The interview can be conducted in person or by phone. What resources is the client reporting on the application or past applications? HIV Medical and Support Service Categories, Research, Funding, & Educational Resources. Coordination of Services and Referrals: If referrals are appropriate or deemed necessary, the agency will: Percentage of clients accessingHome and Community-Based Health Services with documented evidence of referrals, as applicable, to other services as indicated in the clients primary record. 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. Olympia WA 98504-5826; or HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April 2013. p. 42-43. 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 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. | The Home and Community-Based Provider will document in the clients primary record progress notes throughout the course of the treatment, including evidence that the client is not in need of acute care. TK6_ PK ! f?3-]T2j),l0/%b 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 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. This Home and Community Based Services program provides not only care, but also other supports . Explain the medical service card, automatic Medicare D enrollment if not on a creditable coverage or Medicare D Prescription Drug Plan. Wage Range: $40.76-$75.17 per hour plus per diem rate. Functional eligibility for DDA is determined prior to the submission of a financial application. (Source: DSHS Policy591.00 Limitations on Ryan White and State Service Funds for Incarcerated Persons in Community Facilities, Section 5.3). 1s PO Box 45826 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. Refer the client tosocialservicesfor a care assessment if the client contacts the PBSfirst and document the date the client first requested NF care. 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. Back to DSH main webpage. Based on the agencys perception of the client's condition, the client requires a higher level of care than would be considered reasonable in a home/community setting. Any assaults, verbal or physical, must be reported to the monitoring entity within one (1) business day and followed by a written report. Issue the NF award letter to the applicant/recipient and the nursing facility. Cases without a delay reason code or updated with "No Good Cause (NG)" to the DSHS secretary. Caring at Home Respite, In-home Services, Skills, Caregiver Help, Kinship Caregiving, Services, Conferences 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. Please reference the HRSA Program Guidance above. 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. Dont open a case in ACES until you have everything needed to establish financial eligibility. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). Applicant Information 1. Home. Provide the PBS staff with the following information: Residential facility name and address, including room number, if applicable. 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 ! 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. 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). RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). Client transfers services to another service program. Document in ACES remarks, in detail, all eligibility factors discussed during the interview and included on the application. Listed on 2023-03-03. 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)). L2 IHSS Service Desk for Providers & Recipients, (866) 376-7066, Suspect Fraud? Percentage of clients with documented evidence of completed progress notes in the clients primary record. It is the primary responsibility of staff to ensure clients are receiving all needed public and/or private benefits and/or resources for which they are eligible. Jun 2014 - Mar 201510 months. Community Health Worker, Crisis Counselor. Home and Community Services - LTSS Assessment of client's access to primary care, Need for nursing, caregiver, or rehabilitation services. Refer the client to social service intakefor a CAREassessment if the client contacts the PBS first and document the date the client first requested in-home or residential care. 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. This is a reprint of the official rule as published by the Office of the Code Reviser. Referral for Health Care and Support Services Service Standard print version. | Barcode 10570 DSHS form 10-570. Kirkland, WA. Eligibility decisions made, or next steps. Explain what changes of circumstances need to be reported. For medicaid recipients, the first date DSHS was notified of the admission by the nursing facility. Union Gospel Mission: www.ougm.org. Disproportionate Share Hospital Program Eligibility. For in-home service applicants, discuss the food assistance program and inquire if the household would like to apply for food benefits. | To complete an application for apple health, you must also give us all of the other information requested on the application. 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. Complete a Financial Communication to Social Services (07-104) referral when an application is received on an active MAGI case, Add text stating that unless an assessment is completed and determines HCB Waiver is needed, the client will remain on MAGI. Summarize the interview and items still needed to determine eligibility in the ACES narrative. These are the forms used in the application process for LTSS. (PDF) Accessed on October 12, 2020. 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. You mayapply for apple health for another person if you are: An authorized representative (as described in WAC. 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. For information regarding prior fiscal year files, please contact the DSH unit at, Last modified date: Lite. Activities provided under this service category may include referrals to assist HRSA Ryan White HIV/AIDS Program (RWHAP)-eligible clients to obtain access to other public or private programs for which they may be eligible (e.g., Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturers Patient Assistance Programs, and other state or local health care and supportive services, or health insurance Marketplace plans). For calculating time limits, "day one" is the day we get an application from you that includes at least the information described in WAC. Provide advocacy to clients with a clear understanding of community services and support available for their situations. z, /|f\Z?6!Y_o]A PK ! | 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 Ryan White Program & Grants Management, Recipient Resources. $41 to $75 Hourly. We do not delay a decision by using the time limits in this section as a waiting period. When using Collateral Contact (CC) or Other (OT) valid value, document the details of how it was verified. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO A good cause code must be used when finalizing any medical(AU) historically beyond 45 days. Authorize payment for NF care if the client is both functionally and financially eligible. Agency no longer meets the level of care required by the client. Welcome to CareWarePlease select your portal type. 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. The LTSS authorization date, which is described in WAC, If there is a transfer penalty as described in WAC. 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. The agency will maintain ongoing communication with the multidisciplinary medical care team in compliance with Texas Medicaid and Medicare Guidelines. 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. HRhk\ X?Nk; $-Yqiy*KB&I4"@W>eGI'tHaOBhVPRQq[^BJ] v}r'kFtr4Ng n [D!n'h}c l`0_ 85yaBAhFozyJ46_ERgsEc;,'K$zTzy[1 PK ! 7wfQCfjS A parent or caretaker relative of a child age eighteen or younger; A tax filer applying for a tax dependent; A person applying for someone who is unable to apply on their own due to a medical condition and who is in need of long-term care services. Provider Fraud and Elder Abuse complaint line: Case actions and why the actions were taken, and. Explain participation and room and board, how the amount is determined, and that it must be paid to the provider. We determine eligibility as quickly as possible and respond promptly to applications and information received. The determination of Fast Track is ultimately up to social 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. 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. catholic community services hen program. If there is other medical coverage and you can obtain the information during the interview, complete a. 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. (link is external) 360-709-9725. Screen all clients to determine potential for HCB services. What is HCS (PDF in English) What is HCS (PDF in Spanish) Provider Communications 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. 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). Complete - The documentation must support the eligibility decision and allow a reviewer to determine what was done and why. Ask about other medical coverage. The DSHS consent form is preferred as it is used for all programs including medical, food and cash. The PBS also determines maximum client responsibility. z, /|f\Z?6!Y_o]A PK ! DSHS forms, including translations are found on the DSHS forms website. Apply to Event Coordinator, Van Driver, Employment Specialist and more! Coordinate with other agencies in planning and linking clients to referral services (for example: legal, medical, social services, financial, and/or housing). Family members and other representatives are often just learning about the client's income and resources when they apply. A supervisor must sign the case closure summary. Examples are the SSI or SSI-related programs or Apple Health for Workers with Disabilities (HWD). Go over the application, particularly what was declared in the income and resource sections. Progress notes will then be entered into the client record within 14 working days. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. 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 (. 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. 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. General open-ended questions about resources and income should also be asked. For ABD, SSI-related Washington Apple Health programs: This process applies toSSI-related programs only MAGI-based clients are not eligible for HCBwaiver. Determine if a housing maintenance allowance (HMA) is appropriate (current rule states HMA is the amount of the Federal Poverty Level). Home and Community-Based Health Services Standards print version. Conduct a follow-up within 90 days of completed application to determine if additional and/or ongoing needs are present. Have you received Accurintand/or AVS results and reviewed the assets reported? Purpose: Communication to social services intake regarding an individual requesting a functional assessment for long-term services and supports (LTSS). To find an HCS office near you, use the. Listing for: Denham Resources. 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. 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. For Hospice as a medicaidprogram, the hospice authorization date is based on the receipt of the 13-746 (HCA/medicaid Hospice notification). Staff will educate clients about available benefit programs, assess eligibility, assist with applications, provide advocacy with appeals and denials, assist with re-certifications, and provide advocacy in other areas relevant to maintaining benefits/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. Allows at least ten calendar days to provide it. 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. Include Remarks to reconcile any discrepancies, or important information not otherwise captured, including required questions left blank on the application or eligibility review form. Center for Medicare and Medicaid Services (CMS) requires an annual review at least once a year for categorically needy (CN) Medicaid. 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. Funds cannot be used to duplicate referral services provided through other service categories. 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. Staff will follow-up within 10 business days of a referral provided to HIA to determine if the client accessed HIA services. I) word/document.xmlr=U.nA;K]|K0x+CII*?tY =6KWHN Z G!i$.v?h;H E6K$JNI2qAK*FMQuI>sRp648!T2@p =K [20Y(GNc#TchaBid~ygj\6h !$0DU9B#1$qfMNy m@4L9542h7,~O*9Z|1)nfR>P*C utgHGKFh 5zjUtMx'+)MI[]fKR:1tw%=Or. Clients receiving services during the Fast Track period won't receive a medical services card until financial eligibility is established. PK ! All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance.
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dshs home and community services intake and referral