WAC 182-513-1620 Tailored Supports for Older Adults (TSOA) - Presumptive Eligibility

WAC 182-513-1620 Tailored Supports for Older Adults (TSOA) - Presumptive Eligibility (PE).

Effective May 29, 2021

1. A person may be determined presumptively eligible for tailored supports for older adults (TSOA) services upon completion of a prescreening interview.
2. The prescreening interview may be conducted by either:
   1. The area agency on aging (AAA); or
   2. By a home and community services intake case manager or social worker.
3. To receive services under presumptive eligibility (PE), the person must meet:
   1. Nursing facility level of care under WAC 388-106-0355;
   2. TSOA income limits under WAC 182-513-1635; and
   3. TSOA resource limits under WAC 182-513-1640.
4. The presumptive period begins on the date the determination is made and:
   1. Ends on the last day of the month following the month of the presumptive eligibility (PE) determination if a full TSOA application is not completed and submitted by that date; or
   2. Continues through the date the final TSOA eligibility determination is made if a full TSOA application is submitted before the last day of the month following the month of the PE determination.
5. If the person applies and is not determined financially eligible for TSOA, there is no overpayment or liability on the part of the applicant for services received during the PE period.
6. The medicaid agency or the agency's designee sends written notice as described in WAC 182-518-0010 when PE for TSOA is approved or denied.
7. A person may receive services under presumptive eligibility only once within a twenty-four-month period.
8. If the department of social and health services establishes a waitlist for TSOA services under WAC 388-106-1975, PE does not apply.