Referral for Health Care and Support Services Service Standard print version. Ask if any of these bills were incurred within the last 3 months. Need Mental Health Services? Ask about other medical coverage. Home. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). Lakewood, WA. | Did you receive verification of resources with the application? This is a reprint of the official rule as published by the Office of the Code Reviser. 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. Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. Applications for clients under age 65 or ineligible for Medicare should be submitted through this site and will have a real-time determination of Washington Apple Health medical coverage eligibility under the modified adjusted gross income (MAGI) methodology. 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. Complete - The documentation must support the eligibility decision and allow a reviewer to determine what was done and why. Provide advocacy to clients with a clear understanding of community services and support available for their situations. We will allow you more time if you ask for more time or need an accommodation due to disability or limited-English proficiency. 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. 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. APPPLICANT'S NAME: LAST, FIRST, MI 2. Job in Fresno - Fresno County - CA California - USA , 93650. We do not delay a decision by using the time limits in this section as a waiting period. 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? A referral Licensed Masters Mental Health Professional Adult Intake Specialist Staff will follow up within 10 business days of a referral provided to support services to ensure the client accessed the service. 1-(800)-722-0432, Copyright 2023 California Department of Social 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. Determine if the client is likely to attain institutional status and be likely to reside at the nursing facility for 30 days or longer WAC 182-513-1320), or notifiesthe facility when the client doesn't appear to meet the need for nursing facility care. Home and Community-Based Health Services include the following: Home and Community-Based Health Providers work closely with the multidisciplinary care team that includes the client's case manager, primary care provider, and other appropriate health care professionals. Behavioral health services for American Indians & Alaska Natives (AI/AN) Recovery support services What is recovery support? Appropriate mental health, developmental, and rehabilitation services; Day treatment or other partial hospitalization services; Home health aide services and personal care services in the home. z, /|f\Z?6!Y_o]A PK ! Washington COPES Medicaid Waivers Program Staff will follow-up within 10 business days of a referral provided to any core services to ensure the client accessed the service. . 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. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). DSH Replacement State Plan Amendment 16-010. Stick to the facts relevant to determining eligibility or benefit level. Explain to the applicant that there is a Public Benefits Specialist (PBS) and a social service manager making determinations concurrently for LTSS eligibility. A Master's degree in social services, human services, behavioral sciences, or an allied field, and one year as a Social Service Specialist 1 or equivalent paid social Service experience | Careers Home and Community Services - LTSS The hospice provideris required to submit this form within 5 business days of a hospice election on all active and pending Medicaidcases. Provide feedback on your experience with DSHS facilities, staff, communication, and services. Caregiver Support Find out about caregiver support. Shannon Rawlings, LICSW - DSHS WSH Civil Social Work Manager - LinkedIn What resources is the client reporting on the application or past applications? DSH Regulations and Documents - California If the 13-746 is not received timely, count back 5 businessdays from the date of receipt to determine the authorization date. If you have questions about submitting the form please contact your regional office at the number below. 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. PDF Department of Social and Health Services Community Services Division Please take this short survey. 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. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. Listing for: Denham Resources. 53 Community jobs available in Halford, WA on Indeed.com. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013, p. 14-16. The agency must document the situation in writing and immediately contact the client's primary medical care provider. General open-ended questions about resources and income should also be asked. Always include the client's full name and the DSHS client id (if known) on any document mailed or faxed to DSHS. HIV Medical and Support Service Categories, Research, Funding, & Educational Resources. Percentage of clients with documented evidence of completed progress notes in the clients primary record. A request for service may not generate a referral. Access Health Care Language Assistance Services (SB 223). z, /|f\Z?6!Y_o]A PK ! REGION 1 - Pend Oreille, Stevens, Ferry Okanagan, Chelan, Douglas, Grant, Lincoln, Spokane, Adams, Whitman, Klickitat, Kittitas, . If you reside in an institution of mental diseases (as defined in WAC. If you disagree with our decision, you can ask for a hearing. Intake Coordinator. 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. 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. What is HCS (PDF in English) What is HCS (PDF in Spanish) Provider Communications If there are previous versions of this rule, they can be found using the Legislative Search page. Whether there is a housing maintenance allowance and the start date, if appropriate. (link is external) 360-918-8424. | This Home and Community Based Services program provides not only care, but also other supports . 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. 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. Ensure what you document accurately describes what happened with the case. SOCIAL SECURITY NUMBER 5. Staff will educate clients about available benefit programs, assess eligibility, assist with applications, provide advocacy with appeals and denials, assist with re-certifications, and provide advocacy in other areas relevant to maintaining benefits/resources. For ABD, SSI-related Washington Apple Health programs: This process applies toSSI-related programs only MAGI-based clients are not eligible for HCBwaiver. IHSS Fraud Hotline: 888-717-8302 For medicaid recipients, the first date DSHS was notified of the admission by the nursing facility. | Home and Community-Based Health Services | Texas DSHS HCA forms, including translations are found on the HCA forms website. We send you a written notice explaining why we denied your application (per chapter. 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 Day one is the date the application was received. BIRTH DATE 4. Allows at least ten calendar days to provide it. Percentage of clients with documented evidence of assistance provided to access health insurance or Marketplace plans in the primary client record. (PDF) Accessed October 12, 2020. A good cause code must be used when finalizing any medical(AU) historically beyond 45 days. Request verification of transfers, gifts or property sales, if applicable. Any assaults, verbal or physical, must be reported to the monitoring entity within one (1) business day and followed by a written report. Dont open a case in ACES until you have everything needed to establish financial eligibility. Authorize in ACES for in-home or residential HCB waiver if the client is both functionally and financially eligible. Details of how eligibility factor(s) were verified. 6 [Content_Types].xml ( KO0#5.,5ec H0[i ~NhMsg[3xxw;) 'nY?7H(;1{H] 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. 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. | Good cause for a delay in processing the application exists when we acted as promptly as possible but: The delay was the result of an emergency beyond our control; The delay was the result of needing more information or documents that could not be readily obtained; You did not give us the information within the time frame specified in subsection (1) of this section. DOCX Intake and Referral - Manuals.dshs.wa.gov If you seek apple health coverage and are age sixty-five or older, have a disability, are blind, need assistance with medicarecosts, or seek coverage of long-term services and supports,you may apply: By completing the application for aged, blind, disabled/long term care coverage (, In person at a local DSHSCSO or home and community services (HCS) office; or. Exception is N21/N25 AEM MAGI. There is good information on the Washington LawHelp site that explains the timing of an LTSSapplication. Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance. Health Care Services: Clients should be assisted in accessing health insurance or Marketplace plans to assist with engagement in the health care system and HIV Continuum of Care, including medication payment plans or programs. PDF HCS Intake and Referral - Washington Barcode 10570 DSHS form 10-570. In that case, your coverage would start on the first day of your hospital stay; You must meet a medically needy spenddown liability (see WAC, You are eligible under the WAH alien emergency medical program (see WAC, For long-term care, the date your services start is described in WAC. When information is verified using an electronic source (such as BENDEX, AVS, etc.). 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. 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). Ting Vit, About Us Concise - Documentation is subject to public review. | When working on a case that has ACES Equal Access (EA) requirements: If changing ACES EA requirements, clearly document the reason. For medicaid recipients, institutional services are approved based on the first date the admission is known to DSHS as long as the client meets all other eligibility factors. Are you enrolled in Medi-Cal? Asset verification, if not already authorized on the application by the client and financially responsible people (if applicable), may be authorized during the interview process. DSHS 14-532 Authorized representative release of information. Examples are the SSI or SSI-related programs or Apple Health for Workers with Disabilities (HWD). Clients receiving services during the Fast Track period won't receive a medical services card until financial eligibility is established. 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. Kirkland, WA. 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 ! Progress notes will be kept in the client's primary record and must be written the day services are rendered. | 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. Percentage of eligible clients with documented evidence of the follow-up and result(s) to a completed benefit application in the primary client record. | A copy of the police report is sufficient, if applicable. Full. Contact a navigator, health care authority volunteer assistor, or broker. The following are County IHSS program websites. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. When applicable, the client home or current residence is determined to not be physically safe (if not residing in a community facility) and/or appropriate for the provision ofHome and Community-Based Health Services as determined by the agency. IHSS Service Desk for Providers & Recipients, (866) 376-7066, Suspect Fraud? Go over the application, particularly what was declared in the income and resource sections. 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: You are automatically enrolled in apple healthand do not need to submit an application if you are a: Supplemental security income (SSI) recipient; Person deemed to be an SSI recipient under 1619(b) of the SSA; Child in foster care placement as described in WAC. The interview requirement described in subsection (3) of this section may be waived if the applicant is unable to comply: Because the applicant does not have a family member or another individual that is able to conduct the interview on his or her behalf. DSHS 10-570 ( REV. Ensure that service for clients will be provided in cooperation and in collaboration with other agency services and other community HIV service providers to avoid duplication of efforts and encouraging client access to integrated health care.
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