Issue the award letter to the applicant/recipient. z, /|f\Z?6!Y_o]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. There is good information on the Washington LawHelp site that explains the timing of an LTSSapplication. Call the client or their representative to complete an interview. Interfaith Works Homeless Services: www.iwshelter.org. Help Stop Medi-Cal Fraud and Abuse The hospice provideris required to submit this form within 5 business days of a hospice election on all active and pending Medicaidcases. DSHS 10-570 ( REV. Need Mental Health Services? We will allow you more time if you ask for more time or need an accommodation due to disability or limited-English proficiency. The modified adjusted gross income (MAGI)-based apple healthapplication process using Washington Healthplanfinder may provide faster or real-time determination of eligibility for medicaid. Family members and other representatives are often just learning about the client's income and resources when they apply. (link is external) 360-918-8424. 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. General open-ended questions about resources and income should also be asked. Cases without a delay reason code or updated with "No Good Cause (NG)" to the DSHS secretary. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. 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. Appendix 2 to Attachment 4.19-A. J(_ @# word/_rels/document.xml.rels ( Yo6~!0I'n:Ylw-RI"IV. | Determine the client's financial eligibility for LTSSmedicaid and/or noninstitutional medical assistance including a request for retro medical if needed. Assess the client's functional eligibility for in home or residential care. 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)). 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. The HCS case manager coordinates andconsults withthe PBS to see if Fast Track is appropriate. DSH Program State Plan Amendment 14-008. A full-featured portal for all users. Assessment of client's access to primary care, Need for nursing, caregiver, or rehabilitation services. This Home and Community Based Services program provides not only care, but also other supports . $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO 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. You may apply for Washington apple health for yourself. 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. Dont open a case in ACES until you have everything needed to establish financial eligibility. Main Office . Jun 2014 - Mar 201510 months. 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. 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. Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. 6 [Content_Types].xml ( KO0#5.,5ec H0[i ~NhMsg[3xxw;) 'nY?7H(;1{H] . SSI recipients who need institutional services, or HCB waiver, must complete and sign an application, or the. Document in ACES remarks, in detail, all eligibility factors discussed during the interview and included on the application. Explain Estate Recovery and mail the Estate Recovery fact sheet. | 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). Disproportionate Share Hospital Program. Have you received Accurintand/or AVS results and reviewed the assets reported? All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. Staff will follow-up within 10 business days of a referral provided to HIA to determine if the client accessed HIA services. | Has your contact information changed in Review excess home equity, annuity and transfer of resource provisions that are specific to institutional and home and community-based (HCB) waivers. If the 13-746 is not received timely, count back 5 businessdays from the date of receipt to determine the authorization date. Your Washington apple health (WAH) coverage starts on the first day of the month you applied for and we decided you are eligible to receive coverage, unless one of the exceptions in subsection (4) of this section applies to you. The intake and referral form (DSHS 10-570) and instructions can be found on the DSHS forms website What is the difference between a request for services and a referral? A referral The determination of Fast Track is ultimately up to social 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 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. IHSS Fraud Hotline: 888-717-8302 SOCIAL SECURITY NUMBER 5. Denos su opinin sobre sus experiencias con las instalaciones, el personal, la comunicacin y los servicios del DSHS. 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 !H!/tG|B^%=z+]F!lExBa0$ Olympia WA 98504-5826; or Transfer/Discharge:A transfer or discharge plan shall be developed when one or more of the following criteria are met: All services discontinued under above circumstances must be accompanied by a referral to an appropriate service provider agency. We determine eligibility as quickly as possible and respond promptly to applications and information received. Contact a navigator, health care authority volunteer assistor, or broker. Provide PBSstaff with the following information: Whether the client meets nursing facility level of care (NFLOC). For medicaid recipients, the first date DSHS was notified of the admission by the nursing facility. Lite. Home and Community-Based Health Services Standards print version. (link is external) 360-709-9725. Case management that links a soon-to-be-released inmate with primary care is an example of appropriate transitional social services. Percentage of clients with documented evidence of a discharge plan developed with client, as applicable, as indicated in the clients primary record. Por favor, responda a esta breve encuesta. Examples are the SSI or SSI-related programs or Apple Health for Workers with Disabilities (HWD). If the client is unable to complete the interview due to a medical condition or because no one is available to assist the client. 1-(800)-722-0432, Copyright 2023 California Department of Social Services. Tacoma, WA 98418. | 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. 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. If you have questions about submitting the form please contact your regional office at the number below. Per Diem. 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. (Source: DSHS Policy591.00 Limitations on Ryan White and State Service Funds for Incarcerated Persons in Community Facilities, Section 5.3). Listing for: Denham Resources. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. This is a reprint of the official rule as published by the Office of the Code Reviser. 1s When applicable, an employee of the agency has experienced a real or perceived threat to his/her safety during a visit to a client's home, in the company of an escort or not. 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). / % [Content_Types].xml ( N0EHC-j\X $@b/=>"RRQ{c%3X@LCV^i7 Sx[Ab7*@*HRf$g`E*} G;V )B~)K0{j17X$)+n7u9bf}^&i/52\ Statements made by the client and/or their representative. Use Equal Access - Necessary Supplemental Accommodation (NSA) and long-term services and supports policies for LTSS applicants and recipients. The LTSSauthorization date can be backdated for nursing facility services up to 3 months prior to the date of application for a new applicant of Medicaid as long as the client is nursing facility level of care (NFLOC) and financially eligible. INTAKE AND REFFERAL DSHS 10-570 (REV. Barcode 10570 DSHS form 10-570. Consistently report referral and coordination updates to the multidisciplinary medical care team. Home and Community Services - LTSS You are the primary applicant on an application if you complete and sign the application on behalf of your household. Social Service Intake and Referral form (DSHS Form #10-570) The form is available here on the intranet: https://www.dshs.wa.gov/fsa/forms The form is available here on the internet for the public. Ensure AVS procedures are followed. Eligible clients are referred to other core services (outside of a medical, MCM, or NMCM appointment), as applicable to the clients needs, with education provided to the client on how to access these services. For medicaid applicants, institutional services are approved based on the date the client is eligible up to 3 months prior to the date of application. Transitional social services should NOT exceed 180 days. This section describes the application processes used by Aging and Long-term Supports Administration (ALTSA) when determining financial eligibility for Long-Term Services and Supports (LTSS). Give a projected client responsibility amount to the caseworker using the LTSS referral 07-104. v}r'kFtr4Ng n [D!n'h}c l`0_ 85yaBAhFozyJ46_ERgsEc;,'K$zTzy[1 PK ! 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. We deny your application forapple health coverage when: You tell us either orally or in writing to withdraw your request for coverage; or, Based on all information we have received from you and other sources within the time frames stated in WAC, We are unable to determine that you are eligible; or. Ask about any transfers, gifts, or property sales during the 5-year look back and the circumstances of why they were made. Client transfers services to another service program. f?3-]T2j),l0/%b The LTSSstartdate is the date the client is both financially and functionally eligible. 53 Community jobs available in Halford, WA on Indeed.com. 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. Summarize the interview and items still needed to determine eligibility in the ACES narrative. Request verification of transfers, gifts or property sales, if applicable. WAC 182-513-1350). An overpayment isn't established. Client relocates out of the service delivery area. We reconsider our decision to deny your apple healthcoverage without a new application from you when: We receive the information that we need to decide if you are eligible within thirty days of the date on the denial notice; You give us authorization to verify your assets as described in WAC 182-503-0055 within thirty days of the date on the denial notice; You request a hearing within ninety days of the date on the denial letter and an administrative law judge (ALJ) or HCA review judge decides our denial was wrong (per chapter. Apply in-person at a local Home & Community Services office. Appropriate mental health, developmental, and rehabilitation services; Day treatment or other partial hospitalization services; Home health aide services and personal care services in the home. DSHS HCS Intake and . | 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. Did you receive verification of resources with the application? Use the original eligibility review date to open institutional coverage. | Referral for Health Care and Support Services Service Standard print version. Provide feedback on your experience with DSHS facilities, staff, communication, and services. Social services will state fund Fast Track services when the client isn't financially eligible during the fast track period. State Plan Amendments. Training and social services development, delivery and evaluations; budget setting; and relationship cultivation. Aging and Disability Resources Office 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. DSH Replacement State Plan Amendment 16-010. Referrals for health care and support services provided by outpatient/ambulatory health care professionals should be reported under Outpatient/Ambulatory Health Services (OAHS) category. Your WAH coverage may not begin on the first day of the month if: Subsection (3) of this section applies to you. HRSA/HAB Ryan White Program & Grants Management, Recipient Resources. Case actions and why the actions were taken, and. A copy of the police report is sufficient, if applicable. Case Closure Summary: Clients who are no longer in need of assistance through Referral for Health Care and Support Services must have their cases closed with a case closure summary narrative documented in the client primary record. TK6_ PK ! If the NF admission is on a weekend or holiday, the NF has until the first business day to report the admission. 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.

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