dshs home and community services intake and referral

For information regarding prior fiscal year files, please contact the DSH unit at, Last modified date: PO Box 45826 Kirkland, WA. Services cannot be provided in the following facilities: inpatient hospital facilities, nursing homes, and other long term care facilities. You mayapply for apple health for another person if you are: An authorized representative (as described in WAC. p9,u eV)Pp6B*Rk[g8=g S,8!ciLu`A^2 ntw]0+ *mhX1M[zQ=~yOF594 Y8-xf[rt(>zc|C1>4o ?|aBq}D.2L3jI>&,OXOG79Z5:%A PK ! We did not document the good cause reason before missing a time frame specified in subsection (1) of this section. Screen all clients to determine potential for HCB services. Call to request an assessment for home and community services (in-home care in a residential facility, nursing facility coverage) through the HCS central intake lines. Is the client single or married, and which resource standard is being used to make a recommendation. The HCS case manager coordinates andconsults withthe PBS to see if Fast Track is appropriate. Type of client interaction (phone, in-person, etc.). LTSS can begin once a client is found financially and functionally eligible and an approved provider is in place. adult daycare center) in accordance with a written, individualized plan of care established by a licensed physician. 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. We do not delay a decision by using the time limits in this section as a waiting period. PBS determines financial eligibility by comparing the client's income, resources and circumstances to program criteria. CONTACT(S): Rachelle Ames, HCS Program Manager 360-725-2353 amesrl@dshs.wa.gov This Home and Community Based Services program provides not only care, but also other supports . Center for Medicare and Medicaid Services (CMS) requires an annual review at least once a year for categorically needy (CN) Medicaid. Assist clients in making informed decisions on choices of available service providers and resources. Cases without a delay reason code or updated with "No Good Cause (NG)" to the DSHS secretary. Did you receive verification of resources with the application? Authorize payment for NF care if the client is both functionally and financially eligible. Authorize in ACES for in-home or residential HCB waiver if the client is both functionally and financially eligible. 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. A supervisor must sign the case closure summary. 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. What is HCS (PDF in English) What is HCS (PDF in Spanish) Provider Communications L2 Disproportionate Share Hospital Program Eligibility. Apply in-person at a local Home & Community Services office. Refer the client tosocialservicesfor a care assessment if the client contacts the PBSfirst and document the date the client first requested NF care. 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. At a department of social and health services (DSHS) community services office (CSO). We follow the rules about notices and letters in chapter. 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. Explain what changes of circumstances need to be reported. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). 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. The following Standards and Measures are guides to improving health outcomes for people living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program. GENDER Male Female 3. We will allow you more time if you ask for more time or need an accommodation due to disability or limited-English proficiency. 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 . Ensure what you document accurately describes what happened with the case. Are you enrolled in Medi-Cal? Full. Apply to Event Coordinator, Van Driver, Employment Specialist and more! Consistently report referral and coordination updates to the multidisciplinary medical care team. The hospital requires you to stay overnight. You are subject to asset verification and do not provide authorization as described in WAC 182-503-0055. Explain to the applicant that there is a Public Benefits Specialist (PBS) and a social service manager making determinations concurrently for LTSS eligibility. Ensure AVS procedures are followed. Home and Community-Based Health Services Standards print version. Main Office . Privacy Policy 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), Pharmaceutical Manufacturers Patient Assistance Programs, DSHS Policy591.00 Limitations on Ryan White and State Service Funds for Incarcerated Persons in Community Facilities, Section 5.3, State Health Insurance Assistance Plans (SHIPs), Social Security Disability Insurance (SSDI). Complete - The documentation must support the eligibility decision and allow a reviewer to determine what was done and why. 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. Homeless Housing Hotline: 844-628-7343 - Call to connect with homeless services in Thurston County and get referrals to shelter and housing options. Explain the Medicare Savings Program (MSP). Explain Estate Recovery and mail the Estate Recovery fact sheet. If there are previous versions of this rule, they can be found using the Legislative Search page. 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). 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. The agency must document the situation in writing and contact the referring primary medical care provider. Per Diem. Percentage of clients with documented evidence of assistance provided to access health insurance or Marketplace plans in the primary client record. z, /|f\Z?6!Y_o]A PK ! 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). Provider Fraud and Elder Abuse complaint line: 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). Funds cannot be used to duplicate referral services provided through other service categories. To find an HCS office near you, use the. 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. The DSHS consent form is preferred as it is used for all programs including medical, food and cash. You are the primary applicant on an application if you complete and sign the application on behalf of your household. Review excess home equity, annuity and transfer of resource provisions that are specific to institutional and home and community-based (HCB) waivers. | A referral Conduct a follow-up within 90 days of completed application to determine if additional and/or ongoing needs are present. RWHAP Part B and State Services funds can be used to provide transitional social services to establish or re-establish linkages to the community. Back to DSH main webpage. !H!/tG|B^%=z+]F!lExBa0$ (PDF) Accessed on October 12, 2020. TK6_ PK ! 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. Services include: Inpatient hospitals, nursing homes, and other long-term care facilities are not considered an integrated setting for the purposes of providing Home and Community-Based Health Services. Accessed on October 12, 2020. | Eligible clients are referred to additional support services (outside of a medical, MCM, NMCM appointment), as applicable to the clients needs, with education provided to the client on how to access these services. Staff will follow-up within 10 business days of a referral provided to any core services to ensure the client accessed the service. Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance. Note: Servicescan't be backdated prior to the date of the authorization until the date that financial eligibility is established. 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. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). 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. Percentage of clients accessingHome and Community-Based Health Services have follow up documentation to the referral offered in the clients primary record. IHSS Service Desk for Providers & Recipients, (866) 376-7066, Suspect Fraud? Client relocates out of the service delivery area. For Hospice as a medicaidprogram, the hospice authorization date is based on the receipt of the 13-746 (HCA/medicaid Hospice notification). 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. 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. General open-ended questions about resources and income should also be asked. 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. 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. 08/2017) Page 1 of 2 / Intake and Referral form for Social Services. Statements made by the client and/or their representative. You may apply for Washington apple health at any time. Mienh waac HCA forms, including translations are found on the HCA forms website. When using Collateral Contact (CC) or Other (OT) valid value, document the details of how it was verified. Client transfers services to another service program. 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. Summarize the interview and items still needed to determine eligibility in the ACES narrative. 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. 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. 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. 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. Percentage of clients with documented evidence of completed progress notes in the clients primary record. 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. 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. A good cause code must be used when finalizing any medical(AU) historically beyond 45 days. Call the HCS intake line in the area in which you reside to schedule an assessment. | Progress notes will then be entered into the client record within 14 working days. Provide feedback on your experience with DSHS facilities, staff, communication, and services. If the client is likely to attain institutional status. Ensure an Asset Verification System (AVS) Authorization is on file, and if not, follow these procedures. Posted wage ranges represent the entire range from minimum to maximum. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO Conduct prevention activities as outlined in the DSHS . Call the DSHScommunity services customer service contact center number listed on the medicaidapplication form. 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. PK ! | Percentage of clients with documented evidence of education provided on other public and/or private benefit programs in the primary client record. To complete an application for apple health, you must also give us all of the other information requested on the application. Community Services Division Social Services Manual Revision: # 175 Category: Incapacity Determination - When HEN Referral Program Eligibility Ends Issued: February 23, 2023 Revision Author: Evelyn Acopan Division CSD Mail Stop Phone 253-778-2381 Email evelyn.acopan@dshs.wa.gov Summary Eligible clients are referred to other core services (outside of a medical, MCM, or NMCM appointment), as applicable to the clients needs, with education provided to the client on how to access these 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. Determine if a housing maintenance allowance (HMA) is appropriate (current rule states HMA is the amount of the Federal Poverty Level). Assess the client's functional eligibility for in home or residential care. Espaol An overpayment isn't established. Staff will follow-up within 10 business days of a referral provided to HIA to determine if the client accessed HIA services. Percentage of clients with documented evidence of a discharge plan developed with client, as applicable, as indicated in the clients primary record. By calling the Washington Healthplanfindercustomer support center and completing an application by telephone; By completing the application for health care coverage (. Progress notes will be kept in the client's primary record and must be written the day services are rendered. The agency must document the situation in writing and immediately contact the client's primary medical care provider. Provide PBSstaff with the following information: Whether the client meets nursing facility level of care (NFLOC). The hospice provideris required to submit this form within 5 business days of a hospice election on all active and pending Medicaidcases. The agency has attempted to complete an initial assessment and the referred client has been away from home on three occasions. INTAKE AND REFFERAL DSHS 10-570 (REV. 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). :.U`:8H"Jtv&edPi\ZbNu]$#;w2F.v~u\E}:=~G gQDYQ2xe*rhB/Y>as1j{s2Zo3(\XIEfe687jdP|A2L(o5E".eYR?UUCWel6/,/`^jQ[. All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. The agency will maintain ongoing communication with the multidisciplinary medical care team in compliance with Texas Medicaid and Medicare Guidelines. Access Health Care Language Assistance Services (SB 223). Fast Track is a social serviceprocess that allows the authorization of LTSS prior to a financial eligibility determination. DSHS 10-570 ( REV. If we need more information to decide if you can get apple healthcoverage, we will send you a letter within twenty calendar days of your initial application that: States the additional information we need; and. Functional eligibility for DDA is determined prior to the submission of a financial application. APPLICANT'S MAILING ADDRESS (IF DIFFERENT)CITYSTATEZIP CODE 7. Por favor, responda a esta breve encuesta. Location: Wilton<br>Sign-on Bonus - $5,000<br><br>Provides mental health assessment, diagnosis, treatment and crisis intervention services for adult and/or child members who present themselves from psychiatric evaluation with a broad range of mental health needs. 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. Benefits Counseling: Activities should be client-centered facilitating access to and maintenance of health and disability benefits and services. The PBS should reviewthe original application to ensure there are no changes and proceed to determine eligibility. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO Please take this short survey. For medicaid recipients, institutional services are approved based on the first date the admission is known to DSHS as long as the client meets all other eligibility factors. Referrals for health care and support services provided by outpatient/ambulatory health care professionals should be reported under Outpatient/Ambulatory Health Services (OAHS) category.

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