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Revised December 30, 2011 |
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Purpose: Long Term Care Eligibility. This section describes institutional medical programs, Home and Community based Waiver programs authorized by Division of Developmental Disabilities (DDD) 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. CSO staff are responsible for cases with LTC services through Hospice, DDD, Mental Health and family/children related programs. See LTC Overview for detailed information on responsibilities and program administration. |
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Long-term Care WAC Index and WAC crosswalk title 388 to 182 Transition of WAC titles from WAC 388 (DSHS) to WAC 182 (HCA) | |
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Overview Institutional Program and Coverage Groups | |
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Definitions | |
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Long Term Care Standards and Personal Needs Allowance Charts Long Term Care Medical Standards-Personal Needs Allowance (PNA) charts ACES Standards Chart (Cash, Food, Medical, Long Term Care, internal link)
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Eligibility long-term care (LTC) Institutional Medicaid Eligibility Requirements:
Resources:
Income and post eligibility:
Other Long-term care topics:
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HCB Waiver Services (Authorized by HCS or DDD) Roads to Community Living (RCL) and Hospice LTC Home & Community based services and hospice. (COPES, New Freedom, WMIP, PACE) (HCS CN Waiver) (L22, L21 SSI recipients)
DDD Waivers (DDD CN Waivers) (L22, L21 SSI recipients)
Medically needy in-home waiver (MNIW) (HCS MN In-home Waiver)
Medically Needy Residential Waiver Program (MNRW) (HCS MN Residential Waiver)
Hospice (L22)
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Medicaid Personal Care (MPC) Medicaid Personal Care (MPC) (non institutional Medicaid) | |
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Non-institutional SSI related clients living in an adult family home or boarding home (G03) Non-Institutional SSI related clients living in an adult family home or | |
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Medicare, Long-term care insurance and third party resources Online link to apply for Medicare: http://www.socialsecurity.gov/medicareonly/ Long-term care insurance and third party resources | |
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Medical Assistance Programs. Estate Recovery. Managed Care Medical Assistance programs in EAZ Estate Recovery (Including Estate Recovery handout used by ADSA and Legal Services Bulletin) Managed Care (Including information on WMIP project) Managed Care and Medical Care Services (MCS) formally Disability Lifeline-Unemployable (DL-U) (formally GA-U). note: Effective 11/1/2011 G01 will be state funded medical (MCS) only. This link will be instructions for managed care and MCS-State fund medical and nursing home admissions.
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Adult Protective Services (APS) Adult Abuse and Neglect Reporting-Adult Protective Services (APS) | |
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SSI related Medicaid links | |
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Necessary Supplemental Accommodation (NSA) and HCS Services | |
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Long Term Care ACES Links Long Term Care, Alternate Care, Managed Care & Waiver Services ACES manual material Citizenship and Identity verification for Medicaid | |
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Other Long-term care Procedures and links Aging & Disability Services Administration (ADSA) Internet site
HCS Financial LTC Training Modules (internal link) Questions and Answers on the COPES program from Washington LawHelp Questions and Answers on Medicaid for Nursing Home Residents from Washington LawHelp Medicaid supplementation in long-term care settings from Washington LawHelp The effect of marital separation on Medicaid eligibility from Washington LawHelp Washington Law Help bulletins (Aging/Elder Law) including Senior Bulletins Title 388 of Washington Administrative Code (WAC) Department of Social & Health Services (DSHS) Title 182 of Washington Administrative Code (WAC) Health Care Authority (HCA) (State Medicaid Agency) Rules and Policies Assistance Unit (RPAU). Title 388 WAC filings. Indicates filings and proposed rule changes for DSHS. LTC WACs are filed under Aging & Disability Service Administration (ADSA). ADSA is responsible for chapters 388-513 (institutional medicaid), 388-515 (institutional Waivers), 388-561 (Trust, Annuities and Life Estates). Health Care Authority (HCA) recent Medicaid rule filings. Title 182 WAC filings Health Care Authority Medicaid Forms Centers for Medicare & Medicaid Services (CMS) -Health & Human Services Centers for Medicare & Medicaid Services (CMS) Medicaid Manual Chapter 3-Eligibility link SSA's Program Operations Manual System (POMS) (Federal site for policy on SSI related programs ) Code of Federal Regulations (CFR) Railroad Retirement 1-877-772-5772 Statewide Health Insurance Benefits Advisors (SHIBA) Helpline (assistance with Medical insurance including Medicare D plans) Community Service Division (CSD) Statewide Call Center 1-877-501-2233
Washington State Medicaid Help Desk (toll-free number and e-mail link for customers and providers) Client needs a replacement Medical Service Card:
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Modification Date: December 30, 2011