Access to Treatment for TANF, MCS, ABD cash, and Medicaid Clients
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Access to Treatment for TANF, MCS, ABD cash, and Medicaid Clients


Revised July 15, 2013



Purpose: To provide assistance to CSO staff in facilitating referrals and improve access to chemical dependency treatment services for people who are recipients of TANF, SSI, MCS, ABD cash, Categorically Needy and Medically Needy Medical Assistance Programs.

CLARIFYING INFORMATION

  1. The Division of Behavioral Health and Recovery (DBHR) contracts with the counties to provide outpatient chemical dependency treatment services to individuals who receive public assistance.

  2. DBHR contracts directly with treatment agencies to provide residential treatment services.

  3.  DBHR contracted chemical dependency treatment services to individuals receiving public assistance (recipients of income assistance grants or Medicaid , not food assistance) are provided free of charge to the individual.

  4. In some of the smaller counties, the county agency itself is the provider of outpatient treatment services. In other counties, the county agency contracts with state-certified treatment agencies within the county to provide the services.

  5. Every county has a designated Alcohol and Drug Coordinator who works with DBHR and coordinates all services related to outpatient chemical dependency treatment and prevention activities.

  6. Individuals receiving Public Assistance must receive outpatient treatment services from a DBHR certified agency in order to have the treatment paid from DBHR funding.

  7. Public funding through DBHR for chemical dependency treatment services can only be provided if the services are received in a county-identified or DBHR contracted treatment facility.


      

Medicaid-Eligible Adult or Youth or Children's Health Programs

Outpatient Treatment

  1. If a Medicaid-eligible adult or youth or a State Children's Health Program (SCHIP) youth wants to access outpatient treatment services, the person can go directly to any of the agencies identified by the county as a provider of adult or youth outpatient services.

  2. Treatment services are paid as a Medicaid/medical service.

  3. The person uses the medical identification card for payment and the treatment agency bills for services through the Health and Recovery Service's Medical Assistance payment system.

  4. Information on agencies who are contracted to provide outpatient chemical dependency treatment services can be received through the DBHR Regional Administrator or by calling the Washington Recovery Hotline at 1-866-789-1511.

  5. When referring a person to a treatment agency, it is extremely important to identify the program of assistance the person is receiving for the treatment agency.

  6. When the person is receiving MNP due to spenddown, advise the treatment agency of the Medicaid certification period so they will be aware of the time limited eligibility for treatment services.

Residential Treatment - Youth

  1. If a youth receiving Medicaid, SCHIP, or state-funded medical assistance wishes to access residential treatment services, they must receive these services from one of the specific DBHR contracted youth residential treatment providers.

  2. The youth or parents of the youth can work through a county identified youth outpatient treatment provider or contact the residential treatment provider directly to request residential treatment services.

  3. There are a limited number of youth residential treatment beds in the state. Therefore, access to residential treatment is limited based on availability of a bed and the length of the waiting list.

  4. DBHR provides a directory of DBHR funded residential treatment agencies on the website at: Residential Treatment - Adult.

 

Residential Treatment - Adults

  1. If an adult recipient of SSI, TANF, MCS, ABD cash, or other Medicaid program wants to access residential treatment services he/she may choose any county identified treatment agency that serves adults. The agency will complete the assessment, determine the level of care needed by the person, and assist the person in accessing residential care if needed.
  2. Treatment services are provided through the DBHR contract with the residential treatment agency.
  3. Access to residential treatment is limited based on availability of beds and the length of the waiting list.
  4. Information on agencies who are contracted to provide residential treatment services can be received through the DBHR Regional Administrator or by calling the Washington Recovery Help Line: 1-866-789-1511.
  5. It is extremely important to identify the program of assistance the person is receiving for the treatment agency when referring a person to a treatment agency.
  6. When the person is receiving MNP due to spenddown, advise the treatment agency of the Medicaid certification period so they will be aware of the time limited eligibility for treatment services.



Adult Receiving State Funded Medical Care Services

Outpatient Treatment

  1. If a Medical Care Services (state-funded medical assistance) individual wants to access outpatient chemical dependency treatment services, he/she may go directly to any of the treatment agencies identified by the county as a provider of adult outpatient services

  2. Payment for the treatment services is not provided as a medical service using the medical ID card. Payment for the treatment services is provided by the county and paid through the county-funding process.

  3. A directory of certified agencies who provide outpatient chemical dependency treatment services can be accessed on the DBHR webpage or by calling the Washington Recovery Help Line at 1-866-789-1511.

  4. When CSO staff refer a MCS client to a treatment agency, they need to identify the program of assistance the person is receiving for the treatment agency.


WORKER RESPONSIBILITIES

  1. Use the ADATSA/Adult Assessment Referral (DSHS 14-299) form when referring a client to a treatment agency.

  2. Inform the person to take the award letter to the treatment agency to identify the program of assistance if you do not want or need to have feedback from the treatment agency,

  3. Have the person complete a Release of Information form to make sure you are able to receive information from the treatment agency. Send a copy of this form with the referral form to the treatment agency.

Modification Date: July 15, 2013