182-513-1645  <<  182-513-1650 >>   182-513-1655

WAC 182-513-1650

Tailored supports for older adults (TSOA)Changes of circumstances requirements.

(1) Changes in tailored supports for older adults (TSOA) household and family circumstances described in subsection (2) of this section must be reported to the medicaid agency or the agency's designee within thirty days of the date of the change.
(2) The following changes must be reported:
(a) A change in residential or mailing address, including if the TSOA recipient moves out-of-state;
(b) When the TSOA recipient admits to an institution, as defined in WAC 182-500-0050, and is likely to reside there for thirty days or longer; or
(c) When the TSOA recipient dies.
(3) Effective date of changes.
(a) When TSOA terminates because the recipient dies, the effective date is the date of death.
(b) When TSOA terminates because of one of the following reasons, the effective date is the first day of the month following the advance notice period described in subsection (4) of this section. The TSOA recipient:
(i) Is admitted to an institution as defined in WAC 182-503-0050, and is expected to reside there for thirty days or longer;
(ii) Is approved for coverage under a home and community-based waiver program;
(iii) No longer meets nursing facility level of care under WAC 388-106-0355; or
(iv) Becomes eligible for categorically needy (CN) or alternative benefits plan (ABP) apple health coverage. The recipient may continue to receive authorized services through the medical alternative care (MAC) program under WAC 182-513-1600. The person may also apply for other long-term services and supports available under chapters 182-513 and 182-515 WAC.
(4) The advance notice period:
(a) Begins on the day the letter about the change is mailed; and
(b) Is determined according to the rules in WAC 182-518-0025.
(5) When a law or regulation requires a change in TSOA, the date specified by the law or regulation is the effective date of the change.
[Statutory Authority: RCW 41.05.021, 41.05.160, 2016 1st sp.s. c 36 § 213 (1)(e), section 1115 of the Social Security Act, and 42 C.F.R. §§ 431.400 through 431.428. WSR 17-12-019, § 182-513-1650, filed 5/30/17, effective 7/1/17.]
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