1. (1) Applications for tailored supports for older adults (TSOA) are submitted:

   1. (a) Online at Washington Connection at www.washingtonconnection.org;
   2. (b) By sending a completed HCA 18-005 application for TSOA form to P.O. Box 45826, Olympia, WA 98605;
   3. (c) By faxing a completed HCA 18-005 application for TSOA form to 1-855-635-8305;
   4. (d) By contacting the local area agency on aging (AAA) office at 1- 855-567-0252; or
   5. (e) By contacting the local home and community services (HCS) office. To find the local HCS office, see https://www.dshs.wa.gov/ALTSA/resources.

2. (2) Help filing an application:

   1. (a) The medicaid agency or the agency's designee provides help with the application or renewal process in a manner that is accessible to people with disabilities, limitations, or other impairments as described in WAC 182-503-0120 and to those who are limited-English proficient as described in WAC 182-503-0110;

   2. (b) For help filing an application, a person may:

      1. (i) Contact a local AAA office;
      2. (ii) Contact a local HCS office; or
      3. (iii) Have an authorized representative apply on the person's behalf.

3. (3) The following people can apply for the TSOA program:

   1. (a) The applicant (the person receiving care);
   2. (b) The applicant's spouse;
   3. (c) The applicant's caregiver (person providing in-home caregiver services);
   4. (d) A legal guardian; or
   5. (e) An authorized representative, as defined in WAC 182-500-0010.

4. (4) A phone interview is required to establish TSOA financial eligibility, but may be waived if the applicant is unable to comply:

   1. (a) Due to the applicant's medical condition; and
   2. (b) Because the applicant does not have another person that is able to conduct the interview on the applicant's behalf.
5. (5) The agency or the agency's designee processes TSOA applications using the same timelines under WAC 182-503-0060.
6. (6) TSOA begins on the date the person is determined presumptively eligible for TSOA under WAC 182-513-1620, or on the date all eligibility requirements are established if the person is not found presumptively eligible.
7. (7) When the person withdraws an application for TSOA, or is determined ineligible for TSOA services, the agency or the agency's designee denies the application under WAC 182-503-0080.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 23-19-014, § 182-513-1625, filed 9/8/23, effective 10/9/23. Statutory Authority: RCW 41.05.021, 41.05.160, 2016 1st sp.s. c 36 § 213 (1)(e), section 1115 of the Social Security Act, and 42 C.F.R. §§ 431.400 through 431.428. WSR 17-12-019, § 182-513-1625, filed 5/30/17, effective 7/1/17.]