State Funded ALTSA services
DSHS Home Page
Search     for:

DSHS Home    Acronyms    Revisions    WAC Number Index    Site Map    WCCC

State Funded ALTSA services

Revised September 9, 2014

State funded residential or nursing home services under A01 or A05

HCS has a small state funded residential program that does not require CN eligibility.   It is under the MCS medical program and state-funded payments to the provider.  The functional requirements are the same as MPC. 

A01 and A05 MCS is also used for state funded nursing facility services. 

As of 1/1/2014, all individuals that are eligible for federal medicaid because of meeting citizenship requirements have been moved to the Modified Adjusted Gross Income (MAGI) expanded adult group. (N05).  These cases are maintained by the Health Benefit Exchange (HBE).

Social Service Long term care manual:

Aged/Blind/Disabled cash and HEN/MCS program EAZ manual: 

Who is eligible for the A01/A05 coverage?

  • Lawfully present clients, not subject to the 5-year bar, who permanently reside in the U.S. under color of law (PROCUL) (NQ)
  • Undocumented clients are not eligible for A01/A05.
  • Must be eligible for ABD cash or the HEN referral program.
  • Only one applicant/recipient per AU.
  • Scope of care is Medical Care Services which is state funded.
  • Used by HCS for the state-funded residential program and state-funded nursing faciliy program.
  • A01 is Aged/Blind/Disabled.
  • A05 is incapacitated under age 65.

How do I approve the A01/A05 program?

  • The client must apply for cash assistance using the DSHS 14-001 to be able to look at ABD cash/HEN eligibility.
  • Screening:  'A' track AUS will not auto populate in screening. However the medical coverage group will be allowed as a selection in the dropdown list.
    • Default will be MA/D/A01 and will switch to the correct coverage type when finalizing the AU.
  • Step 1: Determine if client is an eligible non-citizen who needs LTC residential or nursing home services.
  • Step 2: Did the client apply for cash assistance using the DSHS 14-001?
  • Step 3: Is client functionally eligible for LTC services?
  • Step 4: If "yes" at steps 1, 2 and 3, screen in a HEN AU and an A01 AU.  Client's who are functional eligible for LTC services meet the incapacity criteria for HEN.
  • Step 5: Process the HEN AU first and then finalize the A01/A05 AU.
  • Step 6: Determine durational requirement for ABD/HEN program for clients under age 65, not blind/disabled:
    • Regions 1 and 3:  Using barcode, complete a 14-084 referral to the CSO incapacity worker.  Indicate on the 14-084:  "Per approved ETR to WAC 388-400-0070, HCS has approved an HEN/MCS case.  Client meets LTC functional requirements, disability determination needed". 
    • Region 2: Complete a referral to the Holgate HCS social worker for a disability determination. 

NOTE:  CSD approved an ETR process to allow HCS clients to be opened on HEN/MCS prior to going through the ABD cash disability determination process. 

  • Step 7: For residential settings, notify the HCS social worker that client has been opened on HEN/MCS medical coverage.  (If in an adult family home indicate any authorized cash amount so they can issue a notice to the client regarding the room and board calculation).
  • Step 8: For nursing facility settings, create a nursing facility award letter. 
  • Step 9: Set a reminder to check on the disability/duration with the incapacity worker if applicable. 

State-funded Long Term Care Program for Non-Citizens (45 slot program)

TheState-funded LTC program  for non citizens is a program for those that are   not eligible under ABD/HEN stated funded Medical Care Services (MCS).  

This program is limited to 45 slots and requires a pre-approved by ALTSA HQ.   The state-funded LTC program can be used in a nursing facility, residential or home setting.

Karyn LaBonte 360-725-2450 ALTSA is the contact for pre-approval of this program. 

ACES instructions for ABD cash and MCS

ABD cash

MCS Medical

Modification Date: September 9, 2014