CBHS Tiers Explained: The Behavioral Health Add-On Behind Some AFH Income

Quick Answer

What are CBHS tiers in a Washington adult family home?

Community Behavioral Health Support (CBHS) is a Medicaid benefit administered by the Health Care Authority with DSHS that pays for supportive supervision of residents with qualifying behavioral health needs. There are six tiers, defined by average hours per day of dedicated staff: Tier 1 is 0.5 to 2 hours, Tier 2 is 2.1 to 6, Tier 3 is 6.1 to 10, Tier 4 is 10.1 to 15, Tier 5 is 15.1 to 20, and Tier 6 is 20.1 to 24.

If an adult family home owner talks about Tier 2 or Tier 4 residents, this is almost certainly the system they mean. It is separate from the A through E classification that sets the base Medicaid rate.

Common questions

Does every AFH receive CBHS payments?

No. The tier belongs to the individual resident, and only residents who meet the eligibility criteria have one.

Can a resident's CBHS tier change?

Yes. Eligibility is reviewed at least once every 12 months, a home can submit a re-tiering request, and if the resident moves out the payment leaves with them.

About the author: David Stein is a Washington State licensed real estate broker (eXp Realty, license #133972) and a Washington State certified residential appraiser (Stein Appraisal, license #1702080), with more than 20 years of experience in both disciplines. More about David.

Real Property Planning

Independent hub for probate, estate & senior transition real estate in Washington State

David Stein — Washington State Licensed Real Estate Broker — David Stein's real estate license is held under eXp Realty

Washington State Certified Residential Appraiser — Stein Appraisal

Phone: (206) 900-3015

Email: info@realpropertyplanning.com

Mailing Address: PO Box 1462, Woodinville, WA 98072

Office: 1455 NW Leary Way, Seattle, WA 98107

Washington State Service Areas

Serving clients throughout Washington State, with especially strong experience in Western Washington and the Puget Sound region.