTP 2.0) and the Health-Related Social Needs (HRSN) Initiative, specifically supporting the launch and readiness of medical respite services under HRSN Phase 1b. 

As the region’s Accountable Community of Health, SWACH serves as the coordinating entity for community-based care systems and will act as the administrator and distributor of HRSN medical respite infrastructure funds for Clark, Klickitat, and Skamania Counties. SWACH will review proposals and make funding recommendations in alignment with HCA guidance, CMS Special Terms and Conditions, and regional priority needs related to medical respite capacity. 

All awarded funds must be used solely for allowable medical respite infrastructure activities as defined under the HRSN Infrastructure Protocol and MTP 2.0. SWACH encourages community partners, residents, and stakeholders to share feedback and insights regarding medical respite needs and regional service gaps at southwestach.org. 

Funding background 

Washington State’s Medicaid Transformation Project 2.0 (MTP 2.0) was renewed in 2023 to expand innovative services that address health-related social needs (HRSN) for Apple Health (Medicaid) members. As part of this renewed demonstration, the Health Care Authority (HCA) is launching a phased approach to HRSN services, including medical respite care for individuals who lack a safe and stable place to recover after a hospital stay. 

Medical respite—also known as recuperative care—is recognized by the Centers for Medicare & Medicaid Services (CMS) as a critical service for individuals experiencing or at risk of homelessness who are medically fragile but do not require inpatient hospitalization. Without access to medical respite, individuals often face preventable complications, repeated hospitalizations, and worsening health outcomes. 

To support the launch of Medicaid-eligible medical respite services, HCA is investing in regional infrastructure through Washington’s nine Accountable Communities of Health (ACHs). This funding allows ACHs, including SWACH, to help local providers build the operational, technological, and workforce capacity needed to begin delivering medical respite services in alignment with CMS Special Terms and Conditions and the HRSN Infrastructure Protocol. 

Award information 

The total amount of available medical respite infrastructure funding is $288,655. There is no set limit on the amount an applicant may request; however, total funding awarded across all applicants cannot exceed the available amount. 

Contracts resulting from this RFP will span one year, beginning March 1, 2026, through March 31, 2027. 

Awarded organizations and a summary of funded medical respite infrastructure projects will be publicly available and updated annually at southwestach.org. 

Eligibility and Reporting: 

Current Medical Respite Providers:

To be eligible for Medical Respite Infrastructure Funding, applicants must: 

1. Serve residents of Clark, Klickitat, or Skamania Counties, or plan to use funds to support medical respite services for people in these counties. 

2. Use all funds only for approved medical respite infrastructure activities outlined by HCA and CMS. 

3. Meet all reporting and documentation requirements set by SWACH and HCA. 

4. Meet qualifying provider requirements, including: 

   • Enrollment in ProviderOne; 

   • Having any required signed provider agreements with HCA; 

   • Being contracted with at least one Managed Care Organization (MCO) to deliver medical respite services; and 

   • Demonstrating how the organization will use infrastructure funding to support HRSN implementation and medical respite readiness. 

Prospective Medical Respite Providers:

Organizations that do not currently meet all eligibility criteria and are interested in becoming a medical respite provider, and meet all the following criteria:  

• Have the capacity and commitment to meet the full eligibility requirements. (see above) 

• Attest that they will meet all eligibility requirements within one year of receiving funding. If an organization does not meet the criteria within one year, then all awarded funds will need to be returned. 

Priority will be given to proposals that:

• Show a clear plan for continuing services after the funding period ends. 

• Intentionally support Native/Tribal communities, LGBTQIA2+ people, rural residents, older adults, and other high-need populations. 

• Help build or strengthen medical respite capacity in Southwest Washington by focusing on: 

  1. Support After Hospitalization

• Helping people recover safely after a hospital stay 

• Preventing avoidable hospital readmissions 

• Supporting individuals with physical, behavioral health, or complex needs 

2. Improving Access and Navigation

• Building referral pathways with hospitals, clinics, and community partners 

• Providing culturally responsive and trauma-informed support 

• Increasing access in rural and frontier areas 

3. Strengthening Local Infrastructure

• Improving technology, workflows, and billing systems 

• Preparing for Medicaid billing and HRSN data reporting 

• Supporting coordination with the Community Care Hub and other partners 

Regional medical respite priorities are informed by community input, local data, and partner feedback across Southwest Washington. All awarded funds must follow HCA’s allowable-use guidelines. SWACH will review proposals, monitor funded projects, and share updates publicly at southwestach.org. 

Allowable Expense Categories 

Workforce Development 

• Hiring staff that support building infrastructure and not direct service staff.  

• Training on HRSN policies and procedures.  

• Salary/benefits for staff supporting HRSN implementation prior to launch.  

• Certifications, technical assistance, or education (e.g., culturally competent or trauma-informed care).  

• Privacy/confidentiality training.  

• Production costs for training materials/expert support. 

Outreach, Education & Stakeholder Convening

• Development and production of outreach/education materials. 

• Translation of materials. 

• Development of culturally competent materials. 

• Planning/facilitation of community-based outreach events. 

• Learning collaboratives or stakeholder convenings. 

• Community engagement activities supporting HRSN launch. 

• Administrative/overhead costs related to outreach/education. 

Unallowable Expense Categories 

The following costs cannot be covered by this funding:

• Expenses already eligible for other Medicaid payments  

• Expenses reimbursed through other infrastructure funding, such as: Foundational community supports  

• Aging and long-term support administration  

• Ongoing operational costs, including: Regular staffing Patient care Day-to-day provider expenses  

• Capital expenses, such as: Construction Facility purchases Furniture, fixtures, or equipment 

Payment and Deliverables Overview: 

Funding will be released based on the milestones below. Milestones are weighed based on their expected difficulty. If all milestones are not met by March 31, 2027, then funding must be returned (or a no cost extension may be considered based on significant milestone completion). 

Current Medical Respite Providers: