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STATE OF WASHINGTON

DEPARTMENT OF SOCIAL AND HEALTH SERVICES

AGING AND DISABILITY SERVICES ADMINISTRATION

PO Box 45600 ( Olympia, WA 98504-5600

H09-018 - Information

May 18, 2009

|TO: |Home and Community Services (HCS) Division Regional Administrators |

| |Area Agency on Aging (AAA) Directors |

|FROM: |Bill Moss, Director, Home and Community Services Division |

|SUBJECT: |Adding Clients in the Healthcare for Workers with Disabilities (HWD) Program to HCS Home and Community-based |

| |Services (HCBS) Waivers |

|Purpose: |To notify HCS and AAA staff that those clients who are enrolled in the HWD Medicaid program may now be |

| |eligible for the COPES waiver |

|Background: |The Ticket to Work Incentives Improvement Act (TWIIA) of 1999 (Public Law 106-170) was passed by Congress to |

| |support the competitive employment of people with disabilities who want to work. As a result of that |

| |legislation, Washington State has implemented two Medicaid coverage programs to enable individuals with |

| |disabilities who work to obtain Medicaid coverage via a premium buy-in. The two coverage groups are the Basic|

| |Coverage Group and the Medical Improvement (MI) Group. Individuals are first enrolled in a basic group and |

| |then continue in the MI group. |

|What’s new, changed, or |Prior to 4/1/2009 HCS clients on HWD could receive services only through Medicaid Personal Care (MPC). |

|Clarified |Effective 4/1/2009, CMS approved HWD as an eligibility group for the COPES waiver so these clients can be |

| |served under either MPC or the COPES waiver. |

| | |

| |In order to qualify for the HWD program, individuals must: |

| |Be a resident of Washington State; |

| |Be age 16 through 64; |

| |Have net income under 220% of the federal poverty level (see the website link below for computation of net |

| |income); |

| |Meet federal disability requirements; and |

| |Be employed full or part-time (including self-employment). |

| | |

| |To receive a Medicaid card, the client must pay a monthly premium, the amount of which varies based on |

| |income. |

| | |

| |Clients eligible for HWD can have gross income over Medicaid special income level (SIL) of $2,022 and still |

| |be eligible for the COPES waiver. |

| | |

| |Clients eligible for HWD do not participate toward personal care but will pay their HWD premium. Clients |

| |living in an Adult Family Home or Boarding Home will continue to pay the ADSA room and board standard which |

| |is currently $611.21. |

| | |

| |The service authorized by HCS (MPC or COPES) will be indicated on the S08 HWD medical coverage group in ACES |

| |on the INST screen. HWD clients on COPES will not be on the C01 medical coverage group. |

|ACTION: |As a reminder: |

| |Each HCS region has an HWD specialist assigned to determine financial eligibility for the program. Working |

| |clients should be referred to the HWD specialist to determine if HWD is beneficial for the client. |

| |All potential HWD clients must be informed of the importance of paying the HWD premium monthly. If a person |

| |does not pay four consecutive monthly premiums, the person is not eligible for HWD coverage for the next four|

| |months and must pay all premium amounts owed before HWD coverage can be approved again. |

| |Financial workers must notify the social worker/case manager of HWD eligibility. |

|Related |WAC 388-515-1507 has been filed as an emergency WAC to include HWD as an eligibility group. |

|REFERENCES: | |

| |WAC 388-475-1000 through 388-475-1250 Healthcare for Workers with Disabilities (HWD) |

| | |

| |EAZ Manual Working Clients on Long-term Care Programs |

| | |

|ATTACHMENT(S): |HWD Handout HWD Handout for Financial Workers: |

| |For Social Workers: |

| |[pic] [pic] |

|CONTACT(S): |Marilee Fosbre Lori Rolley |

| |COPES Waiver Manager Financial Policy Analyst |

| |(360) 725-2536 (360) 725-2271 |

| |FosbrMA@dshs. rollelj@dshs. |

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HCS MANAGEMENT BULLETIN

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