SOCIAL AND HEALTH SERVICES
(Economic Services Administration)
Preproposal statement of inquiry was filed as WSR 03-17-085.
Title of Rule and Other Identifying Information: WAC 388-400-0040 Am I eligible for benefits through the Washington Basic Food program? and 388-416-0015 Certification periods for categorically needy (CN) medical and children's health insurance program (CHIP).
Hearing Location(s): Office Building 2 Auditorium (DSHS Headquarters), 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson), on September 21, 2003 , at 10:00 a.m.
Date of Intended Adoption: Not earlier than September 22, 2004.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA, e-mail firstname.lastname@example.org, fax (360) 664-6185, by 5:00 p.m., September 21, 2004.
Assistance for Persons with Disabilities: Contact Fred Swenson, DSHS Rules Consultant, by September 17, 2004, TTY (360) 664-6178 or (360) 664-6097.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposal amends department rules that provide an overview of requirements related to the Washington Basic Food program and explain certification periods for categorically needy medical programs. The amendments are necessary to support the department's simplified reporting initiative. Simplified reporting reduces the changes clients must report to the department while requiring some clients to complete a six-month report to determine ongoing eligibility for benefits.
Reasons Supporting Proposal: These rules are necessary to implement the department's simplified reporting initiative for cash assistance, medical assistance, and the Washington Basic Food program.
The Farm Security and Rural Investment Act of 2002 provides states the option to implement simplified reporting for the food stamp program. ESB 6411 (chapter 54, Laws of 2004) requires the department to implement simplified reporting for food stamps by October 31, 2004. The department plans to implement simplified reporting for cash, medical, and the Basic Food program beginning in October 2004.
Statutory Authority for Adoption: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510, ESB 6411 (chapter 54, Laws of 2004).
Statute Being Implemented: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510, ESB 6411 (chapter 54, Laws of 2004).
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of Social and Health Services, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: John Camp, Policy Analyst, 1009 College S.E., Lacey, WA 98504, (360) 725-4616.
No small business economic impact statement has been prepared under chapter 19.85 RCW. These proposed rules do not have an economic impact on small businesses, it only affects DSHS clients by outlining the rules clients must meet in order to be eligible for the department's cash assistance or food benefit programs.
A cost-benefit analysis is not required under RCW 34.05.328. These amendments are exempt as allowed under RCW 34.05.328 (5)(b)(vii) which state in-part, "[t]his section does not apply to....rules of the department of social and health services relating only to client medical or financial eligibility and rules concerning liability for care of dependents." These rules adopt federal requirements and implement program options under Title 7 of the Code of Federal Regulations Part 273 regarding eligibility for food stamp benefits.
August 11, 2004
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit3452.1
(1) When you apply for Basic Food, we decide who is in your assistance unit (AU) based on the requirements under WAC 388-408-0035.
(2) To be eligible for Basic Food benefits, your AU must meet the eligibility requirements of the most current version of the Food Stamp Act of 1977.
(3) To be eligible for federal Basic Food benefits, each AU member must:
(a) Be a U.S. citizen or national as described under WAC 388-424-0005; or
(b) Meet the alien status requirements for federal benefits described under WAC 388-424-0020.
(4) An AU member who is not eligible for federal benefits may be eligible for state-funded Basic Food benefits if they meet the requirements described under WAC 388-400-0045.
(5) To be eligible for federal or state Basic Food benefits, each AU member must:
(a) Be a resident of the state of Washington as required under WAC 388-468-0005;
(b) Meet the citizenship or alien status requirements of either WAC 388-424-0020 or 388-424-0025;
(c) Provide their Social Security number as required under WAC 388-476-0005;
(d) Provide proof of identity as required under WAC 388-490-0005;
(e) Participate in the food stamp employment and training program (FSE&T) as required under chapter 388-444 WAC; and
(f) Meet the eligibility criteria for strikers as described under WAC 388-480-0001.
(6) To be eligible for Basic Food, your AU must:
(a) Have countable income at or below gross and net
income standards as described under WAC 388-478-0060; ((
(b) Have countable resources at or below your AU's resource limit under WAC 388-470-0005 unless your AU is categorically eligible under WAC 388-414-0001;
(c) Report changes of circumstances as required under WAC 388-418-0005; and
(d) Complete a six-month report and provide proof of any changes if required under WAC 388-4148-0010.
(7) If your AU has income under the gross income standard, we deduct certain expenses from your income under WAC 388-450-0200 before we calculate your Basic Food benefits.
(8) If an eligible person in your AU is elderly or disabled, some rules may help your AU to be eligible for Basic Food or to get more Basic Food benefits. These include:
(a) Resources limits and excluding certain resources under chapter 388-470 WAC;
(b) An excess shelter deduction over the limit set for AUs without an elderly or disabled individual under WAC 388-450-0190;
(c) A deduction for out-of-pocket medical expenses for the elderly or disabled individual if they are over thirty-five dollars a month under WAC 388-450-0200; and
(d) Being exempt from the gross income standard under WAC 388-478-0060.
(9) For Basic Food, elderly means a person who is age sixty or older;
(10) For Basic Food, disabled means a person who:
(a) Gets SSI;
(b) Gets disability payments or blindness payments under Title I, II, XIV, or XVI of the Social Security Act;
(c) Gets disability retirement benefits from a state, local or federal government agency because of a disability considered permanent under section 221(i) of the Social Security Act;
(d) Gets disability benefits from the Railroad Retirement Act under sections 2 (a)(1)(iv) and (v) and:
(i) Meets Title XIX disability requirements; or
(ii) Is eligible for Medicare.
(e) Receives disability-related medical assistance under Title XIX of the Social Security Act;
(f) Is a veteran and receives disability payments based on one hundred percent disability;
(g) Is a spouse of a veteran and:
(i) Either needs an attendant or is permanently housebound; or
(ii) Has a disability under section 221(i) of the Social Security Act and is eligible for death or pension payments under Title 38 of the USC.
(11) If a person in your AU attends an institution of higher education and does not meet the requirements to be an eligible student under WAC 388-482-0005, we do not consider this person as a member of your AU.
(12) If your AU lives on or near an Indian reservation and participates in a tribal food distribution program approved by Food and Nutrition Service (FNS), your AU is not eligible for Basic Food benefits.
(13) If an AU member is ineligible for any of the following reasons, we count the ineligible person's income as described under WAC 388-450-0140:
(a) Able-bodied adults without dependents who are no longer eligible under WAC 388-444-0030;
(b) Persons fleeing a felony prosecution, conviction, or confinement under WAC 388-442-0010;
(c) Persons who do not attest to citizenship or alien status under WAC 388-424-0005;
(d) Persons who are ineligible aliens under WAC 388-424-0020;
(e) Persons disqualified for an intentional program violation under WAC 388-446-0015;
(f) Persons who do not provide a Social Security number when required under WAC 388-476-0005; or
(g) Persons who failed to meet work requirements under chapter 388-444 WAC.
[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510, and 2004 c 54. 04-14-040, § 388-400-0040, filed 6/29/04, effective 7/30/04. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, and 74.04.510. 03-05-028, § 388-400-0040, filed 2/10/03, effective 4/1/03. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-400-0040, filed 7/31/98, effective 9/1/98.]
Reviser's note: The bracketed material preceding the section above was supplied by the code reviser's office.
Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.3453.1
AMENDATORY SECTION(Amending WSR 04-03-019, filed 1/12/04, effective 2/12/04)
WAC 388-416-0015 Certification periods for categorically needy (CN) medical and children's health insurance program (CHIP). (1) A certification period is the period of time a person is determined eligible for a categorically needy (CN) medical program. Unless otherwise stated in this section, the certification period begins on the first day of the month of application and continues to the last day of the last month of the certification period.
(2) For a child eligible for the newborn medical program, the certification period begins on the child's date of birth and continues through the end of the month of the child's first birthday.
(3) For a woman eligible for a medical program based on pregnancy, the certification period ends the last day of the month that includes the sixtieth day from the day the pregnancy ends.
(4) For families and children the certification period is
six)) twelve months with a six-month report required as a
condition of eligibiilty as described in WAC 388-418-0010. When the medical assistance unit is also receiving benefits
under a cash or food assistance program, the medical
certification period is updated to begin anew at each:
(a) Approved application for cash or food assistance; or
(b) Completed eligibility review.
(5) For an SSI-related person the certification period is twelve months.
(6) When the child turns nineteen the certification
period ends even if the ((
six))twelve-month period is not
over. The certification period may be extended past the end
of the month the child turns nineteen when:
(a) The child is receiving inpatient services on the last day of the month the child turns nineteen;
(b) The inpatient stay continues into the following month or months; and
(c) The child remains eligible except for exceeding age nineteen.
(7) A retroactive certification period can begin up to three months immediately before the month of application when:
(a) The client would have been eligible for medical assistance if the client had applied; and
(b) The client received covered medical services as described in WAC 388-529-0100.
(8) If the client is eligible only during the three-month retroactive period, that period is the only period of certification.
(9) Any months of a retroactive certification period are added to the designated certification periods described in this section.
(10) For a child determined eligible for CHIP medical benefits as described in chapter 388-542 WAC:
(a) The certification periods are described in subsections (1), (4), and (6) of this section;
(b) There is not a retroactive eligibility period as described in subsections (7), (8), and (9); and
(c) For a child who has creditable coverage at the time of application, the certification period begins on the first of the month after the child's creditable coverage is no longer in effect, if:
(i) All other CHIP eligibility factors are met; and
(ii) An eligibility decision is made per WAC 388-406-0035.
[Statutory Authority: RCW 74.08.090, 74.09.530, and 2003 c 10. 04-03-019, § 388-416-0015, filed 1/12/04, effective 2/12/04. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.08.090 and 74.09.450. 00-08-002, § 388-416-0015, filed 3/22/00, effective 5/1/00. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-416-0015, filed 7/31/98, effective 9/1/98. Formerly 388-509-0970, 388-521-2105, 388-522-2210 and 388-522-2230.]