STATE OF WASHINGTON
center31912900STATE OF WASHINGTONDEPARTMENT OF SOCIAL AND HEALTH SERVICESAging and Long-Term Support AdministrationHome and Community Services Divisioncenter1769800HCS MANAGEMENT BULLETIN00HCS MANAGEMENT BULLETINPO Box 45600, Olympia, WA 98504-5600H20-103 – InformationDecember 15, 2020TO: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 Division374332595250Shannon Manion, Director of the Division of Field Services, Developmental Disabilities AdministrationSUBJECT:January 2021 Changes with COLAPURPOSE:To notify staff of their responsibilities regarding client payments for services starting January 1, 2021.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 in ProviderOne. Clients receive correspondence from ProviderOne that reflects their social service authorizations and details related to applied client responsibility.WHAT’S NEW, CHANGED, OR CLARIFIED:Effective January 1, 2021, the following benefits will increase:Social Security Benefits by 1.3%Railroad Retirement (RR) and Veteran’s (VA) Benefits by 1.3%Some pensions, such as federal civil service pensions by 1.3%Effective January 1, 2021, 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, 2021: ACES will:Auto update SSA and SSI income amounts for most clients. Recalculate client responsibility for January 2021 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. ACES will not:Generate a letter for any clients receiving MAGI-based coverage who receive MPC or CFC in a residential setting.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 in ACES. Clients with cases requiring manual updates will receive a postcard reminder (see attached memo) in early January advising them to report their new income amounts.The personal needs allowance (PNA) for clients living in medical institutions and residential settings increases from $70.00 to $71.12 per month. The new room and board amount for all HCS and DDA residential settings is $722.88. This amount is determined by using the following formula of the Federal Benefit Rate: $794 - $71.12 PNA = $722.88. Current residential authorizations with R&B rate of $713 are automatically updated to $722.88 by ProviderOne by January 1, 2021 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) in residential settingsDDA 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) in residential settingsDDA 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.Action Required by Public Benefit 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: Adhoc reports in Barcode can be printed for the Veteran's and Railroad Retirement pensions. A Barcode tickle has been sent for SSA/SSI clients not auto updated by ACES (COL3).Update Food Stamp Medical Expense 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 for a monthly maintenance needs allowance (MMNA), update the spouses unearned income type of AN (MMNA ETR Amount) as well.RELATED REFERENCES:ATTACHMENT(S):January 2021 Medical Income and Resources Standards Chart:Manual Updates Memo: Medical Coverage Group Chart:\sJanuary 2021 Client Responsibility CalculatorCONTACT(S):Jennifer Ferguson, Office Chief, LTC Financial Eligibility & Policy (360) 725-3406 jennifer.ferguson@dshs. Marcell Birdsall, Unit Manager, DDA LTC and Specialty Program Teams(360) 407-1576marcell.birdsall@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, DDA Eligibility and Payment Systems Unit Manager(360) 407-1547Lonnie.Keesee@dshs. ................
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