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. Percentage of clients with documented evidence of education provided on other public and/or private benefit programs in the primary client record. Full Time position. Staff will follow up within 10 business days of a referral provided to support services to ensure the client accessed the service. Professional care is the provision of services in the home by licensed providers for mental health, development health care, and/or rehabilitation services. See "How to request an LTSS assessment" below. HRSA/HAB Ryan White Program & Grants Management, Recipient Resources. If you reside in one of the following counties: Island, King (ZIP codes 98011, 98019, 98072, 98077, 98133, 98177) San Juan, Skagit, Snohomish, or Whatcom and are interested in: If you reside in King County in a ZIP code not listed above and are interested in: If you reside in one of the following counties: Clallam, Clark, Cowlitz, Grays Harbor, Jefferson, Kitsap, Lewis, Mason, Pacific, Pierce, Skamania, Thurston, or Wahkiakum 800-786-3799, FAX 360-586-0499. Percentage of clients accessingHome and Community-Based Health Services have follow up documentation to the referral offered in the clients primary record. Department-designated social service staff: Assess the client's functional eligibility for institutional care. RWHAP Part B and State Services funds can be used to provide transitional social services to establish or re-establish linkages to the community. Case actions and why the actions were taken, and. We will allow you more time if you ask for more time or need an accommodation due to disability or limited-English proficiency. 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. All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. adult daycare center) in accordance with a written, individualized plan of care established by a licensed physician. 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. For information regarding prior fiscal year files, please contact the DSH unit at, Last modified date: Your WAH coverage may not begin on the first day of the month if: Subsection (3) of this section applies to you. (link is external) 360-709-9725. v}r'kFtr4Ng n [D!n'h}c l`0_ 85yaBAhFozyJ46_ERgsEc;,'K$zTzy[1 PK ! Percentage of clients with documented evidence of a discharge plan developed with client, as applicable, as indicated in the clients primary record. The Office of Community and Homeless Services (OCHS), the Office of Housing and Community Development (OHCD) and the Office of Weatherization and Energy Assistance (OWEA) operate within the Housing and Community Services Division (HCS) of the Snohomish County Human Services Department. Applications for LTSS may be submitted using any of the following methods: Mailing or faxing documents to Home and Community Services (HCS), Mail to: The hospital requires you to stay overnight. Update a good cause code when changing a program from an SSI-related assistance unit (AU) to an LTSS AU to prevent the case from being incorrectly reported as a new application. Statements made by the client and/or their representative. L@5f)a>%X5.auU!1qV!h%SAg,U--`8F ydjz 8 'gF$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? Demonstrate the reasonableness of decisions. 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.. 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. 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? Ensure an Asset Verification System (AVS) Authorization is on file, and if not, follow these procedures. $41 to $75 Hourly. The DSHS consent form is preferred as it is used for all programs including medical, food and cash. Behavioral health services for American Indians & Alaska Natives (AI/AN) Recovery support services What is recovery support? Percentage of clients with documented evidence of completed progress notes in the clients primary record. To apply for tailored supports for older adults (TSOA), see WAC. 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. Espaol PK ! APPLICANT'S MAILING ADDRESS (IF DIFFERENT)CITYSTATEZIP CODE 7. z, /|f\Z?6!Y_o]A 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. Provide feedback on your experience with DSHS facilities, staff, communication, and services. Concise - Documentation is subject to public review. LTSS can begin once a client is found financially and functionally eligible and an approved provider is in place. FAX to: 1-855-635-8305. Give a projected client responsibility amount to the caseworker using the LTSS referral 07-104. 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). 253-798-4400 Monday - Friday | 8 a.m. - 4:30 p.m. Clients should be educated about and assisted with accessing and securing all available public and private benefits and entitlement programs. Use Equal Access - Necessary Supplemental Accommodation (NSA) and long-term services and supports policies for LTSS applicants and recipients. 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. Provider Fraud and Elder Abuse complaint line: 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. 08/2017) Page 1 of 2 / Intake and Referral form for Social Services. Explain the medical service card, automatic Medicare D enrollment if not on a creditable coverage or Medicare D Prescription Drug Plan. A request for service may not generate a referral. f?3-]T2j),l0/%b 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. 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. Conduct prevention activities as outlined in the DSHS . 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). ,! 4 word/_rels/document.xml.rels ( VOo0Ow| :lRt[h{sK1u\+2 \\U\K>LLhb=MMr[B\^dk*)a#L!? Massachusetts Department of Public Health Bureau of Infectious Disease Office of HIV/AIDS Standards of Care for HIV/AIDS Services 2009, San Francisco EMA Home-Based Home Health Care Standards of Care February 2004, Texas Administrative Code, Title 40, Part 1, Chapter 97, Subchapter B, Rule 97.211. For Hospice as a medicaidprogram, the hospice authorization date is based on the receipt of the 13-746 (HCA/medicaid Hospice notification). The following Standards and Measures are guides to improving health outcomes for people living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program. PK ! RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). Explain the financial and social service functional eligibility process. f?3-]T2j),l0/%b (PDF) Accessed October 12, 2020. Listed on 2023-03-03. 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. The agency will maintain ongoing communication with the multidisciplinary medical care team in compliance with Texas Medicaid and Medicare Guidelines. DSH Program State Plan Amendment 14-008. Document in ACES remarks, in detail, all eligibility factors discussed during the interview and included on the application. 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. DSH Replacement State Plan Amendment 16-010. 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. DSHS 10-570 ( REV. Ask about other medical coverage. Functional eligibility for DDA is determined prior to the submission of a financial application. SSI recipients who need institutional services, or HCB waiver, must complete and sign an application, or the. 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. Apply in-person at a local Home & Community Services office. GENDER Male Female 3. 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.
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