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Early Intervention Program (EIP) Application

Early Intervention Program Application - English  (PDF 82.75KB)

Early Intervention Program Application - Spanish (PDF 88.75KB)

Early Intervention Program Brochure -English (PDF 235KB)

Early Intervention Program Brochure - Spanish (PDF 237KB)

Early Intervention Program requirements:

• Be HIV+.

• Live in Washington State.

• Have family income at or below 300 percent Federal Poverty Level (FPL). Up to 370 percent FPL if eligible for EIP before 9/1/2002.

• Have individual resources of $10,000 or less (not counting your home, one automobile per licensed driver and some retirement funds) or $15,000 for family resources.

Clients with income of 100 percent or less than Federal Poverty Level ($903 in 2009 for a single person) will have to apply for Medicaid.  Clients who have previously been denied Medicaid may not be required to apply with Medicaid again.  EIP will send Medicaid application information to clients and provide temporary EIP coverage during the Medicaid application period.  You can download a Medicaid application by visiting their website. 

Eligibility and services are subject to change.  Please call us for additional information at 360-236-3426 or 877-376-9316 (toll free).

Alternative File Format Information
Documents posted in .pdf version on the Department of Health web site will be made available on request to users who are unable to download or view them.  For persons with disabilities, .pdf documents will be made available on request in other formats.  To submit a request, contact:  Sheila.Ichita@doh.wa.gov  or call 360-236-3430.

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Washington State Department of Health
HIV Client Services
P.O. Box 47841
Olympia, Washington, 98504-7841

Last Update : 08/05/2009 02:06 PM
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Comments or questions regarding this web site? Send mail to Sheila Ichita.