(1) To be eligible to receive infant case management (ICM), an infant must meet all the following criteria:
- (a) Be covered under categorically needy, medically needy, or state-funded medical programs under Washington apple health.
- (b) Meet the age requirement for ICM, which is the day after the maternity cycle (defined in WAC 182-533-0315) ends, through the last day of the month of the infant's first birthday.
(c) Reside with at least one parent who provides the infant's day-to-day care and is:
- (i) The infant's natural or adoptive parent(s);
- (ii) A person other than a foster parent who has been granted legal custody of the infant; or
- (iii) A person who is legally obligated to support the infant.
- (d) Have a parent(s) who needs assistance in accessing medical, social, educational and/or other services to meet the infant's basic health and safety needs.
- (e) Not be receiving any case management services funded through Title XIX medicaid that duplicate ICM services.
- (2) Clients who meet the eligibility criteria and are enrolled in a medicaid agency-contracted managed care organization (MCO) are eligible for ICM services outside their plan.
- (3) Clients who do not agree with an eligibility decision by the medicaid agency for ICM have a right to a fair hearing under chapter 182-526 WAC.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 19-06-026, § 182-533-0370, filed 2/28/19, effective 4/1/19. Statutory Authority: RCW 41.05.021. WSR 14-09-061, § 182-533-0370, filed 4/16/14, effective 5/17/14. Statutory Authority: RCW 41.05.021 and 2011 c 5. WSR 12-01-097, § 182-533-0370, filed 12/20/11, effective 1/20/12. WSR 11-14-075, recodified as § 182-533-0370, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.760 through 74.09.910, and 2009 c 564 § 1109. WSR 10-12-010, § 388-533-0370, filed 5/21/10, effective 6/21/10. Statutory Authority: RCW 74.08.090, 74.09.760 through 74.09.910. WSR 04-13-049, § 388-533-0370, filed 6/10/04, effective 7/11/04.]