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 Service Desk for Providers & Recipients, (866) 376-7066, Suspect Fraud? Use Equal Access - Necessary Supplemental Accommodation (NSA) and long-term services and supports policies for LTSS applicants and recipients. | word/document.xml\n8}_`u-c t?mk[X`aKHJ|Mf2DUSU~~=DX~PJ6u`r]u+K(q` Qy'AD5}]qT"{J|}]6+t. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013, p. 14-16. Agency no longer meets the level of care required by the client. A request for service s is any request that comes to HCS regardless of source or eligibility. DSHS 10-570 ( REV. the past two years? Welcome to CareWarePlease select your portal type. 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)). :.U`:8H"Jtv&edPi\ZbNu]$#;w2F.v~u\E}:=~G gQDYQ2xe*rhB/Y>as1j{s2Zo3(\XIEfe687jdP|A2L(o5E".eYR?UUCWel6/,/`^jQ[. 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 (. 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. 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). Listed on 2023-03-03. You may apply for Washington apple health for yourself. Open-ended questions often reveal that additional sources of income and assets may exist. 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days: There are two start dates for LTSS, the medicaid eligibility date and the LTSSstart date: If an applicant has withdrawn their request for medical benefits and then decides they want to pursue the application, we will redetermine eligibility for benefits without a new application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. 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. In-home or residential services, call 800-780-7094 or 425-977-6579, FAX 425-339-4859, Nursing home services, call 800-780-7094, FAX 206-373-6855, In-home or residential services, call 206-341-7750, FAX 206-373-6855. You mayapply for apple health for another person if you are: An authorized representative (as described in WAC. This is a reprint of the official rule as published by the Office of the Code Reviser. 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. Intake Coordinator. | Use the original eligibility review date to open institutional coverage. 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. 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. The PBS also determines maximum client responsibility. 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. Include Remarks to reconcile any discrepancies, or important information not otherwise captured, including required questions left blank on the application or eligibility review form. Authorize payment for NF care if the client is both functionally and financially eligible. 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. In that case, your coverage would start on the first day of your hospital stay; You must meet a medically needy spenddown liability (see WAC, You are eligible under the WAH alien emergency medical program (see WAC, For long-term care, the date your services start is described in WAC. Explain how to request an extension if more time is needed. 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. The hospital requires you to stay overnight. For ABD, SSI-related Washington Apple Health programs: This process applies toSSI-related programs only MAGI-based clients are not eligible for HCBwaiver. 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. Union Gospel Mission: www.ougm.org. 1-(800)-722-0432, Copyright 2023 California Department of Social Services. Clients should be educated about and assisted with accessing and securing all available public and private benefits and entitlement programs. 08/2017) Page 1 of 2 / Intake and Referral form for Social Services. Explain what changes of circumstances need to be reported. 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. 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. 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. Staff will follow-up within 10 business days of a referral provided to HIA to determine if the client accessed HIA 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. Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance. Referral for Health Care and Support Services (RFHC) directs a client to needed core medical or support services in person or through telephone, written, or other type of communication. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. 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. Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded 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. The determination of Fast Track is ultimately up to social services. 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. Care plan is updated at least every sixty (60) calendar days. 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. HCA 18-003 Rights and responsibilities (translations can be found at Health Care Authority (HCA) forms under 14-113), HCA 18-005 Washington Apple Health application for aged, blind, disabled/long-term care coverage, HCA 18-008 Washington Apple Health application for tailored supports for older adults (TSOA), DSHS14-001 Application for cash or food assistance. Home and Community-Based Health Providers work closely with the multidisciplinary care team that includes the client's case manager, primary care provider, and other appropriate health care . Job in Fresno - Fresno County - CA California - USA , 93650. We will allow you more time if you ask for more time or need an accommodation due to disability or limited-English proficiency. Caregiver Support Find out about caregiver support. HRSA/HAB Ryan White Program & Grants Management, Recipient Resources. 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 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. f?3-]T2j),l0/%b f?3-]T2j),l0/%b 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. Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. Coordinate with other agencies in planning and linking clients to referral services (for example: legal, medical, social services, financial, and/or housing). 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. 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. 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). Demonstrate the reasonableness of decisions. IHSS Fraud Hotline: 888-717-8302 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. 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. An overpayment isn't established. Lite. This Home and Community Based Services program provides not only care, but also other supports . Home. Apply in-person at a local Home & Community Services office. 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. Peer support & counseling Recovery housing Prevention Substance use disorder prevention & mental health promotion Quick links Apply for or renew Apple Health coverage Apple Health for you Apple Health account logins 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. 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. Always include the client's full name and the DSHS client id (if known) on any document mailed or faxed to DSHS. Authorize in ACES for in-home or residential HCB waiver if the client is both functionally and financially eligible. Type of client interaction (phone, in-person, etc.). The Aging and Disability Resources Program offers a wide range of community-based services that allow older adults and adults with disabilities to remain at home as long as possible. Center for Medicare and Medicaid Services (CMS) requires an annual review at least once a year for categorically needy (CN) Medicaid. 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. 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. PK ! N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~
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