HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. 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. If not already authorized, request authorization for AVS for the client and any applicable financially responsible people. HRSA/HAB Ryan White Program & Grants Management, Recipient Resources. 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. 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. 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. 08/2017) Page 1 of 2 / Intake and Referral form for Social Services. Case actions and why the actions were taken, and. Call the DSHScommunity services customer service contact center number listed on the medicaidapplication form. For calculating time limits, "day one" is the day we get an application from you that includes at least the information described in WAC. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April 2013. p. 42-43. HRSA/HAB Ryan White Program & Grants Management, Recipient Resources. Determine the client's financial eligibility for LTSSmedicaid and/or noninstitutional medical assistance including a request for retro medical if needed. Aging and Disability Resources Office 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. | Conditions of Use PK ! Medicaid eligibility begins, the first day of the month the client is eligible for LTSS. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013, p. 14-16. Is the client single or married, and which resource standard is being used to make a recommendation. Explain what changes of circumstances need to be reported. 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. SOCIAL SECURITY NUMBER 5. For in-home service applicants, discuss the food assistance program and inquire if the household would like to apply for food benefits. Asset verification, if not already authorized on the application by the client and financially responsible people (if applicable), may be authorized during the interview process. Use the original eligibility review date to open institutional coverage. f?3-]T2j),l0/%b For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Assess the client's functional eligibility for in home or residential care. The HCS case manager coordinates andconsults withthe PBS to see if Fast Track is appropriate. Progress notes will be kept in the client's primary record and must be written the day services are rendered. 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. The agency has attempted to complete an initial assessment and the referred client has been away from home on three occasions. z, /|f\Z?6!Y_o]A PK ! Fax form to the Home and Community Services office in your region for intake. All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations planning and operations. You are the primary applicant on an application if you complete and sign the application on behalf of your household. INTAKE AND REFFERAL DSHS 10-570 (REV. If you disagree with our decision, you can ask for a hearing. (link is external) 360-918-8424. 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. For medicaid recipients, the first date DSHS was notified of the admission by the nursing facility. Back to DSH main webpage. For long-term services and supports coverage such as nursing home care, in-home personal care, assisted living facility, adult family home programs, and TSOA Mail your application to: DSHS Home and Community Services PO Box 45826, Olympia, WA 98504-5826 Questions? Privacy Policy 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. 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. Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance. 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. Always include the client's full name and the DSHS client id (if known) on any document mailed or faxed to DSHS. | Department-designated social service staff: Assess the client's functional eligibility for institutional care. | (Source: DSHS Policy591.00 Limitations on Ryan White and State Service Funds for Incarcerated Persons in Community Facilities, Section 5.3). Type of client interaction (phone, in-person, etc.). Disproportionate Share Hospital Program. Lite. Kirkland, WA. 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). z, /|f\Z?6!Y_o]A PK ! Interfaith Works Homeless Services: www.iwshelter.org. If we need more information to decide if you can get apple healthcoverage, we will send you a letter within twenty calendar days of your initial application that: States the additional information we need; and. Your WAH coverage may not begin on the first day of the month if: Subsection (3) of this section applies to you. 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. 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 agency may discontinue services or refuse the client for as long as the threat is ongoing. We did not document the good cause reason before missing a time frame specified in subsection (1) of this section. Summarize the interview and items still needed to determine eligibility in the ACES narrative. (link is external) 360-709-9725. | Listed on 2023-03-03. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). 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). Jun 2014 - Mar 201510 months. You are automatically enrolled in apple healthand do not need to submit an application if you are a: Supplemental security income (SSI) recipient; Person deemed to be an SSI recipient under 1619(b) of the SSA; Child in foster care placement as described in WAC. 3602 Pacific Ave., Suite 200 . 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. Did you receive verification of resources with the application? Tacoma, WA 98418. Referral for Health Care and Support Services Service Standard print version. Open-ended questions often reveal that additional sources of income and assets may exist. If you have questions about submitting the form please contact your regional office at the number below. Ask about other medical coverage. Have you received Accurintand/or AVS results and reviewed the assets reported? You may receive help filing an application. Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. 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. Behavioral health services for American Indians & Alaska Natives (AI/AN) Recovery support services What is recovery support? Accessed on October 12, 2020. Applications for LTSS may be submitted using any of the following methods: Mailing or faxing documents to Home and Community Services (HCS), Mail to: Encourage the applicant to gather documents as soon as possible to expedite the process. What is HCS (PDF in English) What is HCS (PDF in Spanish) Provider Communications 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 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. 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. REGION 1 - Pend Oreille, Stevens, Ferry Okanagan, Chelan, Douglas, Grant, Lincoln, Spokane, Adams, Whitman, Klickitat, Kittitas, . Ensure AVS procedures are followed. / % [Content_Types].xml ( N0EHC-j\X $@b/=>"RRQ{c%3X@LCV^i7 Sx[Ab7*@*HRf$g`E*} G;V )B~)K0{j17X$)+n7u9bf}^&i/52\ L2 Percentage of clients with documented evidence of ongoing communication with the primary medical care provider and care coordination team as indicated in the clients primary record. N _rels/.rels ( j0@QN/c[ILj]aGzsFu]U ^[x 1xpf#I)Y*Di")c$qU~31jH[{=E~ 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. Por favor, responda a esta breve encuesta. HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards Program Part B April, 2013, p. 13-15. 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. z, /|f\Z?6!Y_o]A PK ! The PBS may waive the interview requirement. 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. LTSS can begin once a client is found financially and functionally eligible and an approved provider is in place. Eligible clients are referred to Health Insurance Premium and Cost-Sharing Assistance (HIA) to assist clients in accessing health insurance or Marketplace plans within one (1) week of the referral for health care and support services intake. HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards Part A April 2013. p. 43-44. Training and social services development, delivery and evaluations; budget setting; and relationship cultivation. Give a projected client responsibility amount to the caseworker using the LTSS referral 07-104. Provide PBSstaff with the following information: Whether the client meets nursing facility level of care (NFLOC). Percentage of clients with documented evidence of agency refusal of services with detail on refusal in the clients primary record AND if applicable, documented evidence that a referral is provided for another home or community-based health agency.

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