Remote Support in Washington: Every Service It Fits, and How It Is Paid
In Washington, only the client may start live two-way Remote Support interactions, unless the person-centered service plan says otherwise. Any Washington provider agency can get Vista Enterprise™, the remote support solution, the way it gets an EHR or payroll system, with no state approval. Billing is separate. When an agency runs its own remote support with Vista Enterprise™, its own trained team responds and decides.
Can any Washington agency buy a remote support solution?
Yes. Any Washington provider or agency can get Vista Enterprise™, the remote support solution, which includes VistaLink™, the technology. Like an EHR or payroll system, getting it needs no approval from the Department of Social and Health Services (DSHS), the Developmental Disabilities Administration (DDA), or anyone else.
Billing is a separate question. It depends on the program, the service, your agency’s provider status, and each person’s plan. The rest of this page walks through every place remote support fits in Washington.
Where does remote support fit in Washington?
| Setting or program | How technology is usually paid | What to know |
|---|---|---|
| Basic Plus, Core and IFS waivers | The Remote Support waiver service, which includes the equipment | A DDA-contracted provider delivers it |
| Residential Habilitation | The Remote Support waiver service; in supported living, group training homes and group homes it replaces supervision, coaching and consultation, and the resource manager completes a rate assessment | The residential provider helps write the plan, and a backup person is named for in-person help |
| ICF/IID | The facility’s own cost | Federal staffing floor stays |
| Nursing homes and assisted living | The facility’s own cost | Resident privacy rules apply |
| Home care agencies | The agency’s own cost | Support between visits |
| Any agency, any setting | The agency’s own budget | No approval needed to buy |
What does Washington’s Remote Support service include?
Washington defines remote support in WAC 388-845-0945, and DDA Policy 4.28 sets the procedures. DDA policy says that in September 2024 Distance Based Observation and Reporting (DBOR), a COVID-era component of Assistive Technology, was redesigned as its own service and renamed Remote Support. Under the rule and policy:
- Supervision, coaching and consultation. A contracted remote support provider gives these to a waiver participant from a distant location, to increase their independence and safety at home and in the community when they are not using other DDA-paid services or informal supports.
- Equipment is included. The provider furnishes the equipment, which may include a motion-sensing system, radio frequency identification, video calling via assistive technology, a live audio feed, and web-based monitoring systems.
- The client is in charge. The client must be able to start the service when needed and turn the equipment off when not needed. Only the client may start live two-way interactions, unless the person-centered service plan says otherwise, such as scheduled check-ins.
- Autonomy comes first. Remote support must never be used to restrict a person from their home, community or body autonomy.
- Training is included. The provider supports the client with initial and ongoing training on the remote support system, as the client’s remote support plan specifies.
- It does not overlap. Remote support must not replace, duplicate or be the delivery method for other available paid or unpaid supports or services.
What has to happen before remote support starts in Washington?
- Signed consent. Before contacting providers, the case resource manager (CRM) makes sure there is a current DSHS 14-012 consent form signed by the client and their legal representative, if they have one. Informed consent covers the nature of Remote Support, what using real-time audio and video involves, the expected risks and benefits, and reasonable alternatives, including declining the service.
- A Remote Support plan. The provider writes it with the client and their support system: home, community or both, what the client wants Remote Support to do, the devices, hours each month, who information is shared with, and a safety plan with emergency contacts who can respond face to face. An alternative living provider, a DDA-contracted provider of residential habilitation instruction under WAC 388-829A, is not named as the emergency contact.
- Prior approval. The CRM completes prior approval in the CARE system, and the regional administrator or designee approves it. The client receives a Planned Action Notice that explains the decision and their appeal rights.
- A signed plan. Remote Support is added to the person-centered service plan (PCSP), and services cannot start until the client, their legal representative if they have one, and the chosen provider have signed and dated it.
- Residential Habilitation, if used. The client, the Remote Support provider and the residential agency all discuss the service before prior approval, and a backup person is named for any emergency that needs someone in person. The residential provider gives input to the Remote Support plan, agrees to any duties it takes on, attends plan meetings, and references the plan in the client’s IISP. In supported living, group training homes and group homes, Remote Support replaces supervision, coaching and consultation for the client, and the resource manager completes a rate assessment. In a companion home it is available only when the provider cannot give equivalent support and it promotes greater independence. With alternative living, it can be an added service, and the rate does not change.
What is teleservice in Washington?
Teleservice is different from Remote Support. Under WAC 388-845-0113, it is a way to deliver certain other waiver services remotely, such as assistive technology, life skills or residential habilitation, using a DDA-approved system. The participant chooses it and signs the PCSP, DDA decides the service can be provided remotely, there is no risk to health or safety, and each regularly occurring service is still delivered in person at least once a plan year. A supported living, group training home or group home provider can deliver part of a client’s residential habilitation from a distance when the client chooses it and it is in the PCSP, and documents in the IISP how it is delivered and the technology used. Source: DDA Policy 6.17.
How does Washington pay for remote support?
Your agency gets Vista Enterprise™ directly, as its own remote support solution. Washington then has one way to pay for the enabling technology a person uses:
From the agency’s own budget. Any agency can get Vista Enterprise™ as its own remote support solution, whether or not it bills a service. This is the route for ICFs, nursing homes, assisted living and home care agencies.
1. The Remote Support waiver service. On the Basic Plus, Core and IFS waivers, DDA pays a DDA-contracted Remote Support provider after prior approval. DDA authorizes the service hours and the equipment together. On Basic Plus, remote support is limited to the aggregate budget and emergency assistance funding, if eligible, and on IFS to the annual allocation. Remote support does not pay for internet, data plans or wi-fi.
Sources, checked October 25, 2026: WAC 388-845-0945, What is remote support?; WAC 388-845-0950, qualified providers of remote support; WAC 388-845-0955, limits to remote support; WAC 388-845-0113, teleservice; DDA Policy 4.28, Remote Support, last revised June 2026; DDA Policy 6.17, Remote Support and Teleservice in Residential Habilitation Services; WAC 388-829A, alternative living.
How do consent and privacy work in Washington?
The person supported decides whether remote support is used and where devices go, with help from the people they choose. The person-centered service plan (PCSP) is built with the client and their case resource manager, and the Remote Support plan is written by the provider with the client and their support system. When the person has a legal representative, that person takes part in consent. Consent is informed, voluntary and written down on the DSHS 14-012 form, and it includes the option to decline the service. The client starts the service and can turn the equipment off. At the six-month review and annual assessment, the CRM confirms whether the client wants to continue. The client can say no or withdraw consent at any time. When an agency runs its own remote support with Vista Enterprise™, its own trained team responds and decides, following the plan.
DDA policy says video cameras are not permissible in bedrooms or bathrooms. DDA reviews a client’s own request for a bedroom camera only in an exceptional circumstance, and grants no exception for bathrooms. No cameras are required in bedrooms, bathrooms or other personal spaces.
What if our staffing stays the same, as in an ICF or a fully staffed group home?
An agency in Washington can keep every in-person shift and still use remote support, because technology can raise quality even with full staff.
Even a fully staffed overnight shift cannot be in every room at once, stay fully alert through every hour of the night, or carry every detail from one shift to the next. When nothing answers those human limits, they quietly become limits on the outcomes people supported can reach. That is a limit of people, not a failing of staff.
Enabling technology for human services helps with those gaps without replacing anyone. It gives trained people better information and more of their time for the moments that need a person in the room.
- Fewer night checks that wake people up. For people whose plans do not call for hands-on checks through the night, a door opening on a schedule interrupts sleep and privacy. Non-wearable sensors the person agreed to can let overnight staff know when something may need a person. Whether a plan moves away from scheduled checks is decided through the person’s plan, by the person and their team, with input from the agency’s own nurse or clinician.
- Better information. Plain-language daily reports on sleep, activity and safety events give nurses and the team a fuller picture than a shift note alone.
- Closing gaps in data and judgment. A steady record across shifts means handoffs rest on more than memory, and a change that is hard to read in the middle of the night comes to a trained person with the facts in front of them.
Know the limits.
- Federal ICF rules set the staffing floor. In an intermediate care facility for individuals with intellectual disabilities (ICF/IID), federal rules require responsible direct care staff on duty around the clock when people are present, awake in some living units, plus minimum direct care staff ratios. Remote support adds to on-site staff. It does not replace them.
- Privacy comes first. Federal rules require ICFs to give each person the opportunity for personal privacy. CMS guidance for surveyors says video or audio never takes the place of staff. No cameras are required in bedrooms, bathrooms or other personal spaces. Non-wearable sensors fit that approach.
- The facility pays. An ICF/IID is paid as a facility, not through a person’s waiver plan, so an ICF that uses Vista Enterprise™ pays for it as its own operating cost.
- ICF terms apply. In an ICF/IID, the person’s plan is the Individual Program Plan (IPP), developed by an interdisciplinary team that includes the person and the qualified intellectual disability professional (QIDP). A move away from scheduled night checks is decided by that team, including the person and their legal guardian where they have one, with input from the facility’s own nurse, and written into the IPP. If the change could affect the person’s protection or rights, the facility’s specially constituted committee reviews it, and it goes ahead only with written informed consent from the client, their legal guardian, or a parent if the client is a minor.
- In Washington, Remote Support is a DDA waiver service, so an ICF does not bill it.
- Group homes and privacy. Federal home and community-based settings rules give each person privacy in their sleeping or living unit. Any limit on that must be based on a specific assessed need, written into the person’s plan, and agreed to with informed consent.
Can nursing homes and assisted living in Washington use remote support?
Yes. Nursing homes and assisted living communities get Vista Enterprise™ the same way any agency does, and the facility’s own trained team responds and decides.
- Nursing homes. Federal rules give each resident a right to personal privacy and to be free from restraints that are not needed to treat medical symptoms, and require the facility to give each resident adequate supervision and assistance devices to prevent accidents. Better information can help staff see who needs them without waking everyone. Each resident decides whether devices go in and can say no, and a resident representative decides for the resident only as far as the resident, a court or state law gives them that role. CMS guidance for surveyors treats devices that alert staff when a resident moves as position change alarms, so the facility’s care team checks, in each care plan, that a device does not keep a resident from moving freely or disturb their sleep. Remote support does not prevent falls, and it is not a promise that every fall will be noticed. A trained person on the facility’s own team decides each step. Nursing homes are paid as facilities, so Vista Enterprise™ is the facility’s own purchase. In-person staffing rules do not change.
- Assisted living. Assisted living is licensed by each state, not under the federal nursing home rules, so each community follows its own state’s licensing rules for resident rights, privacy and consent. Where Medicaid home and community-based services (HCBS) pay for a resident’s services there, the federal HCBS settings rules also apply, including privacy in the person’s sleeping or living unit, a door they can lock, and a say in choosing any roommate. Technology placed with each resident’s consent gives staff better information between scheduled visits.
- In Washington, nursing homes and assisted living communities follow the state’s own licensing rules alongside the federal ones.
How does remote support help home care agencies in Washington?
Home care agencies send aides into people’s homes for set hours. Between visits, no one from the agency is there. Remote support helps with that gap: the person keeps their privacy, and the agency’s own trained team can learn when something may need attention and decide who should go.
- Better visits. Aides arrive knowing how the night went.
- Earlier notice. Changes in routine can show up before they become a crisis.
- In Washington, home care agencies follow the state’s own licensing rules.
Who else can remote support help in Washington?
It is not all about disability. Remote support is enabling technology for human services as a whole. It works for people with intellectual and developmental disabilities (IDD), older adults, people with physical disabilities, people recovering from an illness or injury, faith-based organizations that run health ministries, and the staff and families who support them.
How does VistaLink™ fit Washington’s rules?
VistaLink™ uses non-wearable sensors and a display in the home to send events to your agency’s own trained team, and it never acts alone. When an agency runs its own remote support with Vista Enterprise™, its own trained team responds and decides, following each person’s plan.
Your agency stays the provider. Billing the DDA Remote Support waiver service takes a DDA Remote Support contract, which DDA policy ties to agencies whose primary business is technology-based supervision, coaching and consultation. An agency whose main business is residential or supported living services may not fit that description. Either way, it can run its own remote support with Vista Enterprise™ from its own budget.
Vista is not the direct service provider. The agency or facility is. Vista Enterprise™ supports the people who plan and give support: the person, their family or guardian where they have one, the provider’s own team, and any case manager or coordinator. It helps them follow the rights, privacy and consent rules that apply in that setting and state, and build each person’s plan around their own wants and needs. When an agency runs its own remote support with Vista Enterprise™, its own trained team responds and decides.
For states and government agencies
Vista can also work with the Department of Social and Health Services (DSHS) and its Developmental Disabilities Administration (DDA), and with other state and government agencies, for example through a procurement or a contract. Any single agency, in any state or anywhere in the world, can already get Vista Enterprise™ with no state approval.
Remote support for states and government agencies
What does remote support look like for a Washington agency? (composite example)
This is a composite example built from common situations. It is not a real person.
A woman on the Core waiver lives in a supported living home with Residential Habilitation and wants more time on her own in the evenings. She, her legal representative, her CRM, her residential agency and a DDA-contracted Remote Support provider talk it through, and she signs the DSHS 14-012 consent form. Her Remote Support plan lists her evening hours, a cooking routine, and emergency contacts who can come in person, and her PCSP is signed before the service starts. She chooses non-wearable sensors and a display in the home, placed where she directs, and she starts each video call herself. When an event comes in, a trained staff member at the provider checks in the way her plan says, and contacts her backup person when she needs someone in person.
Questions and answers
Can any Washington agency buy a remote support solution?
Yes. Any Washington provider or agency can get Vista Enterprise™, which includes VistaLink™. Like an EHR, it needs no DSHS or DDA approval. Billing follows each program’s rules.
What is Remote Support in Washington?
A standalone DDA waiver service: supervision, coaching and consultation from a contracted remote support provider to a waiver participant from a distant location. It includes the equipment needed to deliver it, and it is meant to increase the person’s independence and safety at home and in the community.
Which Washington waivers include Remote Support?
The Basic Plus, Core and Individual and Family Services (IFS) waivers, to foster developmentally appropriate independence and not to replace informal support.
Who starts a Remote Support interaction in Washington?
The client. The client must be able to start the service when needed and turn off the equipment when not needed, and only the client may start live two-way interactions unless their person-centered service plan says otherwise, such as scheduled check-ins.
Who can provide Remote Support in Washington?
An entity contracted with DDA to provide remote support. DDA policy describes these providers as agencies whose primary business objective is supervision, coaching and consultation to clients with developmental disabilities, using technology. A guardian, legal representative, parent or other family member cannot provide it. Any agency, including a residential or supported living provider, can still run its own remote support with Vista Enterprise™ from its own budget.
What has to be signed before Remote Support starts in Washington?
A DSHS 14-012 consent form signed by the client and their legal representative, if they have one, and the person-centered service plan signed and dated by the client, their legal representative if they have one, and the chosen Remote Support provider.
Can a Washington ICF, nursing home or assisted living facility use remote support?
Yes, as its own tool alongside on-site staff. Federal and state staffing rules still apply in full, and the facility pays for Vista Enterprise™ as its own cost. No cameras are required in bedrooms, bathrooms or other personal spaces.
Who responds when remote support is in place?
Your agency’s own trained team responds and decides, following each person’s plan. VistaLink™ never acts alone.
Is remote support in Washington only for disability services?
No. It fits any human service where staff cannot be everywhere at once: disability services, older adults, assisted living, nursing homes, home care and faith-based health ministries.
Book a demo
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Related pages
- Enabling technology for human services: a remote support solution for any agency
- How states pay for remote support
- Vista Enterprise™
- VistaLink™
- Remote support in the District of Columbia
- Remote support in Maryland
- Remote support in Pennsylvania
- Remote support in Virginia
- Remote support in New Jersey
- Remote support in Delaware
- Remote support in Ohio
- Remote support in Tennessee
- Remote support in Minnesota
- Remote support in Missouri
- Remote support in Indiana
- Remote support in Wisconsin
- Remote support in New York
- Remote support in Colorado
- Remote support in Kentucky
- How to start remote support
- Family guide to choice and consent
- Remote supports FAQ
- Enabling technology: terms, states and settings