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Medicaid Personal Care (MPC)

WA Health Care Authority

Medicaid Personal Care (MPC) is a state-plan benefit available to clients who are (1) functionally eligible for MPC services under WAC 388-106-0200 through 388-106-0235 and (2) financially eligible for a noninstitutional categorically needy (CN) or alternative benefits plan (ABP) Apple Health program. MPC fills the gap below the institutional level of care threshold required for CFC and HCB waivers. Services may be provided at home, in a department-contracted adult family home (AFH), or in a licensed assisted living facility contracted to provide adult residential care services.

Who qualifies

(1) Functionally eligible per WAC 388-106-0200 through 388-106-0235 (does NOT require institutional level of care, that's the CFC/waiver bar); AND (2) financially eligible for noninstitutional CN or ABP Apple Health program.

What it covers

Personal care services in home, adult family home, or adult-residential-care licensed assisted living.

Cost

Clients in an alternate living facility (AFH or contracted AL) keep a Personal Needs Allowance (PNA) and pay up to the room-and-board standard under WAC 182-513-1105 (unless CN eligibility is determined under WAC 182-513-1205). Clients on the HWD program also pay the HWD premium plus room and board if in an ALF. Third-party resources may be owed in addition to room and board. Specific PNA and room-and-board dollar amounts published at hca.wa.gov program-standard-income-and-resources.

How to apply

Apply through your local DSHS Home and Community Services (HCS) office. HCS conducts the CARE functional assessment and the Apple Health financial determination.

Where to get this in Washington

3 organizations deliver this program. Coverage varies, so check the area each one serves.

Source www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple