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. Eligibility decisions made, or next steps. Progress notes will be kept in the client's primary record and must be written the day services are rendered. 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. 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. You may apply for Washington apple health at any time. 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). 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? Provide feedback on your experience with DSHS facilities, staff, communication, and services. Explain the Medicare Savings Program (MSP). Accessed on October 12, 2020. 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? The interview can be conducted in person or by phone. 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. | Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. We reconsider our decision to deny your apple healthcoverage without a new application from you when: We receive the information that we need to decide if you are eligible within thirty days of the date on the denial notice; You give us authorization to verify your assets as described in WAC 182-503-0055 within thirty days of the date on the denial notice; You request a hearing within ninety days of the date on the denial letter and an administrative law judge (ALJ) or HCA review judge decides our denial was wrong (per chapter. Ask about other medical coverage. Use Equal Access - Necessary Supplemental Accommodation (NSA) and long-term services and supports policies for LTSS applicants and recipients. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. 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. Clients receiving services during the Fast Track period won't receive a medical services card until financial eligibility is established. Health Care Services: Clients should be assisted in accessing health insurance or Marketplace plans to assist with engagement in the health care system and HIV Continuum of Care, including medication payment plans or programs. By calling the Washington Healthplanfindercustomer support center and completing an application by telephone; By completing the application for health care coverage (. A good cause code must be used when finalizing any medical(AU) historically beyond 45 days. When working on a case that has ACES Equal Access (EA) requirements: If changing ACES EA requirements, clearly document the reason. Funds cannot be used to duplicate referral services provided through other service categories. All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. 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. We send you a written notice explaining why we denied your application (per chapter. f?3-]T2j),l0/%b APPLICANT'S HOME ADDRESSCITYSTATEZIP CODE 6. Help Stop Medi-Cal Fraud and Abuse For ABD, SSI-related Washington Apple Health programs: This process applies toSSI-related programs only MAGI-based clients are not eligible for HCBwaiver. adult daycare center) in accordance with a written, individualized plan of care established by a licensed physician. Functional eligibility for DDA is determined prior to the submission of a financial application. N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ Assessment of client's access to primary care, Need for nursing, caregiver, or rehabilitation services. The agency has attempted to complete an initial assessment and the referred client has been away from home on three occasions. Call the DSHScommunity services customer service contact center number listed on the medicaidapplication form. 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. SOCIAL SECURITY NUMBER 5. | If you disagree with our decision, you can ask for a hearing. 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). DSH Replacement State Plan Amendment 16-010. Percentage of clients who received a referral for other support services who have documented evidence of the education provided to the client on how to access these services in the primary client record. Ensure what you document accurately describes what happened with the case. 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.. 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. The LTSSstartdate is the date the client is both financially and functionally eligible. 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. 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. Explain Estate Recovery and mail the Estate Recovery fact sheet. xar *O.c H?Y+oaB]6y&$i8]U}EvH*%94F%[%A PK ! Encourage the applicant to gather documents as soon as possible to expedite the process. Document in ACES remarks, in detail, all eligibility factors discussed during the interview and included on the application. Lite. Accessed on October 12, 2020. Percentage of clients with documented evidence of completed progress notes in the clients primary record. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. The ALJ does not consider the previous absence of information or failure to respond in determining if you are eligible. J(_ @# word/_rels/document.xml.rels ( Yo6~!0I'n:Ylw-RI"IV. 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. 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. DSHS HCS Intake and . Determine if the client is likely to attain institutional status and be likely to reside at the nursing facility for 30 days or longer WAC 182-513-1320), or notifiesthe facility when the client doesn't appear to meet the need for nursing facility care. Cases without a delay reason code or updated with "No Good Cause (NG)" to the DSHS secretary. | Social services will state fund Fast Track services when the client isn't financially eligible during the fast track period. Provide PBSstaff with the following information: Whether the client meets nursing facility level of care (NFLOC). Por favor, responda a esta breve encuesta. Olympia WA 98504-5826; or Community Health Worker, Crisis Counselor. For medicaid recipients, the first date DSHS was notified of the admission by the nursing facility. / % [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\ Determine if a housing maintenance allowance (HMA) is appropriate (current rule states HMA is the amount of the Federal Poverty Level). 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 Appendix 2 to Attachment 4.19-A. If the 13-746 is not received timely, count back 5 businessdays from the date of receipt to determine the authorization date. 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). APPLICANT'S MAILING ADDRESS (IF DIFFERENT)CITYSTATEZIP CODE 7. Day one is the date the application was received. Good cause for a delay in processing the application exists when we acted as promptly as possible but: The delay was the result of an emergency beyond our control; The delay was the result of needing more information or documents that could not be readily obtained; You did not give us the information within the time frame specified in subsection (1) of this section. How do I notify PEBB that my loved one has passed away? Intake Coordinator. Caring at Home Respite, In-home Services, Skills, Caregiver Help, Kinship Caregiving, Services, Conferences Job specializations: Social Work. Ask if there are unpaid medical expenses and request verification if medical expenses exist. Percentage of clients with documented evidence of a discharge plan developed with client, as applicable, as indicated in the clients primary record. Provide feedback on your experience with DSHS facilities, staff, communication, and services. 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 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 (. Any assaults, verbal or physical, must be reported to the monitoring entity within one (1) business day and followed by a written report. 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. This is a reprint of the official rule as published by the Office of the Code Reviser. A referral / % [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\ PK ! Social service staff and case managers determine functional eligibility and what services to authorize based on a complete and comprehensive CAREassessment. A full-featured portal for all users. | Professional care is the provision of services in the home by licensed providers for mental health, development health care, and/or rehabilitation services. Homeless Housing Hotline: 844-628-7343 - Call to connect with homeless services in Thurston County and get referrals to shelter and housing options. A copy of the police report is sufficient, if applicable. Benefits Counseling: Activities should be client-centered facilitating access to and maintenance of health and disability benefits and services. 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. 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. 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. If the nursing facility admission is on a weekend or holiday, the authorization date is the date of admission as long as DSHSis notified by the next business day. We determine eligibility as quickly as possible and respond promptly to applications and information received. | Full Time position. If the client isn't financially eligible, notify social services. 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. You may apply for Washington apple health for yourself. 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. Training and social services development, delivery and evaluations; budget setting; and relationship cultivation. the past two years? 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. 12/1/2022 2:44 PM. Por favor, responda a esta breve encuesta. What resources is the client reporting on the application or past applications? 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. Stick to the facts relevant to determining eligibility or benefit level. Ensure AVS procedures are followed. | Apply to Event Coordinator, Van Driver, Employment Specialist and more! Concise - Documentation is subject to public review. 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. 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. At a department of social and health services (DSHS) community services office (CSO). Ask if any of these bills were incurred within the last 3 months. Family members and other representatives are often just learning about the client's income and resources when they apply. NOTE: If an 18-005 is received on an active MAGI case and the client is in a NF or Hospice care center, no action is needed by the PBS. When information is verified using an electronic source (such as BENDEX, AVS, etc.). DSHS 10-570 ( REV. All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. Always include the client's full name and the DSHS client id (if known) on any document mailed or faxed to DSHS. Authorize payment for NF care if the client is both functionally and financially eligible. As specified in subsection (2) of this section, if you are a child, pregnant, a parent or caretaker relative, or an adult age sixty-four and under without medicare. Ensure that service for clients will be provided in cooperation and in collaboration with other agency services and other community HIV service providers to avoid duplication of efforts and encouraging client access to integrated health care. You must apply directly with the service provider for the following programs: The breast and cervical cancer treatment program under WAC, For the confidential pregnant minor program under WAC. Allows at least ten calendar days to provide it. N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~
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