dshs home and community services intake and referralsamantha wallace and dj self
Has your contact information changed in Screen all clients to determine potential for HCB services. Staff will follow up within 10 business days of a referral provided to support services to ensure the client accessed the service. Care plan is updated at least every sixty (60) calendar days. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. xar *O.c H?Y+oaB]6y&$i8]U}EvH*%94F%[%A PK ! Denos su opinin sobre sus experiencias con las instalaciones, el personal, la comunicacin y los servicios del DSHS. INTAKE AND REFFERAL DSHS 10-570 (REV. The hospice provideris required to submit this form within 5 business days of a hospice election on all active and pending Medicaidcases. I) word/document.xmlr=U.nA;K]|K0x+CII*?tY =6KWHN Z G!i$.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. At a department of social and health services (DSHS) community services office (CSO). The modified adjusted gross income (MAGI)-based apple healthapplication process using Washington Healthplanfinder may provide faster or real-time determination of eligibility for medicaid. 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. 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. 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. WAC 182-513-1350). Espaol HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April 2013. p. 42-43. For in-home service applicants, discuss the food assistance program and inquire if the household would like to apply for food benefits. | Conditions of Use The application process begins and the application date is established when the request for benefits is received. 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 people described in subsection (3) of this section who are not applying with a household containing people described in subsection (2) of this section: Call orvisit a local DSHSCSO or HCS office; or. 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. SOCIAL SECURITY NUMBER 5. To apply for tailored supports for older adults (TSOA), see WAC. 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. Percentage of clients who received a referral for other support services who have documented evidence of the education provided to the client on how to access these services in the primary client record. Issue the award letter to the applicant/recipient. TK6_ PK ! 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. 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. Welcome to CareWarePlease select your portal type. If you reside in an institution of mental diseases (as defined in WAC. 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. Give your local county office your updated contact information so you can stay enrolled. Jun 2014 - Mar 201510 months. Determine if a housing maintenance allowance (HMA) is appropriate (current rule states HMA is the amount of the Federal Poverty Level). Percentage of clients with documented evidence of a comprehensive evaluation completed by the Home and Community-Based Health Agency Provider in the clients primary record. Whether there is a housing maintenance allowance and the start date, if appropriate. 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. MAGI covers NF and Hospice under the scope of care. These are the forms used in the application process for LTSS. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). Per Diem. | 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. | Ensure an Asset Verification System (AVS) Authorization is on file, and if not, follow these procedures. Home and Community Services - LTSS 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. Accessed on October 12, 2020. (PDF) Accessed October 12, 2020. Home and Community-Based Health Services Standards print version. If not already authorized, request authorization for AVS for the client and any applicable financially responsible people. Provide the PBS staff with the following information: Residential facility name and address, including room number, if applicable. Lakewood, WA. Complete - The documentation must support the eligibility decision and allow a reviewer to determine what was done and why. 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. Back to DSH main webpage. If we denied your application because we do nothave enough information, the ALJ will consider the information we already have and any more information you give us. DSHS HCS Intake and . Disproportionate Share Hospital Program Eligibility. Percentage of clients with documented evidence of referrals provided to any core services that had follow-up documentation within 10 business days of the referral in the primary client record. If they can't be reached, or are unavailable, send an appointment letter (DSHS 0011-01) and a request for verification letter for what is needed to determine eligibility, based only on what was declared on the application. (link is external) 360-918-8424. Use the original eligibility review date to open institutional coverage. Appendix 2 to Attachment 4.19-A. The HCS case manager coordinates andconsults withthe PBS to see if Fast Track is appropriate. :.U`:8H"Jtv&edPi\ZbNu]$#;w2F.v~u\E}:=~G gQDYQ2xe*rhB/Y>as1j{s2Zo3(\XIEfe687jdP|A2L(o5E".eYR?UUCWel6/,/`^jQ[. Did you receive verification of resources with the application? Examples are the SSI or SSI-related programs or Apple Health for Workers with Disabilities (HWD). How do I notify SEBB that my loved one has passed away? 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). 0 6 /20 20 INSTRUCTIONS HOME AND COMMUNITY SERVICES Intake and Referral DATE Section 1. 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.. The PBS also determines maximum client responsibility. For Hospice as a medicaidprogram, the hospice authorization date is based on the receipt of the 13-746 (HCA/medicaid Hospice notification). The interview requirement described in subsection (3) of this section may be waived if the applicant is unable to comply: Because the applicant does not have a family member or another individual that is able to conduct the interview on his or her behalf. For information regarding prior fiscal year files, please contact the DSH unit at, Last modified date: $[53j(,U+/6-FBR[lvn! }k}HG4"jhznn'XwB$\HODuDX7o u'8>@)OLA@"yoTP8nd lAO Note: Servicescan't be backdated prior to the date of the authorization until the date that financial eligibility is established. For non-urgent mental health services, please contact your county mental health department . REGION 1 - Pend Oreille, Stevens, Ferry Okanagan, Chelan, Douglas, Grant, Lincoln, Spokane, Adams, Whitman, Klickitat, Kittitas, . DSHS 14-532 Authorized representative release of information. Explain the medical service card, automatic Medicare D enrollment if not on a creditable coverage or Medicare D Prescription Drug Plan. Functional eligibility for DDA is determined prior to the submission of a financial application. LTSS can begin once a client is found financially and functionally eligible and an approved provider is in place. L2 The LTSS authorization date, which is described in WAC, If there is a transfer penalty as described in WAC. Lite. A good cause code must be used when finalizing any medical(AU) historically beyond 45 days. | word/document.xml\n8}_`u-c t?mk[X`aKHJ|Mf2DUSU~~=DX~PJ6u`r]u+K(q` Qy'AD5}]qT"{J|}]6+t. 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. 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. 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. Summarize what verification is needed to complete the application and send a request for information letter. A request for service s is any request that comes to HCS regardless of source or eligibility. HRhk\ X?Nk; $-Yqiy*KB&I4"@W>eGI'tHaOBhVPRQq[^BJ] Details of how eligibility factor(s) were verified. 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. Name Unit Division Phone *Medicaid Helpline: Medicaid: HCS: 1-800-562-3022: Abbott, Amy: Director's Office, RCS: RCS: 360.725.2401: Acoba, Curtis: OT - IT Security Percentage of clients with documented evidence of a care plan completed based on the primary medical care providers order as indicated in the clients primary record. If you reside in one of the following counties: Island, King (ZIP codes 98011, 98019, 98072, 98077, 98133, 98177) San Juan, Skagit, Snohomish, or Whatcom and are interested in: If you reside in King County in a ZIP code not listed above and are interested in: If you reside in one of the following counties: Clallam, Clark, Cowlitz, Grays Harbor, Jefferson, Kitsap, Lewis, Mason, Pacific, Pierce, Skamania, Thurston, or Wahkiakum 800-786-3799, FAX 360-586-0499. 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. What is HCS (PDF in English) What is HCS (PDF in Spanish) Provider Communications 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. 6. 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. 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). 08/2017) Page 1 of 2 / Intake and Referral form for Social Services. Good cause for a delay in processing the application does NOT exist when: Failing to ask you for information timely; or, Failing to act promptly on requested information when you provided it timely; or. The agency may discontinue services or refuse the client for as long as the threat is ongoing. 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. Home and Community-Based Health Services are provided to an eligible client in an integrated setting appropriate to a clients needs, based on a written plan of care established by a medical care team under the direction of a licensed clinical provider. Apply in-person at a local Home & Community Services office. Please take this short survey. The interview can be conducted in person or by phone. catholic community services hen program. N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ Por favor, responda a esta breve encuesta. The DSHS consent form is preferred as it is used for all programs including medical, food and cash. 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. Ask if any of these bills were incurred within the last 3 months. | Explain Estate Recovery and mail the Estate Recovery fact sheet. | 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. Behavioral health services for American Indians & Alaska Natives (AI/AN) Recovery support services What is recovery support? adult daycare center) in accordance with a written, individualized plan of care established by a licensed physician. Assessment of client's access to primary care, Need for nursing, caregiver, or rehabilitation services. | 6 [Content_Types].xml ( KO0#5.,5ec H0[i ~NhMsg[3xxw;) 'nY?7H(;1{H] Wage Range: $40.76-$75.17 per hour plus per diem rate. Please report broken links or content problems. Posted wage ranges represent the entire range from minimum to maximum. Main Office . Transitional social services should NOT exceed 180 days. This Home and Community Based Services program provides not only care, but also other supports . Percentage of clients accessingHome and Community-Based Health Services have follow up documentation to the referral offered in the clients primary record. An overpayment isn't established. Full. PBS determines financial eligibility by comparing the client's income, resources and circumstances to program criteria. You may apply for Washington apple health for yourself. Staff will follow-up within 10 business days of a referral provided to HIA to determine if the client accessed HIA services. Applicant Information 1. 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. If there is other medical coverage and you can obtain the information during the interview, complete a. In-home or residential services, call 800-780-7094 or 425-977-6579, FAX 425-339-4859, Nursing home services, call 800-780-7094, FAX 206-373-6855, In-home or residential services, call 206-341-7750, FAX 206-373-6855. Case actions and why the actions were taken, and. 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). 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. Benefits Counseling: Activities should be client-centered facilitating access to and maintenance of health and disability benefits and services. You mayapply for apple health for another person if you are: An authorized representative (as described in WAC.