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Revised April 30, 2013 |
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Long-term care |
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Purpose: Many individuals receiving services through Home and Community Services (HCS) and Developmental Disability Services (DDD) or Mental Health Division (RSN) have court ordered guardianships. This section gives information on who to send the court documents if received by the CSO or HCS financial worker and information on guardianships. |
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Guardianship fees for clients of the department These rules implement RCW 11.92.180 and 43.20B.460 to the extent that those statutes require the department to establish by rule the maximum amount of guardianship fees and additional compensation for administrative costs that may be allowed by the court for a guardian or limited guardian of an incapacitated person who is a Medicaid client of the department and is thus required by federal law to contribute to the cost of the client's long-term care. | |
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Clarifying Information Guardianship fees described in chapter 388-79 WAC are allowed as a post eligibility deduction when determining participation for long-term care Medicaid programs. These are DDD and HCS Waivers and individuals who are receiving LTC Medicaid in a Medical institution. Financial workers receive a copy of the final order describing the guardian/attorney fees allowed by the court. WAC 182-515-1509 Describes the determination of participation for HCS CN-P Waivers. WAC 182-515-1510 Describes the determination of participation for DDD Waivers WAC 182-513-1380 Describes the determination of participation for those in medical institutions. Once the department has a court order, the department must allow the expense in the post eligibility process for the C01 Waivers and L02 Institutional programs. The combination of PNA, mandatory taxes, wages, guardianship fees and administrative costs cannot exceed the MNIL for clients in a medical institution. (WAC 182-513-1380 (4) ). There are times when the guardianship and/or administrative fees are over the amount allowed in a month (MNIL). It may take 2 or more months to allow for the administrative cost and guardianship fee. For Waivers in an alternate living facility (ALF), an ETR to is needed to allow administrative costs or guardianship fees out of room and board. Room and Board is not participation, therefore an approval through the Regional Designee is needed. For HCS cases, the ETR request is sent to the Regional HCS Financial Program Manager. (see list below for regional designee). For DDD cases, the ETR request goes to the DDD case manager. The deduction from service participation must always come first before allowing a deduction from room and board. Guardianship fees is not an allowable deduction when determining eligibility for SSI related medical programs such as S-series or G03. Guardianship fees are coded on the LTCX, LTC expense screen in ACES for the K, C and L track programs. More information regarding guardianships and ACES is located below. | |
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Guardianship training packet for Financial Workers The HCS training packet with examples explains how Guardianship deductions work in determining the client's contribution toward the cost of care for institutional (medical institutions) and institutional Waivers (DDD and HCS Waiver programs). Chapter 11.92 RCW Guardianship-powers and duties of guardian or limited guardian | |
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Worker Responsibilities Chapter 388-79 WAC states the guardian must notify the Regional office of the agency authorizing services prior to a court date to authorize guardianship fees. The guardians should be notifying the Regional Office of the agency authorizing services directly of the court notification. This would be either the HCS or DDD Regional Designee. For Mental Health, this would be the RSN. The department is entitled to be notified by the guardian/attorney of the court proceedings as described in RCW 11.92.150. If the department decides to contest the proposed fees and costs, it is the responsibility of the HCS, DDD Regional designee to start that process. For clients receiving services with HCS, each HCS regional office has a designee who is notified by the guardian. The HCS regional designee will notify of the HCS financial worker of the court order. For HCS Waiver clients in an ALF, approved guardianship fees must be deducted from personal care participation first. An ETR must be submitted to the Regional designee for approval before a deduction from room and board is allowed. Guardianship fees are coded on the LTCX screen, any approved ETR from room and board is coded as an ETR on the LTCX screen. For CN Waiver programs, see WAC 182-515-1509 for HCS (COPES)Waiver, WAC 182-515-1514 for DDD Waivers. Guardianship fees are not an allowable deduction in post eligibility for HCS MN Waivers (MNRW and MNIW). For MNRW cases, use the HCS ETR process to the HCS Regional designee for possible room and board deduction. The financial worker allows guardianship fees and administrative fees as a deduction in determining participation for waivers and institutional medicaid once there is an approved court order as described in WAC 182-513-1380 (4) and WAC 388-79. If the court order indicates in excess of the amount allowed by WAC 388-79, contact the Regional Designee indicated indicated below. Find local HCS offices by county For clients receiving services through HCS the court notices and documents regarding guardianships must go to the following HCS Regional Designee. DSHS has 3 Regions. Click on the Map to determine what region your county is in. HCS Regional Designee Contacts: Region 1 North -Stevens, Pend Oreille, Grant, Adams, Lincoln, Okanogan, Ferry, Douglas, Whitman, Spokane. Spokane HCS Attn: Terry Brauner FAX (509) 329-3642 Region 1 South- Klickitat, Yakima, Walla Walla, Franklin, Benton, Garfield, Columbia, Asotin, Kittitas. Yakima Office Attn: Annie Vasquez (509) 575-2286 Region 2 South-King County Attn: Jerald Ulrich for Greg Heartburg Fax (206) 341-7607 Region 2 North-Snohomish, Whatcom, Skagit, Island Attn: Wendy Healey for Greg Heartburg, FAX (425)339-4859 Everett HCS Region 3 HCS Pierce, Kitsap, Clallam, Jefferson, Mason, Thurston, Lewis, Pacific, Grays Harbor, Cowlitz, Clark Counties Attn: Ian Horlor FAX (253) 476-7158 Tacoma HCS For clients receiving services through DDD the financial worker needs to fax or mail the guardianship court notices and documents to the following DDD Regional Designee: DSHS has 3 Regions. Click on the Map to determine what region your county is in. DDD Regional and Facility Contacts Region 1 North DDD: Attn: Kim Abe-Gunter Fax 509-568-3037 611 West Indiana Ave Spokane WA 99205-4221 Region 1 South DDD: Attn: Tory Fiedler Fax 509-574-5607 PO Box 12500 Yakima WA 98909-2500 Region 2 DDD: Attn: Martha Gluck Fax 206-720-3334 1700 East Cherry St Seattle WA 98122 Region 3 DDD (and Frances Haddon Morgan Center RHC) Attn: Anna Facio 6860 Capitol Blvd SE Point Plaza East Olympia WA 98504 Fax: 360-586-6502 360-725-4307 DDD Facilities Guardianship paperwork is sent or faxed to: Lakeland Village RHC Attn: Laura Ryan Fax 509-299-1070 PO Box 200 Medical Lake WA 99022-0220 Yakima Valley School Attn: Martin Brown Fax 509-698-1323 509-698-1322 609 Speyers Rd Selah WA 98942 Fircrest School Attn: Lura Dunn Fax 206-361-3035 15230 15th NE Shoreline WA 98155-7196 Rainier School Attn: Alan McLaughlin PO Box 600 Buckley WA 98321-0600 Guardianship notices for Eastern and Western State Hospital residents: Indicate attention Guardianship-Administrator Eastern State Hospital: PO Box 800 Western State Hospital Western State Hospital: Public Information Officer | |
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Guardianships and ACES Guardianships in a Medical Institution 7//2008 an ACES fix was promoted to match the policy per WAC 182-513-1380 (4) regarding the guardian deduction. The combination of PNA, mandatory taxes, wages from approved employment and guardianship/attorney fees cannot exceed the MNIL in a month. The correct order of deductions that cannot exceed the MNIL are:
Note: 65 and 1/2 deduction is not allowed for earnings in a Medical institution, however a wage deduction is allowed dollar for dollar up to the MNIL after allowing the PNA and mandatory tax deduction. Approved wages need to be coded as RH. | |
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Modification Date: April 30, 2013