What is the process for in-home or residential waiver services?

This process applies to SSI-related programs only MAGI-based clients are not eligible for HCB waiver.

Department-designated social service staff:

Assess the client's functional eligibility for in home or residential care.

Provide the PBS staff with the following information: Service start date Type of service Residential facility name and address, including room number, if applicable.

Public Benefits Specialists:

Refer the client to social service intake for a CARE assessment if the client contacts the PBS first and document the date the client first requested in-home or residential care.

Give a projected client responsibility amount to the case worker using the LTSS referral 07-104. Clearly indicate this is a projection and the financial application is in process.

Determine the client's financial eligibility for LTSS Medicaid and/or noninstitutional medical assistance including a request for retro medical if needed.

Authorize in ACES for in-home or residential HCB waiver if the client is both functionally and financially eligible.

Issue the award letter to the applicant/recipient.

Backdating services

Services can't be backdated prior to the date of the authorization until the date that financial eligibility is established.

Clients switching from private pay to Medicaid are advised to apply for benefits 30 to 45 days before being resource eligible for the program. There is good information on the Washington LawHelp website that explains the timing of an LTSS application.