Revised Code of Washington
Chapter 74.09 - Medical Care.
74.09.886 - Apple health and homes program—Establishment—Eligibility—Services.

RCW 74.09.886
Apple health and homes program—Establishment—Eligibility—Services.

(1) Subject to the availability of amounts appropriated for this specific purpose, the apple health and homes program is established to provide a permanent supportive housing benefit and a community support services benefit through a network of community support services providers for persons assessed with specific health needs and risk factors.
(a) The program shall operate through the collaboration of the department, the authority, the department of social and health services, local governments, the coordinating entity or entities, community support services providers, local housing providers, local health care entities, and community-based organizations in contact with potentially eligible individuals, to assure seamless integration of community support services, stable housing, and health care services.
(b) The entities operating the program shall coordinate resources, technical assistance, and capacity building efforts to help match eligible individuals with community support services, health care, including behavioral health care and long-term care services, and stable housing.
(2) To be eligible for community support services and permanent supportive housing under subsection (3) of this section, a person must:
(a) Be 18 years of age or older;
(b)(i) Be enrolled in a medical assistance program under this chapter and eligible for community support services;
(ii)(A) Have a countable income that is at or below 133 percent of the federal poverty level, adjusted for family size, and determined annually by the federal department of health and human services; and
(B) Not be eligible for categorically needy medical assistance, as defined in the social security Title XIX state plan; or
(iii) Be assessed as likely eligible for, but not yet enrolled in, a medical assistance program under this chapter due to the severity of behavioral health symptom acuity level which creates barriers to accessing and receiving conventional services;
(c) Have been assessed:
(i) By a licensed behavioral health agency to have a behavioral health need which is defined as meeting one or both of the following criteria:
(A) Having mental health needs, including a need for improvement, stabilization, or prevention of deterioration of functioning resulting from the presence of a mental illness; or
(B) Having substance use disorder needs indicating the need for outpatient substance use disorder treatment which may be determined by an assessment using the American society of addiction medicine criteria or a similar assessment tool approved by the authority;
(ii) By the department of social and health services as needing either assistance with at least three activities of daily living or hands-on assistance with at least one activity of daily living and have the preliminary determination confirmed by the department of social and health services through an in-person assessment conducted by the department of social and health services; or
(iii) To be a homeless person with a long-continuing or indefinite physical condition requiring improvement, stabilization, or prevention of deterioration of functioning, including the ability to live independently without support; and
(d) Have at least one of the following risk factors:
(i)(A) Be a homeless person at the time of the eligibility determination for the program and have been homeless for 12 months prior to the eligibility determination; or
(B) Have been a homeless person on at least four separate occasions in the three years prior to the eligibility determination for the program, as long as the combined occasions equal at least 12 months;
(ii) Have a history of frequent or lengthy institutional contact, including contact at institutional care facilities such as jails, substance use disorder or mental health treatment facilities, hospitals, or skilled nursing facilities; or
(iii) Have a history of frequent stays at adult residential care facilities or residential treatment facilities.
(3) Once a coordinating entity verifies that a person has met the eligibility criteria established in subsection (2) of this section, it must connect the eligible person with a community support services provider. The community support services provider must:
(a) Deliver pretenancy support services to determine the person's specific housing needs and assist the person in identifying permanent supportive housing options that are appropriate and safe for the person;
(b) Fully incorporate the eligible person's available community support services into the case management services provided by the community support services provider; and
(c) Deliver ongoing tenancy-sustaining services to support the person in maintaining successful tenancy.
(4) Housing options offered to eligible participants may vary, subject to the availability of housing and funding.
(5) The community support services benefit must be sustained or renewed in accordance with the eligibility standards in subsection (2) of this section, except that the standards related to homelessness shall be replaced with an assessment of the person's likelihood to become homeless in the event that the community support services benefit is terminated. The coordinating entity must adopt procedures to conduct community support services benefit renewals, according to authority standards.

[ 2022 c 216 § 3.]
NOTES:

Findings—Intent—Short title—2022 c 216: See notes following RCW 74.09.885.

Structure Revised Code of Washington

Revised Code of Washington

Title 74 - Public Assistance

Chapter 74.09 - Medical Care.

74.09.010 - Definitions.

74.09.015 - Nurse hotline, when funded.

74.09.035 - Medical care services—Eligibility, standards—Limits.

74.09.037 - Identification card—Social security number restriction.

74.09.050 - Director's powers and duties—Personnel—Medical screeners—Medical director.

74.09.053 - Annual reporting requirement (as amended by 2009 c 479).

74.09.055 - Copayment, deductible, coinsurance, other cost-sharing requirements authorized.

74.09.075 - Employability and disability evaluation—Medical condition—Medical reports—Medical consultations and assistance.

74.09.080 - Methods of performing administrative responsibilities.

74.09.120 - Purchases of services, care, supplies—Nursing homes—Veterans' homes—Institutions for persons with intellectual disabilities—Institutions for mental diseases.

74.09.150 - Personnel to be under existing merit system.

74.09.160 - Presentment of charges by contractors.

74.09.171 - Contracts for medicaid services—Border communities.

74.09.180 - Chapter does not apply if another party is liable—Exception—Subrogation—Lien—Reimbursement—Delegation of lien and subrogation rights.

74.09.185 - Third party has legal liability to make payments—State acquires rights—Lien—Equitable subrogation does not apply.

74.09.190 - Religious beliefs—Construction of chapter.

74.09.195 - Audits of health care providers by the authority—Requirements—Procedure.

74.09.200 - Audits and investigations—Legislative declaration—State authority.

74.09.210 - Fraudulent practices—Penalties.

74.09.215 - Medicaid fraud penalty account.

74.09.220 - Liability for receipt of excess payments.

74.09.230 - False statements, fraud—Penalties.

74.09.240 - Bribes, kickbacks, rebates—Self-referrals—Penalties.

74.09.250 - False statements regarding institutions, facilities—Penalties.

74.09.260 - Excessive charges, payments—Penalties.

74.09.270 - Failure to maintain trust funds in separate account—Penalties.

74.09.280 - False verification of written statements—Penalties.

74.09.290 - Audits and investigations of providers—Patient records—Penalties.

74.09.295 - Disclosure of involuntary commitment information.

74.09.300 - Department to report penalties to appropriate licensing agency or disciplinary board.

74.09.315 - Whistleblowers—Workplace reprisal or retaliatory action.

74.09.325 - Reimbursement of a health care service provided through telemedicine or store and forward technology—Audio-only telemedicine.

74.09.327 - Audio-only telemedicine—Fee-for-service reimbursement.

74.09.328 - Use of substitute providers—When permitted—Reimbursement requirements.

74.09.330 - Reimbursement methodology for ambulance services—Transport of a medical assistance enrollee to a mental health facility or chemical dependency program.

74.09.335 - Reimbursement of health care services provided by fire departments—Adoption of standards.

74.09.340 - Personal needs allowance, adjusted.

74.09.390 - Access to baby and child dentistry program—Coverage for eligible children—Authority's duties—Report to legislature.

74.09.395 - Access to baby and child dentistry program—Outreach and engagement—Stakeholder collaboration.

74.09.402 - Children's health care—Findings—Intent.

74.09.460 - Children's affordable health coverage—Findings—Intent.

74.09.470 - Children's affordable health coverage—Authority duties.

74.09.4701 - Apple health for kids—Unemployment compensation.

74.09.475 - Newborn delivery services to medical assistance clients—Policies and procedures—Reporting.

74.09.480 - Performance measures—Provider rate increases—Report.

74.09.490 - Children's mental health—Improving medication management and care coordination.

74.09.495 - Access to children's behavioral health services—Report to legislature.

74.09.4951 - Children and youth behavioral health work group—Advisory groups—Report to governor and legislature.

74.09.497 - Authority review of payment codes available to health plans and providers related to primary care and behavioral health—Requirements—Principles considered—Matrices—Reporting.

74.09.500 - Medical assistance—Established.

74.09.510 - Medical assistance—Eligibility.

74.09.515 - Medical assistance—Coverage for youth released from confinement.

74.09.520 - Medical assistance—Care and services included—Funding limitations.

74.09.522 - Medical assistance—Agreements with managed health care systems for provision of services to medicaid recipients—Principles to be applied in purchasing managed health care.

74.09.5222 - Medical assistance—Section 1115 demonstration waiver request.

74.09.5223 - Findings—Chronic care management.

74.09.5225 - Medical assistance—Payments for services provided by rural hospitals—Participation in Washington rural health access preservation pilot.

74.09.5229 - Primary care health homes—Chronic care management—Findings—Intent.

74.09.523 - PACE program—Definitions—Requirements.

74.09.530 - Medical assistance—Powers and duties of authority.

74.09.540 - Medical assistance—Working individuals with disabilities—Intent.

74.09.545 - Medical assistance or limited casualty program—Eligibility—Agreements between spouses to transfer future income—Community income.

74.09.555 - Medical assistance—Reinstatement upon release from confinement—Expedited eligibility determinations.

74.09.557 - Medical assistance—Complex rehabilitation technology products.

74.09.565 - Medical assistance for institutionalized persons—Treatment of income between spouses.

74.09.575 - Medical assistance for institutionalized persons—Treatment of resources.

74.09.585 - Medical assistance for institutionalized persons—Period of ineligibility for transfer of resources.

74.09.595 - Medical assistance for institutionalized persons—Due process procedures.

74.09.597 - Medical assistance—Durable medical equipment and medical supplies—Providers.

74.09.600 - Post audit examinations by state auditor.

74.09.605 - Incorporation of outcomes/criteria into contracts with managed care organizations.

74.09.611 - Hospital quality incentive payments—Noncritical access hospitals.

74.09.630 - Opioid overdose reversal medications—Reimbursement.

74.09.632 - Opioid overdose reversal medications—Technical assistance—Written materials.

74.09.634 - Opioid overdose reversal medications—Bulk purchasing and distribution program.

74.09.640 - Opioid use disorder—Nonpharmacologic treatments.

74.09.645 - Opioid use disorder—Coverage without prior authorization.

74.09.650 - Prescription drug assistance program.

74.09.653 - Drug reimbursement policy recommendations.

74.09.655 - Smoking cessation assistance.

74.09.657 - Findings—Family planning services expansion.

74.09.658 - Home health—Reimbursement—Telemedicine.

74.09.659 - Family planning waiver program request.

74.09.660 - Prescription drug education for seniors—Grant qualifications.

74.09.670 - Medical assistance benefits—Incarcerated or committed persons—Suspension.

74.09.671 - Incarcerated persons—Local jails—Behavioral health services—Federal funding.

74.09.672 - Inmates of a public institution—Exclusion from medicaid coverage—Work release and partial confinement programs.

74.09.675 - Gender affirming care services—Prohibited discrimination.

74.09.700 - Medical care—Limited casualty program.

74.09.710 - Chronic care management programs—Medical homes—Definitions.

74.09.715 - Access to dental care.

74.09.717 - Dental health aide therapist services—Federal funding.

74.09.719 - Compact of free association islander dental care program.

74.09.720 - Prevention of blindness program.

74.09.725 - Prostate cancer screening.

74.09.730 - Disproportionate share hospital adjustment.

74.09.741 - Adjudicative proceedings.

74.09.745 - Medicaid funding for home visiting services—Recommendations to legislature.

74.09.748 - Regional service areas—Certain reimbursements required or allowed upon adoption of fully integrated managed health care system.

74.09.756 - Medicaid and state children's health insurance program demonstration project.

74.09.758 - Medicaid procurement of services—Value-based contracting for medicaid and public employee purchasing.

74.09.760 - Short title—1989 1st ex.s. c 10.

74.09.770 - Maternity care access system established.

74.09.780 - Reservation of legislative power.

74.09.790 - Definitions.

74.09.800 - Maternity care access program established.

74.09.810 - Alternative maternity care service delivery system established—Remedial action report.

74.09.820 - Maternity care provider's loan repayment program.

74.09.825 - Donor human milk—Standards—Federal funding.

74.09.830 - Postpartum health care coverage.

74.09.850 - Conflict with federal requirements.

74.09.860 - Request for proposals—Foster children—Integrated managed health and behavioral health care—Continuation of health care benefits following reunification.

74.09.870 - Regional service areas—Establishment.

74.09.871 - Behavioral health services—Contracting process.

74.09.875 - Reproductive health care services—Prohibited discrimination.

74.09.877 - Statewide plan to implement coordinated specialty care programs providing early identification and intervention for psychosis.

74.09.880 - Z code collection—Incentives and funding.

74.09.885 - Apple health and homes program—Definitions.

74.09.886 - Apple health and homes program—Establishment—Eligibility—Services.

74.09.888 - Apple health and homes program—Authority duties—Funding—Reports to legislature.

74.09.900 - Other laws applicable.

74.09.920 - Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.