WSR 01-16-087

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Economic Services Administration)

[ Filed July 25, 2001, 3:56 p.m. , effective September 1, 2001 ]

     Date of Adoption: July 23, 2001.

     Purpose: This WAC chapter advises clients about the letters they may receive from the department. It explains:

When the department sends letters;
What information is included on the letters;
The timeframes for sending the letters; and
The clients' rights regarding notification from the department.

     Citation of Existing Rules Affected by this Order: Chapter 388-458 WAC, Notices and letters; and repealing WAC 388-458-0001, 388-458-0005, 388-458-0010, and 388-458-0015.

     Statutory Authority for Adoption: RCW 74.08.090 and 74.04.510.

      Adopted under notice filed as WSR 01-12-055 on June 1, 2001.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 7, Amended 0, Repealed 3; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 3, Amended 0, Repealed 1.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 10, Amended 0, Repealed 4.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 0, Repealed 0.
     Effective Date of Rule: September 1, 2001.

July 23, 2001

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

2948.2
NEW SECTION
WAC 388-458-0002   The department of social and health services (DSHS) sends you letters to tell you about your case.   (1) When you apply for or get benefits, we send you letters to tell you about your case.

     (2) If you speak another language and cannot read English, we send letters to you in your primary language.

     (3) There are seven basic types of letters that we send to you:

     (a) Withdrawals;

     (b) Denials;

     (c) Approvals;

     (d) Requests;

     (e) Changes;

     (f) Terminations; and

     (g) Other.

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NEW SECTION
WAC 388-458-0006   DSHS sends you a letter when you withdraw your application.   (1) We send you a withdrawal letter when you tell us that you no longer want to apply for benefits.

     (2) On this letter, we tell you:

     (a) The date we stopped processing your application; and

     (b) Your right to have your case reviewed or ask for a fair hearing.

     (3) We send this letter to you according to the rules in chapter 388-406 WAC.

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NEW SECTION
WAC 388-458-0011   DSHS sends you a denial letter when you can't get benefits.   (1) When we finish processing your application, we send you a denial letter if you cannot get benefits.

     (2) On this letter, we tell you:

     (a) Why you cannot get benefits;

     (b) The rules that support our decision;

     (c) The date we stopped processing your application; and

     (d) Your right to have your case reviewed or ask for a fair hearing.

     (3) If we are denying your application because you did not give us some information that we needed and we can't figure out if you are eligible without it, we also tell you on the letter:

     (a) What information you didn't give to us;

     (b) The date we asked for the information and the date it was due;

     (c) That we cannot figure out if you can get benefits without this information; and

     (d) That we will review your eligibility if:

     (i) For cash and medical, you give us the information within thirty days of the date of the notice;

     (ii) For food assistance, you give us the information within sixty days of the date you applied; and

     (iii) Your circumstances have not changed.

     (4) We send denial letters to you according to the rules in chapter 388-406 WAC.

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NEW SECTION
WAC 388-458-0016   DSHS sends you an approval letter when you can get benefits.   (1) When we finish processing your application, we send you an approval letter if you can get benefits.

     (2) On this letter, we tell you:

     (a) What kind of benefits you get;

     (b) If you applied for cash or food assistance, the amount of benefits you get;

     (c) If you applied for medical, what type of medical;

     (d) How long you will get the benefits; and

     (e) Your right to have your case reviewed or ask for a fair hearing.

     (3) We send approval letters to you according to the rules in chapter 388-406 WAC.

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NEW SECTION
WAC 388-458-0020   You get a request letter when we need more information.   (1) We send a request letter to you when we need some information from you or you have to do something in order to get benefits.

     (2) On the letter, we tell you:

     (a) What is needed;

     (b) The date it is due; and

     (c) What will happen to your benefits if you don't do what we ask.

     (3) You get at least ten days to give us the information or do the activity. You can ask for more time if you need it.

     (4) If the tenth day is on a weekend or holiday, you have until the next business day to do what we need.

     (5) If we don't get what we need by the due date, we may deny, reduce, or stop your benefits. We will send you another letter if this happens.

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NEW SECTION
WAC 388-458-0025   We send you a change letter if the amount of benefits you are getting is changing.   (1) We send you a change letter if the amount of benefits you are getting is changing.

     (2) On the letter, we tell you:

     (a) What your benefits are changing to;

     (b) When the change is going to happen;

     (c) The reason for the change;

     (d) The rules that support our decision; and

     (e) Your right to have your case reviewed or ask for a fair hearing.

     (3) We send the letter to you before the change happens. If your benefits are going down, we give you at least ten days notice unless:

     (a) You ask us to reduce your benefits;

     (b) We have to change benefits for a lot of people at once because of a law change;

     (c) For cash and food assistance:

     (i) We told you on your approval letter that your benefits might change every month because you have fluctuating income; or

     (ii) We already told you that the supplement would end.

     (d) For cash assistance, we told you that the AREN payment described in WAC 388-436-0002 was for one month only.

     (4) The ten-day count starts on the day we mail or give you the letter and ends on the tenth day.

     (5) If we don't have to give you ten days notice, we send the letter to you:

     (a) For cash and medical, by the date of the action.

     (b) For food assistance, by the date you normally get your benefits.

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NEW SECTION
WAC 388-458-0030   We send you a termination letter when your benefits stop.   (1) We send you a termination letter when your benefits stop.

     (2) On the letter, we tell you:

     (a) When your benefits are going to end;

     (b) The reason they are ending;

     (c) The rules that support our decision; and

     (d) Your right to have your case reviewed or ask for a fair hearing.

     (3) We tell you at least ten days before your benefits end unless;

     (a) You asked us to stop your benefits;

     (b) We have proof that everyone in your assistance unit has moved to another state or will move to another state before the next benefits are issued;

     (c) We have proof that everyone in your assistance unit has died;

     (d) We have to change benefits for a lot of people at once because of a law change; or

     (e) For food assistance, your certification period is ending.

     (4) The ten-day count starts on the day we mail or give you the letter and ends on the tenth day.

     (5) If we don't have to give you ten days notice, we send the letter to you:

     (a) For cash and medical, by the date of the action.

     (b) For food assistance, by the date you normally get your benefits.

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NEW SECTION
WAC 388-458-0035   Why do you give me ten days notice before you reduce or stop my benefits?   (1) We give you ten days notice before reducing or stopping your benefits so that you have some time to either:

     (a) Get the needed information to us; or

     (b) Prepare yourself and your family for the change.

     (2) You can also use this time to request a fair hearing.

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NEW SECTION
WAC 388-458-0040   What happens if I ask for a fair hearing before the change happens?   (1) If you ask for a fair hearing within the ten-day notice period, you may keep getting the amount of benefits you were getting before the change. This is called continued benefits.

     (2) If the tenth day falls on a weekend or holiday, you have until the next business day to ask for a fair hearing and still be able to get continued benefits.

     (3) If the tenth day happens before the end of the month, you have until the end of the month to ask for a fair hearing and still be able to get continued benefits.

     (4) For food assistance, you cannot get continued benefits if your certification period is ending.

     (5) If you get continued benefits, you keep getting them through the end of the month the fair hearing decision is mailed unless:

     (a) You:

     (i) Tell us in writing that you do not want continued benefits;

     (ii) Withdraw your fair hearing request in writing; or

     (iii) Do not follow through with the fair hearing process.

     (b) An administrative law judge (ALJ) tells us in writing to stop your continued benefits before the hearing.

     (c) For food assistance, your certification period ends.

     (6) After the fair hearing, you have to pay back continued benefits you get, as described in chapter 388-410 WAC, if the ALJ agrees with our decision.

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NEW SECTION
WAC 388-458-0045   Will I get other kinds of letters?   Yes. We also send you letters in special circumstances. These letters are specific to your situation. Here are some examples:

     (1) Appointment letters;

     (2) Overpayment letters; and

     (3) Fair Hearing letters.

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REPEALER

     The following sections of the Washington Administrative Code are repealed:
WAC 388-458-0001 How the department requests information or action needed when a client applies for assistance or reports a change.
WAC 388-458-0005 Adequate notice of denial or withdrawal.
WAC 388-458-0010 Adequate notice of adverse action to recipients.
WAC 388-458-0015 Translation of written communications with limited English proficient clients.

© Washington State Code Reviser's Office