ALTSA Phone Numbers - Washington BIRTH DATE 4. | We send you a written notice explaining why we denied your application (per chapter. You are automatically enrolled in apple healthand do not need to submit an application if you are a: Supplemental security income (SSI) recipient; Person deemed to be an SSI recipient under 1619(b) of the SSA; Child in foster care placement as described in WAC. If you disagree with our decision, you can ask for a hearing. 0 6 /20 20 INSTRUCTIONS HOME AND COMMUNITY SERVICES Intake and Referral DATE Section 1. Give a projected client responsibility amount to the caseworker using the LTSS referral 07-104. Type of client interaction (phone, in-person, etc.). 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. If you have questions about submitting the form please contact your regional office at the number below. Summarize what verification is needed to complete the application and send a request for information letter. County IHSS Offices - California Department of Social Services Por favor, responda a esta breve encuesta. 1s Lead and manage training development . Barcode 10570 DSHS form 10-570. Issue the award letter to the applicant/recipient. 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. 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). | Conditions of Use | HRSA/HAB Ryan White Program & Grants Management, Recipient Resources. 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. Give your local county office your updated contact information so you can stay enrolled. 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. 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. 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. If there are previous versions of this rule, they can be found using the Legislative Search page. 253-798-4400 Monday - Friday | 8 a.m. - 4:30 p.m. Percentage of clients with documented evidence of referrals provided to any support services that had follow-up documentation within 10 business days of the referral in the primary client record. Percentage of clients accessingHome and Community-Based Health Services have follow up documentation to the referral offered in the clients primary record. 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 Purpose: Communication to social services intake regarding an individual requesting a functional assessment for long-term services and supports (LTSS). Current assessment and needs of the client, including activities of daily living needs (personal hygiene care, basic assistance with cleaning, and cooking activities), Need forHome and Community-Based Health Services, Types, quantity, and length of time services are to be provided. Kirkland, WA. Mienh waac GENDER Male Female 3. 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. Has your contact information changed in Aging and Disability Resources Office Social service staff and case managers determine functional eligibility and what services to authorize based on a complete and comprehensive CAREassessment. 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. 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. When working on a case that has ACES Equal Access (EA) requirements: If changing ACES EA requirements, clearly document the reason. Help Stop Medi-Cal Fraud and Abuse Community Jobs, Employment in Halford, WA | Indeed.com There are a a few sites that do not have IHSS details, however you can use the links below to find the appropriate Social Services office contact information. For Hospice as a medicaidprogram, the hospice authorization date is based on the receipt of the 13-746 (HCA/medicaid Hospice notification). Clients receiving services during the Fast Track period won't receive a medical services card until financial eligibility is established. General open-ended questions about resources and income should also be asked. 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. 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. Intake and Referral - DocsLib APPLICANT'S HOME ADDRESSCITYSTATEZIP CODE 6. Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance. | You may apply for Washington apple health for yourself. Functional eligibility for DDA is determined prior to the submission of a financial application. | 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. 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. Percentage of clients with documented evidence of assistance provided to access health insurance or Marketplace plans in the primary client record. | word/document.xml\n8}_`u-c t?mk[X`aKHJ|Mf2DUSU~~=DX~PJ6u`r]u+K(q` Qy'AD5}]qT"{J|}]6+t. An overpayment isn't established. Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. | Access Health Care Language Assistance Services (SB 223). 7wfQCfjS 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. 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.. Wage Range: $40.76-$75.17 per hour plus per diem rate. Explain participation and room and board, how the amount is determined, and that it must be paid to the provider. Shannon Rawlings, LICSW - DSHS WSH Civil Social Work Manager - LinkedIn Ask about other medical coverage. \{#+zQh=JD ld$Y39?>}'C#_4$ The determination of Fast Track is ultimately up to social services. 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. 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. 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. The agency may discontinue services or refuse the client for as long as the threat is ongoing. | Medicaid eligibility begins, the first day of the month the client is eligible for LTSS. 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. Agency no longer meets the level of care required by the client. Conduct a follow-up within 90 days of completed application to determine if additional and/or ongoing needs are present. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). Is the client single or married, and which resource standard is being used to make a recommendation. Please take this short survey. 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. See "How to request an LTSS assessment" below. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. Call the DSHScommunity services customer service contact center number listed on the medicaidapplication form. 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. HIV Medical and Support Service Categories, Research, Funding, & Educational Resources. TK6_ PK ! HCA forms, including translations are found on the HCA forms website. Social services will state fund Fast Track services when the client isn't financially eligible during the fast track period. Note: Servicescan't be backdated prior to the date of the authorization until the date that financial eligibility is established. Center for Medicare and Medicaid Services (CMS) requires an annual review at least once a year for categorically needy (CN) Medicaid. Licensed Masters Mental Health Professional Adult Intake Specialist Department-designated social service staff: Assess the client's functional eligibility for institutional care. PDF Washington Apple Health Application You may receive help filing an application. Statements made by the client and/or their representative. . At a department of social and health services (DSHS) community services office (CSO). $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO 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. Disproportionate Share Hospital Program. Call the HCS intake line in the area in which you reside to schedule an assessment. SSI recipients who need institutional services, or HCB waiver, must complete and sign an application, or the. 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. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. Olympia WA 98504-5826; or HCS Management Bulletins - Washington N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ Ensure an Asset Verification System (AVS) Authorization is on file, and if not, follow these procedures. How do I notify SEBB that my loved one has passed away? Welcome to CareWarePlease select your portal type. Listing for: Denham Resources. For in-home service applicants, discuss the food assistance program and inquire if the household would like to apply for food benefits. 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. adult daycare center) in accordance with a written, individualized plan of care established by a licensed physician. APPPLICANT'S NAME: LAST, FIRST, MI 2. 6 [Content_Types].xml ( KO0#5.,5ec H0[i ~NhMsg[3xxw;) 'nY?7H(;1{H] 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. IHSS Fraud Hotline: 888-717-8302 DSH Regulations and Documents - California You are subject to asset verification and do not provide authorization as described in WAC 182-503-0055. Dont open a case in ACES until you have everything needed to establish financial eligibility. The hospital requires you to stay overnight. A supervisor must sign the case closure summary. For HCS clients, both functional and financial eligibility are determined concurrently. Fast Track is a social serviceprocess that allows the authorization of LTSS prior to a financial eligibility determination. Home and Community-Based Health Services are therapeutic, nursing, supportive and/or compensatory health services provided by a licensed/certified home health agency in a licensed/certified home or community-based setting (e.g. 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 care plans reviewed and/or updated as necessary based on changes in the clients situation at least every sixty (60) calendar days as evidenced in the clients primary record.