WSR 04-12-042

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)

[ Filed May 28, 2004, 8:30 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 04-07-165.

Title of Rule: WAC 388-478-0075 Monthly income standards based on the federal poverty level (FPL).

Purpose: To permanently adopt the increased FPL standards.

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

Statute Being Implemented: RCW 74.08.090, 74.04.057, 74.04.050, and 74.09.530.

Summary: See Purpose above.

Reasons Supporting Proposal: Department standards must comply with those published by the United States Department of Health and Human Services in the Federal Register, (Volume 69, Number 30, pages 7335 to 7338) on February 13, 2004.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Joanie Scotson, MAA, P.O. Box 45534, Olympia, WA 98504-5534, (360) 725-1330.

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

Rule is necessary because of federal law, Federal Register, (Volume 69, Number 30) on February 13, 2004, pages 7335 to 7338 per 42 U.S.C. 9902(2).

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

Proposal Changes the Following Existing Rules: See Purpose and Reasons Supporting Proposal above.

No small business economic impact statement has been prepared under chapter 19.85 RCW. This proposed rule has no impact on small businesses. It affects client eligibility for medical assistance programs.

RCW 34.05.328 does not apply to this rule adoption. RCW 34.05.328 (5)(b)(vii) exempts DSHS medical and financial eligibility rules from this requirement. The proposed rule affects client eligibility for medical assistance programs.

Hearing Location: Blake Office Park (behind Goodyear Courtesy Tire), 4500 10th Avenue S.E., Rose Room, Lacey, WA 98503, on July 6, 2004, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator by July 1, 2004, phone (360) 664-6097, TTY (360) 664-6178, e-mail fernaax@dshs.wa.gov.

Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, mail to P.O. Box 45850, Olympia, WA 98504-5850, deliver to 4500 10th Avenue S.E., Lacey, WA, fax (360) 664-6185, e-mail fernaax@dshs.wa.gov, by 5:00 p.m., July 6, 2004.

Date of Intended Adoption: Not sooner than July 7, 2004.

May 24, 2004

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3371.3
AMENDATORY SECTION(Amending WSR 03-15-088, filed 7/17/03, effective 7/17/03)

WAC 388-478-0075   Medical programs--Monthly income standards based on the federal poverty level (FPL).   (1) The department bases the income standard upon the Federal Poverty Level (FPL) for the following medical programs:

(a) Pregnant women's program up to one hundred eighty-five percent of FPL;

(b) Children's categorically needy program up to two hundred percent of FPL;

(c) Healthcare for workers with disabilities (HWD) up to two hundred twenty percent of FPL; and

(d) The state children's health insurance program (SCHIP) is over two hundred percent of FPL but ((under)) not over two hundred fifty percent of FPL.

(2) The department uses the FPL income standards to determine:

(a) The mandatory or optional Medicaid status of an individual; and

(b) Premium amount, if any, for a Medicaid child.

(3) There are no resource limits for the programs under this section.

(4) Beginning ((April 1, 2003)) April 1, 2004, the monthly FPL standards are:


((
FAMILY

SIZE

100%

FPL

185%

FPL

200%

FPL

220%

FPL

250%

FPL

1 $749 $1385 $1497 $1647 $1871
2 $1010 $1869 $2020 $2222 $2525
3 $1272 $2353 $2544 $2798 $3180
4 $1534 $2837 $3067 $3374 $3834
5 $1795 $3321 $3590 $3949 $4488
6 $2057 $3805 $4114 $4525 $5142
7 $2319 $4289 $4637 $5101 $5796
8 $2580 $4773 $5160 $5676 $6450
9 $2842 $5258 $5684 $6252 $7105
10 $3104 $5742 $6207 $6828 $7759
Add to the ten person standard for each person over ten:
$262 $485 $524 $576 $655
))
FAMILY SIZE 100% FPL Benchmark 133% FPL 150% FPL 185% FPL 200% FPL 220% FPL 250% FPL
1 $ 776 $1032 $1164 $1436 $1552 $1707 $1940
2 $1041 $1385 $1562 $1926 $2082 $2290 $2603
3 $1306 $1737 $1953 $2416 $2612 $2873 $3265
4 $1571 $2090 $2357 $2907 $3142 $3456 $3928
5 $1836 $2442 $2754 $3397 $3672 $4039 $4590
6 $2101 $2795 $3152 $3887 $4202 $4622 $5253
7 $2366 $3147 $3549 $4377 $4732 $5205 $5915
8 $2631 $3499 $3947 $4868 $5262 $5788 $6578
9 $2896 $3852 $4344 $5358 $5792 $6371 $7240
10 $3161 $4204 $4742 $5848 $6322 $6954 $7903
Add to the ten person standard for each person over ten:
$ 265 $353 $398 $ 491 $530 $583 $663
(((3) There are no resource limits for the programs under this section.))

[Statutory Authority: RCW 74.08.090, 74.04.050, 74.04.057, 74.09.530, and 42 U.S.C. 9902(2). 03-15-088, 388-478-0075, filed 7/17/03, effective 7/17/03. Statutory Authority: RCW 74.08.090, 74.08A.100, 74.09.080, and 74.09.415. 02-17-030, 388-478-0075, filed 8/12/02, effective 9/12/02. Statutory Authority: RCW 74.04.050, 74.08.090, 74.09.500, 74.09.510, and Section 1902 (a)(10)(A)(ii)(XV) and (XVI) of the Social Security Act. 02-07-090, 388-478-0075, filed 3/19/02, effective 4/1/02. Statutory Authority: RCW 74.08.090, 74.04.050, 74.04.057, 74.09.530, and Section 673(2) (42 U.S.C. 9902(2)). 01-18-056, 388-478-0075, filed 8/30/01, effective 9/30/01; 00-17-085, 388-478-0075, filed 8/14/00, effective 9/14/00; 99-19-005, 388-478-0075, filed 9/3/99, effective 10/4/99. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, 388-478-0075, filed 7/31/98, effective 9/1/98. Formerly WAC 388-507-0805, 388-508-0810, 388-509-0910, 388-509-0920, 388-509-0940 and 388-509-0960.]

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