STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
AGING AND DISABILITY SERVICES ADMINISTRATION
PO Box 45600 Olympia, WA 98504-5600
HCS MANAGEMENT BULLETIN
H09-018 - Information
May 18, 2009
TO: Home and Community Services (HCS) Division Regional Administrators
Area Agency on Aging (AAA) Directors
FROM: Bill Moss, Director, Home and Community Services Division
SUBJECT: Adding Clients in the Healthcare for Workers with Disabilities (HWD)
Program to HCS Home and Community-based Services (HCBS)
PURPOSE: To notify HCS and AAA staff that those clients who are enrolled in the
HWD Medicaid program may now be eligible for the COPES waiver
BACKGROUND: The Ticket to Work Incentives Improvement Act (TWIIA) of 1999 (Public
Law 106-170) was passed by Congress to support the competitive
employment of people with disabilities who want to work. As a result of
that legislation, Washington State has implemented two Medicaid
coverage programs to enable individuals with disabilities who work to
obtain Medicaid coverage via a premium buy-in. The two coverage
groups are the Basic Coverage Group and the Medical Improvement (MI)
Group. Individuals are first enrolled in a basic group and then continue in
the MI group.
WHAT’S NEW, Prior to 4/1/2009 HCS clients on HWD could receive services only
CHANGED, OR through Medicaid Personal Care (MPC). Effective 4/1/2009, CMS
CLARIFIED approved HWD as an eligibility group for the COPES waiver so these
clients can be served under either MPC or the COPES waiver.
In order to qualify for the HWD program, individuals must:
Be a resident of Washington State;
Be age 16 through 64;
Have net income under 220% of the federal poverty level (see the
website link below for computation of net income);
Meet federal disability requirements; and
Be employed full or part-time (including self-employment).
To receive a Medicaid card, the client must pay a monthly premium, the
amount of which varies based on income.
Clients eligible for HWD can have gross income over Medicaid special
income level (SIL) of $2,022 and still be eligible for the COPES waiver.
Clients eligible for HWD do not participate toward personal care but will
pay their HWD premium. Clients living in an Adult Family Home or
Boarding Home will continue to pay the ADSA room and board standard
which is currently $611.21.
The service authorized by HCS (MPC or COPES) will be indicated on the
S08 HWD medical coverage group in ACES on the INST screen. HWD
clients on COPES will not be on the C01 medical coverage group.
ACTION: As a reminder:
Each HCS region has an HWD specialist assigned to determine
financial eligibility for the program. Working clients should be
referred to the HWD specialist to determine if HWD is beneficial
for the client.
All potential HWD clients must be informed of the importance of
paying the HWD premium monthly. If a person does not pay four
consecutive monthly premiums, the person is not eligible for HWD
coverage for the next four months and must pay all premium
amounts owed before HWD coverage can be approved again.
Financial workers must notify the social worker/case manager of
RELATED WAC 388-515-1507 has been filed as an emergency WAC to include
REFERENCES: HWD as an eligibility group.
WAC 388-475-1000 through 388-475-1250 Healthcare for Workers with
EAZ Manual Working Clients on Long-term Care Programs
ATTACHMENT(S): HWD Handout HWD Handout for Financial Workers:
For Social Workers:
HWD Handout for HWD Handout for
Social Workers.doc Financial Workers.doc
CONTACT(S): Marilee Fosbre Lori Rolley
COPES Waiver Manager Financial Policy Analyst
(360) 725-2536 (360) 725-2271