Background
Many acute care hospital patients who are referred to the Department’s Home and Community Services (HCS) division are new to long-term care services and will require a functional and/or financial eligibility determination. Ensuring timely transitions to services is essential in reducing the number of days patients spend in acute care settings when they no longer meet medical necessity. Aging and Long-Term Support Administration must coordinate transitions with border acute hospitals and more than 50 acute care hospitals statewide. Successful transition planning involves strong collaboration and partnership with regional staff, hospitals, managed care organizations, providers, and communities, to provide appropriate services and community options that honor patient choice and reduce medical costs while increasing individual wellbeing, and quality of life.
Refer to Chapter 9a.docx (live.com) of the long-term care manual for details of HCS policies and procedures on acute care hospital assessments.
A smaller group of individuals referred to HCS for long-term care services deal with multi-faceted barriers such as extensive criminal history, complex behavior challenges, medical complexity, bariatric, lack of decision maker, and/or not meeting Medicaid financial eligibility making the transition more complicated and time intensive. To reduce some of the pressure on an already strained healthcare system, DSHS in partnership with acute care hospitals implemented a Guardianship pilot project which targeted a smaller number of individuals for assistance with identifying Certified Public Guardians/Conservators.
Given the successful outcomes of the pilot project, DSHS has transitioned the pilot project to a program. The program will be a state-funded program called the HCS Guardianship and Conservatorship Assistance Program (GCAP). GCAP becomes effective September 1, 2024. Information pertaining to GCAP may be found in Chapter 388-106-2100 WAC.
Acute Care Hospital Referral Resources
- HCS Referral Guide for Acute Hospitals
- DSHS Intake and Referral Intake Form 10.570
- Hospital Certification of Potentially Disabling Condition
- Expedited Acute Hospital Application Chart and Cover Letter (November 2023)
- HCS Escalation Contacts (Updated November 2023)
- State-funded long-term care for noncitizens | Washington State Health Care Authority
- 2023 LTSS PE Fact Sheet for Acute Care Hospitals
- LTSS Presumptive Eligibility Program
- Nurse Delegation Reference Sheet - Frequently Asked Questions
DisclaimerRegional contacts will be periodically updated as Guardianship Case Managers are identified. |
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Guardianship and Conservatorship Assistance Program (GCAP) Information and Forms
- Guardian Conservator Search Form (PDF)
- Due Diligence Checklist
- GCAP Referral Form
- GCAP Referral Process Overview
- GCAP Eligibility Criteria, Referral Process, and Program Details (WAC 388-106-2100)
- HCS Guardianship Pilot Project- 1 Year Summary
- Meet the GCAP Team
GCAP Contractor Resources
- ProviderOne User Manual
- GCAP Contractor Eligibility Information (WAC 388-106-2100)
- GCAP Quarterly Contractor Report
GCAP Regional Contacts
 Program ManagerSarah Tremblay |
Region 1 Melanie Thomason |
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| Region 2 Marissa Heeley |
Region 3 Susan Asp |
GCAP Contractor Contacts
| Program Manager Sarah Tremblay |
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| Region 1 Amy Depaolo |
Region 2 Angelique Johnson |
| Region 2 Kendra Kruse |
Region 3 Cathleen Hansen |
Training Resources
- Acute Care Hospital Staff Training: Guardianship pilot training and referrals—This training is designed to outline the purpose, eligibility criteria, and referral process for the Guardianship pilot. Also clarifies roles for both acute care hospital staff and HCS staff in coordinating transitions to Long-term care services.
- Audio recording of the Acute Care Hospital Staff Training: Guardianship pilot training & referrals (YouTube video)
- Q & A of the Acute Care Hospital Staff Training: Guardianship pilot training & Referrals.
- Acute Care Hospital Staff 101 Training (YouTube Video): It clarifies roles for both hospital staff and HCS staff, assists hospital staff in establishing Medicaid eligibility and describes process for development of a plan of care.
- Consent, Capacity and Guardianship Frequently Asked Questions