Health Care Authority

The Washington State Health Care Authority (HCA) is a U.S. state government entity based in Olympia, Washington, that has been registered to receive federal awards since 2009. As Washington's Medicaid agency and primary health care authority, HCA administers comprehensive healthcare programs and behavioral health services across the state. The organization serves as the prime recipient for numerous federal contracts and grants, working in partnership with state agencies, tribal organizations, community-based providers, and healthcare systems to deliver integrated health and behavioral health services to Washington residents.

Health Care Authority's federal contract work is limited but significant, consisting primarily of sub-contract awards through technical assistance and research partnerships. The entity received sub-contract awards from the National Association of State Mental Health Program Directors Inc. for mental health and technical assistance services (awarded January 2025 and January 2024), and collaborated with research organization MDRC in 2022 to assist with program provider engagement, service provision, and data collection and reporting related to behavioral health initiatives. These contract awards reflect HCA's role in supporting national efforts to improve mental health systems and contribute to evidence-based research on behavioral health program effectiveness.

Health Care Authority's federal grant portfolio is extensive and diverse, reflecting its central role in administering behavioral health, substance use disorder treatment, and rural health transformation initiatives across Washington State. The organization serves as prime grantee for substantial cooperative agreements and project grants from the Centers for Medicare and Medicaid Services, including a landmark $181.3 million Rural Health Transformation grant (awarded December 2025) designed to improve rural healthcare access and outcomes through initiatives addressing workforce development, technology investment, and financial solvency for rural providers. HCA also administers multiple grants from the Substance Abuse and Mental Health Services Administration (SAMHSA), including Block Grants for Community Mental Health Services, Substance Abuse Prevention and Treatment Block Grants, Projects for Assistance in Transition from Homelessness (PATH) formula grants, and multiple discretionary project grants addressing opioid response, school-based services, crisis services, and specialized mental health programs. Additional funding flows from the Bureau of Justice Assistance for residential substance abuse treatment in correctional facilities, drug court support, and comprehensive opioid and stimulant use disorder initiatives. HCA frequently issues sub-awards to Behavioral Health Administrative Services Organizations, peer-run recovery support organizations, tribal nations, county governments, educational service districts, and specialized providers including Recovery Cafes and the Island County Behavioral Health and Criminal Justice Partnership, enabling the delivery of treatment services, crisis response, recovery support, workforce training, and prevention initiatives throughout Washington State. The grant programs support activities ranging from evidence-based medication-assisted treatment and harm reduction to mobile crisis response, integrated care for children with serious emotional disturbances, community prevention coalitions, and school-based mental health services, demonstrating HCA's comprehensive approach to addressing behavioral health needs across diverse populations and service settings.