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Medical Expenses Specific to Long-Term Care

WAC 182-513-1350 (6) (b) gives the criteria for allowable medical expenses used to reduce excess resources. DDA Waivers, HCS CN Waivers, Hospice and participation rules point to this WAC as to allowable out-of-pocket medical expenses.

Premiums, deductibles, and coinsurance/copayment charges for health insurance and Medicare premiums

Necessary medical care recognized under state law, but not covered under the state's Medicaid plan;

Necessary medical care covered under the state's Medicaid plan incurred prior to Medicaid eligibility.

Expenses for nursing facility care are reduced at the state rate for the facility that the client owes the expense to

As long as the incurred medical expenses:

Were not incurred more than three months before the month of the medicaid application;

Are not subject to third-party payment or reimbursement

Have not been used to satisfy a previous spend down liability

Have not previously been used to reduce excess resources

Have not been used to reduce client responsibility toward cost of care

Were not incurred during a transfer of asset penalty described in WAC 182-513-1363.

Are amounts for which the client remains liable.

Expenses not allowed to reduce excess resources or participation in personal care are:

Unpaid expense(s) prior to HCB Waiver eligibility to an adult family home (AFH) or boarding home is not a medical expense.

Personal care cost in excess of approved hours determined by the CARE assessment described in 106 WAC is not a medical expense

Covered Items Under Medicare, Medicaid or a Medicare/Medicaid Managed Care Plan is not an allowable Deduction From Participation

﻿Medical services covered by Medicare, Medicaid or covered under a Washington Apple Health (WAH) - managed care plan is not an allowable deduction from long-term care participation because it is considered "covered". WAH-Managed care is formally known as Healthy Options (HO) If the client's medical practitioner indicates an item or service is medically necessary and the item or service is denied, the client must file an appeal with Medicare, Medicaid or the WAH managed care plan. The reduction of participation is the last resort after all other resources are pursued. Most medically necessary items should be covered by either medicare, medicaid fee-for-service or WAH managed care under the scope of care. This includes transportation cost, over the counter items, cough and cold products, vitamins, topical and durable medical equipment and supplies, incontinent supplies, foot care, hearing aids, that are covered by Medicare, Medicaid or WAH managed care. See: Long-term care and WAH managed care See: Long-term care insurance and third party resources.

What if a client chooses a non medicare/medicaid contracted provider?

If a client chooses to go to a non-medicaid contracted provider or outside the Washington Apple Health (WAH) managed care network, the charge is the client's responsibility as the service is covered under their medicare, medicaid or WAH managed care plan. Health Care Authority has an agreement to pay for health care services that is signed by the provider and client. HCA 13-879 The exception is when a client has "creditable" insurance coverage through their retirement, pension, employer sponsored plan or COBRA continuation plan. These client's may have copayments. These copayments are an allowable deduction only if Medicaid does not pay the copayments due the provider not having a Medicaid contract. Individuals with creditable insurance coverage are not limited to Medicaid contracted providers. An exception to rule (ETR) may be requested through the HCS Regional Designee for HCS cases or Marcie Birdsall for DDA cases if a client goes out of network due to special circumstances.

Health Care Authority links - What is covered under Medicaid?

What if the item is covered, but there is no contracted provider in the area?

There are situations where a needed contracted medicaid provider is not available within a reasonable distance. The most common situation is when a client is unable to find a medicaid contracted dentist within a reasonable distance.

An exception to rule (ETR) may be requested. The reasoning must be documented. A medical expense is not allowed at the private rate if the care/expense is available under the medicaid rate.

ETR requests for a medical deduction that is listed as a covered item under medicare, medicaid or HO must go through the HCS Regional Financial Program Manager for HCS offices. For DDA cases, an ETR request to reduce participation for a covered item must go through HCS HQ Marcie Birdsall.

Example: An exception to rule (ETR) can be considered for any medically necessary expense to reduce participation if an item is needed right away and the client has requested an appeal through Health Care Authority, Medicare or the WAH managed care plan. ETRs are forwarded to the HCS Regional designee (Financial Program Manager). DDA LTC Specialty unit ETR requests are forwarded to Marcie Birdsall.

Incontinence supplies

A common expense turned in as a participation deduction is incontinence supplies.

Incontinence supplies are covered under Medicare/Medicaid. If the client is in need of more supplies than normally allowed, a medically necessary justification may be requested by Medicare or Health Care Authority in order to authorize more supplies.

Do not allow incontinence supplies as a participation deduction.

Medication organizers/bubble packing

Bubble-packing prescription drugs is not an allowable expense from participation.

Facilities such as adult family homes, assisted living and nursing facilities have specific regulations that ensure the proper labeling and organizing of a client's medication.

If a facility chooses to send the medications to a vendor to be bubble-packed, it is not an allowable deduction from participation.

What does Medicare cover?

Individuals on Medicare and Medicaid are called Full Benefit Dual Eligible (FBDE). Individuals on institutional medicaid and HCB waivers do not have copayments toward medicare services.

Individuals on institutional and HCB services on Medicare D for prescription drugs may have a premium cost that is an allowable medical deduction if the client has chosen a non benchmark Medicare D PDP.

Drugs that are allowed under ANY PDP formulary under Medicare D, but not allowed in the specific PDP the client has chosen is not an allowable deduction from participation. Guidance from CMS has indicated if the drug is in any formulary it is a covered item.

Individuals on "credible coverage" for prescriptions are not enrolled in Medicare D. Prescription copayments due to credible coverage insurance is an allowable medical deduction from participation.

Medicare has a web tool to check for covered items under the Medicare program.

CMS notice to providers regarding QMB and Medicaid eligible clients. Providers are not allowed to charge QMB clients copayments.

If you have an institutional or HCB Waiver client being charged a Medicare D copayment, refer them back to the provider and indicate if the provider doesn't refund the copayment, the client will need to call the 1-800-MEDICARE helpline.

LTC and Medicare C and D charges

Medicare Programs describes Medicare programs, buy-in, Medicare buy-in unit contact information, what is Medicare and the different Medicare programs. This includes information on Medicare A, B, C and D and referral numbers for help on Medicare related issues.
Medicaid Covered Drugs for Part D Dual Eligible
CMS guidance on expenses related to Medicare D for spenddown

Medicare and Long-Term Care link has detailed information on Medicare and long-term care including participation issues.
Medicare and spenddown
Medicare premiums and LTC overview

Once a LTC client is eligible for Medicaid, the Medicare premiums are paid.

Allow a medicare premium deduction that is considered out-of-pocket to the client. Don't allow a Medicare premium that will be covered under a Medicare Savings Program (MSP) or a state buy-in program.

S05/SLMB eligibility is effective up to 3 months prior to the date of application if eligible.

S03/QMB eligibility is effective the first of the following month the client is determined eligible. Allow the Medicare A/B premium as a participation reduction in the month(s) prior to the S03 opening.

Medicare D/Low income subsidy is for all active MSP or Medicaid clients. It is effective immediately. Client's can choose a nonbenchmark plan which may have additional premium costs that is allowed as a participation deduction. Institutional and HCB Waiver clients have no medicare D copayments.

For individuals not eligible for a Medicare Savings Program (MSP), it takes approximately two months before the department begins paying state buy-in. Allow the Medicare A/B premium as a participation reduction. This should only occur when there is a retro or historical opening prior to MSP eligibility.

For questions related to insurance or Medicare premium payments, contact HCA Coordination of Benefits section at 1-800-562-3022 EXT: 1-6129 or email.

If using the contact us email, use the client button. Indicate your contact information and question. Indicate you are a financial worker and your office. Include the ACES client ID.

HCA no longer pays Medicare C premiums with the exception of a small existing caseload subject to funding (these cases were grandfathered for Medicare C payment).

Spenddown

For more information on Medical Spenddown such as base periods, medical transportation, public programs and ACES screens see Spenddown

The spenddown clarifying information gives guidance as to allowable medical expenses:
What about expenses paid with a credit card
What about expenses sent to a collection agency.

What are the differences between expenses allowed to reduce participation and those used in MN spenddown?

﻿The medical expense chart used for MN spenddown is the same basic guideline used to reduce participation for LTC programs.

There are situations that are unique to long term care programs.

Expenses incurred during a LTC transfer penalty are not allowed to reduce participation.

For LTC, a medical expense prior to eligibility must be unpaid. For spenddown, expenses incurred and paid 3 months prior to the application can be used.

Private personal care cost in excess of approved hours determined by the CARE assessment described in 106 WAC is not a medical expense.

Unpaid expenses prior to HCB Waiver eligibility to an adult family home (AFH) or boarding home is not a medical expense. This applies to both participation and MN spenddown. These facilities are not medical facilities. Another term for AFH and boarding homes is alternate living facility (ALF).

Expenses of the community spouse or family members. This includes health insurance premiums. If the health insurance premium is for the couple, we allow one half of the expense for the LTC recipient if we are unable to determine the amount of the LTC recipient's share.

Health insurance premiums paid by a 3rd party including HCA COB unit are not used to reduce participation. Health insurance premiums paid on a client's behalf by COB are considered an income deduction for the MN Spenddown program.

Medical expense deduction from participation that is a covered item under the state plan is not allowed as a deduction if the client was on Medicaid during the date of service.

Medical expense deduction for copayments or deductibles from participation that is a covered item under Medicare is not allowed as a deduction if the client was on Medicaid and QMB during the date of service.

Medical expense deduction from participation that is a covered item under the Managed Care plan (formerly Healthy Options) is not allowed as a deduction if a client chooses the service outside of the Healthy Options network.

Liquid supplements (such as Ensure, Resource) are covered by HCA Medicaid when medically necessary. Liquid supplements (enteral nutritional products) not approved by HCA are not considered a medical expense used to reduce participation even if the client has a medical prescription.

Effective 11/22/2012 reasonable limits on allowable medical expense deductions described in WAC 182-513-1350 was final.

Expenses for nursing facility care are reduced at the state rate for nursing facility care that is owed by the client prior to Medicaid eligibility. It is based on the state rate for the particular facility the bill was incurred.

Medical expenses incurred more than three months before the month of application is not an allocable medical deduction to reduce participation.

Note: If an expense was used to meet a prior spenddown or to reduce excess resources for LTC programs, it cannot be used to reduce participation. This is the same rule as the spenddown program. An expense is allowed once.

Expenses of a medically necessary service animal

A description of service animals is described in WAC 388-473-0040 food for service animals as an ongoing additional requirements. Although this section describes when to authorize food for services animals of an SSI or TANF recipient, it can also be used as a guideline when determining if expenses related to a service animal can be used as a medical expense.

In order for expenses related to a service animal to be used as a medical expense:

Consult CARE and the client's social service specialist/case manager as to whether the service animal is medically necessary. If the social service specialist is unable to determine if the service animal is medically necessary get a statement by the client's physician/practitioner as to why the expense is medically necessary.

The service animal must be performing a task that is necessary for the health and safety of the individual.

For LTC recipients with service animals that are on SSI, consider food for service animals as an ongoing additional requirement. If authorized, do not allow the food as a medical expense to reduce participation.

Medical expenses and room and board

Noncovered necessary medical expenses is an allowable deduction to determine the client's participation. For HCS Waiver clients residing in alternate living facilities, it is not an allowable deduction from room and board without an exception to rule (ETR).

Submit an ETR request to the HCS regional designee for a medical expenses that would have been used to reduce participation if there had been available participation.

Room and board for ABD cash recipients is not reduced by medical expenses. Do not refer ABD cash cases for an ETR.

Reducing room and board is the last resort as it is state funded. If the expense can be deducted through participation, but takes a few months because of low participation, use that method rather than an ETR to reduce room and board.

Medicare supplements, called MEDI-GAP are not an allowable ETR from room and board if the client is eligible for a Medicare Savings Program (MSP), this is because MSP covers the same thing as a MEDI-GAP plan. For more information see What about Medicare Insurance Supplements, also called MEDI-GAP plans. (scroll down to this section).

See: HCS Waivers, Room and Board, ETRs and Bed holds.

DDA Waiver has a process to reduce room and board for necessary medical expenses and guardianship fees. DDA has authorized the case manager as the designee to approve these costs from room and board. DDA case-managers notify the financial worker via the DSHS 15-345.

Any deduction from room and board must be coded as an ETR in ACES 3G in the decision tree under the Institutional Care/Expenses.

TPL, COB, Premium Assistance program
Medical Assistance-Third party liability Long-term care and Third Party Resources, LTC Insurance
When to allow medical expenses

Changes including medical expenses must be reported within the timeframes outlined in WAC 182-504-0110. WAC 182-504-0105

Effective 10/2013 WAC 182-504-0105 Washington Apple Health - Changes that must be reported will be used for all medical including institutional medical programs.

If a medical expense is not reported within required time frames, we are not able to use the expense as a post eligibility deduction for institutional medicaid. For HCB Waiver, we may allow a medical expense if unpaid as long it meets the criteria in WAC 182-513-1350 (6) and (7).

If a medical expense increases and is not reported within time frames, we can't go back historically and change the amount. If a medical expense ends, (such as a health insurance premium), and it is not reported timely, it is an overpayment.

In order to allow a medically necessary non covered item, we will need verification:

Of the cost

Item is prescribed by an allowable practitioner and is considered a medically necessary item

Item is not covered by Medicare, Medicaid or WAH managed care. Most medically necessary items should be covered for individuals receiving long-term care. Any item indicated on the covered list, including over the counter items such as cough/cold medications or vitamins cannot be allowed as a participation deduction.

For durable medical equipment (DME) or environmental modifications, check with the social worker/case manager as to whether it should be covered under the HCB Waiver? Most DME is covered under the Medicaid scope of care or HCB Waiver. HCS MB H13-030 dated June 24, 2013 has more information regarding DME vendors.

If the reported expense appears to be covered, send a letter explaining why the expense is not allowed using the text templates that include the rule.

Send the medical expense fact sheet to all new openings and clients that turn in expenses that are not allowed as a participation reduction.

Noncovered allowable medical expenses. Differences in how we apply the medical deduction in institutional medical and HCB Waiver

Once it is determined the medically necessary expense is allowed as a deduction, there is differences in institutional and HCB Waiver cases on when we allow the medical deduction.

Post eligibility participation (WAC 182-513-1380, WAC 182-515-1509, WAC 182-515-1514)

There are 3 methods of allowing expenses in post eligibility described in WAC 182-504-0120 (11) for institutional programs and WAC 182-504-0120 (12) for HCB Waivers.

Federal guidance allows method 1 or 2 for institutional cases. (Those residing in medical institutions).

Federal option allows method 3 for HCB Waivers.

1. Method 1: Allow the expense in the month it was incurred; or

2. Method 2: Estimate medical expense incurred in the preceding period, not to exceed 6 months if the expenses are expected to continue. (Method 2)

1. At the end of the prospective period, or if there is a significant change of 25%, the expense is reconciled for the next time period.

2. A reconciliation is required, at least every 6 months when using method 2. Use barcode ticklers to track the expenses and reconciliation period.

3. Use the Method 2 training instructions and calculator and document that method 2 is being used to estimate medical expenses.

3. Method 3: When there is a change in income, or allowable expenses, changes the amount of the cost of your care for a home and community-based waiver or service, we calculate the new participation amount effective the first of the month following the date the change was reported, except that the new participation amount will be effective the month the change occurs if the change is the loss of an income source that you report within thirty days of the change.

For additional information on Method 1, Method 2 and Method 3 go to the financial SharePoint site, financial training under the policy and program changes. HCB Waiver-Method 3

What if a Provider appears to be charging a client extra?

If a Medicaid or Medicare/Medicaid client is turning in medical expense charges that appear to be covered or the client is being charged the difference between the medicaid or medicare rate, you may need to refer the situation for an investigation.

Nursing facility, Assistance Living, Group Homes or Adult Family homes contact: Residential Care Services (RCS) complaint email box Complaint Resolution Unit (DSHS/RCS) cru@dshs.wa.gov

All other Medicaid providers contact the Health Care Authority. Include your name, phone number, client and provider information and what the issue is.

Refer complaints regarding Medicare claims to 1-800-Medicare

If provider fraud is suspected, follow the procedures in HCS MB H13-011 issued 3/5/2013: procedures for report suspected fraud.

Example:

Both Spouse's are at home receiving COPES. Spouse #2 has an insurance premium and income over PNA. Spouse #1 has no insurance premium, income over PNA. Allow a portion of the insurance premium as a deduction for spouse #2 and the remainder of the premium as a deduction for Spouse #1

Copes at home

Copes at home

Income $1400

Income $1000

Insurance Premium $150

Allow deduction from the premium to bring Spouse #2 to current PNA. Allow the remainder of Insurance Premium to Spouse #1

Code at the LTCX

Code at the LTCX Screen

Set Tickler for COLA and premium adjustments
Example:

Both spouse's are home receiving COPES. Spouse #2 has an insurance policy premium and has income below PNA. Spouse #1 has income over PNA, no insurance premium. Allow the insurance premium from spouse #2 to spouse #1 as a deduction.

Copes at home

Copes at home

Insurance Premium $100

Allow insurance premium $100 from Spouse #2 to reduce participation for Spouse #1

Code at the LTCX for Spouse #1

Set tickler for yearly COLA and insurance adjustments

Practitioners

Allowable practitioners

MD physicians

Opticians

DO Osteopath

Pharmacists

DDS Dentists, Denturist, Orthodontist, Periodontitis

ARNP Advanced Registered Nurse Practitioners

DC Chiropractors

Psychologists/Psychiatrists

PA Physicians Assistants

CRN Certified Registered Nurses

DPM Podiatrists

Midwives

OD Optometrist

X-ray Technicians

Dental Hygienists

Electrotherapist

Hydro therapist

Inhalation/Respiratory Therapists

Physical Therapists

Speech Therapists

Allowable practitioners with a documented referral from an M.D., D.O., D.D.S., OR A.R.N.P.

Acupuncturist

Dieticians

Naturopaths

Licensed Massage Therapist

Non Allowable Practitioners

Herbalists

Homeopaths

Holistic Healers

Hypnotists

Masseurs or manipulators

Psychic or faith healers

Sanipractors

Veterinarians (unless the expense is for a medically necessary service animal)

Practitioners not licensed under WA State Law

Medical Marijuana Distributor

Nonallowable expenses, services and supplies

Nonallowable expenses, services and supplies

Services obtained out of the US

Drugs not approved by the Federal Drug Administration (FDA)

Interest and fees incurred on an unpaid medical bill

Out of state billings for medical services not recognized under Washington State law.

Durable medical equipment or modification approved under the HCB Waiver program for individuals receiving Waiver services is not an allowable participation deduction

Items covered under Medicare, Medicaid or a Healthy Options plan is not an allowable deduction from long-term care participation. If a client chooses to go to a non medicaid/medicare contracted provider or outside the healthy options managed care network, the cost is their responsibility.

Insurance premiums for policies that pay a cash benefit to the insured and the benefit is not intended to reimburse a provider.

These premiums are not health insurance but pay directly to the insurance holder under certain conditions. (usually a daily rate when the client is unable to work, in the hospital or has a certain type of medical condition).

Contact the carrier to find out if it is a health insurance or one of these policies that pay a cash benefit to the client and not a provider because of a health condition.

This does not include LTC insurance. LTC insurance premiums are an allowable deduction.

LTC insurance policies waive the premiums when the client starts receiving benefits from the LTC insurance. Once the client is accessing LTC insurance, remove the premium as a deduction.

Food/special diets is not a medical expense

Nutritional supplements unless prescribed as medically necessary. Examples are enteral liquid and powdered supplements.

For active Medicaid clients, liquid supplements that are medically necessary are covered by Health Care Authority (HCA) Liquid supplements (enteral supplements) not approved by HCA are not considered a medically necessary expense to be used to reduce participation.

Food items are covered under the basic food program, consider eligibility for basic food for individuals not in a facility claiming food items as a medical expense.
AFH, Assisted living facilities, NF and RHCs are required to provide meals taking into account an individuals special dietary needs. Meals are included in the daily rate.

In home cooking/cleaning services/yard work/property maintenance

Over the counter drugs & medications not prescribed or considered not medically necessary. Many over the counter drugs, medications and vitamins are covered by Medicaid.

Telephone charges including long-distance charges

Health camps, trips or retreats

Commercial diet clinics, gyms and pools that are not monitored by a licensed physical therapist

Medical marijuana. Cannabis is not an approved prescription drug under the Federal Food, Drug and Cosmetic Act and has not been approved by the FDA for treatment

Toiletries such as toothpaste, shampoo, personal grooming products

Unpaid participation incurred while active on a Medicaid program

Private alternate living facility (ALF) charges are not considered a medical expense.

Dietetics

See WAC 182-513-1205 for possible eligibility of Medicaid using rules for individuals living in state contracted ALFs.

Spouse's unpaid medical expenses are not allowed to reduce participation.

Note: LTC medical expenses are indicated on the LTCX screen. The MEDX screen is used for recipients on other programs such as food assistance. Non medicare health insurance premiums are indicated on the MEDX screen for non institutional spenddown cases. Make sure the medical expense is indicated on the LTCX and MEDX screen when a LTC recipient is on food assistance.

ACES and Medical Expenses

Institutional Care in ACES 3G decision tree used in institutional medicaid programs to indicate medical expenses.

Expenses in ACES 3G decision tree used to indicate health insurance premiums for spenddown. Used to indicate all medical expenses for food assistance including COPES participation.

ACES on line summary and detail used to indicate medical expenses for spenddown.
ACES-Medical expenses as a deduction

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Medical Expenses Specific to Long-Term Care WAC 182-513-1350 (6) (b) gives the criteria for allowable medical expenses used to reduce excess resources. DDA Waivers, HCS CN Waivers, Hospice and participation rules point to this WAC as to allowable out-of-pocket medical expenses.

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779 total diaper requests

712 have been new requests

67 have been repeat

They have sent truckloads of diapers to the community

Average family size is 4

Most families fall under the poverty line

Wipes and baby wash are also being supplied

They are still taking partner applications

Still need more partners in the Lower Valley

You do not need to be an organization to be a partner

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Community Resilience in Times of Change - May 14

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Community Resilience in Times of Change - May 14

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Non-Profit Fair is happening tonight from 6-8PM at the seasons. Hosted by New Leaders Yakima County and United Way CW. I will be there. :)

- Amber Ortiz Diaz

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Key Leaders Luncheon-Sunnyside United Unidos

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Key Leaders Luncheon-Sunnyside United Unidos

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Article about Daisy Cruz, the advocate mom who helped organize the Autism Awareness Book-Walk

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Article about Daisy Cruz, the advocate mom who helped organize the Autism Awareness Book-Walk

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Daisy Cruz y Pedro Madrigal son dos padres que han aprendido a navegar en un mundo diferente para ayudar a su pequeña Darla Madrigal Cruz, de 2 años, quien fue diagnosticada con autismo en 2020.

Desde su embarazo, Cruz entró al programa de educación temprana y ayuda para niños Primeros Pasos para el exito escolar, que ofrece la organización Save the Children en colaboración con el Distrito Escolar de Grandview y que proporciona atención a las madres durante su embarazo y educación temprana a sus hijos.

“El programa se ofrece a nivel nacional y en otros países y es para las madres y sus hijos desde antes de nacer hasta los 5 años, y está dividido en dos etapas: de cero a tres con educación temprana, y de tres a cinco para lectura y nivel preescolar”, explicó María López, coordinadora del programa Primeros Pasos de Save the Children en Grandview.

“Nosotros patrocinamos y organizamos diversos eventos comunitarios, los padres de familia reciben nuestra información y las madres de familia pueden inscribirse desde el embarazo. Cuando sus hijos nacen, nosotros los vistamos cada mes y les hacemos unos cuestionarios para monitorear el avance psico motor de sus bebés”, explicó López.

El programa comenzó a operar en el Valle Bajo del condado de Yakima hace tres años con la colaboración de los distritos escolares de Grandview y Mabton.

Desde que Cruz entró a este programa comenzó a recibir información y recursos sin saber que esto le daría las herramientas para entender el comportamiento de su hija y obtener la ayuda necesaria para atenderla.

“Cuando mi hija estaba creciendo, yo sentía que algo estaba raro; no aprendía como otros niños; no podía hablar ni comunicarse; siempre estaba aislada; se asustaba mucho y gritaba con frecuencia, se pegaba en la cabeza; se ponía mal con sonidos fuertes o se ponía ansiosa. Después, comenzó a alinear sus juguetes y todo en la casa, pero su doctor decía que era normal, pero yo sabía que no lo era”, dijo Cruz.

Primeros Pasos le proporcionó materiales didácticos de educación temprana, recursos de ayuda y artículos para bebé.

“Ellos hacen unas pruebas cada mes para ver el avance de los bebés y María López, nuestra visitadora, me dijo que mi hija tenía niveles de retras,” agregó.

La joven madre, originaria de Grandview, y su esposo, oriundo de Michoacán, México, comenzaron a buscar información basados en los síntomas de su hija.

“El doctor no me escuchaba como madre, pensaba que yo exageraba, pero un día gracias a la información que recibía de los Primeros Pasos decidí buscar otra opinión. Fue así como otro doctor que sí le hizo pruebas cuando (Darla) tenía casi un año y medio y salieron positivas, que mi hija fue diagnosticada con autismo”.

Un tabú

El diagnostico, dijo Cruz, “me llenó de mucho miedo y lo que la gente me decía me causaba más angustia, así me di cuenta que dentro de la comunidad hispana es un tabú hablar de esto. Muchos me decían que ella iba a aprender solita ya en la escuela o que le pegara para que dejara de hacer berrinches o para que hablara o dejara esos comportamientos, fueron momentos muy duros”, narró Cruz.

A principios de 2021, el doctor refirió a su hija a la clínica Children’s Village en Yakima, del Hospital Memorial del Valle de Yakima, donde comenzó terapias en septiembre de 2021.

Cuando llegó la pandemia, “esto fue más difícil porque la niña no tenía interacción con nadie de fuera, incluso sus terapias son virtuales, y eso no la ayudó mucho al principio”.

Sin embargo, contar con el apoyo del programa de educación temprana Primeros Pasos y las visitas mensuales de María fue de gran ayuda, dijo, porque adaptaron los materiales para apoyar a la pequeña con sus terapias.

“Aunque la terapista y nuestra visitadora no se hablan directamente, ellas me dan la información para que use los materiales como apoyo para hacer sus terapias en casa, y con esto mi hija ha avanzado mucho”, comentó Cruz.

“Por ejemplo, mi hija tiene problemas con texturas, le da mucho miedo tocar o estar cerca del algodón y otras cosas, lloraba y gritaba, pero María nos ha traído bombones y tubitos con pelusas, que se ven como juguetes de colores y que le ayudan a tocar sin miedo”, relató Cruz.

López también les ha llevado muchos libros y materiales sobre el autismo, “nos han educado a ser padres de una niña con autismo y a entender que esta condición le va a afectar toda su vida. Y en lugar de miedo, ahora reconocemos y entendemos cómo tratarla; ella siempre va a ser especial, porque hace y ve las cosas a su manera, pero eso no es malo, solo es diferente”, comentó Cruz.

El programa tiene actividades para interactuar, añadió Cruz, “tenemos un día de juegos, nos unimos con otras familias de Save the Children en un día de convivencia en el parque o en una escuela, y eso le ha ayudado a mi hija a socializar. Aunque habla poco, ya se da a entender, yo la veo feliz jugando con otros niños, eso bueno porque le cuesta trabajo estar con la gente. Durante la pandemia, sin ver a nadie, se retrasó en sus habilidades sociales ”.

Primeros Pasos

El programa Primeros Pasos (Early Steps en inglés) cuenta con cuatro representantes en Grandview, cada una atiende a 20 familias. Y además de visitar a la familia de Darla, visitan a otras con tres niños con autismo y a otras familias con hijos con necesidades de aprendizaje o desarrollo.

“Sabemos que la intervención temprana en su aprendizaje es lo más importante para que avancen y nuestro trabajo es apoyar a los padres en todo lo que necesitan. Además de ofrecerles materiales, actividades e información de recursos que los ayuden a agarrar ayuda para sus hijos lo antes posible, como sucedió con Daisy y su hija Darla”, dijo López.

Y explicó, “mis compañeras y yo estamos desde que empezó el programa y, al principio fue difícil, la gente no nos conocía y casi no teníamos familias, pero hemos crecido mucho, tenemos lista de espera, pues los niños están en nuestro programa cinco años y nos estamos expandiendo a otras áreas en el Valle Bajo y en Tri Cities, esperamos atender más familias hispanas”.

Cruz aconsejó que “los padres vigilen a sus hijos y si ven o sienten que algo no está bien, deben buscar ayuda”.

Las terapias en Children’s Village dos veces al mes y las visitas de Pimeros Pasos de Save The Children “han ayudado a mi hija y nos han educado para vivir en el mundo del autismo. Pido a los padres educarse para ser la voz que va a abogar por ellos. Me alegra compartir mi experiencia y ayudar otras familias”, expresó.

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AMÉRICA BARCELÓ-FELDMAN Para El Sol de Yakima

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Educación temprana ayuda a padres de niños con autismo

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Daisy Cruz y Pedro Madrigal son dos padres que han aprendido a navegar en un mundo diferente para ayudar a su pequeña Darla Madrigal Cruz, de 2 años, quien fue diagnosticada con autismo en 2020.

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Fall Early Learning Conference in the works...

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Fall Early Learning Conference in the works...

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April 23rd - Día del Niño event at Nuestra Casa

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April 23rd - Día del Niño event at Nuestra Casa

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Currently paused as they are making adjustments

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The Partner Toolkit was created to provide communication tools to support partners with their communications about Help Me Grow Washington. Help Me Grow Washington partners include anyone who is part of the network: parents, caregivers, service providers, employers and professionals of all kinds who focus on connecting families to the local resources they need.
Help Me Grow WA Universal Messaging

Help Me Grow WA Localized Messaging

This messaging will be helpful when describing Help Me Grow Washington in specific counties or regions in the state.

Digital and print materials are available below to download. Please email us if you have any questions or feedback; we welcome suggestions on new materials!

Digital Materials

Help Me Grow WA Logos

Social Media Graphics

Print Materials

Help Me Grow Flyers

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The Partner Toolkit was created to provide communication tools to support partners with their communications about Help Me Grow Washington. Help Me Grow Washington partners include anyone who is part of the network: parents, caregivers, service providers, employers and professionals of all kinds who focus on connecting families to the local resources they need.

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Big Thanks!

This project would not have been possible without the many advocates, experts, and WCFC Early Childhood Network members who provided valuable time, input, and skills. Special thanks to the following individuals who participated on the Fair Start for Kids Act Communication Workgroup:

Toolkit design & content creation

Colleen Condon, Molly Curtiss, Molly Draben, Cadie Dye, Debbie Ham, Brittany Hartikainen, Katie Maisch, Eiledon McLellan, Melissa McPheeters, April Messenger, Linden Obel, Nancy Spurgeon

Toolkit translation

Marina Medrano

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Fair Start for Kids Act Communication Toolkit - Washington Communities For Children

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This project would not have been possible without the many advocates, experts, and WCFC Early Childhood Network members who provided valuable time, input, and skills.

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Please follow this link to sign in to today's meeting:

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Please follow this link to sign in to today's meeting:

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Why Early Learning is Important:

Research has shown that children who are able to participate in early learning programs perform better throughout their years of schooling. Early learning programs focus on six areas of kindergarten readiness:

Social-Emotional - Children do better in school when they can regulate their emotions, establish positive relationships with others, and constructively participate in group settings.

Physical - The early years are important for the development of fundamental gross-motor and fine-motor skills needed to be active learners.

Language - Children need to understand increasingly complex language and use language to express their thoughts, ideas, needs, and feelings.

Cognitive - Children are more successful in school when they have positive approaches to learning, and are able to attend, engage, and persist to solve problems.

Literacy - A child's progress in reading and writing is one of the best predictors of whether the child will function competently in school and in life.

Math - Research shows that math is the number one predictor of future success in reading and math.*

*Duncan, Greg. University of California, 2007. Early Childhood Longitudinal studies. "The strongest predictors of later achievement are school-entry math, reading, and attention skills. Early math skills have the greatest predictive power."

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Research has shown that children who are able to participate in early learning programs perform better throughout their years of schooling. Early learning programs focus on six areas of kindergarten readiness: Social-Emotional - Children do better in school when they can regulate their emotions, establish positive relationships with others, and constructively participate in group settings.

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Health Providers we have provided trainings to:

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Health Providers we have provided trainings to:

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Dr. Felt with YVFWC

WCAAP Cohort in Central WA

Yakima Pediatrics

Dr. Jocelyn Pedrosa with Yakima Neighborhood Health

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Washington Communities for Children (WCFC) is a network of coalitions dedicated to improving the wellbeing of children, families, and communities. Ten WCFC Regions across the state that have trusted relationships with over six-hundred organizations and individuals. Trusted partners include early learning providers, social service agencies, early intervention services, child welfare organizations, libraries, juvenile courts, school districts, public health agencies, higher education, families, and many others.

MISSION

Connecting local and statewide efforts to improve the wellbeing of children, families, and communities.

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Washington Communities for Children (WCFC) is a network of coalitions dedicated to improving the wellbeing of children, families, and communities. Ten WCFC Regions across the state that have trusted relationships with over six-hundred organizations and individuals.

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Early Learning Final Budget (WCFC: Page 502)

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Early Learning Final Budget (WCFC: Page 502)

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Eva Chavez or Suman Pandey at YVFWC, Lincoln

Amanda Lee at YVFWC in Toppenish

Stephen Pearson at Central WA Family Medicine

Central WA Family Medicine Branch in Ellensburg

Sarah Ortner BHC at Ellensburg

Questions for consideration:

How can we do outreach in Kittitas?

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Join Zoom Meeting
https://us02web.zoom.us/j/87431306497

Meeting ID: 874 3130 6497

Dial by your location
+1 253 215 8782 US (Tacoma)
+1 669 900 6833 US (San Jose)

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Across the nation, Help Me Grow offers families seamless access to community services and supports so they can easily connect to the resources they need, when they need them.

The Help Me Grow Washington network represents a growing, powerful coalition of communities and individuals invested in building an organized system of community resources to help children grow up healthy.

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The Help Me Grow Washington network represents a growing, powerful coalition of communities and individuals invested in building an organized system of community resources to help children grow up healthy.

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Resources | Investing in Children Coalition

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New parents often need assistance when preparing for the birth of a child and caring for them after birth until age five. You can benefit from specially trained professionals who will show you how to get medical, social, educational, and other parenting resources to build a strong network of support for yourself and your child.

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Carina worked with a client who is pregnant and was having trouble applying for medical insurance. Carina helped her receive Safeway gift cards and health insurance. The client will also be joining a play and learn group for her older child.

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Health Provider Outreach - Presentation Slides

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Health Provider Outreach - Presentation Slides

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April Meeting Padlet (click the image below to go to our last meeting's padlet)

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April Meeting Padlet (click the image below to go to our last meeting's padlet)