AGING AND LONG-TERM SUPPORT ADMINISTRATION (ALTSA) HOME AND COMMUNITY SERVICES (HCS) GOVERNOR'S OPPORTUNITY FOR SUPPORTIVE HOUSING (GOSH) GOSH Referral DATE HCS / AAA Case Manager (CM) to send completely filled-out Referral form, with all documents attached, toRegional GOSH PM. APPLICANT'S HOME ADDRESSCITYSTATEZIP CODE 6. A request for service may not generate a referral. Apply to Event Coordinator, Van Driver, Employment Specialist and more! DSHS forms, including translations are found on the DSHS forms website. APPLICANT'S MAILING ADDRESS (IF DIFFERENT)CITYSTATEZIP CODE 7. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO 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. Department-designated social service staff: Assess the client's functional eligibility for institutional care. To complete an application for apple health, you must also give us all of the other information requested on the application. If you are an SSI recipient, then you, your authorized representative as defined in WAC, An individual applying for Washington apple health (WAH) (as defined in WAC. You must apply directly with the service provider for the following programs: The breast and cervical cancer treatment program under WAC, For the confidential pregnant minor program under WAC. Provider Fraud and Elder Abuse complaint line: Repaying the state for medical and long-term services and supports, DSHS 14-501 Community resource declaration (used to evaluate resources (assets) for an applicant and their spouse based on date of institutionalization. Questions to consider when making aFast Track recommendation: Social services cant begin Fast Track until a CAREassessment is completed. SOCIAL SECURITY NUMBER 5. The LTSSstartdate is the date the client is both financially and functionally eligible. Assessment of client's access to primary care, Need for nursing, caregiver, or rehabilitation services. z, /|f\Z?6!Y_o]A PK ! Is the client single or married, and which resource standard is being used to make a recommendation. WAC 182-513-1350). Staff will follow up within 10 business days of a referral provided to support services to ensure the client accessed the service. Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. Family members and other representatives are often just learning about the client's income and resources when they apply. Document in ACES remarks, in detail, all eligibility factors discussed during the interview and included on the application. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). | Contact Us A simple and sleek portal for staff. 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. 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 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. 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 Clients active on MAGI except AEM N21 and N25), don't need to submit an additional application if they are functionally eligible for, and in need of the following: If a client needs waiver services they must submit an application and may need a disability determination. Job in Fresno - Fresno County - CA California - USA , 93650. DSH Program State Plan Amendment 14-008. Home. PK ! Use Equal Access - Necessary Supplemental Accommodation (NSA) and long-term services and supports policies for LTSS applicants and recipients. Aging and Disability Resources Office Are you enrolled in Medi-Cal? Exception is N21/N25 AEM MAGI. Cases without a delay reason code or updated with "No Good Cause (NG)" to the DSHS secretary. For Hospice as a medicaidprogram, the hospice authorization date is based on the receipt of the 13-746 (HCA/medicaid Hospice notification). Interfaith Works Homeless Services: www.iwshelter.org. The agency must document the situation in writing and contact the referring primary medical care provider. Tacoma, WA 98418. State Plan Amendments. Provide the PBS staff with the following information: Residential facility name and address, including room number, if applicable. Conduct a follow-up within 90 days of completed application to determine if additional and/or ongoing needs are present. !ISWvuutZWh'gfG0^$n6g%LjQ:@(]t)eh -^k]8 zAG s#d (link is external) 360-709-9725. When using Collateral Contact (CC) or Other (OT) valid value, document the details of how it was verified. A request for service s is any request that comes to HCS regardless of source or eligibility. Determine the client's financial eligibility for LTSSmedicaid and/or noninstitutional medical assistance including a request for retro medical if needed. Summarize the interview and items still needed to determine eligibility in the ACES narrative. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO Review excess home equity, annuity and transfer of resource provisions that are specific to institutional and home and community-based (HCB) waivers. TK6_ PK ! | Home Professionals & Providers Management Bulletins 2020 HCS Management Bulletins 2020 HCS Management Bulletins Note: These documents are available only in Word and/or Excel formats. Your WAH coverage may not begin on the first day of the month if: Subsection (3) of this section applies to you. When information is verified using an electronic source (such as BENDEX, AVS, etc.). We provide equal access (EA) services as described in WAC, Ask for EA services, you apply for or receive long-term services and supports, or we determine that you would benefit from EA services; or, Have limited-English proficiency as described in WAC. HIV Medical and Support Service Categories, Research, Funding, & Educational Resources. A referral Demonstrate the reasonableness of decisions. 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. | Provide feedback on your experience with DSHS facilities, staff, communication, and services. Services may be authorized using Fast Track for a maximum of 90 days. The PBS should make a Fast Track recommendation based on the information, verifications and cross-matches available, and send this determination via 07-104 to social services. The authorization can't be backdated for HCB waiver, CFC, or MPC unless socialservices has fast-tracked services and the client is subsequently found financially eligible. Request verification of transfers, gifts or property sales, if applicable. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013, p. 14-16. 6 [Content_Types].xml ( KO0#5.,5ec H0[i ~NhMsg[3xxw;) 'nY?7H(;1{H] Ask if there are unpaid medical expenses and request verification if medical expenses exist. All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. Determine if a housing maintenance allowance (HMA) is appropriate (current rule states HMA is the amount of the Federal Poverty Level). Ask if any of these bills were incurred within the last 3 months. | In the case of the community spouse, explain how all resources in excess of the $2,000 resource limit must be transferred to the spouse within 1 year and the requirement to provide verification of this by the first annual review. Mienh waac 0 6 /20 20 INSTRUCTIONS HOME AND COMMUNITY SERVICES Intake and Referral DATE Section 1. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. The interview can be conducted in person or by phone. A good cause code must be used when finalizing any medical(AU) historically beyond 45 days. 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. Social service staff and case managers determine functional eligibility and what services to authorize based on a complete and comprehensive CAREassessment. If they can't be reached, or are unavailable, send an appointment letter (DSHS 0011-01) and a request for verification letter for what is needed to determine eligibility, based only on what was declared on the application. Center for Health Emergency Preparedness & Response, Texas Comprehensive Cancer Control Program, Cancer Resources for Health Professionals, Resources for Cancer Patients, Caregivers and Families, Food Manufacturers, Wholesalers, and Warehouses, Emergency Medical Services (EMS) Licensure, National Electronic Disease Surveillance System (NEDSS), Health Care Information Collection (THCIC), Pharmaceutical Manufacturers Patient Assistance Programs, DSHS Policy591.00 Limitations on Ryan White and State Service Funds for Incarcerated Persons in Community Facilities, Section 5.3, State Health Insurance Assistance Plans (SHIPs), Social Security Disability Insurance (SSDI). Por favor, responda a esta breve encuesta. REGION 1 - Pend Oreille, Stevens, Ferry Okanagan, Chelan, Douglas, Grant, Lincoln, Spokane, Adams, Whitman, Klickitat, Kittitas, . Your Washington apple health (WAH) coverage starts on the first day of the month you applied for and we decided you are eligible to receive coverage, unless one of the exceptions in subsection (4) of this section applies to you. Accessed on October 12, 2020. Center for Health Emergency Preparedness & Response, Texas Comprehensive Cancer Control Program, Cancer Resources for Health Professionals, Resources for Cancer Patients, Caregivers and Families, Food Manufacturers, Wholesalers, and Warehouses, Emergency Medical Services (EMS) Licensure, National Electronic Disease Surveillance System (NEDSS), Health Care Information Collection (THCIC). 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. The hospice provideris required to submit this form within 5 business days of a hospice election on all active and pending Medicaidcases. At a department of social and health services (DSHS) community services office (CSO). Client will be contacted within one (1) business day of the referral, and services should be initiated at the time specified by the primary medical care provider, or within two (2) business days, whichever is earlier. If the client isn't financially eligible, notify social services. z, /|f\Z?6!Y_o]A PK ! | Accessibility Certification, 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. PK ! For long-term services and supports coverage such as nursing home care, in-home personal care, assisted living facility, adult family home programs, and TSOA Mail your application to: DSHS Home and Community Services PO Box 45826, Olympia, WA 98504-5826 Questions? Access Health Care Language Assistance Services (SB 223). You may have an authorized representative apply on your behalf as described in WAC, We help you with your application or renewal for apple health in a manner that is accessible to you. Call the client or their representative to complete an interview. For calculating time limits, "day one" is the day we get an application from you that includes at least the information described in WAC. 3602 Pacific Ave., Suite 200 . Social services indicates the start date for HCB waiver on the DSHS 14-443 (communication from social services to HCS PBS), or the DSHS 15-345 (communication from DDA case manager to the DDA PBS). Ensure an Asset Verification System (AVS) Authorization is on file, and if not, follow these procedures. Barcode 10570 DSHS form 10-570. Has your contact information changed in For medicaid applicants, institutional services are approved based on the date the client is eligible up to 3 months prior to the date of application. Summarize what verification is needed to complete the application and send a request for information letter. :.U`:8H"Jtv&edPi\ZbNu]$#;w2F.v~u\E}:=~G gQDYQ2xe*rhB/Y>as1j{s2Zo3(\XIEfe687jdP|A2L(o5E".eYR?UUCWel6/,/`^jQ[. A supervisor must sign the case closure summary. There is good information on the Washington LawHelp site that explains the timing of an LTSSapplication. You are the primary applicant on an application if you complete and sign the application on behalf of your household. LTSS can begin once a client is found financially and functionally eligible and an approved provider is in place. CONTACT(S): Rachelle Ames, HCS Program Manager 360-725-2353 amesrl@dshs.wa.gov xar *O.c H?Y+oaB]6y&$i8]U}EvH*%94F%[%A PK ! If the NF admission is on a weekend or holiday, the NF has until the first business day to report the admission. Applications for LTSS may be submitted using any of the following methods: Mailing or faxing documents to Home and Community Services (HCS), Mail to: Disproportionate Share Hospital Program. We do not delay a decision by using the time limits in this section as a waiting period. When applicable, an employee of the agency has experienced a real or perceived threat to his/her safety during a visit to a client's home, in the company of an escort or not. Examples are the SSI or SSI-related programs or Apple Health for Workers with Disabilities (HWD). Subrecipients must provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area to inform all individuals of the availability of language assistance services. 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. Please report broken links or content problems. Funds cannot be used to duplicate referral services provided through other service categories. We will allow you more time if you ask for more time or need an accommodation due to disability or limited-English proficiency. 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 ! Collaborates with treating physician, psychiatric and allied health professional team to plan and direct each individual member . Kirkland, WA. Eligible clients are referred to other core services (outside of a medical, MCM, or NMCM appointment), as applicable to the clients needs, with education provided to the client on how to access these services. APPPLICANT'S NAME: LAST, FIRST, MI 2. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. GENDER Male Female 3. IHSS Service Desk for Providers & Recipients, (866) 376-7066, Suspect Fraud? Statements made by the client and/or their representative. Jun 2014 - Mar 201510 months. 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. 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)). 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. We did not document the good cause reason before missing a time frame specified in subsection (1) of this section. Progress notes will then be entered into the client record within 14 working days. | If we need more information to decide if you can get apple healthcoverage, we will send you a letter within twenty calendar days of your initial application that: States the additional information we need; and. This service category works to maximize public funding by assisting clients in identifying all available health and disability benefits supported by funding streams other than RWHAP Part B and/or State Services funds. Contact a navigator, health care authority volunteer assistor, or broker. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). Full Time position. 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 f?3-]T2j),l0/%b PO Box 45826 f?3-]T2j),l0/%b adult daycare center) in accordance with a written, individualized plan of care established by a licensed physician. Explain the financial and social service functional eligibility process. We follow the rules about notices and letters in chapter. Ask about any transfers, gifts, or property sales during the 5-year look back and the circumstances of why they were made. Clients receiving services during the Fast Track period won't receive a medical services card until financial eligibility is established. . | Information to determine clients ability to perform activities of daily living and the level of attendant care assistance the client needs to maintain living independently. Percentage of clients who received a referral for other core services who have documented evidence of the education provided to the client on how to access these services in the primary client record. Purpose: Communication to social services intake regarding an individual requesting a functional assessment for long-term services and supports (LTSS). Home and Community Services - LTSS Referral for Health Care and Support Services Service Standard print version. IHSS Fraud Hotline: 888-717-8302 A parent or caretaker relative of a child age eighteen or younger; A tax filer applying for a tax dependent; A person applying for someone who is unable to apply on their own due to a medical condition and who is in need of long-term care services. Professional care is the provision of services in the home by licensed providers for mental health, development health care, and/or rehabilitation services. 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: Main Office . Include Remarks to reconcile any discrepancies, or important information not otherwise captured, including required questions left blank on the application or eligibility review form. Allows at least ten calendar days to provide it. The agency or its designee may contact an individual by phone or in writing to gather any additional information that is needed to make an eligibility determination. 1-(800)-722-0432, Copyright 2023 California Department of Social Services. 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. Staff will explore the following as possible options for clients, as appropriate: Staff will assist eligible clients with completion of benefits application(s) as appropriate within 14 business days of the eligibility determination date. 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.
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