Language assistance must be provided to individuals who have limited English proficiency and/or other communication needs at no cost to them in order to facilitate timely access to all health care and services. If you reside in an institution of mental diseases (as defined in WAC. | The determination of Fast Track is ultimately up to social services. | Clearly indicate this is a projection and the financial application is in process. Lite. The interview can be conducted in person or by phone. INTAKE AND REFFERAL DSHS 10-570 (REV. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. !H!/tG|B^%=z+]F!lExBa0$ Lakewood, WA. MAGI covers NF and Hospice under the scope of care. The ALJ does not consider the previous absence of information or failure to respond in determining if you are eligible. Provide feedback on your experience with DSHS facilities, staff, communication, and services. Ensure what you document accurately describes what happened with the case. The PBS should reviewthe original application to ensure there are no changes and proceed to determine eligibility. Hmoob Transfer/Discharge:A transfer or discharge plan shall be developed when one or more of the following criteria are met: All services discontinued under above circumstances must be accompanied by a referral to an appropriate service provider agency. | word/document.xml\n8}_`u-c t?mk[X`aKHJ|Mf2DUSU~~=DX~PJ6u`r]u+K(q` Qy'AD5}]qT"{J|}]6+t. N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ Percentage of clients with documented evidence of a discharge plan developed with client, as applicable, as indicated in the clients primary record. Por favor, responda a esta breve encuesta. These are the forms used in the application process for LTSS. 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. Open-ended questions often reveal that additional sources of income and assets may exist. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013, p. 14-16. Statements made by the client and/or their representative. / % [Content_Types].xml ( N0EHC-j\X $@b/=>"RRQ{c%3X@LCV^i7 Sx[Ab7*@*HRf$g`E*} G;V )B~)K0{j17X$)+n7u9bf}^&i/52\ For people described in subsection (3) of this section who are not applying with a household containing people described in subsection (2) of this section: Call orvisit a local DSHSCSO or HCS office; or. 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. CONTACT(S): Rachelle Ames, HCS Program Manager 360-725-2353 amesrl@dshs.wa.gov 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. 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. Home intravenous and aerosolized drug therapy (including prescription drugs administered as part of such therapy); Specialty care and vaccinations for hepatitis co-infection, provided by public and private entities. 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. 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. | Peer support & counseling Recovery housing Prevention Substance use disorder prevention & mental health promotion Quick links Apply for or renew Apple Health coverage Apple Health for you Apple Health account logins 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. Applicant Information 1. Assess the client's functional eligibility for in home or residential care. Give your local county office your updated contact information so you can stay enrolled. | 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.. Determine the client's financial eligibility for LTSSmedicaid and/or noninstitutional medical assistance including a request for retro medical if needed. Explain what changes of circumstances need to be reported. Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance. | 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. Tacoma, WA 98418. Ask about any transfers, gifts, or property sales during the 5-year look back and the circumstances of why they were made. What resources is the client reporting on the application or past applications? Provide PBSstaff with the following information: Whether the client meets nursing facility level of care (NFLOC). For calculating time limits, "day one" is the day we get an application from you that includes at least the information described in WAC. DSHS 14-532 Authorized representative release of information. An ongoing permanent history of actions and decisions made; A support of eligibility, ineligibility and benefit determination; Credibility for decisions when used as evidence in legal matters; A trail for reviewers to determine the accuracy of the benefits issued. Home and Community-Based Health Services Standards print version. 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. A supervisor must sign the case closure summary. Did you receive verification of resources with the application? Include Remarks to reconcile any discrepancies, or important information not otherwise captured, including required questions left blank on the application or eligibility review form. Determine if a housing maintenance allowance (HMA) is appropriate (current rule states HMA is the amount of the Federal Poverty Level). For in-home service applicants, discuss the food assistance program and inquire if the household would like to apply for food benefits. The LTSSauthorization date can be backdated for nursing facility services up to 3 months prior to the date of application for a new applicant of Medicaid as long as the client is nursing facility level of care (NFLOC) and financially eligible. Transitional social services should NOT exceed 180 days. This is used for any cash, food or medical care services (MCS) request as MCS is tied to ABD cash/HEN eligibility, HCA 14-194 Medical coverage information (used to report third party insurance coverage including LTC insurance), DSHS14-539 Revocable burial fund provision for SSI-related health care, DSHS 14-540 Irrevocable burial fund provision for SSI-related health care, DSHS 14-454 Estate recovery fact sheet. 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). When information is verified using an electronic source (such as BENDEX, AVS, etc.). A good cause code must be used when finalizing any medical(AU) historically beyond 45 days. PK ! Note: Servicescan't be backdated prior to the date of the authorization until the date that financial eligibility is established. $41 to $75 Hourly. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO Barcode 10570 DSHS form 10-570. 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? Request verification of transfers, gifts or property sales, if applicable. Clients should be educated about and assisted with accessing and securing all available public and private benefits and entitlement programs. Percentage of clients with documented evidence of agency refusal of services with detail on refusal in the clients primary record AND if applicable, documented evidence that a referral is provided for another home or community-based health agency. Accessed on October 12, 2020. Social service staff and case managers determine functional eligibility and what services to authorize based on a complete and comprehensive CAREassessment. The intake and referral form (DSHS 10-570) and instructions can be found on the DSHS forms website What is the difference between a request for services and a referral? catholic community services hen program. Percentage of clients with documented evidence of completed progress notes in the clients primary record. The modified adjusted gross income (MAGI)-based apple healthapplication process using Washington Healthplanfinder may provide faster or real-time determination of eligibility for medicaid. Call the client or their representative to complete an interview. :.U`:8H"Jtv&edPi\ZbNu]$#;w2F.v~u\E}:=~G gQDYQ2xe*rhB/Y>as1j{s2Zo3(\XIEfe687jdP|A2L(o5E".eYR?UUCWel6/,/`^jQ[. Please report broken links or content problems. | Help Stop Medi-Cal Fraud and Abuse 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. | 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. The LTSSstart date for nursing facility services on an active medicaid recipient is based on the first date the admission is reported to DSHS as long as the client meets all other eligibility factors. For HCS clients, both functional and financial eligibility are determined concurrently. 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. Please take this short survey. Professional care is the provision of services in the home by licensed providers for mental health, development health care, and/or rehabilitation services. Questions to consider when making aFast Track recommendation: Social services cant begin Fast Track until a CAREassessment is completed. If there are previous versions of this rule, they can be found using the Legislative Search page. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. 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. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. Espaol HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013, p. 14-16. 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. Social services will state fund Fast Track services when the client isn't financially eligible during the fast track period. Policy Notices and Program Letters, Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds Policy Clarification Notice (PCN) #16-02 (PDF) (Revised 10/22/2018), DSHS Policy 591.000, Section 5.3 regarding Transitional Social Service linkage, Interim Guidance for the Use of Telemedicine and Telehealth for HIV Core and Support Services, March 2020, Interim Guidance for the Use of Telemedicine and Telehealth for HIV Core and Support Services Users Guide and FAQs, March 2020, HIV Medical and Support Service Categories, Research, Funding, & Educational Resources, Referral for Health Care and Support Services. 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. The LTSS authorization date, which is described in WAC, If there is a transfer penalty as described in WAC. Type of client interaction (phone, in-person, etc.). You are subject to asset verification and do not provide authorization as described in WAC 182-503-0055. A simple and sleek portal for staff. J(_ @# word/_rels/document.xml.rels ( Yo6~!0I'n:Ylw-RI"IV. (PDF) Accessed on October 12, 2020. HRSA/HAB Ryan White Program & Grants Management, Recipient Resources. A request for service may not generate a referral. 1-(800)-722-0432, Copyright 2023 California Department of Social Services. Percentage of clients accessingHome and Community-Based Health Services have follow up documentation to the referral offered in the clients primary record. The LTSSstartdate is the date the client is both financially and functionally eligible. f?3-]T2j),l0/%b 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 (. Current assessment and needs of the client, including activities of daily living needs (personal hygiene care, basic assistance with cleaning, and cooking activities), Need forHome and Community-Based Health Services, Types, quantity, and length of time services are to be provided. Job specializations: Social Work. How do I notify PEBB that my loved one has passed away? Posted: October 21, 2022. 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. PBS determines financial eligibility by comparing the client's income, resources and circumstances to program criteria. This Home and Community Based Services program provides not only care, but also other supports . 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. You may apply for Washington apple health at any time. 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. HOME > ben faulkner child actor Uncategorized > Uncategorized. IHSS Timesheet Issues/Questions: 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. Por favor, responda a esta breve encuesta. 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. Issue the NF award letter to the applicant/recipient and the nursing facility. We send you a written notice explaining why we denied your application (per chapter. General open-ended questions about resources and income should also be asked. IHSS Fraud Hotline: 888-717-8302 Life, home, auto, AD&D, LTD, & FSA benefits, Overview of prior authorization (PA), claims & billing, Step-by-step guide for prior authorization (PA), Program benefit packages & scope of services, Community behavioral support (CBHS) services, First Steps (maternity support & infant care), Ground emergency medical transportation (GEMT), Home health care services: electronic visit verification, Substance use disorder (SUD) consent management guidance, Enroll as a health care professional practicing under a group or facility, Enroll as a billing agent or clearinghouse, Find next steps for new Medicaid providers, Washington Prescription Drug Program (WPDP), Governor's Indian Health Advisory Council, Analytics, research & measurement (ARM) data dashboard suite, Foundational Community Supports provider map, Medicaid maternal & child health measures, Washington State All Payer Claims Database (WA-APCD), Personal injury, casualty recoveries & special needs trusts, Information about novel coronavirus (COVID-19). The agency must document the situation in writing and immediately contact the client's primary medical care provider. This is a reprint of the official rule as published by the Office of the Code Reviser. 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. Your WAH coverage may not begin on the first day of the month if: Subsection (3) of this section applies to you. Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance. 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. 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 ! The PBS may waive the interview requirement. The PBS also determines maximum client responsibility. Activities provided under this service category may include referrals to assist HRSA Ryan White HIV/AIDS Program (RWHAP)-eligible clients to obtain access to other public or private programs for which they may be eligible (e.g., Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturers Patient Assistance Programs, and other state or local health care and supportive services, or health insurance Marketplace plans). | The hospice provideris required to submit this form within 5 business days of a hospice election on all active and pending Medicaidcases. N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ Have you received Accurintand/or AVS results and reviewed the assets reported? Explain Estate Recovery and mail the Estate Recovery fact sheet. DSH Replacement State Plan Amendment 16-010. If you disagree with our decision, you can ask for a hearing. All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. To apply for tailored supports for older adults (TSOA), see WAC. D@. Need Mental Health Services? Training and social services development, delivery and evaluations; budget setting; and relationship cultivation. ,! 4 word/_rels/document.xml.rels ( VOo0Ow| :lRt[h{sK1u\+2 \\U\K>LLhb=MMr[B\^dk*)a#L!? Percentage of clients with documented evidence, as applicable, of a transfer plan developed and documented with referral to an appropriate service provider agency as indicated in the clients primary record.
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