To be eligible to receive covered services through community care hubs, a person must be enrolled in Washington apple health and:
(1) Meet one or more of the following social risk factors:
(a) Be homeless or at risk of homelessness, as defined by 24 C.F.R. § 91.5, except for the annual income requirement in 24 C.F.R. § 91.5 (1)(i);
(b) Meet the U.S. Department of Agriculture's (USDA) definition of low food security or very low food security;
(c) Be experiencing poverty or near poverty, as defined by income below 200 percent of the federal poverty level (FPL); or
(d) Screen positive for a health-related social need; and
(2) Have at least one of the following clinical risk factors:
(a) Complex behavioral health needs;
(b) Developmental disability needs;
(c) Assessed as having a complex physical health need;
(d) Experienced interpersonal violence;
(e) Repeated emergency department use and crisis encounters;
(f) Be pregnant or up to 12 months postpartum; or
(g) Be a child age six or younger who currently has at least one of the following conditions:
(i) Malnutrition, risk of developmental or growth delay, or impairment because of insufficient nutrition as a clinical risk factor for case management related to nutrition services only;
(ii) Child maltreatment, as defined by the Centers for Disease Control and Prevention. (See https://www.cdc.gov/violence-prevention/?CDC_AAref_Val=https://www.cdc.gov/violenceprevention/pdf/%2520CM_Surveillancea.pdf);
(iii) Is a child with a special health care need (CYSHCN) as defined by the Health Resources and Services Administration. (See https://mchb.hrsa.gov/programs-impact/focus-areas/children-youth-special-health-care-needs-cyshcn);
(iv) Low birth weight;
(v) A mental health condition; or
(vi) Health conditions, including behavioral health and developmental syndromes, stemming from trauma, child abuse, and neglect; or
(h) Be an adult age 65 or older who currently has at least one of the following:
(i) Two or more chronic conditions as defined in RCW 74.09.010;
(ii) Social isolation, which may place the person at risk for early death, neurocognitive disorders, sleep disruption, cardiovascular disease, or elder abuse;
(iii) Malnutrition as a clinical risk factor for case management related to nutrition services only;
(iv) Health conditions, including behavioral health and developmental syndromes, stemming from trauma, child abuse, and neglect; or
(v) Requires assistance with activities of daily living as defined in WAC 182-565-0110 or instrumental activities of daily living as defined in WAC 388-106-0010; or
(i) Be eligible under one of the following programs:
(i) Medicaid personal care (MPC) as described in WAC 388-106-0210;
(ii) Nursing facility care services as described in WAC 388-106-0355; or
(iii) Long-term care services as described in WAC 388-106-0045.