The hospice provideris required to submit this form within 5 business days of a hospice election on all active and pending Medicaidcases. 1-(800)-722-0432, Copyright 2023 California Department of Social Services.
Denos su opinin sobre sus experiencias con las instalaciones, el personal, la comunicacin y los servicios del DSHS. Health care services: Clients should be provided assistance in accessing health insurance or Marketplace health insurance plans to assist with engagement in the health care system and HIV Continuum of Care, including medication payment plans or programs. 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. Home and Community-Based Health Services Standards print version. 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. 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.
Agency no longer meets the level of care required by the client.
Home.
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. Provide feedback on your experience with DSHS facilities, staff, communication, and services.
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What resources is the client reporting on the application or past applications?
Concise - Documentation is subject to public review. |
If the client is unable to complete the interview due to a medical condition or because no one is available to assist the client.
Client relocates out of the service delivery area. / % [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\ 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. | 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. | word/document.xml\n8}_`u-c t?mk[X`aKHJ|Mf2DUSU~~=DX~PJ6u`r]u+K(q` Qy'AD5}]qT"{J|}]6+t. Ensure AVS procedures are followed.
Accessed on October 12, 2020. Apply in-person at a local Home & Community Services office.
For Hospice as a medicaidprogram, the hospice authorization date is based on the receipt of the 13-746 (HCA/medicaid Hospice notification).
Purpose: Communication to social services intake regarding an individual requesting a functional assessment for long-term services and supports (LTSS).
All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. 1s |
If you have questions about submitting the form please contact your regional office at the number below.
Disproportionate Share Hospital Program Eligibility.
3602 Pacific Ave., Suite 200 .
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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. The agency must document the situation in writing and immediately contact the client's primary medical care provider.
Lead and manage training development . Behavioral health services for American Indians & Alaska Natives (AI/AN) Recovery support services What is recovery support? $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO Coordination of Services and Referrals: If referrals are appropriate or deemed necessary, the agency will: Percentage of clients accessingHome and Community-Based Health Services with documented evidence of referrals, as applicable, to other services as indicated in the clients primary record.
APPLICANT'S HOME ADDRESSCITYSTATEZIP CODE 6.
Review excess home equity, annuity and transfer of resource provisions that are specific to institutional and home and community-based (HCB) waivers.
Percentage of clients accessingHome and Community-Based Health Services have follow up documentation to the referral offered in the clients 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. Request verification of transfers, gifts or property sales, if applicable. As specified in subsection (2) of this section, if you are a child, pregnant, a parent or caretaker relative, or an adult age sixty-four and under without medicare.
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CONTACT(S): Rachelle Ames, HCS Program Manager 360-725-2353 amesrl@dshs.wa.gov
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. |
If there is other medical coverage and you can obtain the information during the interview, complete a. 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. In-home or residential services, call 800-780-7094 or 425-977-6579, FAX 425-339-4859, Nursing home services, call 800-780-7094, FAX 206-373-6855, In-home or residential services, call 206-341-7750, FAX 206-373-6855. 08/2017) Page 1 of 2 / Intake and Referral form for Social Services. Refer the client tosocialservicesfor a care assessment if the client contacts the PBSfirst and document the date the client first requested NF care. v}r'kFtr4Ng n
[D!n'h}c l`0_ 85yaBAhFozyJ46_ERgsEc;,'K$zTzy[1 PK ! Include Remarks to reconcile any discrepancies, or important information not otherwise captured, including required questions left blank on the application or eligibility review form. Call to request an assessment for home and community services (in-home care in a residential facility, nursing facility coverage) through the HCS central intake lines. xar
*O.c H?Y+oaB]6y&$i8]U}EvH*%94F%[%A PK ! 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.
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. The hospital requires you to stay overnight.
We did not document the good cause reason before missing a time frame specified in subsection (1) of this section. Progress notes will be kept in the client's primary record and must be written the day services are rendered. PBS determines financial eligibility by comparing the client's income, resources and circumstances to program criteria. 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.
DSH Program State Plan Amendment 14-008. Por favor, responda a esta breve encuesta.
There is good information on the Washington LawHelp site that explains the timing of an LTSSapplication.
Benefits counseling: Services should facilitate a clients access to public/private health and disability benefits and programs. HRSA Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds Policy Clarification Notice (PCN) #16-02(Revised 10/22/2018) Accessed on October 16, 2020. 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.
To apply for tailored supports for older adults (TSOA), see WAC. Issue the NF award letter to the applicant/recipient and the nursing facility. Percentage of clients who received a referral for other support services who have documented evidence of the education provided to the client on how to access these services in the primary client record. 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.
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HCA forms, including translations are found on the HCA forms website.
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The interview can be conducted in person or by phone. Care plan is updated at least every sixty (60) calendar days. Access Health Care Language Assistance Services (SB 223). The HCS case manager coordinates andconsults withthe PBS to see if Fast Track is appropriate.
For in-home service applicants, discuss the food assistance program and inquire if the household would like to apply for food benefits. DSHS forms, including translations are found on the DSHS forms website.
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).
Explain the financial and social service functional eligibility process.
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Exception is N21/N25 AEM MAGI.
State Plan Amendments.
Provide advocacy to clients with a clear understanding of community services and support available for their situations.
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. Go over the application, particularly what was declared in the income and resource sections.
Professional care is the provision of services in the home by licensed providers for mental health, development health care, and/or rehabilitation services. Need Mental Health Services? INTAKE AND REFFERAL DSHS 10-570 (REV. The agency has attempted to complete an initial assessment and the referred client has been away from home on three occasions.
Encourage the applicant to gather documents as soon as possible to expedite the process. Whether there is a housing maintenance allowance and the start date, if appropriate. |
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. 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. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). 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)). 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.
The application process begins and the application date is established when the request for benefits is received.
Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance.
Demonstrate the reasonableness of decisions. |
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. DSH Replacement State Plan Amendment 16-010. Services focus on assisting clients entry into and movement through the care service delivery network such that RWHAP and/or State Services funds are payer of last resort.
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. Help Stop Medi-Cal Fraud and Abuse
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^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ It is the primary responsibility of staff to ensure clients are receiving all needed public and/or private benefits and/or resources for which they are eligible. (link is external) 360-709-9725. Social services indicates the start date for HCB waiver on the DSHS 14-443 (communication from social services to HCS PBS), or the DSHS 15-345 (communication from DDA case manager to the DDA PBS).
TK6_ PK ! Interfaith Works Homeless Services: www.iwshelter.org. Get Services IHSS; Medi-Cal Offices; County Public Authority; IHSS Recipients: IHSS Training/Information - Resources; Fact Sheets; Educational Videos; IHSS Providers: How to Become an IHSS Provider; How to Appeal if You are Denied; IHSS Provider Resources; IHSS Timesheet Issues/Questions: IHSS Service Desk for Providers & Recipients, (866) 376 .
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^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ Ask about other resources not declared on the application.
Provide PBSstaff with the following information: Whether the client meets nursing facility level of care (NFLOC).
HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April 2013. p. 42-43. 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. Department-designated social service staff: Assess the client's functional eligibility for institutional care.
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Referrals for health care and support services provided by outpatient/ambulatory health care professionals should be reported under Outpatient/Ambulatory Health Services (OAHS) category. Call the HCS intake line in the area in which you reside to schedule an assessment.
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. |
Conduct a follow-up within 90 days of completed application to determine if additional and/or ongoing needs are present.
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. We determine eligibility as quickly as possible and respond promptly to applications and information received. Olympia WA 98504-5826; or
Consistent - Explain how conflicts or inconsistencies of information were addressed.
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.
HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44.
RWHAP Part B and State Services funds can be used to provide transitional social services to establish or re-establish linkages to the community.
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Clientsswitching from private pay to medicaid are advised to apply for benefits 30 to 45 days before being resource eligible for the program. All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. The Home and Community-Based Provider will document in the clients primary record progress notes throughout the course of the treatment, including evidence that the client is not in need of acute 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. Give your local county office your updated contact information so you can stay enrolled. Privacy Policy
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.
Social services will state fund Fast Track services when the client isn't financially eligible during the fast track period. 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. 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 catholic community services hen program. Explain the medical service card, automatic Medicare D enrollment if not on a creditable coverage or Medicare D Prescription Drug Plan. |
Stick to the facts relevant to determining eligibility or benefit level.
A phone or in-person interview is required to determine initial financial eligibility for WAH long-term care services.
Explain what changes of circumstances need to be reported.
Services cannot be provided in the following facilities: inpatient hospital facilities, nursing homes, and other long term care facilities.
Home and Community Services - LTSS Explain to the applicant that there is a Public Benefits Specialist (PBS) and a social service manager making determinations concurrently for LTSS eligibility.
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. (PDF) Accessed October 12, 2020.
Training and social services development, delivery and evaluations; budget setting; and relationship cultivation. COPES, for short, is a Washington State Medicaid (Apple Health) waiver program designed to enable individuals who require nursing home level care to receive that care in their home or alternative care environment, such as an assisted living residence. PK !
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.
If there are previous versions of this rule, they can be found using the Legislative Search page. A request for service may not generate a referral. p9,u eV)Pp6B*Rk[g8=g S,8!ciLu`A^2 ntw]0+
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?|aBq}D.2L3jI>&,OXOG79Z5:%A PK ! Open-ended questions often reveal that additional sources of income and assets may exist.
Medicaid eligibility begins, the first day of the month the client is eligible for LTSS.
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