H19-017 ICHS_PACE_New_Contractor_King_County_5.1.19



318706549974500STATE OF WASHINGTONDEPARTMENT OF SOCIAL AND HEALTH SERVICESAging and Long-Term Support AdministrationHome and Community Services DivisionPO Box 45600, Olympia, WA 98504-560018859501998345HCS MANAGEMENT BULLETIN00HCS MANAGEMENT BULLETINH18-017 – InformationApril 11, 2019Amended April 29, 2019TO:Area Agency on Aging (AAA) DirectorsHome and Community Services (HCS) Division Regional AdministratorsFROM:Bea Rector, Director, Home and Community Services DivisionSUBJECT:New Contractor: Program of All-Inclusive Care for the Elderly (PACE) Updates (Note: currently only available in King County)PURPOSE:To inform staff of the availability of a second contractor, International Community Health Services (ICHS), for the PACE program in King county.BACKGROUND:The PACE program is a center-based, all-inclusive medical, mental health, chemical dependency, and long-term care managed care model, previously only provided in Washington by Providence ElderPlace. The PACE program will now include a second contractor, ICHS. At the PACE centers, clients receive medical, dental, therapies, prescriptions, meals, activities, etc. The PACE provider contracts with a network of providers to meet participants needs including personal care providers, residential providers, behavioral and physical health providers, and provides ongoing case management services. Clients who are able to attend the PACE center are picked up by transportation coordinators who come into their home and assist them in getting to the center. The clients interdisciplinary care team (IDT) meets regularly to discuss client care, any issues, changes, or additional services needed. Eligible clients are age 55 or older, meet Nursing Facility Level of Care (NFLOC) and live in an eligible King County zip code. Clients qualify who are Medicaid-only, dually eligible for Medicaid and Medicare, Medicare-only and private pay. WHAT’S NEW, CHANGED, OR CLARIFIED:Effective May 1, 2019, ICHS will be an additional contracted PACE provider in the following zip codes:98004, 98005, 98006, 98007, 98008, 98009, 98015, 98033, 98034, 98039, 98040, 98052, 98055, 98056, 98057, 98083, 98101, 98102, 98103, 98104, 98105, 98106, 98107, 98108, 98109, 98112, 98115, 98116, 98117, 98118, 98119, 98121, 98122, 98124, 98125, 98126, 98134, 98144, 98145, 98146, 98154, 98164, 98168, 98178, 98181, 98185, 98191, 98195, 98199Form 17-218 has been updated to reflect the addition of a new contractor and better describe the PACE program.Form 14-443 has been updated to reflect the additional PACE contractor. ACTION:Staff are instructed as follows:ReferralsAt each face to face assessment, AAA and HCS staff within the King County area must:Bring a copy of DSHS Form 17-218, attached below, with them.\sExplain the form to eligible (NFLOC, age 55+) clients during their normal discussion about program options.Bring the form back to the office after the assessment and fill it out completely and legibly. Also, the “Yes” or “No” option of receiving additional information about PACE must be clearly marked. Note the addition of the Client’s Phone Number field.Send each form via DMS Hotmail (Staff will not see a DMS assignment for these forms).Headquarters staff will collect and track all referral information and send spreadsheets to the PACE provider, weekly, of clients who indicated they would like more information about the PACE program.Notification to HCS Financial When a client plans to enroll in PACE and a financial eligibility determination or a change to the financial program is needed, social services will select between PACE contractors in Barcode on the DSHS 14-443 Financial/Social Services Communication form. There is a new radio button for the new PACE provider; social services will now need to indicate either PACE – Providence or PACE – ICHS. Financial staff are instructed as follows:Review the DSHS 14-443 Financial/Social Services Communication form received from social services when a client plans to enroll in PACE. If a financial eligibility determination is needed, financial will communicate with the client and case manager the additional information that is needed. A change to financial program (L31 and L32) is necessary for SSI and SSI-related clients. Financial will select the correct PACE contractor in ACES based on the 14-443 received from social services (i.e.?PACE – Providence or PACE – ICHS).?RELATED REFERENCES:Providence ElderPlace (PACE) website: ATTACHMENT(S):Referrals:Referral Form DSHS # 17-218:\sCan also be found at: (S):Kathryn Pittelkau, PACE Program Manager(360) 725-2366kathryn.pittelkau@dshs.Kelli Emans, Integration Unit Manager(360) 725-3213emanskc@dshs. ................
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