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Aging and Long Term Support Administration lays out service mix, workforce and regulatory priorities
Summary
Assistant Secretary Bea Rector told the committee ALTSA serves tens of thousands monthly across home and residential settings, regulates licensed long-term care facilities, and recommended investments for caregiver supports, workforce training and legal assistance for certain Medicaid residents.
Bea Rector, assistant secretary of the Aging and Long Term Support Administration (ALTSA) at DSHS, briefed the Human Services, Youth, & Early Learning committee on the administration’s scope, caseload and priorities.
Rector said ALTSA provides services to more than 70,000 individuals each month through Medicaid-funded home and community‑based services, helps 300–400 people a month transition out of skilled nursing facilities and about 30 people a month out of state psychiatric hospitals, and regulates roughly 4,810 licensed long‑term care settings (including adult family homes and assisted‑living facilities) that serve approximately 80,000 people statewide. She said about 64% of people ALTSA serves receive services in their homes, 26% in residential settings and 10% in nursing facilities.
Rector emphasized demographic pressures: she showed projected growth in the population aged 85 and older and noted a shrinking share of working‑age adults available to provide paid direct care. Rector identified workforce initiatives—high‑school training pipelines, supervisor training and investments in wages and job quality—and said ALTSA has conserved Medicaid spending by expanding home‑and‑community options rather than relying on more costly institutional care.
Rector described Adult Protective Services activity (about 51,000 investigations in 2023), services for people who are deaf or hard of hearing, and the administration’s regulation and oversight role. She pointed to a policy request in the judicial/administrative office budgets to extend civil legal aid to Medicaid residents in adult family homes, assisted living and enhanced services facilities to meet federal comparability rules for drawdown of Medicaid match.
On caseload composition, Rector noted a shift toward younger adults with complex behavioral‑health needs and said that the interaction of behavioral health, housing shortages and residential settings is changing service demand and costs. She told the committee ALTSA has saved substantial dollars by building community alternatives since 1996 and that continued investment is needed to manage caseload and costs as the population ages.
Rector answered a brief round of member questions and offered follow‑up on workforce and provider capacity at members’ requests.
