What if the applicant for LTSS is already on Washington Apple Health?

A new application isn't required for clients active on ABD SSI-related Apple Health who need LTSS as long as the Public Benefit Specialist (PBS) is able to determine institutional eligibility using information in the current case record. Examples are the SSI or SSI-related programs or Apple Health for Workers with Disabilities (HWD). Use the original eligibility review date to open institutional coverage. Center for Medicare and Medicaid Services (CMS) requires an annual review at least once a year for categorically needy (CN) Medicaid.

Review excess home equity, annuity and transfer of resource provisions that are specific to institutional and home and community-based (HCB) waivers.

SSI recipients who need institutional services, or HCB waiver, must complete and sign an application, or the DSHS 14-416 - Eligibility Review for Long Term Services and Supports and complete an interview. Don't hold up eligibility for long-term care awaiting a signed review. If an application, eligibility review, or LTSS review is in the electronic case record within the past year, a new review form isn't needed.

Ensure an Asset Verification System (AVS) Authorization is on file, and if not, follow these procedures.