WSR 98-15-053

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES

(Medical Assistance Administration)

[Filed July 10, 1998, 9:24 a.m.]



Original Notice.

Preproposal statement of inquiry was filed as WSR 98-07-039.

Title of Rule: WAC 388-508-0805 Pregnant woman--Income standards, 388-509-0920 Children's health program, and 388-509-0960 Children's income standards.

Purpose: This proposed amendment is necessary to adopt new income levels to reflect the federal poverty level standards effective April 1, 1998.

Statutory Authority for Adoption: RCW 74.08.090, 74.04.050, 74.04.057, and 74.09.530.

Statute Being Implemented: Poverty guidelines updated annually in the Federal Register under authority of Section 673(2) of the Omnibus Budget Reconciliation Act of 1981 (42 USC 9902(2)).

Summary: These amendments increase income standards to reflect the new federal poverty level. These changes will increase the number of pregnant women and children who are eligible for medical assistance.

Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Joanie Scotson, Medical Assistance Administration, 617 8th S.E., Olympia, WA, (360) 753-7462.

Name of Proponent: Department of Social and Health Services, governmental.

Rule is necessary because of federal law, Section 673(2) of the Omnibus Budget Reconciliation Act of 1981 (42 USC 9902(2)).

Explanation of Rule, its Purpose, and Anticipated Effects: See Summary above.

Proposal Changes the Following Existing Rules: Changes income standards based on the federal poverty level.

No small business economic impact statement has been prepared under chapter 19.85 RCW. This proposed rule does not have an economic impact on small businesses. This rule affects eligibility of public assistance clients.

RCW 34.05.328 does not apply to this rule adoption. This rule does not meet the definition of "significant legislative rule" so a cost benefit analysis has not been prepared.

Hearing Location: Lacey Government Center (behind Tokyo Bento Restaurant), 1009 College Street S.E., Room 104-B, Lacey, WA 98503, on August 25, 1998, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact Paige Wall by August 14, 1998, voice (360) 902-7540, or TTY (360) 902-8324.

Submit Written Comments to: Paige Wall, Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 902-8292, by August 25, 1998.

Date of Intended Adoption: August 31, 1998.

July 7, 1998

Marie Myerchin-Redifer, Manager

Rules and Policies Assistance Unit

SHS-2363:3

AMENDATORY SECTION (Amending WSR 97-16-008, filed 7/24/97, effective 7/24/97)



WAC 388-508-0805  Pregnant woman--Income standards. (((1) The department shall find)) This chapter describes the income standards used to determine the eligibility of a pregnant woman for a medical program. A pregnant woman is eligible for categorically needy Medicaid ((as categorically needy)) when the ((pregnant woman meets the income requirements of this section.

(2) The department shall ensure total family income will)) countable family income does not exceed one hundred eighty-five percent of the Federal Poverty Level (FPL). One hundred eighty-five percent of the ((current)) FPL is:



Family Size Monthly Income
(((a))) (1) One $((1,217)) 1,242
(((b))) (2) Two $((1,636)) 1,673
(((c))) (3) Three $((2,056)) 2,105
(((d))) (4) Four $((2,475)) 2,537
(((e))) (5) Five $((2,894)) 2,968
(((f))) (6) Six $((3,314)) 3,400
(((g))) (7) Seven $((3,733)) 3,832
(((h))) (8) Eight $((4,152)) 4,263
(((i))) (9) Nine $((4,572)) 4,695
(((j))) (10) Ten $((4,991)) 5,127


(((k))) (11) For ((family)) assistance units with more than ten members, add $((420)) 432 to the monthly income for each additional member.



[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530 and Social Security Act, Federal Register, March 10, 1997, pgs. 10856 - 10859, 42 U.S.C. 1396 (a)(l)(m). 97-16-008, 388-508-0805, filed 7/24/97, effective 7/24/97. Statutory Authority: RCW 74.08.090. 96-15-029, 388-508-0805, filed 7/10/96, effective 7/10/96; 95-11-045 (Order 3848), 388-508-0805, filed 5/10/95, effective 6/10/95; 94-10-065 (Order 3732), 388-508-0805, filed 5/3/94, effective 6/3/94. Formerly WAC 388-83-032 (part).]

SHS-2364:6

AMENDATORY SECTION (Amending WSR 97-16-008, filed 7/24/97, effective 7/24/97)



WAC 388-509-0920  Children's health program. This section describes the children's health program for children who are ineligible for Medicaid. (1) ((The department shall consider)) A child ((seventeen years of)) under age ((or younger,)) eighteen is eligible for state-funded medical services, with the same coverage as categorically needy, when((:

(a))) the child is not eligible for a federally-funded Medicaid program((; and

(b) The child's nonexempt family income does not exceed one hundred percent of the current federal poverty level (FPL). See income guidelines as described under subsection (4) of this section.

(2) The department shall determine nonexempt family income by:

(a) Following AFDC methodology; and

(b) Applying the medical income rules as described under WAC 388-506-0610.

(3) The department shall not require a child to meet the following eligibility factors:

(a) Citizenship;

(b) Social Security number; or

(c) Resources limits.

(4) The department shall find that)) and meets the income standards described in subsection (4).

(2) Citizenship, Social Security number, and resource standards are not eligibility factors for the children's health program.

(3) Countable family income is determined using TANF methodology and the medical income rules as described under WAC 388-506-0610.

(4) The countable income in the child's assistance unit may not exceed one hundred percent of the federal poverty level (FPL). One hundred percent of the current FPL equals:



Family Size Monthly Income
(a) One $((658)) 671
(b) Two $((885)) 905
(c) Three $((1,111)) 1,138
(d) Four $((1,338)) 1,371
(e) Five $((1,565)) 1,605
(f) Six $((1,791)) 1,838
(g) Seven $((2,018)) 2,071
(h) Eight $((2,245)) 2,305
(i) Nine $((2,471)) 2,538
(j) Ten $((2,698)) 2,771


(k) For ((family)) assistance units with more than ten members, add $((227)) 234 to the monthly income for each additional member.

(5) ((For a child determined eligible under this section, the department shall not consider)) A change in family income during the certification period does not affect eligibility for a child determined eligible under this section.



[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530 and Social Security Act, Federal Register, March 10, 1997, pgs. 10856 - 10859, 42 U.S.C. 1396 (a)(l)(m). 97-16-008, 388-509-0920, filed 7/24/97, effective 7/24/97. Statutory Authority: RCW 74.08.090. 96-15-029, 388-509-0920, filed 7/10/96, effective 7/10/96; 95-11-056 (Order 3848A), 388-509-0920, filed 5/11/95, effective 6/11/95; 94-17-036 (Order 3769), 388-509-0920, filed 8/10/94, effective 9/10/94; 94-10-065 (Order 3732), 388-509-0920, filed 5/3/94, effective 6/3/94. Formerly WAC 388-83-033 (part).]



AMENDATORY SECTION (Amending WSR 97-16-008, filed 7/24/97, effective 7/24/97)



WAC 388-509-0960  Children's income standards. This section describes income standards used to determine a child's Medicaid eligibility. (1) ((The department shall determine)) A child meeting the eligibility requirements under WAC 388-509-0910 is eligible as categorically needy when the ((total family)) countable income in the child's assistance unit does not exceed two hundred percent of the federal poverty level (FPL). ((The department shall find that)) Two hundred percent of the ((current)) FPL equals:



Family Size Monthly Income
(a) One $((1,315)) 1,342
(b) Two $((1,769)) 1,809
(c) Three $((2,222)) 2,275
(d) Four $((2,675)) 2,742
(e) Five $((3,129)) 3,209
(f) Six $((3,582)) 3,675
(g) Seven $((4,035)) 4,142
(h) Eight $((4,489)) 4,609
(i) Nine $((4,942)) 5,075
(j) Ten $((5,395)) 5,542

(k) For ((family)) assistance units with more than ten members, add $((454)) 467 to the monthly income for each additional member.

(2) ((For a child determined eligible under WAC 388-509-0910, the department shall not consider)) A change in ((family)) the assistance unit's income during the certification period does not affect eligibility for a child determined eligible under WAC 388-509-0910.



[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530 and Social Security Act, Federal Register, March 10, 1997, pgs. 10856 - 10859, 42 U.S.C. 1396 (a)(l)(m). 97-16-008, 388-509-0960, filed 7/24/97, effective 7/24/97. Statutory Authority: RCW 74.08.090. 96-15-029, 388-509-0960, filed 7/10/96, effective 7/10/96; 95-11-056 (Order 3848A), 388-509-0960, filed 5/11/95, effective 6/11/95. Statutory Authority: RCW 74.08.090 and Letter from HCFA approving State Plan Transmittal 94-21. 95-05-023 (Order 3833), 388-509-0960, filed 2/8/95, effective 3/11/95. Statutory Authority: RCW 74.08.090. 94-17-036 (Order 3769), 388-509-0960, filed 8/10/94, effective 9/10/94; 94-10-065 (Order 3732), 388-509-0960, filed 5/3/94, effective 6/3/94. Formerly WAC 388-83-033 (part).]

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