Referrals for prior authorization to the Home and Community Services (HCS) residential program manager
If the client needs Long-Term Services and Supports (LTSS) at home, in a residential setting or in a nursing facility while processing the AMP request, a prior authorization request must be made to the HCS residential program manager.
For CSD or HCA staff who are processing an application which also includes a request for LTSS services, send an email referral to Emily Watts.
Indicate:
Name
Client ID
Where client is located
Type of LTSS service needed (in home, residential setting or nursing facility)
Dates of service needed
Region 1 HCS: Theresa Mayou Region 2 King County HS: Mathew Sipes Region 2 North HCS: Sherry Dennis, Tyler Ramsey Region 3 HCS: Tammy Hargrave, Laurie Alvarino
State-funded long-term care for noncitizens
Continue processing the AEM request for medical assistance pending the result of the HCS prior authorization request. If the HCA medical consultant:
Approves medical condition for AEM coverage, process the non institutional medical coverage using coverage group S07.
Denies medical condition. Deny the S07 and mark all documents complete.
The HCS program manager will coordinate the LTSS referral if a slot is approved for the state-funded program. There is no need to forward documents in DMS to HCS.