Long Term Care
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Long Term Care


Revised September 9, 2014



Purpose: Long Term Care Eligibility. This section describes institutional medical programs, Home and Community based Waiver programs authorized by Developmental Disabilities Administration (DDA) and Home and Community Services (HCS), Hospice authorized by Health Care Authority (HCA), Mental Health facilities, Medicaid Personal Care (MPC) and Adult Protective Services (APS). HCS has financial staff responsible for cases receiving services from HCS. DDA LTC Specialty unit staff are responsible for cases with LTC services through Hospice, DDA, Mental Health. See LTC Overview for detailed information on responsibilities and program administration.

NOTE:

Effective January 1, 2013 the institutional WACs in chapters 388-513, 388-515 and the Life Estate, Annuity and Trust WACs in chapter 388-561 will be re-codified from Title 388 (DSHS) to Title 182 (Health Care Authority).  This process is a result of House Bill (HB) 1738 which moves the State Medicaid agency out of the Department of Social & Health Services (DSHS) and into the Health Care Authority (HCA)

Only the Title is changed during the re-codification process.  The text of the WAC will still reference chapters 388.  These chapters will be re-opened in order to change the text to correct the WAC references. 

The EAZ manual will be re-linked to point to the correct rule.  The WAC on the legislative site will not be re-linked until the process of changing the text goes through the rule making process.

The LTC WAC index and WAC 388 to WAC 182 crosswalk can be used during this process. 

Example of change:  388-513-1301 will be 182-513-1301 effective 1/1/2013.

Life Estates, Annuities and Trusts will be re-codified from chapter 388-561 WAC to 182-516 WAC.  By moving the chapter to 516, it will align closer to the LTC eligibility chapters.  The 516 is not a typo. 

Affordable Care Act (ACA) Transition plan

Washington Health Care Authority WAC (rules) index


Long-term Care (LTC) Overview and Index Page


Long-term Care and Medical Definitions


Long Term Care Standards, Payment standards and Personal Needs Allowance Charts


Long-term Care eligibility (Institutional Medical)

  • Resources (Resources, Transfers, Hardship Waivers, Trusts, Annuities, Life Estate, LTC Partnership, Lump sums, Facilities with an entrance fee).
  • Income and post eligibility (Available income, exclusions and disregards, Institutional Participation,  Allowable Medical Expenses, Guardianships, VA benefits)

Home & Community Based (HCB) Waiver Services (Authorized by HCS or DDA) Roads to Community Living (RCL) and Hospice (L21, L22, L24)


DSHS & HCA Forms, WACs, Rule making, and useful LTC links

DSHS & HCA Forms, WACs, Rule Making and Useful LTC links
Modification Date: September 9, 2014