Intake Coordinator. Exception is N21/N25 AEM MAGI. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. Document in ACES remarks, in detail, all eligibility factors discussed during the interview and included on the application. | word/document.xml\n8}_`u-c t?mk[X`aKHJ|Mf2DUSU~~=DX~PJ6u`r]u+K(q` Qy'AD5}]qT"{J|}]6+t. Determine if a housing maintenance allowance (HMA) is appropriate (current rule states HMA is the amount of the Federal Poverty Level). Determine the client's financial eligibility for LTSSmedicaid and/or noninstitutional medical assistance including a request for retro medical if needed. Assessment of client's access to primary care, Need for nursing, caregiver, or rehabilitation services. 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 Acronyms utilized should be DSHS/HCA approved. 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. Ensure AVS procedures are followed. 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. This is a reprint of the official rule as published by the Office of the Code Reviser. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. Provide the PBS staff with the following information: Residential facility name and address, including room number, if applicable. We determine eligibility as quickly as possible and respond promptly to applications and information received. Ensure an Asset Verification System (AVS) Authorization is on file, and if not, follow these procedures. Assist clients in making informed decisions on choices of available service providers and resources. Please reference the HRSA Program Guidance above. Ask if any of these bills were incurred within the last 3 months. Get Services IHSS; Medi-Cal Offices; County Public Authority; IHSS Recipients: IHSS Training/Information - Resources; Fact Sheets; Educational Videos; IHSS Providers: How to Become an IHSS Provider; How to Appeal if You are Denied; IHSS Provider Resources; IHSS Timesheet Issues/Questions: IHSS Service Desk for Providers & Recipients, (866) 376 . 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. To find an HCS office near you, use the. 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 HCS clients, both functional and financial eligibility are determined concurrently. N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ Website feedback: Tell us how were doing, Copyright 2023 Washington Health Care Authority, I help others apply for & access Apple Health, I help others apply for and access Apple Health, Long-term services & supports (LTSS) manual, www.hca.wa.gov/free-or-low-cost-health-care, Equal Access - Necessary Supplemental Accommodation (NSA) and long-term services and supports, HCA 80-020 Authorization for Release of Information, Apple Health for Workers with Disabilities (HWD), Medically Intensive Children's Program (MICP), Behavioral health services for prenatal, children & young adults, Wraparound with Intensive Services (WISe), Behavioral health services for American Indians & Alaska Natives (AI/AN), Substance use disorder prevention & mental health promotion, Introduction overview for general eligibility, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Medical plans & benefits (including vision), Life, home, auto, AD&D, LTD, FSA, & DCAP benefits. Home and Community Services - LTSS Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. If you have questions about submitting the form please contact your regional office at the number below. The following Standards and Measures are guides to improving healthcare outcomes for people living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program. Conduct prevention activities as outlined in the DSHS . Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance. By calling the Washington Healthplanfindercustomer support center and completing an application by telephone; By completing the application for health care coverage (. xar *O.c H?Y+oaB]6y&$i8]U}EvH*%94F%[%A PK ! Screen all clients to determine potential for HCB services. N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ The Aging and Disability Resources Program offers a wide range of community-based services that allow older adults and adults with disabilities to remain at home as long as possible. Please report broken links or content problems. Privacy Policy The LTSSstart date for nursing facility services on an active medicaid recipient is based on the first date the admission is reported to DSHS as long as the client meets all other eligibility factors. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April 2013. p. 42-43. NOTE: If an 18-005 is received on an active MAGI case and the client is in a NF or Hospice care center, no action is needed by the PBS. 253-798-4400 Monday - Friday | 8 a.m. - 4:30 p.m. Services may be authorized using Fast Track for a maximum of 90 days. DSHS HCS Intake and . The hospice provideris required to submit this form within 5 business days of a hospice election on all active and pending Medicaidcases. :.U`:8H"Jtv&edPi\ZbNu]$#;w2F.v~u\E}:=~G gQDYQ2xe*rhB/Y>as1j{s2Zo3(\XIEfe687jdP|A2L(o5E".eYR?UUCWel6/,/`^jQ[. Summarize what verification is needed to complete the application and send a request for information letter. Back to DSH main webpage. Interfaith Works Homeless Services: www.iwshelter.org. Percentage of clients with documented evidence of assistance provided to access health insurance or Marketplace plans in the primary client record. . Provide feedback on your experience with DSHS facilities, staff, communication, and services. We do not delay a decision by using the time limits in this section as a waiting period. 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. For non-urgent mental health services, please contact your county mental health department . Collaborates with treating physician, psychiatric and allied health professional team to plan and direct each individual member . If the nursing facility admission is on a weekend or holiday, the authorization date is the date of admission as long as DSHSis notified by the next business day. For Hospice as a medicaidprogram, the hospice authorization date is based on the receipt of the 13-746 (HCA/medicaid Hospice notification). We did not document the good cause reason before missing a time frame specified in subsection (1) of this section. The agency must document the situation in writing and contact the referring primary medical care provider. PO Box 45826 Homeless Housing Hotline: 844-628-7343 - Call to connect with homeless services in Thurston County and get referrals to shelter and housing options. A referral Social Service Intake and Referral form (DSHS Form #10-570) The form is available here on the intranet: https://www.dshs.wa.gov/fsa/forms The form is available here on the internet for the public. 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. A new application isn't required for clients active on ABD SSI-related Apple Health who need LTSS as long as the Public Benefit Specialist (PBS) is able to determine institutional eligibility using information in the current case record. | 08/2017) Page 1 of 2 / Intake and Referral form for Social Services. Refer the client tosocialservicesfor a care assessment if the client contacts the PBSfirst and document the date the client first requested NF care. APPLICANT'S MAILING ADDRESS (IF DIFFERENT)CITYSTATEZIP CODE 7. Authorize payment for NF care 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. 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 (. Note: Servicescan't be backdated prior to the date of the authorization until the date that financial eligibility is established. Authorize in ACES for in-home or residential HCB waiver if the client is both functionally and financially eligible. Clientsswitching from private pay to medicaid are advised to apply for benefits 30 to 45 days before being resource eligible for the program. Did you receive verification of resources with the application? Consistently report referral and coordination updates to the multidisciplinary medical care team. Day one is the date the application was received. Hmoob You may apply for Washington apple health at any time. (PDF) Accessed October 12, 2020. Explain what changes of circumstances need to be reported. (PDF) Accessed on October 12, 2020. 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). If you do not have software that can open these files, you may download a free file viewer . Clients receiving services during the Fast Track period won't receive a medical services card until financial eligibility is established. L@5f)a>%X5.auU!1qV!h%SAg,U--`8F ydjz 8 'gF$v5q~~ enLr38uX*#XH)'#+Uabj8 ,]-r8| HuS.q"1,4>5H0 v!Nya" &~'iOJZG8eCvvJj(FMuT_j4f18#/SiO*i )nJE3 UXO+!h(G;:iYB0^,-x;p =8rkOS%Paa"gb-wSc%@/-|FJxD:`Au$yLt'2xi? Home. This service category works to maximize public funding by assisting clients in identifying all available health and disability benefits supported by funding streams other than RWHAP Part B and/or State Services funds. Call the client or their representative to complete an interview. When information is verified using an electronic source (such as BENDEX, AVS, etc.). Concise - Documentation is subject to public review. | 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. 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. The case closure summary must include a brief synopsis of all services provided and the result of those services documented as completed and/or not completed.. $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO 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. For medicaid recipients, the first date DSHS was notified of the admission by the nursing facility. Provider Fraud and Elder Abuse complaint line: Stick to the facts relevant to determining eligibility or benefit level. State Plan Amendments. Care plan is updated at least every sixty (60) calendar days. Explain to the applicant that there is a Public Benefits Specialist (PBS) and a social service manager making determinations concurrently for LTSS eligibility. | 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. Provide PBSstaff with the following information: Whether the client meets nursing facility level of care (NFLOC). Percentage of clients with documented evidence of referrals provided for HIA assistance that had follow-up documentation within 10 business days of the referral in the primary client record. | When working on a case that has ACES Equal Access (EA) requirements: If changing ACES EA requirements, clearly document the reason. | For medicaid applicants, institutional services are approved based on the date the client is eligible up to 3 months prior to the date of application. 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. 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. | Percentage of clients with documented evidence of education provided on other public and/or private benefit programs in the primary client record. Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance. A supervisor must sign the case closure summary. Benefits Counseling: Activities should be client-centered facilitating access to and maintenance of health and disability benefits and services. 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. Caring at Home Respite, In-home Services, Skills, Caregiver Help, Kinship Caregiving, Services, Conferences 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. Social service staff and case managers determine functional eligibility and what services to authorize based on a complete and comprehensive CAREassessment. Social services will state fund Fast Track services when the client isn't financially eligible during the fast track period. HRSA/HAB Ryan White Program & Grants Management, Recipient Resources. If the NF admission is on a weekend or holiday, the NF has until the first business day to report the admission. Progress notes will be kept in the client's primary record and must be written the day services are rendered. 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. PK ! We send you a written notice explaining why we denied your application (per chapter. 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. Provide advocacy to clients with a clear understanding of community services and support available for their situations. Percentage of clients accessingHome and Community-Based Health Services have follow up documentation to the referral offered in the clients primary record. A comprehensive evaluation of the clients health, psychosocial status, functional status, and home environment will be completed to include: Percentage of clients with documented evidence of needs assessment completed in the clients primary record. Purpose: Communication to social services intake regarding an individual requesting a functional assessment for long-term services and supports (LTSS). 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. Full. Ask about other resources not declared on the application. 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. Massachusetts Department of Public Health Bureau of Infectious Disease Office of HIV/AIDS Standards of Care for HIV/AIDS Services 2009, San Francisco EMA Home-Based Home Health Care Standards of Care February 2004, Texas Administrative Code, Title 40, Part 1, Chapter 97, Subchapter B, Rule 97.211. DSHS 10-438 Long-term care partnership (LTCP) asset designation form (used to designate assets (resources) for those with a long-term care partnership insurance policy), DSHS 14-012 Consent (release of information form) (used for all DSHS programs), DSHS27-189Asset Verification Authorization. All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. Percentage of clients with documented evidence of other public and/or private benefit applications completed as appropriate within 14 business days of the eligibility determination date in the primary client record. 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. Request verification of transfers, gifts or property sales, if applicable. 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. N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ 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. IHSS Timesheet Issues/Questions: Accessed on October 12, 2020. The DSHS consent form is preferred as it is used for all programs including medical, food and cash. GENDER Male Female 3. You are subject to asset verification and do not provide authorization as described in WAC 182-503-0055. Include Remarks to reconcile any discrepancies, or important information not otherwise captured, including required questions left blank on the application or eligibility review form. Percentage of eligible clients with documented evidence of the follow-up and result(s) to a completed benefit application in the primary client record. Policy Notices and Program Letters, Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds Policy Clarification Notice (PCN) #16-02 (PDF) (Revised 10/22/2018), DSHS Policy 591.000, Section 5.3 regarding Transitional Social Service linkage, Interim Guidance for the Use of Telemedicine and Telehealth for HIV Core and Support Services, March 2020, Interim Guidance for the Use of Telemedicine and Telehealth for HIV Core and Support Services Users Guide and FAQs, March 2020, HIV Medical and Support Service Categories, Research, Funding, & Educational Resources, Referral for Health Care and Support Services.