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)). Explain Estate Recovery and mail the Estate Recovery fact sheet. An overpayment isn't established. Dont open a case in ACES until you have everything needed to establish financial eligibility. How do I notify PEBB that my loved one has passed away? There is good information on the Washington LawHelp site that explains the timing of an LTSSapplication. The hospital requires you to stay overnight. adult daycare center) in accordance with a written, individualized plan of care established by a licensed physician. Wage Range: $40.76-$75.17 per hour plus per diem rate. 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. Home and Community-Based Health Services include the following: 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 professionals. 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. Staff will follow-up within 10 business days of a referral provided to HIA to determine if the client accessed HIA services. When working on a case that has ACES Equal Access (EA) requirements: If changing ACES EA requirements, clearly document the reason. When using Collateral Contact (CC) or Other (OT) valid value, document the details of how it was verified. The LTSS authorization date, which is described in WAC, If there is a transfer penalty as described in WAC. 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. Percentage of clients with documented evidence of a discharge plan developed with client, as applicable, as indicated in the clients primary record. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. Progress notes will then be entered into the client record within 14 working days. Lakewood, WA. Disproportionate Share Hospital Program Eligibility. | Are you enrolled in Medi-Cal? Home and Community-Based Health Services Standards print version. Espaol 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. If you are an SSI recipient, then you, your authorized representative as defined in WAC, An individual applying for Washington apple health (WAH) (as defined in WAC. 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. Authorize payment for NF care if the client is both functionally and financially eligible. 1-(800)-722-0432, Copyright 2023 California Department of Social Services. 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. HOME > ben faulkner child actor Uncategorized > Uncategorized. 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. Medicaid eligibility begins, the first day of the month the client is eligible for LTSS. 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. Percentage of clients with documented evidence of ongoing communication with the primary medical care provider and care coordination team as indicated in the clients primary record. | Conditions of Use 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 (. (link is external) 360-918-8424. For the Ryan White Part B/SS funded providers and Administrative Agencies, telehealth and telemedicine services are to be provided in real-time via audio and video communication technology which can include videoconferencing software. Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. This is a reprint of the official rule as published by the Office of the Code Reviser. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). The LTSSauthorization date can be backdated for nursing facility services up to 3 months prior to the date of application for a new applicant of Medicaid as long as the client is nursing facility level of care (NFLOC) and financially eligible. For ABD, SSI-related Washington Apple Health programs: This process applies toSSI-related programs only MAGI-based clients are not eligible for HCBwaiver. Percentage of eligible clients with documented evidence of the follow-up and result(s) to a completed benefit application in the primary client record. The hospice provideris required to submit this form within 5 business days of a hospice election on all active and pending Medicaidcases. Complete - The documentation must support the eligibility decision and allow a reviewer to determine what was done and why. | Services may be authorized using Fast Track for a maximum of 90 days. If the client is likely to attain institutional status. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. Referral for Health Care and Support Services Service Standard print version. How do I notify SEBB that my loved one has passed away? Explain what changes of circumstances need to be reported. 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. Benefits Counseling: Activities should be client-centered facilitating access to and maintenance of health and disability benefits and services. Provide feedback on your experience with DSHS facilities, staff, communication, and services. 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. If the client isn't financially eligible, notify social services. What resources is the client reporting on the application or past applications? 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. IHSS Service Desk for Providers & Recipients, (866) 376-7066, Suspect Fraud? For apple health programs for children, pregnant people, parents and caretaker relatives, and adults age sixty-four and under without medicare, (including people who have a disability or are blind), you may apply: Online via the Washington Healthplanfinder at. 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. Por favor, responda a esta breve encuesta. Explain the Medicare Savings Program (MSP). 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). Include Remarks to reconcile any discrepancies, or important information not otherwise captured, including required questions left blank on the application or eligibility review form. 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.