APPLICANT'S MAILING ADDRESS (IF DIFFERENT)CITYSTATEZIP CODE 7. 253-798-4400 Monday - Friday | 8 a.m. - 4:30 p.m. Are you enrolled in Medi-Cal? 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. REGION 1 - Pend Oreille, Stevens, Ferry Okanagan, Chelan, Douglas, Grant, Lincoln, Spokane, Adams, Whitman, Klickitat, Kittitas, . For ABD, SSI-related Washington Apple Health programs: This process applies toSSI-related programs only MAGI-based clients are not eligible for HCBwaiver. :.U`:8H"Jtv&edPi\ZbNu]$#;w2F.v~u\E}:=~G gQDYQ2xe*rhB/Y>as1j{s2Zo3(\XIEfe687jdP|A2L(o5E".eYR?UUCWel6/,/`^jQ[. For medicaid recipients, the first date DSHS was notified of the admission by the nursing facility. Benefits Counseling: Activities should be client-centered facilitating access to and maintenance of health and disability benefits and services. SOCIAL SECURITY NUMBER 5. Consistent - Explain how conflicts or inconsistencies of information were addressed. Por favor, responda a esta breve encuesta. 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. Disproportionate Share Hospital Program Eligibility. Hmoob Main Office . | DSH Replacement State Plan Amendment 16-010. Percentage of clients with documented evidence of education provided on other public and/or private benefit programs in the primary client record. 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 (. MAGI covers NF and Hospice under the scope of care. You are subject to asset verification and do not provide authorization as described in WAC 182-503-0055. An overpayment isn't established. 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. When using Collateral Contact (CC) or Other (OT) valid value, document the details of how it was verified. 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. If there are previous versions of this rule, they can be found using the Legislative Search page. Statements made by the client and/or their representative. 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. 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. Please reference the HRSA Program Guidance above. 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. Assess the client's functional eligibility for in home or residential care. DSH Regulations and Documents - California | Contact Us Concise - Documentation is subject to public review. 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. 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. \{#+zQh=JD ld$Y39?>}'C#_4$ 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. 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. ALTSA Phone Numbers - Washington A request for service may not generate a referral. 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. Center for Medicare and Medicaid Services (CMS) requires an annual review at least once a year for categorically needy (CN) Medicaid. 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. HRSA/HAB Ryan White Program & Grants Management, Recipient Resources. 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. 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. Client transfers services to another service program. Has your contact information changed in 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. Washington COPES Medicaid Waivers Program If the 13-746 is not received timely, count back 5 businessdays from the date of receipt to determine the authorization date. 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. 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. 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. | 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. (PDF) Accessed on October 12, 2020. 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. 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. Issue the NF award letter to the applicant/recipient and the nursing facility. 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? Ask about any transfers, gifts, or property sales during the 5-year look back and the circumstances of why they were made. | Location: Wilton<br>Sign-on Bonus - $5,000<br><br>Provides mental health assessment, diagnosis, treatment and crisis intervention services for adult and/or child members who present themselves from psychiatric evaluation with a broad range of mental health needs. Massachusetts Department of Public Health Bureau of Infectious Disease Office of HIV/AIDS Standards of Care for HIV/AIDS Services 2009, San Francisco EMA Home-Based Home Health Care Standards of Care February 2004, Texas Administrative Code, Title 40, Part 1, Chapter 97, Subchapter B, Rule 97.211. We process applications for Washington apple health medicaid within forty-five calendar days, with the following exceptions: If you are pregnant, we process your application within fifteen calendar days; If you are applying for a program that requires a disability decision, we process your application within sixty calendar days; or. f?3-]T2j),l0/%b (PDF) Accessed October 12, 2020. Provide feedback on your experience with DSHS facilities, staff, communication, and services. DSHS 14-532 Authorized representative release of information. The agency may discontinue services or refuse the client for as long as the threat is ongoing. Care plan is updated at least every sixty (60) calendar days. PDF HCS Intake and Referral - Washington N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO Your WAH coverage may not begin on the first day of the month if: Subsection (3) of this section applies to you. Staff will follow up within 10 business days of a referral provided to support services to ensure the client accessed the service. Welcome to CareWare - California 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. Coordinate with other agencies in planning and linking clients to referral services (for example: legal, medical, social services, financial, and/or housing). Mienh waac Medicaid eligibility begins, the first day of the month the client is eligible for LTSS. BIRTH DATE 4. 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. This service category works to maximize public funding by assisting clients in identifying all available health and disability benefits supported by funding streams other than RWHAP Part B and/or State Services funds. I) word/document.xmlr=U.nA;K]|K0x+CII*?tY =6KWHN Z G!i$.v?h;H E6K$JNI2qAK*FMQuI>sRp648!T2@p =K [20Y(GNc#TchaBid~ygj\6h !$0DU9B#1$qfMNy m@4L9542h7,~O*9Z|1)nfR>P*C utgHGKFh 5zjUtMx'+)MI[]fKR:1tw%=Or. 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. | We send you a written notice explaining why we denied your application (per chapter. You mayapply for apple health for another person if you are: An authorized representative (as described in WAC. IHSS Service Desk for Providers & Recipients, (866) 376-7066, Suspect Fraud? 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. Percentage of clients with documented evidence of completed progress notes in the clients primary record. | Tacoma, WA 98418. 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. 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. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013, p. 14-16. 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. Provide PBSstaff with the following information: Whether the client meets nursing facility level of care (NFLOC). Wage Range: $40.76-$75.17 per hour plus per diem rate. | 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. A new application isn't required for clients active on ABD SSI-related Apple Health who need LTSS as long as the Public Benefit Specialist (PBS) is able to determine institutional eligibility using information in the current case record. Housing & Community Services - Snohomish County, WA Per Diem. Ask about other resources not declared on the application. Clients receiving services during the Fast Track period won't receive a medical services card until financial eligibility is established. Purpose: Communication to social services intake regarding an individual requesting a functional assessment for long-term services and supports (LTSS). The Home and Community-based Services program provides individualized services and supports to persons with intellectual disabilities who are living with their family, in their own home or in other community settings, such as small group homes. | Review excess home equity, annuity and transfer of resource provisions that are specific to institutional and home and community-based (HCB) waivers. Referral for Health Care and Support Services includes benefits/entitlement counseling and referral to health care services to assist eligible clients to obtain access to other public and private programs for which they may be eligible.
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