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ACES
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Revised July 6, 2009 |
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Alcohol and Drug Addiction Treatment Support Act - (ADATSA)(GW/W01) Alcohol and Drug Addiction Treatment Support Act - (ADATSA)(W02) | ||||||||||||||||||||||||||||||||||||||
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ALCOHOL AND DRUG ADDICTION TREATMENT SUPPORT ACT (ADATSA) (GW/W01) Who is eligible to receive W01 medical?
Who is eligible to receive W01 medical?
· Clients active on ADATSA cash (GW/W01) with a financial responsibility code of RE (Recipient) receive W01 medical coverage in addition to W01 cash benefits.
· Eligible clients automatically receive W01 medical when they are opened on ADATSA cash (GW/W01).
· See Alcohol and Drug Addiction Treatment Support Act (ADATSA) (GW/W01) for instructions on opening an ADATSA cash case. | ||||||||||||||||||||||||||||||||||||||
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ALCOHOL AND DRUG ADDICTION TREATMENT SUPPORT ACT (ADATSA) (W02) Who is eligible to receive W02 medical?
What treatment options are available under the ADATSA program?
How long is the W02 certification period?
How do I process a pending W02 AU?
How do I process W02 for a client who is determined not financially eligible?
How do I process an application for a client in Methadone Maintenance?
Will ACES close a W02 when the End Date has been reached?
What is the coding for various treatment situations?
Who is eligible to receive W02 medical?
· Individuals who meet the requirements may be eligible for ADATSA treatment and support. See EAZ Manual – WAC 388-800-0048 Who is eligible for ADATSA?
What treatment options are available under the ADATSA program?
· Medical Only Waiting Admission to a Treatment Facility. See EAZ Manual – Chemical Dependency Treatment – ADATSA Program Information.
· Medical Only Methadone Maintenance. See EAZ Manual – Chemical Dependency Treatment – Opiate Substitution.
How long is the W02 certification period?
· W02 is certified for up to six months.
· To screen a W02 AU, take the following steps:
1. From the Welcome Back page in aces.online, click the Screen New Application link at the top of the page. The Applicant page displays in a new window.
o If you have a pending cash AU (GW/W W01), do not deny it. Leave it in pending status and use the Add a Program feature from the Case Maintenance tab to add a medical only, MA/W W02 AU.
2. On the Applicant page, enter the applicant’s (head of household) Name, Residential and Mailing Addresses. Continue with the screening process until you reach the Programs page.
3. On the Programs page:
o Click the checkbox next to Medical.
o Click the Next button.
4. On the Finalize page, click the Specify program box.
5. On the Specify Program page:
o Select Medical (MA) from the drop down menu.
o Select ADATSA Medical Only (W02) from the Medical Coverage Group drop down menu.
o Click NEXT.
6. On the Finalize page:
o Click the box next to Medical Assistance (MA), Coverage Group ADATSA Medical Only (W02).
o Enter the application date.
o Click Commit.
How do I process a pending W02 AU?
· To process a W02 AU, take the following steps:
1. From AMEN, select Option O – Interview.
2. On the STAT screen, enter [PN] - Applicant in the Finl Resp field for the applicant.
3. On the DEM1 screen, enter [appropriate valid value] in the Living Arngmt field. See <F1> Help.
4. On the DEM2 screen:
o In the Dis/Incp Type field, enter [W] – Chemical Dependency (Non-Shelter ADATSA).
o In the Approv Source field, enter [AW] – ADATSA Assess – Waiting List field.
o Enter the appropriate Approv Date, Estab Date and End Date fields from the ADATSA assessment provided by Social Services.
5. Complete the interview following the steps in the Interview chapter.
6. After committing the interview data, follow the instructions in the Process Application Month chapter for all pending months.
7. After all pending months have been processed, follow the instructions in the Finalize Application chapter to complete the W02 eligibility determination.
How do I process W02 for a client who is determined not financially eligible?
· If the client is not financially eligible, take the following steps to deny the application:
1. From AMEN, select Option O – Interview.
2. On the STAT screen, enter a 500 level Reason Code in the AU Status Reasons field.
3. Complete the interview following the instructions in the Interview chapter.
4. After committing the interview data, follow the instructions in the Process Application Month chapter for all pending months.
5. After all pending months have been processed, follow the instructions in the Finalize Application chapter to complete the W02 eligibility determination.
6. No letter is generated for a 500 reason code. The system will not allow an entry in the Letter Override field. Create a denial letter in aces.online, citing the reason for the denial and the appropriate WAC reference in the free form text box.
How do I process an application for a client in Methadone Maintenance?
· For clients approved by social services for the Methadone Maintenance program, take the following steps:
1. From AMEN, select Option O – Interview.
2. On the DEM1 screen, enter [the appropriate code] in the Living Arngmt field. See <F1> Help.
3. On the DEM2 screen:
o In the Dis/Incp Type field, enter [W] - Chemical Dependency (Non-shelter ADATSA).
o In the Approv Source field, enter [AM] – ADATSA Assess – Methadone Maint Only.
o In the Approv Date, Estab Date and End Date fields, enter the appropriate dates in the Approv Date, Estab Date and End Date fields from the ADATSA assessment provided by Social Services.
4. Complete the interview following the steps in the Interview chapter.
5. After committing the interview data, follow the instructions in the Process Application Month chapter for all pending months.
6. After all pending months have been processed, follow the instructions in the Finalize Application chapter to complete the W02 eligibility determination.
· If a client is determined by social services to not be eligible for ADATSA treatment, take the following steps:
1. From AMEN, select Option O – Interview.
2. On the DEM1 screen, enter [the appropriate code] in the Liv Arngmt field. See <F1> Help.
3. On the DEM2 screen, leave the Dis/Incp, Approv Source, Approv Date, Estab Date and End Date fields blank.
4. Call DONE and <Transmit>.
· Follow the steps in the Process Application Month and Finalize Chapters.
Will ACES close a W02 when the End Date has been reached?
· ACES will not AUTO close a W02 AU based on the End Date field on the DEM1 screen. To close a W02 AU, on the STAT screen, enter [the appropriate reason code] in the AU Status Reasons field or the client Rsn field. See <F1> Help.
What is the coding for various treatment situations?
· For coding of various treatment situations see the chart below.
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ALCOHOLISM AND DRUG DETOXIFICATION PROGRAM (W03)
Who is eligible to receive W03 medical?
How long is the W03 certification period?
How do I process a pending W03 AU?
· W03 (DETOX) is a program for which ACES issues medical benefits but does not determine eligibility. Benefits are paid directly to the providers.
Who is eligible to receive W03 medical?
· Individuals who meet the following conditions may be eligible for W03 (DETOX):
o Applicants who are not eligible for CN or MN medical in other DSHS programs
o Applicants who have income and resources at or below the TANF standards
o Applicants in counties that do not have direct DETOX contracts with the Division of Alcohol and Substance Abuse (DASA).
· See EAZ Manual – WAC 388-800-0020 Chemical Dependency Treatment - Detoxification Services.
How long is the W03 certification period?
· W03 is certified through the end of the month in which 3 to 5 days of covered treatment ends.
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· To screen a W03 AU, complete the following steps:
1. From the Welcome Back page in aces.online, click the Screen New Application link at the top of the page. The Applicant page displays in a new window.
2. On the Applicant page, enter the applicant’s (head of household) Name, Residential and Mailing Addresses. Continue with the screening process until you reach the Programs page.
3. On the Programs page:
o Click the checkbox next to Medical.
o Click the Next button.
4. On the Finalize page, click the Specify Program box.
5. On the Specify Program page:
o Go to Select Program.
o Click on DETOX Medical Care Services W03 from list of Medical Coverage Groups.
6. On the Finalize page:
o Enter application date
o Click Commit.
How do I process a pending W03 AU?
· To process a pending W03 AU after manually determining eligibility, take the following steps:
1. From AMEN , select Option O – Interview.
2. Complete the interview following the instructions in the Interview chapter.
3. After the interview data has been committed, access the AU from the AMEN Option P – Process Application Months and follow the steps in Process Application Months.
4. After all pending months have been processed, select Option Q – Finalize. Follow the instructions in the Finalize Application chapter to complete the W03 processing and to finalize the application.
o The SPEC screen will automatically appear during the finalize process. On the SPEC screen, enter [Y] in the confirm field.
o ACES will auto deny the ongoing month with Reason Code 243 – Detox Auto Denial – For Administrative Use Only. User must determine eligibility in any other pending months. | ||||||||||||||||||||||||||||||||||||||
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