WSR 99-12-121

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Economic Services Administration)

[ Filed June 2, 1999, 10:33 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 99-07-105.

Title of Rule: WAC 388-418-0012 Prospective eligibility for food assistance, 388-418-0030 Notifying a recipient of intent to reduce, suspend, or terminate assistance, 388-406-0015 Expedited service for food assistance, 388-406-0035 Time limits for application processing, 388-406-0040 Delays in application processing, and 388-406-0050 Completing the application process.

Purpose: Changes rules to be consistent will federal laws, rules, and regulations.

Statutory Authority for Adoption: RCW 74.08.090 and 74.04.510.

Statute Being Implemented: RCW 74.08.090 and 74.04.510.

Summary: WAC 388-418-0012, created WAC to reflect requirement that clients be prospectively eligible for food assistance. WAC 388-418-0030, clarified that notice must be mailed ten days before an adverse action is taken. WAC 388-406-0015, added definition of what expedited service includes and clarified time frame. WAC 388-406-0035, added application processing time frame for food assistance. WAC 388-406-0040, added text to clarify that medical applications are not to be delayed when an application for other assistance is pending. WAC 388-406-0050, removed incorrect reference to medical for no-shows to be considered as a withdrawn application.

Reasons Supporting Proposal: Current rules are not consistent with federal laws, rules, and regulations.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: John Camp, Division of Assistance Programs, P.O. Box 45480, Olympia, WA 98504-5480, (360) 413-3232.

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

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: Changes rules to be consistent with federal laws, rules, and regulations.

Proposal Changes the Following Existing Rules: WAC 388-418-0030 Notifying a recipient of intent to reduce, suspend, or terminate assistance, 388-406-0015 Expedited service for food assistance, 388-406-0035 Time limits for application processing, 388-406-0040 Delays in application processing, and 388-406-0050 Completing the application process.

Proposal creates the following new rule: WAC 388-418-0012 Prospective eligibility for food assistance.

WAC 388-418-0012, created WAC to reflect requirement that clients be prospectively eligible for food assistance. WAC 388-418-0030, clarified that notice must be mailed ten days before an adverse action is taken. WAC 388-406-0015, added definition of what expedited service includes and clarified time frame. WAC 388-406-0035, added application processing time frame for food assistance. WAC 388-406-0040, added text to clarify that medical applications are not to be delayed when an application for other assistance is pending. WAC 388-406-0050, removed incorrect reference to medical for no-shows to be considered as a withdrawn application.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The changes as a result of this rule do not affect small businesses.

RCW 34.05.328 does not apply to this rule adoption. This rule does not meet the definition of significant legislative rule.

Hearing Location: Lacey Government Center (behind Tokyo Bento Restaurant), 1009 College Street S.E., Room 104-B, Lacey, WA 98503, on July 6, 1999, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact Paige Wall by June 25, 1999, phone (360) 664-6094, TTY (360) 664-6178, e-mail wallpg@dshs.wa.gov.

Submit Written Comments to: Identify WAC Numbers, Paige Wall, Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 902-8292, by July 6, 1999.

Date of Intended Adoption: July 9, 1999.

May 28, 1999

Marie Myerchin-Redifer, Manager

Rules and Policies Assistance Unit


NEW SECTION
WAC 388-418-0012
Prospective eligibility for food assistance.

(1) We determine eligibility for food assistance every month for all households based on the household's expected circumstances. This is called prospective eligibility.

(2) Households must meet all eligibility requirements in WAC 388-400-0040 or 388-400-0045 in order to be eligible for food assistance unless the household meets the categorical eligibility (CE) requirements in WAC 388-414-0001.

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2581.2
AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-418-0030
Notifying a recipient of intent to reduce, suspend or terminate assistance.

(1) For cash, medical and food assistance a ((recipient)) notice to reduce, suspend, or terminate assistance must be ((notified)) mailed to the recipient at least ten days in advance of ((an)) the action ((to reduce, suspend or terminate assistance)).  Certain types of circumstances do not require advance notice.

(2) When a ten day advance notice is not required:

(a) For cash assistance and medical, the notice must be mailed or given to the recipient by the date of the action to reduce, suspend or terminate the benefits.

(b) For food assistance, the notice must be mailed or given to the recipient by the date the benefits are received or should have been received.

(3) The ten day advance notice period is not required:

(a) For recipients of cash and food assistance when:

(i) The recipient's whereabouts are unknown and mail was returned by the post office marked no forwarding address;

(ii) The recipient requests termination;

(iii) The department has factual information that the assistance unit has moved to another state or will move to another state before the next benefits are issued; or

(iv) The recipient states in writing that they understand the information they provided will reduce, suspend or terminate their benefits.

(b) For cash and food assistance when the action is based on information provided on a monthly report.

(c) For cash assistance when:

(i) The department has factual information that the recipient or nonrecipient caretaker has died when no other caretaker is available;

(ii) A recipient child is removed from the home under a court order or is voluntarily placed in foster care by the adult caring for the child; or

(iii) A recipient was admitted or committed to an institution which makes them ineligible for benefits.

(d) When a cash assistance recipient's benefits are reduced or terminated because of long-term hospital stay or the recipient is placed in a nursing home.

(e) For food assistance only, when:

(i) The department has factual information that all assistance unit members have died;

(ii) The federal or state government makes mass changes;

(iii) The benefits are reduced because cash assistance is approved;

(iv) An assistance unit member is disqualified for an intentional program violation and the benefits of the remaining members are reduced or terminated because of this disqualification; or

(v) The department reduces the allotment to collect for an overpayment and the assistance unit already received advance notice.

(4) A separate notice is not required:

(a) For cash and food assistance when:

(i) Benefits were approved the recipient was notified of the amount of benefits for each month because the amounts varied.

(ii) The recipient was already notified when a supplemental payment or increased allotment to restore lost benefits would end.

(b) For cash assistance, when the recipient was already notified that an emergent need payment was for one month only.

(5) A client continues to receive the same benefits received prior to a ten-day advance notice of reduction, suspension or termination of benefits (continued benefits) when:

(a) The client requests a fair hearing during this ten-day period; and

(b) For food assistance only, the client's certification period has not expired.

(6) A client receives continued benefits through the end of the month the fair hearing decision is mailed unless:

(a) The client:

(i) States in writing that the assistance unit does not want continued benefits;

(ii) Withdraws the fair hearing request in writing; or

(iii) Abandons the fair hearing request; or

(b) An administrative law judge issues a written order that ends continued benefits prior to the fair hearing.

(7) For food assistance clients, continued benefits end when the certification period expires.

(8) Any continued benefits a client receives pending a fair hearing decision are considered an overpayment when the fair hearing decision agrees with the department's action.

(9) When eligibility for medical care is terminated the client is provided with advance and adequate written notice.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.  98-16-044, 388-418-0030, filed 7/31/98, effective 9/1/98. Formerly WAC 388-522-2205 and 388-525-2570.]

2579.2
AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-406-0015
Expedited service for food assistance.

(1) ((Households eligible for)) Expedited service means a client will have verification postponed and receive food assistance benefits by the end of the fifth calendar day from the day after the date ((of)) the application is filed. The day after that date is day one.  ((For SSI recipients, this time frame begins on the date the:

(a) Applicant's local CSO receives the application of a noninstitutionalized SSI household; or

(b) Applicant is released from a public institution.

(2) Applicants are eligible for expedited service when the household:

(a) Has liquid resources of one hundred dollars or less and has gross monthly income under one hundred fifty dollars; or

(b) Has combined gross monthly income and liquid resources which are less than the household's current monthly rent and applicable utility allowance; or

(c) When all members are homeless; or

(d) Includes a destitute migrant or seasonal farmworker, as defined in WAC 388-406-0020, whose liquid resources do not exceed one hundred dollars.

(3) A household must provide verification of:

(a) The identity of the applicant; or

(b) The identity of the authorized representative who is applying for the household; and

(c) Other eligibility factors that can be verified within the five day time period specified in subsection (1) of this section.

(4) A household is not limited to the number of times it can receive expedited service if, following the last expedited certification, the household:

(a) Completes the postponed verification requirements; or

(b) Was certified by the regular nonexpedited processing methods.

(5) When a household is eligible for expedited service and an office interview is not required, the household will have:

(a) A telephone interview or home visit; and

(b) Still receive their benefits within the five-day expedited time period.

(6) A household is entitled to an agency conference within two working days from the date of denial for expedited service))

(2) The five-day period starts at a time after the date the application is filed in the following situations:

(a) The five-day period starts the date of the rescheduled interview when the client is screened as expedited service eligible and causes a delay by not showing for the initial interview;

(b) The five-day period starts the date identification is provided when the client causes a delay by not providing identification at the interview; or

(c) The five-day period starts the date of the interview when the client:

(i) Waives the expedited interview and is found eligible for the service at the scheduled interview;

(ii) Is screened as ineligible for expedited service and later found eligible for the service at the scheduled interview; or

(iii) Does not request expedited service on the application and is found eligible for the service at the interview.

(3) For SSI recipients, the five-day period begins on the date the:

(a) Applicant’s local office receives the application of a noninstitutionalized SSI household; or

(b) Applicant is released from a public institution.

(4) When clients request expedited service on a recertification form, the five-day period:

(a) Starts the first day of the new certification period when the recertification is made prior to the end of the current certification period;

(b) Starts the first day of the new certification period or the date of interview, whichever is later, when the client causes a delay in the recertification; or

(c) Is the same as a new application when the recertification is made after the current certification period ends.

(5) Clients are eligible for expedited service when:

(a) The household has liquid resources of one hundred dollars or less and has gross monthly income under one hundred fifty dollars; or

(b) The household has combined gross monthly income and liquid resources which are less than the household's current monthly rent and applicable utility allowance; or

(c) All household members are homeless; or

(d) The household includes a destitute migrant or seasonal farmworker, as defined in WAC 388-406-0020, whose liquid resources do not exceed one hundred dollars.

(6) A household must provide verification of:

(a) The identity of the applicant; or

(b) The identity of the authorized representative who is applying for the household; and

(c) Other eligibility factors that can be verified within the five day time period specified in subsection (1) of this section.

(7) A household is not limited to the number of times it can receive expedited service if, following the last expedited certification, the household:

(a) Completes the postponed verification requirements; or

(b) Was certified by the regular nonexpedited processing methods.

(8) Households eligible for expedited service that are not required to have an office interview will:

(a) Have a telephone interview or home visit; and

(b) Still receive their benefits within the five-day expedited time period.

(9) A household is entitled to an agency conference within two working days from the date of denial for expedited service.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.  98-16-044, 388-406-0015, filed 7/31/98, effective 9/1/98.]


AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-406-0035
Time limits for processing applications.

(1) The application process as defined in WAC 388-406-0050(1) must be completed as quickly as possible.  The time limits specified in this section cannot be used as a waiting period for determining eligibility.

(2) When applying the time limits specified in this section, day one is the date following the date:

(a) A request for benefits form is received by the department as specified under WAC 388-406-0010;

(b) A household consisting solely of persons eligible for SSI files a food assistance application at the SSADO; or

(c) An SSI recipient applying for food assistance is released from a public institution when the person filed an application with the SSADO before release.

(3) Time limits are in calendar days unless otherwise specified.  Time limits for application process completion are no more than:

(a) Thirty days for TANF, SFA, RCA, consolidated emergency assistance program (CEAP), ((and)) diversion cash assistance (DCA), and food assistance;

(b) Forty-five days for general assistance and alcohol and drug abuse treatment and shelter assistance (ADATSA); and

(c) Medical program benefits must be processed no more than:

(i) Sixty days when a disability decision is required;

(ii) Fifteen working days for pregnant women; and

(iii) Forty-five days for all other categories.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.  98-16-044, 388-406-0035, filed 7/31/98, effective 9/1/98. Formerly WAC 388-504-0470.]


AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-406-0040
Delays in application processing.

(1) When the department discovers that a food assistance application has not been processed within the initial thirty day time limit, and:

(a) The department has sufficient information to determine eligibility, the application will be processed without further delay; or

(b) If additional information is needed to determine eligibility, the household will be:

(i) Mailed or given a written request for the additional information needed to determine eligibility; and

(ii) Allowed an additional thirty day period to provide the information.

(2) When a household files a joint application requesting food assistance and medical or cash assistance:

(a) Approval of the food assistance application cannot be delayed pending the processing of the application for medical or cash assistance; ((and))

(b) A new application for food assistance cannot be required if the application for medical or cash assistance is denied;

(c) Approval for a medical program is not delayed pending the processing of the application for cash or food assistance.

(3) For medical and cash assistance, application processing may be delayed only when good cause exists as specified in WAC 388-406-0045.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.  98-16-044, 388-406-0040, filed 7/31/98, effective 9/1/98. Formerly WAC 388-504-0480.]


AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-406-0050
Completing the application process.

(1) Application processing is completed when the department makes an eligibility decision and:

(a) Authorizes benefits and, for food assistance, mails or gives a written approval notice to the applicant; or

(b) Mails or gives a written withdrawal or denial notice to the applicant.

(2) The applicant will be notified of the department's eligibility decision in writing.  A notice of denial or withdrawal must meet the adequate notice requirements in WAC 388-458-0005.

(3) For cash, medical, and food assistance, an applicant may voluntarily withdraw an application orally or in writing.

(4) For ((medical and)) cash assistance, an application is considered withdrawn when the applicant:

(a) Fails to appear for a scheduled interview required for eligibility determination; and

(b) Does not contact the department to reschedule the interview within thirty days from the date of application.

(5) For approved applications, the date the applicant becomes eligible for assistance is established according to WAC 388-406-0055.

(6) A decision to deny an application must be made according to the requirements of WAC 388-406-0060.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.  98-16-044, 388-406-0050, filed 7/31/98, effective 9/1/98. Formerly WAC 388-525-2505.]

Washington State Code Reviser's Office