How New Freedom Works

Eligibility Determination

Home & Community Services (HCS) is the Medicaid agency that:

  • Approves someone’s application for long-term care services
  • Determines and explains all program options available including NF
  • When an applicant decides to enroll in NF, sends a referral for Care Consultation and Financial Management Services.

Case Coordination/Eligibility Assessment

In King County, Asian Counseling and Referral Services (ACRS) provides Case Coordination to all New Freedom (NF) Participants.   In Pierce County Eligibility Assessor services are combined with case coordination activities.  This Case Coordinator/Eligibility Assessor is responsible for the following tasks:

  • Determines ongoing eligibility on an annual basis
  • Conducts assessment to identify care needs
  • Coordinates with nursing staff to gain medical expertise for assessment purposes 
  • Sets up alternative services to those who disenroll from the program.

Care Consultation

When a Participant enrolls in New Freedom they will receive support of a Care Consultant at Sunrise Services.  The Care Consultant assists the Participant with the following tasks:

  • Provides education and coaching to the Participant on how Participant Directed Services works
  • Orients and coaches the Participant on managing their own budget
  • Assists the Participant to create a Spending Plan that includes strategies and services to meet needs identified in the assessment
  • Assist the Participant with identifying a personal care assistant if that is a service identified in the Spending Plan
  • Is available to the Participant on a regular basis to amend the Spending Plan as needed
  • Communicates with the Financial Management Services as needed

Financial Management Services

Once the Spending Plan has been completed the Care Consultant refers the Participant to the Financial Management Services (FMS) who will assist them to implement their Plan.  The FMS is responsible for the following tasks:

  • Provides information to the Participant about their budget, balances, etc.
  • Sets up an individual participant accounting record
  • Contracts with providers for all services
  • Authorizes individual provider services Washington’s Social Services Payment System
  • Pays for all participant services and goods
  • Provides quarterly budget report to Participant