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. Summarize what verification is needed to complete the application and send a request for information letter.
Fast Track is a social serviceprocess that allows the authorization of LTSS prior to a financial eligibility determination. The LTSS authorization date, which is described in WAC, If there is a transfer penalty as described in WAC.
RN Referral Intake Nurse Hospice and Home Health Call the DSHScommunity services customer service contact center number listed on the medicaidapplication form.
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.
The PBS may waive the interview requirement. Full.
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=K [20Y(GNc#TchaBid~ygj\6h !$0DU9B#1$qfMNy m@4L9542h7,~O*9Z|1)nfR>P*C utgHGKFh 5zjUtMx'+)MI[]fKR:1tw%=Or. 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. Eligible clients are referred to Health Insurance Premium and Cost-Sharing Assistance (HIA) to assist clients in accessing health insurance or Marketplace plans within one (1) week of the referral for health care and support services intake. GENDER Male Female 3. Explain the Medicare Savings Program (MSP). A good cause code must be used when finalizing any medical(AU) historically beyond 45 days.
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.
f?3-]T2j),l0/%b HIV Medical and Support Service Categories, Research, Funding, & Educational Resources. Assist clients in making informed decisions on choices of available service providers and resources. Client relocates out of the service delivery area. Conduct a follow-up within 90 days of completed application to determine if additional and/or ongoing needs are present.
We send you a written notice explaining why we denied your application (per chapter. Explain the medical service card, automatic Medicare D enrollment if not on a creditable coverage or Medicare D Prescription Drug Plan. When information is verified using an electronic source (such as BENDEX, AVS, etc.).
HRSA/HAB Ryan White Program & Grants Management, Recipient Resources.
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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. 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. 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.
Ask about other medical coverage.
Applications for LTSS | Washington State Health Care Authority 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. Questions to consider when making aFast Track recommendation: Social services cant begin Fast Track until a CAREassessment is completed.
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.
Use Equal Access - Necessary Supplemental Accommodation (NSA) and long-term services and supports policies for LTSS applicants and recipients.
SSI recipients who need institutional services, or HCB waiver, must complete and sign an application, or the.
Kirkland, WA.
HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15.
Note: The HCA 80-020 Authorization for Release of Information is for medical benefits under Health Care Authority and will be accepted as a release of information for all medical programs including LTSSprograms. 3602 Pacific Ave., Suite 200 . Access Health Care Language Assistance Services (SB 223). 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.
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HCS Management Bulletins - Washington 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.
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.
Encourage the applicant to gather documents as soon as possible to expedite the process. Refer the client tosocialservicesfor a care assessment if the client contacts the PBSfirst and document the date the client first requested NF care. MAGI covers NF and Hospice under the scope of care. When working on a case that has ACES Equal Access (EA) requirements: If changing ACES EA requirements, clearly document the reason.
A supervisor must sign the case closure summary.
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 one of the following counties: Adams, Asotin, Chelan, Colombia, Douglas, Ferry, Franklin, Garfield, Grant, Kittitas, Klickitat, Lincoln, Okanogan, Pend Oreille, Spokane, Stevens, Walla Walla, Whitman, or Yakima509-568-3767 or 866-323-9409,FAX 509-568-3772.
Examples are the SSI or SSI-related programs or Apple Health for Workers with Disabilities (HWD). Good cause for a delay in processing the application does NOT exist when: Failing to ask you for information timely; or, Failing to act promptly on requested information when you provided it timely; or.
the past two years?
Assess the client's functional eligibility for in home or residential care.
California Department of State Hospitals
Training and social services development, delivery and evaluations; budget setting; and relationship cultivation.
253-798-4400 Monday - Friday | 8 a.m. - 4:30 p.m. Always include the client's full name and the DSHS client id (if known) on any document mailed or faxed to DSHS.
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J(_ @# word/_rels/document.xml.rels ( Yo6~!0I'n:Ylw-RI"IV. Consistently report referral and coordination updates to the multidisciplinary medical care team. REGION 1 - Pend Oreille, Stevens, Ferry Okanagan, Chelan, Douglas, Grant, Lincoln, Spokane, Adams, Whitman, Klickitat, Kittitas, .
Have you received Accurintand/or AVS results and reviewed the assets reported?
Licensed Masters Mental Health Professional Adult Intake Specialist
You may receive help filing an application. 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. 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?
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General open-ended questions about resources and income should also be asked. 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 If the client is likely to attain institutional status.
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.
Provide PBSstaff with the following information: Whether the client meets nursing facility level of care (NFLOC). Social Service Intake and Referral form (DSHS Form #10-570) The form is available here on the intranet: https://www.dshs.wa.gov/fsa/forms The form is available here on the internet for the public.
Lakewood, WA.
Did you receive verification of resources with the application?
For ABD, SSI-related Washington Apple Health programs: This process applies toSSI-related programs only MAGI-based clients are not eligible for HCBwaiver. For apple health programs for children, pregnant people, parents and caretaker relatives, and adults age sixty-four and under without medicare, (including people who have a disability or are blind), you may apply: Online via the Washington Healthplanfinder at. APPPLICANT'S NAME: LAST, FIRST, MI 2.
Apply in-person at a local Home & Community Services office.
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.
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).
Care plan is updated at least every sixty (60) calendar days.
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.
Please take this short survey. Home and Community-Based Health Services Standards print version. 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.
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. Has your contact information changed in
Authorize in ACES for in-home or residential HCB waiver if the client is both functionally and financially eligible. HCA forms, including translations are found on the HCA forms website.
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We will allow you more time if you ask for more time or need an accommodation due to disability or limited-English proficiency.
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. Percentage of clients with documented evidence of assistance provided to access health insurance or Marketplace plans in the primary client record. 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. A copy of the police report is sufficient, if applicable. 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. Use Remarks to document information specific to the ACES page: Follow these principles when documenting: Document standard of promptness for all medical applications pending more than45 days: There are two start dates for LTSS, the medicaid eligibility date and the LTSSstart date: If an applicant has withdrawn their request for medical benefits and then decides they want to pursue the application, we will redetermine eligibility for benefits without a new application as long as the client has notified the department within 30 days of the withdrawal.
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?