Center for Medicare and Medicaid Services (CMS) requires an annual review at least once a year for categorically needy (CN) Medicaid. Percentage of clients with documented evidence of a discharge plan developed with client, as applicable, as indicated in the clients primary record. p9,u eV)Pp6B*Rk[g8=g S,8!ciLu`A^2 ntw]0+ *mhX1M[zQ=~yOF594 Y8-xf[rt(>zc|C1>4o ?|aBq}D.2L3jI>&,OXOG79Z5:%A PK ! Complete a Financial Communication to Social Services (07-104) referral when an application is received on an active MAGI case, Add text stating that unless an assessment is completed and determines HCB Waiver is needed, the client will remain on MAGI. Progress notes will be kept in the client's primary record and must be written the day services are rendered. Hmoob | Include Remarks to reconcile any discrepancies, or important information not otherwise captured, including required questions left blank on the application or eligibility review form. Percentage of clients with documented evidence of care plans reviewed and/or updated as necessary based on changes in the clients situation at least every sixty (60) calendar days as evidenced in the clients primary record. The Office of Community and Homeless Services (OCHS), the Office of Housing and Community Development (OHCD) and the Office of Weatherization and Energy Assistance (OWEA) operate within the Housing and Community Services Division (HCS) of the Snohomish County Human Services Department. A request for service may not generate a referral. DSHS 10-438 Long-term care partnership (LTCP) asset designation form (used to designate assets (resources) for those with a long-term care partnership insurance policy), DSHS 14-012 Consent (release of information form) (used for all DSHS programs), DSHS27-189Asset Verification Authorization. Percentage of clients with documented evidence of a care plan completed based on the primary medical care providers order as indicated in the clients primary record. Eligible clients are referred to additional support services (outside of a medical, MCM, NMCM appointment), as applicable to the clients needs, with education provided to the client on how to access these services. DSHS HIV Care Services requires that for Ryan White Part B or SS funded services providers must use features to protect ePHI transmission between client and providers. At a department of social and health services (DSHS) community services office (CSO). Home and Community Services Division PO Box 45600, Olympia, WA 98504-5600 H 20 0 53 Information June 9 , 2020 TO: Area Agency on Aging (AAA) Directors Home and Community Services (HCS) Division Regional Administrators FROM: Bea Rector, Director, Home and Community Services Division SUBJECT: Applicant Information 1. Assess the client's functional eligibility for in home or residential care. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April 2013. p. 42-43. Contact a navigator, health care authority volunteer assistor, or broker. Based on the agencys perception of the client's condition, the client requires a higher level of care than would be considered reasonable in a home/community setting. 3602 Pacific Ave., Suite 200 . Interfaith Works Homeless Services: www.iwshelter.org. Questions to consider when making aFast Track recommendation: Social services cant begin Fast Track until a CAREassessment is completed. Olympia WA 98504-5826; or Use the original eligibility review date to open institutional coverage. APPLICANT'S MAILING ADDRESS (IF DIFFERENT)CITYSTATEZIP CODE 7. WAC 182-513-1350). If you are experiencing a mental health crisis and need immediate assistance, please call "911" and explain the nature of your problem to the operator. L@5f)a>%X5.auU!1qV!h%SAg,U--`8F ydjz 8 'gF$v5q~~ enLr38uX*#XH)'#+Uabj8 ,]-r8| HuS.q"1,4>5H0 v!Nya" &~'iOJZG8eCvvJj(FMuT_j4f18#/SiO*i )nJE3 UXO+!h(G;:iYB0^,-x;p =8rkOS%Paa"gb-wSc%@/-|FJxD:`Au$yLt'2xi? This is a reprint of the official rule as published by the Office of the Code Reviser. Percentage of clients with documented evidence of referrals provided for HIA assistance that had follow-up documentation within 10 business days of the referral in the primary client record. Client transfers services to another service program. Refer the client to social service intakefor a CAREassessment if the client contacts the PBS first and document the date the client first requested in-home or residential care. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013, p. 14-16. Determine the client's financial eligibility for LTSSand noninstitutional medical assistance including 3 months retroactive medical coverage if financially eligible. Purpose: Communication to social services intake regarding an individual requesting a functional assessment for long-term services and supports (LTSS). Case management that links a soon-to-be-released inmate with primary care is an example of appropriate transitional social services. HRhk\ X?Nk; $-Yqiy*KB&I4"@W>eGI'tHaOBhVPRQq[^BJ] Authorize in ACES for in-home or residential HCB waiver if the client is both functionally and financially eligible. Benefits Counseling: Activities should be client-centered facilitating access to and maintenance of health and disability benefits and services. Job specializations: Social Work. Screen all clients to determine potential for HCB services. The agency may discontinue services or refuse the client for as long as the threat is ongoing. As the primary applicant or head of household, you may start an application for apple health by providing your: Physical address, and mailing addresses (if different). (Source: DSHS Policy591.00 Limitations on Ryan White and State Service Funds for Incarcerated Persons in Community Facilities, Section 5.3). The following are eligibility related documents and files, including the annual final eligibility lists, peer grouping report, and the Low-Income Utilization Rate, Medicaid Utilization Rate, and Omnibus Budget Reconciliation Act formulas. | word/document.xml\n8}_`u-c t?mk[X`aKHJ|Mf2DUSU~~=DX~PJ6u`r]u+K(q` Qy'AD5}]qT"{J|}]6+t. Jun 2014 - Mar 201510 months. IHSS Timesheet Issues/Questions: Document in ACES remarks, in detail, all eligibility factors discussed during the interview and included on the application. PK ! !H!/tG|B^%=z+]F!lExBa0$ Client relocates out of the service delivery area. 0 6 /20 20 INSTRUCTIONS HOME AND COMMUNITY SERVICES Intake and Referral DATE Section 1. Use Equal Access - Necessary Supplemental Accommodation (NSA) and long-term services and supports policies for LTSS applicants and recipients. Help Stop Medi-Cal Fraud and Abuse For HCS clients, both functional and financial eligibility are determined concurrently. We follow the rules about notices and letters in chapter. We reconsider our decision to deny your apple healthcoverage without a new application from you when: We receive the information that we need to decide if you are eligible within thirty days of the date on the denial notice; You give us authorization to verify your assets as described in WAC 182-503-0055 within thirty days of the date on the denial notice; You request a hearing within ninety days of the date on the denial letter and an administrative law judge (ALJ) or HCA review judge decides our denial was wrong (per chapter. PBS determines financial eligibility by comparing the client's income, resources and circumstances to program criteria. adult daycare center) in accordance with a written, individualized plan of care established by a licensed physician. Family members and other representatives are often just learning about the client's income and resources when they apply. Note: Servicescan't be backdated prior to the date of the authorization until the date that financial eligibility is established. Percentage of clients with documented evidence of completed progress notes in the clients primary record. Transitional social services should NOT exceed 180 days. Update a good cause code when changing a program from an SSI-related assistance unit (AU) to an LTSS AU to prevent the case from being incorrectly reported as a new application. Ensure AVS procedures are followed. Send a general correspondence letter to the client indicating the application was received and because the client is currently receiving Medicaid services, additional information isn't needed for financial eligibility. Call to request an assessment for home and community services (in-home care in a residential facility, nursing facility coverage) through the HCS central intake lines. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO Website feedback: Tell us how were doing, Copyright 2023 Washington Health Care Authority, I help others apply for & access Apple Health, I help others apply for and access Apple Health, Long-term services & supports (LTSS) manual, www.hca.wa.gov/free-or-low-cost-health-care, Equal Access - Necessary Supplemental Accommodation (NSA) and long-term services and supports, HCA 80-020 Authorization for Release of Information, Apple Health for Workers with Disabilities (HWD), Medically Intensive Children's Program (MICP), Behavioral health services for prenatal, children & young adults, Wraparound with Intensive Services (WISe), Behavioral health services for American Indians & Alaska Natives (AI/AN), Substance use disorder prevention & mental health promotion, Introduction overview for general eligibility, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Medical plans & benefits (including vision), Life, home, auto, AD&D, LTD, FSA, & DCAP benefits. Referral for Health Care and Support Services (RFHC) directs a client to needed core medical or support services in person or through telephone, written, or other type of communication. If you reside in one of the following counties: Island, King (ZIP codes 98011, 98019, 98072, 98077, 98133, 98177) San Juan, Skagit, Snohomish, or Whatcom and are interested in: If you reside in King County in a ZIP code not listed above and are interested in: If you reside in one of the following counties: Clallam, Clark, Cowlitz, Grays Harbor, Jefferson, Kitsap, Lewis, Mason, Pacific, Pierce, Skamania, Thurston, or Wahkiakum 800-786-3799, FAX 360-586-0499. | Concise - Documentation is subject to public review. Percentage of clients with documented evidence of other public and/or private benefit applications completed as appropriate within 14 business days of the eligibility determination date in the primary client record. Caregiver Support Find out about caregiver support. Complete - The documentation must support the eligibility decision and allow a reviewer to determine what was done and why. Refer the client tosocialservicesfor a care assessment if the client contacts the PBSfirst and document the date the client first requested NF care. Community Services Division Social Services Manual Revision: # 175 Category: Incapacity Determination - When HEN Referral Program Eligibility Ends Issued: February 23, 2023 Revision Author: Evelyn Acopan Division CSD Mail Stop Phone 253-778-2381 Email evelyn.acopan@dshs.wa.gov Summary DSHS 10-570 ( REV. DSHS 14-532 Authorized representative release of information. Listed on 2023-03-03. For Hospice as a medicaidprogram, the hospice authorization date is based on the receipt of the 13-746 (HCA/medicaid Hospice notification). Percentage of clients who are no longer in need of assistance through Referral for Health Care and Support Services that have a documented case closure summary in the primary client record. If we denied your application because we do nothave enough information, the ALJ will consider the information we already have and any more information you give us. The case closure summary must include a brief synopsis of all services provided and the result of those services documented as completed and/or not completed.. Acronyms utilized should be DSHS/HCA approved. If the client is likely to attain institutional status. Tacoma, WA 98418. MAGI covers NF and Hospice under the scope of care. The following Standards and Measures are guides to improving healthcare outcomes for people living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program. Referrals for health care and support services provided by outpatient/ambulatory health care professionals should be reported under Outpatient/Ambulatory Health Services (OAHS) category. Services include: Inpatient hospitals, nursing homes, and other long-term care facilities are not considered an integrated setting for the purposes of providing Home and Community-Based Health Services. The PBS should reviewthe original application to ensure there are no changes and proceed to determine eligibility. Care plan is updated at least every sixty (60) calendar days. The PBS may waive the interview requirement. For medicaid recipients, the first date DSHS was notified of the admission by the nursing facility. Clientsswitching from private pay to medicaid are advised to apply for benefits 30 to 45 days before being resource eligible for the program. Collaborates with treating physician, psychiatric and allied health professional team to plan and direct each individual member . Name Unit Division Phone *Medicaid Helpline: Medicaid: HCS: 1-800-562-3022: Abbott, Amy: Director's Office, RCS: RCS: 360.725.2401: Acoba, Curtis: OT - IT Security Summarize the interview and items still needed to determine eligibility in the ACES narrative. Case Closure Summary: Clients who are no longer in need of assistance through Referral for Health Care and Support Services must have their cases closed with a case closure summary narrative documented in the client primary record. For the Ryan White Part B/SS funded providers and Administrative Agencies, telehealth and telemedicine services are to be provided in real-time via audio and video communication technology which can include videoconferencing software. Referrals for health care and support services provided by case managers (medical and non-medical) should be reported in the appropriate case management service category (e.g., Medical Case Management (MCM) or Non-Medical Case Management (NMCM)). | Provide PBSstaff with the following information: Whether the client meets nursing facility level of care (NFLOC). We process applications for Washington apple health medicaid within forty-five calendar days, with the following exceptions: If you are pregnant, we process your application within fifteen calendar days; If you are applying for a program that requires a disability decision, we process your application within sixty calendar days; or. Refusal of referral: The home or community-based health agency may refuse a referral for the following reasons only: The client's home or current residence is determined to not be physically safe (if not residing in a community facility) before services can be offered or continued. Sometimes we can start your coverage up to three months before the month you applied (see WAC, If you are confined or incarcerated as described in WAC, You are hospitalized during your confinement; and. The Home and Community-based Services program provides individualized services and supports to persons with intellectual disabilities who are living with their family, in their own home or in other community settings, such as small group homes. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO Has your contact information changed in The DSHS consent form is preferred as it is used for all programs including medical, food and cash. Referral for Health Care and Support Services includes benefits/entitlement counseling and referral to health care services to assist eligible clients to obtain access to other public and private programs for which they may be eligible. Eligibility decisions made, or next steps. If the applicant is eligible for an MSP based on income and resource guidelines and all information is received to determine eligibility for MSP, don't hold up processing this program while the LTSS medical is pending. Please take this short survey. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. | Conditions of Use Funds cannot be used to duplicate referral services provided through other service categories. z, /|f\Z?6!Y_o]A PK ! We will allow you more time if you ask for more time or need an accommodation due to disability or limited-English proficiency. Determine the client's financial eligibility for LTSSmedicaid and/or noninstitutional medical assistance including a request for retro medical if needed. For households containing people described in subsection (2) of this section: Call the Washington Healthplanfindercustomer support center number listed on the application for health care coverage form (. Your WAH coverage may not begin on the first day of the month if: Subsection (3) of this section applies to you. Conduct a follow-up within 90 days of completed application to determine if additional and/or ongoing needs are present. Disproportionate Share Hospital Program.