The interview requirement described in subsection (3) of this section may be waived if the applicant is unable to comply: Because the applicant does not have a family member or another individual that is able to conduct the interview on his or her behalf. What is HCS (PDF in English) What is HCS (PDF in Spanish) Provider Communications Clients should be educated about and assisted with accessing and securing all available public and private benefits and entitlement programs. 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? 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. Details of how eligibility factor(s) were verified. | 3602 Pacific Ave., Suite 200 . Agency no longer meets the level of care required by the client. Progress notes will be kept in the client's primary record and must be written the day services are rendered. Policy Notices and Program Letters, 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), 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, Referral to health care/supportive services, Health Insurance Plans/Payment Options (CARE/, Pharmaceutical Patient Assistance Programs (PAPS). A request for service s is any request that comes to HCS regardless of source or eligibility. Back to DSH main webpage. d{ word/_rels/document.xml.rels ( VMo W87GJmziRokm:Kbi6P{3c33{Jp^MQKT %*|`3i4PwA'NX_D)BW<6t|XC{9qS4Yr-6M#jlHv$d@. V&ca\H>le?S9As<1CRYN]drRI/0!b We provide equal access (EA) services as described in WAC, Ask for EA services, you apply for or receive long-term services and supports, or we determine that you would benefit from EA services; or, Have limited-English proficiency as described in WAC. 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)). Consistent - Explain how conflicts or inconsistencies of information were addressed. D@. INTAKE AND REFFERAL DSHS 10-570 (REV. Main Office . 53 Community jobs available in Halford, WA on Indeed.com. Give your local county office your updated contact information so you can stay enrolled. 1s | 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. The HCS case manager coordinates andconsults withthe PBS to see if Fast Track is appropriate. 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. Collaborates with treating physician, psychiatric and allied health professional team to plan and direct each individual member . / % [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\ f?3-]T2j),l0/%b 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. Social service staff and case managers determine functional eligibility and what services to authorize based on a complete and comprehensive CAREassessment. Explain the medical service card, automatic Medicare D enrollment if not on a creditable coverage or Medicare D Prescription Drug Plan. Explain the Medicare Savings Program (MSP). HIV Medical and Support Service Categories, Research, Funding, & Educational Resources. 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. / % [Content_Types].xml ( N0EHC-j\X $@b/=>"RRQ{c%3X@LCV^i7 Sx[Ab7*@*HRf$g`E*} G;V )B~)K0{j17X$)+n7u9bf}^&i/52\ DSHS 14-532 Authorized representative release of information. Need Mental Health Services? Information to determine clients ability to perform activities of daily living and the level of attendant care assistance the client needs to maintain living independently. The authorization can't be backdated for HCB waiver, CFC, or MPC unless socialservices has fast-tracked services and the client is subsequently found financially eligible. If the client is likely to attain institutional status. Summarize what verification is needed to complete the application and send a request for information letter. Dont open a case in ACES until you have everything needed to establish financial eligibility. For HCS clients, both functional and financial eligibility are determined concurrently. Contact a navigator, health care authority volunteer assistor, or broker. N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ Provide the PBS staff with the following information: Residential facility name and address, including room number, if applicable. Sometimes we can start your coverage up to three months before the month you applied (see WAC, If you are confined or incarcerated as described in WAC, You are hospitalized during your confinement; and. Transitional social services should NOT exceed 180 days. 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. Tacoma, WA 98418. 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. For non-urgent mental health services, please contact your county mental health department . Ask if there are unpaid medical expenses and request verification if medical expenses exist. 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. 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. State Plan Amendments. J(_ @# word/_rels/document.xml.rels ( Yo6~!0I'n:Ylw-RI"IV. Percentage of clients with documented evidence of other public and/or private benefit applications completed as appropriate within 14 business days of the eligibility determination date in the primary client record. Did you receive verification of resources with the application? | When information is verified using an electronic source (such as BENDEX, AVS, etc.). 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. Percentage of clients with documented evidence of referrals provided for HIA assistance that had follow-up documentation within 10 business days of the referral in the primary client 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. 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. Call the client or their representative to complete an interview. For medicaid recipients, the first date DSHS was notified of the admission by the nursing facility. If you disagree with our decision, you can ask for a hearing. (link is external) 360-709-9725. 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. 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. Exception is N21/N25 AEM MAGI. 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 [Content_Types].xml ( KO0#5.,5ec H0[i ~NhMsg[3xxw;) 'nY?7H(;1{H] SSI recipients who need institutional services, or HCB waiver, must complete and sign an application, or the. Denos su opinin sobre sus experiencias con las instalaciones, el personal, la comunicacin y los servicios del DSHS. 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. Cases without a delay reason code or updated with "No Good Cause (NG)" to the DSHS secretary. You may apply for Washington apple health at any time. WAC 182-513-1350). Kirkland, WA. The DSHS consent form is preferred as it is used for all programs including medical, food and cash. Accessed on October 12, 2020. You mayapply for apple health for another person if you are: An authorized representative (as described in WAC. 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. Complete - The documentation must support the eligibility decision and allow a reviewer to determine what was done and why. Services focus on assisting clients entry into and movement through the care service delivery network such that RWHAP and/or State Services funds are payer of last resort. 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. 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. Request verification of transfers, gifts or property sales, if applicable. 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. 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. Home Professionals & Providers Management Bulletins 2020 HCS Management Bulletins 2020 HCS Management Bulletins Note: These documents are available only in Word and/or Excel formats. For people described in subsection (3) of this section who are not applying with a household containing people described in subsection (2) of this section: Call orvisit a local DSHSCSO or HCS office; or. 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. How do I notify PEBB that my loved one has passed away? For information regarding prior fiscal year files, please contact the DSH unit at, Last modified date: Union Gospel Mission: www.ougm.org. | 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. Assess the client's functional eligibility for in home or residential care. 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. Staff will follow-up within 10 business days of a referral provided to HIA to determine if the client accessed HIA services. Provide feedback on your experience with DSHS facilities, staff, communication, and services. To apply for tailored supports for older adults (TSOA), see WAC. Concise - Documentation is subject to public review. Denos su opinin sobre sus experiencias con las instalaciones, el personal, la comunicacin y los servicios del DSHS. Any assaults, verbal or physical, must be reported to the monitoring entity within one (1) business day and followed by a written report. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April 2013. p. 42-43. 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. Full. Ensure an Asset Verification System (AVS) Authorization is on file, and if not, follow these procedures. Life, home, auto, AD&D, LTD, & FSA benefits, Overview of prior authorization (PA), claims & billing, Step-by-step guide for prior authorization (PA), Program benefit packages & scope of services, Community behavioral support (CBHS) services, First Steps (maternity support & infant care), Ground emergency medical transportation (GEMT), Home health care services: electronic visit verification, Substance use disorder (SUD) consent management guidance, Enroll as a health care professional practicing under a group or facility, Enroll as a billing agent or clearinghouse, Find next steps for new Medicaid providers, Washington Prescription Drug Program (WPDP), Governor's Indian Health Advisory Council, Analytics, research & measurement (ARM) data dashboard suite, Foundational Community Supports provider map, Medicaid maternal & child health measures, Washington State All Payer Claims Database (WA-APCD), Personal injury, casualty recoveries & special needs trusts, Information about novel coronavirus (COVID-19).
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