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COPES in Washington: who qualifies and what services it covers

COPES is Washington's Medicaid waiver for people who meet nursing facility level of care but want to stay in the community. DSHS says it serves over 51,000 clients at home, in adult family homes and in assisted living.

Carevo editorial team Updated October 27, 2026 Source checked by Carevo editorial team, October 27, 2026

COPES is Washington's Medicaid waiver for people who meet nursing facility level of care but choose to stay in the community. The DSHS Long-Term Care Manual, last revised 05/2026, says it serves over 51,000 clients living in their own homes, adult family homes or assisted living facilities.

What COPES is

The manual says COPES is one of the 1915(c) Medicaid waivers operated by Home and Community Services in the Home and Community Living Administration. It gives people who would otherwise need nursing facility care the chance to get home and community-based services instead. It was first established in 1982. The rules are in WAC 388-106-0300 through 0335.

COPES is not a personal care program. The manual says its services wrap around the State Plan's Community First Choice (CFC) program, and that since July 1, 2015 personal care is no longer available in COPES. It adds that it would be highly unusual for a person to be enrolled in COPES and not also in CFC. For personal care without COPES, see Medicaid Personal Care in Washington.

Who is eligible

The manual says the client must meet all of the following before services can be authorized.

  • Age: 65 or older, or 18 or older and blind or disabled as WAC 182-512-0050 describes.
  • Functional need: the CARE assessment finds nursing facility level of care, or the person will likely need that level within 30 days unless waiver services are provided. The client also chooses community services over nursing facility services.
  • Financial: meets Supplemental Security Income disability criteria and is eligible for the institutional categorically needy medical coverage group.
  • Needs beyond CFC: the client's needs exceed what CFC provides.

The manual points to Chapter 7a of the Long-Term Care Manual for the financial rules. We did not read it, so we do not state income or asset limits. Ask DSHS for current figures.

The choice form

Clients who qualify can choose an institution or the community. The manual says the Acknowledgment of Services form (DSHS 14-225) records that the choices were explained and the client chose waiver services, and that waiver services cannot be authorized without the client's signature on it.

Services

The manual says clients may receive any combination of waiver services if they meet each service's own criteria, and services cannot duplicate each other. The listed services are:

  • adult day care and adult day health;
  • client support training and wellness education;
  • community choice guide;
  • community supports: goods and services;
  • environmental modifications;
  • home delivered meals;
  • nursing services and skilled nursing;
  • specialized medical equipment and supplies; and
  • transportation.

Some of these are available only in a residential setting. The manual has a chart by setting. In-home COPES includes adult day care, environmental modifications and home delivered meals, for example. Community supports goods and services are shown as available to help with moving to an in-home setting from a residential one. Ask your case manager what applies to you.

The manual says waiver services must not replace services available under Medicaid, Medicare, health insurance or long-term care insurance. If you have other coverage, case managers must document the denial of benefits first. Providers must meet qualifications and be contracted through the local Area Agency on Aging before services are authorized.

Nursing facility stays

If a waiver client enters a nursing facility for under 30 days, waiver services cannot be provided during the stay, but enrollment is not terminated and eligibility does not need to be re-determined. If the stay is 30 days or longer, waiver services are terminated, the client is dis-enrolled, and eligibility must be reestablished on return, with a new DSHS 14-225.

Recent waiver changes

A DSHS notice says an amendment to the COPES waiver took effect January 1, 2025. The proposals described there included adding experience requirements for people who do evaluations and assessments, removing the manual 30-minute personal care reduction for each hour of adult day care, and adding a death doula provider type under client support training. We read the notice, not the final approved text, so check with DSHS for the current rule.

Where to start

  1. Contact DSHS Home and Community Services or your Area Agency on Aging and ask for a CARE assessment.
  2. Ask whether you meet nursing facility level of care, which decides between COPES with CFC and Medicaid Personal Care.
  3. Ask which COPES services your plan of care would include and which providers are contracted.

For coverage questions, Medicaid.gov lists the Health Care Authority at 800-562-3022. See also the Washington program overview, paid family caregiver in Washington, home care in Washington, home health in Washington, nursing homes in Washington and developmental disability services in Washington.

Carevo is a connection platform and directory. We do not run COPES, decide eligibility or hours, or vouch for providers.

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Common questions

What is COPES?

The DSHS Long-Term Care Manual describes COPES as a 1915(c) Medicaid waiver for people who would otherwise need the level of care a nursing facility gives. It says the waiver was first established in 1982 and serves over 51,000 clients in their own homes, adult family homes or assisted living facilities.

Who is eligible for COPES?

The manual says a client must meet all of these: age 65 or older, or 18 or older and blind or disabled; nursing facility level of care through the CARE assessment, or likely to need it within 30 days without waiver services; choose community services over a nursing facility; meet SSI disability criteria and be eligible for the institutional categorically needy Medicaid group; and have needs that exceed what Community First Choice provides.

Does COPES pay for personal care?

Not directly. The manual says COPES services wrap around Community First Choice, and that since July 1, 2015 personal care is no longer available in COPES. It says it would be highly unusual to be on COPES and not also on Community First Choice.

What happens if I go into a nursing facility?

For under 30 days, waiver services stop while you are there but enrollment continues. For 30 days or longer, the manual says waiver services are terminated and you must have your eligibility reestablished to return to waiver services.

What services does COPES cover?

The manual lists adult day care, adult day health, client support training and wellness education, community choice guide, community supports goods and services, environmental modifications, home delivered meals, nursing services, skilled nursing, specialized medical equipment and supplies, and transportation. Which ones you can get depends on your setting and plan of care.

Does Carevo enroll people in COPES?

No. Carevo is a connection platform and directory. DSHS Home and Community Services and your Area Agency on Aging handle assessment and authorization.

Sources

Review status: Carevo checked this page against the primary sources listed above. It has not been professionally reviewed by a registered nurse, licensed social worker, benefits counselor or attorney. See our editorial standards.

This page is general information, not financial, legal or medical advice. Rules and services vary by state and by individual circumstances. Use the official sources and decision-maker named on the page. Carevo is a connection platform, not a care provider.