Equal Access - Necessary Supplemental Accommodation (NSA) and long-term services and supports

Revised date
Purpose statement

To explain Aging and Long Term support administration (ALTSA) policies related to NSA and long-term care.

Necessary Supplemental Accommodation (NSA) is also known as equal access (EA)

NSA-Equal Access and clients receiving long term services and supports (LTSS)

Apple Health Equal access services Aging and Long-Term support administration (ALTSA) has additional policies for individuals receiving ALTSA services.

Refer to chapter 3 of the long-term care manual used by ALTSA/HCS social services for the responsibilities of the HCS SW or AAA case manager. All ALTSA LTSS clients are treated as if they are NSA and their special needs are documented in the CARE assessment tool.

Individuals who have a mental, neurological, physical, or sensory impairment or other problems that prevent them from getting program benefits in the same way as those who are not impaired are considered in need of necessary supplemental accommodation/Equal Access. (WAC 182-503-0120)

Developmental Disabilities Administration (DDA) follows Policy 5.02 Necessary Supplemental Accommodation in the DDA policy manual.

ALTSA/HCS Financial Worker Responsibilities

  • Currently ALTSA individuals are presumed to be designated NSA (Necessary Supplemental Accommodation now known as Equal Access (EA)). EA accommodation plans are documented in ALTSA case files Comprehensive Assessment Reporting and Evaluation (CARE). NSA screens do not need to be completed in the ACES system as long as the plan is documented in CARE.
  • If requested information needed to complete an application is not received, refer to the assigned social worker or case manager using the 07-104 for assistance in getting the needed information into the office.  Check for a response after 10 days and make sure to contact the social worker or case manager regarding the status prior to denying the application.
  • If an eligibility review or request for information to establish eligibility is overdue and information has been sent to the client with no response, refer to the individual social worker or case manager using the 07-104 for assistance in getting the needed information into the office. Do not terminate LTC with an overdue review prior to NSA steps taken.
  • Complete a 07-104 referral to the client social worker or case manager requesting assistance in providing necessary information. Clearly indicate on the referral what is needed for continued eligibility and what is needed to assist the individual in providing that information.
  • Make sure all attempts to assist the ALTSA client is documented including phone calls to the client, referrals or discussions with the social worker or case manager.

It is the policy of ALSTA to ensure all clients receiving LTC services are given the required NSA/EA to services. See Renewals for complete instructions on processing late reviews.