Clarifying information
Disability determination for Apple Health Non-Grant Medical Assistance (NGMA)
For information on procedures to obtain a determination of disability or blindness that enables adult not receiving federal cash benefits to be related to Medicaid, see the Non-Grant Medical Assistance (NGMA) overview and Non-Grant Medical Assistance (NGMA) examples.
If the applicant is working and their income (gross income after deductions for impairment related work expenses or blind work expenses) is over the SGA standard or their resources exceed other program standards, forward the application, using the contact information below:
Address for all DDA and HCS documents
Home and Community Services
PO BOX 45826
Olympia, WA 98504-5826
FAX: 1-855-635-8305
Region 3 HCS financial cases are under office 095 and split by alphabetical caseload.
DDA HWD specialists (maintains HWD cases on DDA services and those not on HCS services)
800-871-9275
DDA LTC Pool: @HWD 17
Office #17
- Brandy Sanchez ACES ID: BJSA
- Jill Hamilton ACES ID: JIHA
- Amy MacCalla, backup ACES ID AMSC
- Jeannie Valdez, DDA HWD PBS Supervisor
- Mark Smith, FHC ACES ID MSMI
- Danielle Lopez, SHPC DDA
HCS HWD specialists (maintains HWD on HCS services and spouses of clients on HCS services)
Region 1 HCS - Eastern Washington Pend Oreille, Grant, Adams, Lincoln, Okanogan, Ferry, Douglas, Whitman, Spokane, Klickitat, Yakima, Walla Walla, Franklin, Benton, Garfield, Columbia, Asotin, Kittitas, Stevens counties
Spokane HCS Office #57
800-459-0421
TTY 509-568-3697
- Sean Cummings 509-601-2236, Spokane HCS ACE ID CUSE
- Michelle Bakken 509-568-3788, Supervisor Spokane HCS
- Alexandra (Alex) Stevens 509-564-9194, backup Ellensburg HCS ACES ID AXSV
- Mary Aspen 509-306-5053 Supervisor
Region 2 North HCS - North King County, Snohomish, Whatcom, Skagit, Island and San Juan counties.
All Region 2 North cases are under Office #92 Everett
Region 2 North includes the following North King County zip codes: 98004, 98007, 98008, 98011, 98028, 98033, 98034, 98052, 98072, 98077, 98117, 98125, 98133, 98155, 98177, 98224. All other King County cases are done by 056 Holgate HCS.
Toll Free # 800-780-7094 TTY 425-339-1884
- Jill Russell, 425-405-2316 ACES ID SLJI Bellingham HCS
- Sherry Dennis, Supervisor 425-977-9049 Everett HCS
- Emily Hill, 206-341-7643 ACES ID HJCO backup Holgate HCS
Region 2 South HCS - King County except the following zip codes: 98004, 98007, 98008, 98011, 98028, 98033, 98034, 98052, 98072, 98077, 98117, 98125, 98133, 98155, 98177, 98224 are handled by Region 2 North/Everett #92
Holgate HCS Office #56 - 206-341-7604 or 1-800-346-9257 TTY: 1-800-833-6384
- Emily Hill 206-341-7643 ACES ID HJCO
- Jill Russell 425-504-2316 ACES ID SLJI Bellingham HCS, backup
Region 3 HCS Office #95 - Pierce, Kitsap, Clallam, Jefferson, Thurston, Mason, Lewis, Cowlitz, Clark, Pacific, Grays Harbor, Skamania, Wahkiakum
253-476-7200 or 800-442-5129 TTY: 253-593-5471
Or 360-501-2540 or 1-800-605-7322
TTY: 711 for TTY-based Telecommunications Relay Service | Federal Communications Commission (fcc.gov)
- Angela Eaton 253-476-7268, Tacoma HCS ACES ID EAAN, Alpha A-K
- Ariel Reichel 253-381-4734, Supervisor
- Roxanne LaRoy 564-200-2612, Centralia HCS, ACES ID LROX, Alpha L-Z
- Nanette Sanders 253-281-1932, Supervisor
- Patrick Dettling 360-764-6643, Centralia HCS HWD backup, ACES ID DTPA
Disability determination for the HWD Medical Improvement Group
To continue eligibility for HWD as a member of the Medical Improvement Group (MIG), an individual must have been eligible and approved for the program as a member of the Basic Coverage Group (BCG). The HWD program manager determines whether an individual meets HWD MIG requirements and consults with DDS staff when appropriate.
Having the MIG option or coverage group ensures that an individual who continues to have a significant impairment may continue to receive health care services that support their employment.
Worker responsibilities
HWD designated staff responsibilities
For an individual receiving HWD benefits who appears to no longer meet the disability requirements for the BCG, follow procedures below.
Example: #1 - An HWD individual receives a letter from SSA that states he/she no longer meets the disability requirement to receive SSDI cash after completing his/her Trial Work Period (TWP) and has earnings at or above the substantial gainful activity (SGA) level for one subsequent month.
He/she will be eligible for and receive the SSDI benefit for that one month and the following two months. However, during any month in which earnings fall below the SGA level, the individual remains eligible for his/her SSDI cash benefit during the Extended Period of Eligibility (EPE). The EPE begins the month after the TWP ends. The individual should contact the Social Security Administration (SSA) to confirm when their TWP ended once their SSA cash benefit ends because of earning at or above the SGA level. To receive SSDI for a month in which earnings fall below SGA, the client must call SSA and document for them the amount of earnings; no application is necessary.
When an individual receives this letter from SSA, it might appear he/she does not continue to meet disability requirements for coverage under the HWD Basic Coverage Group (BCG). This is not true, since the client remains eligible for coverage under the BCG during the EPE. Staff need to recalculate the monthly premium amount and send proper notification. Staff should email the HWD program manager in Olympia, if they have questions about the client's coverage during the EPE.
For more information about this SSDI work incentives, see the SSA Red Book Extended Period of Eligibility.
Example: #2: An individual completes the EPE and remains enrolled in HWD. If medical improvement has occurred, the client's coverage continues until the completion of a disability determination for the Medically Improved Group (MIG) is completed. Email the HWD program manager to request a determination of eligibility under MIG and continue coverage until one is completed. .
To approve HWD coverage for a member of the MIG, use the new "Disability Source" (CD) code to indicate the client has a medically improved disability as determined by the HWD program manager.
For an individual receiving HWD benefits that no longer meets the eligibility requirements for BCG or MIG, continue HWD coverage until you redetermine eligibility for other medical programs.