Washington State Wins National Recognition for Coordinating Care Across Systems for Youth with Complex Needs

Oxon Hill, Md.— The National Association of Medicaid Directors (NAMD) today announced Washington State’s Health Care Authority (HCA) as a recipient of the 2026 Spotlight Award. The award recognizes HCA’s client escalation pathway, a cross-agency approach that helps children, youth, and young adults with complex needs get timely care when services are the responsibility of multiple systems.

Young people with intellectual or developmental disabilities, behavioral health conditions, or both, along with those leaving the child welfare system, behavioral health system, homeless youth programs or leaving juvenile justice, often fall into the gaps between agencies. Some remain in hospitals or emergency rooms after being identified as medically stable for discharge because the support for a safe discharge is difficult to access. When HCA studied the youth who needed help through data and escalation pathways, more than 90% were Medicaid eligible, making Medicaid the natural center of the solution.

“Our youth and children deserve our best, and too often our systems made that hard to deliver,” said Trinity Wilson, Washington State Medicaid Director. “Families told us they were stuck between ‘not sick enough’ and ‘too dangerous to stay at home,’ and no single agency could solve that alone. By keeping youth and families at the center and bringing every system to the same table, we’re finding solutions that weren’t possible before.”

Making the Most of Existing Investments

Rather than seek a new funding stream, HCA built the pathways on the care coordination funding already provided to Medicaid managed care organizations (MCOs) and held plans accountable for using it well. The program’s creative and pragmatic solutions include:

• Clear MCO expectations through contract language, technical assistance, and monitoring for intensive, person-centered care coordination
• Cross-agency education so partners in juvenile justice, child welfare, developmental disabilities, and schools know how to request care coordination and escalate to HCA when needed
• A single point of contact for families, with the coordinator who has the strongest relationship with the youth empowered to convene partners across systems
• Data tracking that documents barriers to drive system improvements and inform the state legislature

“Every state is grappling with how to better serve children who touch multiple systems at once. Washington has shown what’s possible when those systems work as one team to better serve children, and states across the nation are paying attention,” said Kate McEvoy, Executive Director of the National Association of Medicaid Directors. “By making smart use of the care coordination dollars already in its managed care contracts, HCA has built an approach that is both deeply person-centered and can be tailored by other states and territories.”

About NAMD’s Spotlight Award

The National Association of Medicaid Directors’ annual Spotlight Award recognizes exceptional leadership and innovation in Medicaid administration. The award highlights achievements that demonstrate excellence in driving value through improved member experience and efficient use of taxpayer resources. Learn more about the other 2026 winners here.