Case Maintenance
- Client is in inpatient treatment (active GW-Y W01) and goes to outpatient treatment.
- Counties make the payment to clients in outpatient treatment. It is the county's responsibility to inform the CSO how much the client will be receiving while in outpatient treatment.
To make changes to the active GW-Y W01 AU:
-
On the (AMEN) enter the case through Option [R] Interim / Hist Change, for the month the client left inpatient treatment.
-
Change the valid values on the appropriate screens as follows:
| (DEM1) |
Living Arngmt field = [Varies per client]
Must be changed from [AR] to current living situation.
|
| (INST) |
Leave Date field = Enter [date client LEFT/WILL LEAVE inpatient treatment]
(As long as the living arrangement code is not AR, the date entered here can be a future date.)
|
| (SHEL) |
Enter [amount of client's rental obligation]
(If none entered, system will compute financial eligibility based on supplied shelter standard)
|
| Results: |
Program Code = GW
Program Type = W
Med Cvrg Group = W01
Payment Stnd = MAID only
|
-
On the(CAFI) for the month the client left treatment, ACES calculates an underpayment for the difference between the CPI benefit and a full payment standard.
-
Enter [IG] in the UP field as we do not make the payments for clients in outpatient treatment.
-
Override the system generated letter and confirm the data.
-
For each month after the month the client left inpatient treatment through and including the ongoing month,
-
Change the Valid Values on the appropriate screens as follows:
| (DEM1) |
Living Arngmt field = [Varies per client] Must be changed from [AR] to current living situation. |
| (INST) |
Enter [Y] in the Del field - Delete indicator - to delete the inpatient treatment information. |
| (SHEL) |
Enter [amount of client's rental obligation] (if none entered, system will compute financial eligibility based on supplied shelter standard. |
- Finalize and confirm the benefits for the month and override the system generated letter and send one of the following letters depending on type of treatment being received.
| Outpatient Treatment: |
Letter 0002-05 - Approval for ADATSA Outpatient Benefits |
| Inpatient Treatment: |
Letter 0002-04 - Approval for ADATSA Residential Services |
| Medical Only: |
Letter 0002-03 - Approval for ADATSA Medical Only |
See Letters.
- When processing the change from inpatient treatment to outpatient treatment during the adverse action period the user must waive adverse action on the case by entering [Y] in the Waive Adv Act Per field on the (CAFI).
In most cases, the client will be eligible to receive more money while in outpatient treatment than while in inpatient treatment.
ACES sees the case as going from paying a cash benefit to not paying a benefit, and will issue the inpatient treatment benefit for the next month if adverse action is not waived.
|
Inpatient Treatment
Extended Care Treatment - 90 Day Maximum
Enter Valid Values on the appropriate screens as follows:
| ( DEM1 ) |
Living Arngmt field = [AR] |
| ( DEM2 ) |
Disability / Incapacity
|
| (INST) |
Type field = [LA]
Level of Care field = [A]
|
| Results: |
Program Code = GW
Program Type = Y
Med Cvrg Group = W01
Payment Stnd = CPI
|
Intensive Inpatient Treatment
Client is approved for and goes into intensive inpatient treatment.
Enter Valid Values on the appropriate screens as follows:
| ( DEM1 ) |
Living Arngmt field = [AR] |
| ( DEM2 ) |
Disability / Incapacity
- Dis / Incp Type field = [W]
- Approv Source field = [AA]
|
| (INST) |
Type field = [II]
Entry Date field = [Date client entered inpatient treatment]
Level of Care field = [A]
LTC – Rate field = [The private rate. No need to enter the state rate set by parameter. System uses rates to compute participation.]
|
| Results: |
Program Code = GW
Program Type = Y
Med Cvrg Group = W01
Payment Stnd = CPI
|
Long Term Residential Treatment - 180 Day Maximum
Enter Valid Values on the appropriate screens as follows:
| ( DEM1 ) |
Living Arngmt field = [AR] |
| ( DEM2 ) |
Disability / Incapacity
|
| ( INST ) |
Type field = [LO]
Level Of Care field = [A]
|
| Results: |
Program Code = GW
Program Type = Y
Med Cvrg Group = W01
Payment Stnd = CPI
|
Recovery House Treatment
Enter Valid Values on the appropriate screens as follows:
| ( DEM1 ) |
Living Arngmt field = [AR] |
| ( DEM2 ) |
Disability / Incapacity
|
| ( INST ) |
Type field = [RH]
Level Of Care field = [A]
|
| Results: |
Program Code = GW
Program Type = Y
Med Cvrg Group = W01
Payment Stnd = CPI
|
|
Medical ADATSA is a program to assist in the rehabilitation of alcoholics and drug addicts who can benefit from treatment. There are a variety of programs available to clients found eligible to receive ADATSA.
See EA-Z Manual: Chemical Dependency
C. ADATSA - Program Information WAC 388-800-0040, WAC 388-800-0045, and WAC 388-800-0100
Single Individual Applying for ADATSA Cash
-
Complete the interview and, if financially eligible, refer the case to the social worker using ACES Letter 0065-02, ADATSA Assessment Referral, and DSHS 14-050, Statement of Education, Employment and Health.
-
Social worker refers client to the Assessment Center. Case remains pending (not processed or finalized) until information comes back from Assessment Center.
See EA-Z Manual - Applications - D. Time Limits for Processing Applications WAC 388-406-0035
Take the following steps to process an ADATSA case going from medical only to Inpatient:
-
In this situation the case will have an active MA-W, W02 MA AU and a pending GW-Y, W01 cash AU.
If the case unit does not have a pending GW-Y, W01 AU, screen Add A Program for the GW-Y W01.
-
Enter Option [O] Interview, in the Selection field on the (AMEN) for the pending GW-Y, W01 AU. This also allows access to the (STAT) for the MA-W, W02 AU.
-
Enter Reason Code [587] Already Eligible for Program in Different AU, in the AU Status Reasons field to close the MA-W, W02.
-
Update demographic information.
-
Review the following screens and fields to insure the cash case is opened correctly. Entry in these fields will vary depending on type of treatment client is receiving.
| (DEM1) |
Living Arngmt field = [AR] |
| (DEM2) |
Disability / Incapacity
|
| (INST) |
Type field = [II]
Level Of Care field = [A]
|
-
Process and finalize all AUs.
-
To avoid a dual participation edit when finalizing, the MA-W W02 closure must be confirmed first.
Shelter eligible but client declined services. Not eligible for cash, eligible for medical only. May need to screen Add A Program for the medical. Request Medical not ADATSA on the(KIND). Need MA-Z W02 on the (INCH). If screen ADATSA, AU will be denied.
Enter valid values on the appropriate screens as follows:
| (DEM1) |
Living Arngmt field = [AH] |
| (DEM2) |
Disability / Incapacity
|
| Results: |
Program Code = MA
Program Type = Z
Med Cvrg Group = W02
Payment Stnd = MAID only
|
Client must be in state approved methadone maintenance program. Screen medical MA-W W02. Don't screen ADATSA or the AU will be denied.
Enter valid values on the appropriate screens as follows:
| (DEM1) |
Living Arngmt field = [AH] |
| (DEM2) |
Disability / Incapacity
|
| Results: |
Program Code = MA
Program Type = W
Med Cvrg Group = W02
Payment Stnd = MAID Only
|
Client is approved for treatment but on a waiting list for a bed. If you have a pending cash GW-W W01 AU do not deny it. Leave it in pending status. Screen Add a Program for medical only, MA-W W02.
Enter valid values on the appropriate screens as follows:
| (DEM1) |
Living Arngmt field = [AH] |
| (DEM2) |
Disability / Incapacity
|
| Results: |
Program Code = MA
Program Type = W
Med Cvrg Group = W02
Payment Stnd = MAID Only
|
When the client enters treatment, close the MA-W W02 AU, change applicable valid value on the (DEM2), process and finalize the GW-W W01 AU.
|
-
ACES does not issue cash payments for clients eligible to receive ADATSA outpatient treatment. Individual counties issue cash payments on these cases.
-
In ACES, a benefit amount displays on the (CAFI) as ACES still does the eligibility calculation. This benefit will not display in benefit history.
-
Communication between the county and CSO in this situation is important in that the county is responsible to report to the CSO the amount of payment being made to the client and this cash payment is used to compute Basic Food benefits if eligible.
-
In most situations, the county will be paying the client the same amount they would have been receiving from the state.
However, it is the responsibility of the county to keep the CSO informed of the client's cash benefit amount. The counties' source of funding for this program is the same as for the state so the client is still considered to be receiving public assistance.
Enter valid values on the appropriate screens as follows:
| (DEM1) |
Living Arngmt field = [AH] |
| (DEM2) |
Disability / Incapacity
|
| Results: |
Program Code = GW
Program Type = W
Med Cvrg Group = W01
Payment Stnd = Counties pay cash. State issues MAID only.
|
- When a client goes from inpatient (GW-Y W01) to outpatient (GW-W W01) treatment, ACES calculates an under-issuance for the difference between the CPI standard and the full payment standard. This under-issuance displays on the (CAFI) screen when the GW-W W01 AU is finalized. Ignore this under-issuance. Even if the under-issuance is approved, and the BEG confirmed, no warrant will be generated for an AU program and type GW-W.
|
