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Is the client single or married, and which resource standard is being used to make a recommendation. 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. Percentage of clients with documented evidence of ongoing communication with the primary medical care provider and care coordination team as indicated in the clients primary record. 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. Caring at Home Respite, In-home Services, Skills, Caregiver Help, Kinship Caregiving, Services, Conferences You are subject to asset verification and do not provide authorization as described in WAC 182-503-0055. 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 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. . Transitional social services should NOT exceed 180 days. adult daycare center) in accordance with a written, individualized plan of care established by a licensed physician. 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. The ALJ does not consider the previous absence of information or failure to respond in determining if you are eligible. The determination of Fast Track is ultimately up to social services. Care plan is updated at least every sixty (60) calendar days. An interview with the applicant or authorized representative is required to determine eligibility for institutional, HCB waiver services, or TSOA services. 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. 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. 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. | word/document.xml\n8}_`u-c t?mk[X`aKHJ|Mf2DUSU~~=DX~PJ6u`r]u+K(q` Qy'AD5}]qT"{J|}]6+t. 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. Statements made by the client and/or their representative. CONTACT(S): Rachelle Ames, HCS Program Manager 360-725-2353 amesrl@dshs.wa.gov Benefits counseling: Services should facilitate a clients access to public/private health and disability benefits and programs. The PBS should make a Fast Track recommendation based on the information, verifications and cross-matches available, and send this determination via 07-104 to social services. If the 13-746 is not received timely, count back 5 businessdays from the date of receipt to determine the authorization date. INTAKE AND REFFERAL DSHS 10-570 (REV. Your WAH coverage may not begin on the first day of the month if: Subsection (3) of this section applies to you. HRSA Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds Policy Clarification Notice (PCN) #16-02, Health Education-Risk Reduction (HE/RR) - Minority AIDS Initiative, Health Insurance Premium and Cost Sharing Assistance for Low-Income Individuals, Local AIDS Pharmaceutical Assistance (LPAP), Medical Case Management (including Treatment Adherence Services), Outreach Services - Minority AIDS Initiative (MAI), Referral for Health Care and Support Services, Interim Guidance for the Use of Telemedicine, Teledentistry, and Telehealth for HIV Core and Support Services - Users Guide and FAQs, Interim Guidance for the Use of Telemedicine, Teledentistry, and Telehealth for HIV Core and Support Services. DSH Program State Plan Amendment 14-008. The following are County IHSS program websites. 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. Lakewood, WA. Consistently report referral and coordination updates to the multidisciplinary medical care team. Consistent - Explain how conflicts or inconsistencies of information were addressed. If not already authorized, request authorization for AVS for the client and any applicable financially responsible people. 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. 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. Examples are the SSI or SSI-related programs or Apple Health for Workers with Disabilities (HWD). The DSHS consent form is preferred as it is used for all programs including medical, food and cash. DSHS HCS Intake and . L2 Details of how eligibility factor(s) were verified. For non-urgent mental health services, please contact your county mental health department . Call the HCS intake line in the area in which you reside to schedule an assessment. RWHAP Part B and State Services funds can be used to provide transitional social services to establish or re-establish linkages to the community. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. HOME > ben faulkner child actor Uncategorized > Uncategorized. 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. If you reside in an institution of mental diseases (as defined in WAC. J(_ @# word/_rels/document.xml.rels ( Yo6~!0I'n:Ylw-RI"IV. | 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. 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. D@. 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 comprehensive evaluation of the clients health, psychosocial status, functional status, and home environment will be completed to include: Percentage of clients with documented evidence of needs assessment completed in the clients primary record. How do I notify SEBB that my loved one has passed away? Espaol Percentage of clients with documented evidence of referrals provided to any core services that had follow-up documentation within 10 business days of the referral in the primary client record. Help Stop Medi-Cal Fraud and Abuse 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. Posted: October 21, 2022. Percentage of clients with documented evidence of assistance provided to access health insurance or Marketplace plans in the primary client record. This section describes the application processes used by Aging and Long-term Supports Administration (ALTSA) when determining financial eligibility for Long-Term Services and Supports (LTSS). Explain to the applicant that there is a Public Benefits Specialist (PBS) and a social service manager making determinations concurrently for LTSS eligibility. Medicaid eligibility begins, the first day of the month the client is eligible for LTSS. Give your local county office your updated contact information so you can stay enrolled. Determine the client's financial eligibility for LTSSmedicaid and/or noninstitutional medical assistance including a request for retro medical if needed. A good cause code must be used when finalizing any medical(AU) historically beyond 45 days. DSH Replacement State Plan Amendment 16-010. catholic community services hen program. Per Diem. This is a reprint of the official rule as published by the Office of the Code Reviser. Whether there is a housing maintenance allowance and the start date, if appropriate. | f?3-]T2j),l0/%b APPLICANT'S HOME ADDRESSCITYSTATEZIP CODE 6. Questions to consider when making aFast Track recommendation: Social services cant begin Fast Track until a CAREassessment is completed. Provide the PBS staff with the following information: Residential facility name and address, including room number, if applicable. Union Gospel Mission: www.ougm.org. Clientsswitching from private pay to medicaid are advised to apply for benefits 30 to 45 days before being resource eligible for the program. Refer the client tosocialservicesfor a care assessment if the client contacts the PBSfirst and document the date the client first requested NF care. Por favor, responda a esta breve encuesta. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. 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 What resources is the client reporting on the application or past applications? Ensure an Asset Verification System (AVS) Authorization is on file, and if not, follow these procedures. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. Conduct a follow-up within 90 days of completed application to determine if additional and/or ongoing needs are present. Apply in-person at a local Home & Community Services office. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013, p. 14-16. 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. Percentage of clients with documented evidence of a comprehensive evaluation completed by the Home and Community-Based Health Agency Provider in the clients primary record. 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)). 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. 6. We deny your application forapple health coverage when: You tell us either orally or in writing to withdraw your request for coverage; or, Based on all information we have received from you and other sources within the time frames stated in WAC, We are unable to determine that you are eligible; or. How do I notify PEBB that my loved one has passed away? | RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). 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. Encourage the applicant to gather documents as soon as possible to expedite the process. If the client is likely to attain institutional status. 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. Dont open a case in ACES until you have everything needed to establish financial eligibility. 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? HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April 2013. p. 42-43. The agency must document the situation in writing and immediately contact the client's primary medical care provider. APPPLICANT'S NAME: LAST, FIRST, MI 2. Clients should be educated about and assisted with accessing and securing all available public and private benefits and entitlement programs. 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. 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. ,! 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 of a care plan completed based on the primary medical care providers order as indicated in the clients primary record. Authorize in ACES for in-home or residential HCB waiver if the client is both functionally and financially eligible. 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. For medicaid recipients, the first date DSHS was notified of the admission by the nursing facility. We send you a written notice explaining why we denied your application (per chapter. f?3-]T2j),l0/%b Privacy Policy Assist clients in making informed decisions on choices of available service providers and resources. 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. 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. Are you enrolled in Medi-Cal? 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. 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. 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. We do not delay a decision by using the time limits in this section as a waiting period. 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. Stick to the facts relevant to determining eligibility or benefit level. Denos su opinin sobre sus experiencias con las instalaciones, el personal, la comunicacin y los servicios del DSHS. 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. | Agency no longer meets the level of care required by the client. 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 (. 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. IHSS Fraud Hotline: 888-717-8302 | Conditions of Use State Plan Amendments. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO Provide advocacy to clients with a clear understanding of community services and support available for their situations. 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 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. See "How to request an LTSS assessment" below. 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. Lead and manage training development . 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. 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. Go over the application, particularly what was declared in the income and resource sections. 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). Accessed on October 12, 2020. Tacoma, WA 98418. (link is external) 360-709-9725. Intake Coordinator. Barcode 10570 DSHS form 10-570. Percentage of eligible clients with documented evidence of the follow-up and result(s) to a completed benefit application in the primary client record. The agency must document the situation in writing and contact the referring primary medical care provider. For Hospice as a medicaidprogram, the hospice authorization date is based on the receipt of the 13-746 (HCA/medicaid Hospice notification). There is good information on the Washington LawHelp site that explains the timing of an LTSSapplication. Wage Range: $40.76-$75.17 per hour plus per diem rate. This is used for any cash, food or medical care services (MCS) request as MCS is tied to ABD cash/HEN eligibility, HCA 14-194 Medical coverage information (used to report third party insurance coverage including LTC insurance), DSHS14-539 Revocable burial fund provision for SSI-related health care, DSHS 14-540 Irrevocable burial fund provision for SSI-related health care, DSHS 14-454 Estate recovery fact sheet. \{#+zQh=JD ld$Y39?>}'C#_4$ Location: Wilton<br>Sign-on Bonus - $5,000<br><br>Provides mental health assessment, diagnosis, treatment and crisis intervention services for adult and/or child members who present themselves from psychiatric evaluation with a broad range of mental health needs. Information to determine clients ability to perform activities of daily living and the level of attendant care assistance the client needs to maintain living independently. 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 the NF admission is on a weekend or holiday, the NF has until the first business day to report the admission. / % [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\