1s PO Box 45826 z, /|f\Z?6!Y_o]A PK ! Percentage of clients with documented evidence of referrals provided to any support services that had follow-up documentation within 10 business days of the referral in the primary client record. Main Office . When working on a case that has ACES Equal Access (EA) requirements: If changing ACES EA requirements, clearly document the reason. Case actions and why the actions were taken, and. !H!/tG|B^%=z+]F!lExBa0$ Privacy Policy Percentage of clients with documented evidence, as applicable, of a transfer plan developed and documented with referral to an appropriate service provider agency as indicated in the clients primary record. The modified adjusted gross income (MAGI)-based apple healthapplication process using Washington Healthplanfinder may provide faster or real-time determination of eligibility for medicaid. See "How to request an LTSS assessment" below. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013, p. 14-16. Encourage the applicant to gather documents as soon as possible to expedite the process. Olympia WA 98504-5826; or 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. Percentage of clients with documented evidence of assistance provided to access health insurance or Marketplace plans in the primary client record. 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. We follow the rules about notices and letters in chapter. RWHAP Part B and State Services funds can be used to provide transitional social services to establish or re-establish linkages to the community. There is good information on the Washington LawHelp site that explains the timing of an LTSSapplication. 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. Ensure what you document accurately describes what happened with the case. 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. 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. HRSA 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), Referral for Health Care and Support Services, 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. 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. DSHS 10-570 ( REV. Functional eligibility for DDA is determined prior to the submission of a financial application. Provide PBSstaff with the following information: Whether the client meets nursing facility level of care (NFLOC). An interview with the applicant or authorized representative is required to determine eligibility for institutional, HCB waiver services, or TSOA services. For calculating time limits, "day one" is the day we get an application from you that includes at least the information described in WAC. Lite. 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. 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. adult daycare center) in accordance with a written, individualized plan of care established by a licensed physician. 6 [Content_Types].xml ( KO0#5.,5ec H0[i ~NhMsg[3xxw;) 'nY?7H(;1{H] 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. The HCS case manager coordinates andconsults withthe PBS to see if Fast Track is appropriate. 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)). Provide advocacy to clients with a clear understanding of community services and support available for their situations. The application process begins and the application date is established when the request for benefits is received. APPPLICANT'S NAME: LAST, FIRST, MI 2. Ask if there are unpaid medical expenses and request verification if medical expenses exist. Applications for LTSS may be submitted using any of the following methods: Mailing or faxing documents to Home and Community Services (HCS), Mail to: f?3-]T2j),l0/%b 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. 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. The interview can be conducted in person or by phone. Benefits Counseling: Activities should be client-centered facilitating access to and maintenance of health and disability benefits and services. A request for service s is any request that comes to HCS regardless of source or eligibility. The agency will maintain ongoing communication with the multidisciplinary medical care team in compliance with Texas Medicaid and Medicare Guidelines. Provide feedback on your experience with DSHS facilities, staff, communication, and services. At a department of social and health services (DSHS) community services office (CSO). Por favor, responda a esta breve encuesta. When using Collateral Contact (CC) or Other (OT) valid value, document the details of how it was verified. the past two years? 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). Have you received Accurintand/or AVS results and reviewed the assets reported? If the client is unable to complete the interview due to a medical condition or because no one is available to assist the client. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. Hmoob 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). Explain Estate Recovery and mail the Estate Recovery fact sheet. 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. Help Stop Medi-Cal Fraud and Abuse 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. Use the original eligibility review date to open institutional coverage. The DSHS consent form is preferred as it is used for all programs including medical, food and cash. IHSS Timesheet Issues/Questions: Concise - Documentation is subject to public review. State Plan Amendments. 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. 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. Consistently report referral and coordination updates to the multidisciplinary medical care team. 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. Denos su opinin sobre sus experiencias con las instalaciones, el personal, la comunicacin y los servicios del DSHS. Back to DSH main webpage. A referral Social services will state fund Fast Track services when the client isn't financially eligible during the fast track period. 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. f?3-]T2j),l0/%b Ask about any transfers, gifts, or property sales during the 5-year look back and the circumstances of why they were made. Purpose: Communication to social services intake regarding an individual requesting a functional assessment for long-term services and supports (LTSS). IHSS Service Desk for Providers & Recipients, (866) 376-7066, Suspect Fraud? We do not delay a decision by using the time limits in this section as a waiting period. Medicaid eligibility begins, the first day of the month the client is eligible for LTSS. SSI recipients who need institutional services, or HCB waiver, must complete and sign an application, or the. Client relocates out of the service delivery area. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO 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. If you do not have software that can open these files, you may download a free file viewer . | Contact Us Caregiver Support Find out about caregiver support.

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