STATE OF WASHINGTON



center31912900STATE OF WASHINGTONDEPARTMENT OF SOCIAL AND HEALTH SERVICESAging and Long-Term Support AdministrationHome and Community Services Divisioncenter1941195HCS MANAGEMENT BULLETIN00HCS MANAGEMENT BULLETINPO Box 45600, Olympia, WA 98504-5600H18-074 – InformationDecember 13, 2018Amended – December 20, 2018TO:Home and Community Services (HCS) Division Regional AdministratorsDevelopmental Disabilities Administration (DDA) Regional AdministratorsArea Agency on Aging (AAA) DirectorsFROM:Bea Rector, Director, Home and Community Services DivisionDebbie Roberts, Acting Deputy Assistant Secretary, Developmental Disabilities AdministrationSUBJECT:January 2019 Changes with COLAPURPOSE:To notify staff of their responsibilities regarding client payments for services starting January 1, 2019.BACKGROUND:Many clients are required to pay toward the cost of their care before the Department pays for services. The Department determines this amount for all long-term care services.HCS and DDA residential clients, other than Adult Protective Services (APS) residential clients, pay toward their cost of room and board. HCS staff see Chapter 8, Residential Services, in the Long-Term Care Manual for details on room and board. DDA staff see DDA Policy 6.06 Client Responsibility for details on room and board. The client’s total contribution for room and board and the cost of their personal care services is indicated on the provider’s authorization correspondence from ProviderOne. Clients receive a copy of this correspondence.WHAT’S NEW, CHANGED, OR CLARIFIED:Effective January 1, 2019, the following benefits will increase:Social Security Benefits by 2.8%Railroad Retirement (RR) and Veteran’s (VA) Benefits by 2.8%Some pensions, such as federal civil service pensions by 2.8%Effective January 1, 2019, the following standards will increase:Special Income Level (SIL)Categorically Needy Income Level (CNIL)Medically Needy Income Level (MNIL)Federal Benefit Rate (FBR)Maintenance allowance for in-home waiver recipient with community spouseResidential room and board standardCommunity spouse maintenance allocationFederal spousal resource transfer maximumHome Equity LimitMedical Institution Personal Needs Allowance (PNA)HCS and DDA Waiver Residential PNAEffective January 1, 2019, ACES will:Auto update SSA and SSI income amounts for most clients. Recalculate client responsibility for January 2019 and generate COLA letters and translations, if necessary, for HCS and DDA waivers, PACE, SSI-related residential MPC, CFC, and Roads to Community Living clients. Not generate a letter for any clients receiving MAGI-based coverage who receive MPC or CFC in a residential setting.Not generate a letter for any clients active on Medical Care Services (A01/A05) coverage group in a residential setting. VA and RR benefits must be manually updated. Clients with cases requiring manual updates will receive a letter from financial (see attached memo) in early January advising them to report their new income amounts.The new room and board amount for all HCS and DDA residential settings is $701. This amount is determined by using the following formula of the Federal Benefit Rate: $771 - $70 = $701. Current residential authorizations with R&B rate of $685.95 are automatically updated to $701 by ProviderOne by January 1, 2019 for clients in the following programs:SSI-related residential MPCCFCHCS and DDA waiversPACERoads to Community LivingService authorizations must be entered before the month of service begins for Client Responsibility to calculate correctly and send the correct letters timely to clients and providers.ACTION:Action Required by Case Managers:Calculate and update client responsibility using the calculator attached below on the financial screen in CARE for clients on the following programs:HCS Waivers/MPC/CFC Fast TrackDDA and HCS MAGI-based coverage groups (N-track)DDA and HCS Non-citizens on the ABD Cash/HEN programs (A01/A05)– AFHDDA and HCS State-funded LTC Program for Non-Citizens if receiving MAGI coverage (N21 and N25 coverage groups)DDA State Funded Group HomesSend the Client Responsibility Notice (DSHS 18-720 for HCS or DSHS 18-692 for DDA) to these clients informing them of the amount they have to pay for room and board. If the client is active on basic food or cash, the social service specialist must verify the income by looking at the income verified in ACES. If the client is only active on a MAGI-based program, the case manager may use the client’s self-attested income found in ACES online on the client level screen under Health Plan Finder Income.HCS - Do not increase client responsibility while a bed hold is in place. Include client responsibility information in your bed hold request. Bed hold staff will check ACES to verify correct client responsibility before reopening services. Action Required by Financial Service Specialists: Manually update cases for clients:Who have Veteran’s, Railroad Retirement, or SSA/SSI benefits that were not auto updated by ACES With a community spouse with income that needs to be updated Note: These lists can be printed from the Reports tab in ACES Online and adhoc reports in Barcode.Update Food Stamp Medical Expense (FSME) for at-home HCS or DDA waiver clients who pay client responsibility in excess of $35.00 and receive Basic Food.Update room and board (R&B) exception to rule (ETR) amounts based on the change in residential PNA. If the ETR is for a monthly maintenance needs allowance (MMNA), update the spouses unearned income type of AN (MMNA ETR Amount) as well.Residential HWD clients will not receive an auto-generated letter for the change in room and board. The LTC Specialty Unit HWD FSS's and HCS HWD specialists are required to generate an award letter manually. RELATED REFERENCES:ATTACHMENT(S):January 2018 Medical Income and Resources Standards Chart:\sReports for Manual Updates Memo: Medical Coverage Group Chart:\sJanuary 2019 Client Responsibility CalculatorCONTACT(S):Catherine Kinnaman, Office Chief, LTC Financial Eligibility & Policy (360) 725-2318 catherine.kinnaman@dshs. Graham Zuch, HCS ACES Program Manager(206) 341-7781 graham.zuch@dshs.Dustin Quinn Campbell, Payment Policy and Systems Unit Manager(360) 725-2535dustin.quinncampbell@dshs.Lonnie Keesee, Acting DDA Eligibility and Payment Systems Unit Manager(360) 407-1547Lonnie.Keesee@dshs. ................
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