WSR 13-13-076
PROPOSED RULES
DEPARTMENT OF
SOCIAL AND HEALTH SERVICES
(Economic Services Administration)
[Filed June 19, 2013, 9:49 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 12-08-063.
Title of Rule and Other Identifying Information: The department is proposing to amend WAC 388-310-1800 WorkFirst—Post employment services, 388-410-0001 What is a cash/medical assistance overpayment?, 388-410-0005 Cash and medical assistance overpayment amount and liability, 388-432-0005 Can I get help from DSHS for a family emergency without receiving monthly cash assistance?, 388-466-0150 Refugee employment and training services, and 388-472-0040 What are the department's responsibilities in giving NSA services to me?
Hearing Location(s): Office Building 2, Lookout Room, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at http://www1.dshs.wa.gov/msa/rpau/RPAU-OB-2directions.html), on July 23, 2013, at 10:00 a.m.
Date of Intended Adoption: Not earlier than July 24, 2013.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5 p.m. on July 23, 2013.
Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by July 2, 2013, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at jennisha.johnson@dshs.wa.gov.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The community services division is proposing to amend the above WACs to remove medical language references from rules regarding post-employment services, overpayments, diversion cash assistance, refugee employment and training services, and NSA services. These changes are necessary as the health care authority (HCA) is amending, repealing, or creating medical assistance programs rules under Title 182 WAC to implement new regulations.
Reasons Supporting Proposal: These proposed amendments are necessary to comply with 2E2SHB 1738, chapter 15, Laws of 2011, which designated HCA as the single state agency responsible for the administration and supervision of Washington's medicaid programs.
Statutory Authority for Adoption: RCW 74.04.050, 74.04.055, 74.04.500, 74.04.510, 74.08.090, and 74.08A.120.
Statute Being Implemented: 2E2SHB 1738, chapter 15, Laws of 2011.
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: Leslie Kozak, 712 Pear Street S.E., Olympia, 98501, (360) 725-4589.
No small business economic impact statement has been prepared under chapter 19.85 RCW. These proposed changes do not have an economic impact on small business.
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)(ii) Rules relating only to internal governmental operations that are not subject to violation by a nongovernmental party;
(b)(vii) "(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."
May 20, 2013
Katherine I. Vasquez
Rules Coordinator
AMENDATORY SECTION (Amending WSR 10-22-061, filed 10/29/10, effective 12/1/10)
WAC 388-310-1800 WorkFirst—Post employment services. (1) What is the purpose of post employment services?
Post employment services help TANF or SFA parents who are working twenty hours or more a week keep and cope with their current jobs, look for better jobs, gain work skills for a career and become self sufficient.
(2) How do I obtain post employment services?
(a) You can obtain post employment services by:
(i) Asking for a referral from the local community service office;
(ii) Contacting community or technical colleges; or
(iii) Contacting the employment security department.
(3) Who provides post employment services and what kind of services do they provide?
(a) The employment security department can help you increase your wages, increase your job skills or find a better job by providing you with:
(i) Employment and career counseling;
(ii) Labor market information;
(iii) Job leads for a better job (sometimes called job development);
(iv) On the job training;
(v) Help with finding a job that matches your interests, abilities and skills (sometimes called job matching); and
(vi) Help with finding a new job after job loss (sometimes called reemployment).
(b) Any Washington state technical and community college can approve a skill-training program for you that will help you advance up the career ladder. Their staff will talk to you, help you decide what training would work best for you and then help you get enrolled in these programs. The college may approve the following types of training for you at any certified institution:
(i) High school/GED,
(ii) Vocational education training,
(iii) Job skills training,
(iv) Adult basic education,
(v) English as a second language training, or
(vi) Preemployment training.
(4) What other services are available while you receive post employment services?
While you receive post employment services, you may qualify for:
(a) Working connections childcare if you meet the criteria for this program (described in chapter 170-290 WAC).
(b) Other support services, such as help in paying for transportation or work expenses if you meet the criteria for this program (WAC 388-310-0800).
(c) Other types of assistance for low-income families such as food stamps((, medical assistance)) or help with getting child support that is due to you and your children.
(5) Who is eligible for post employment services?
If you are a current TANF or SFA recipient, you may qualify for post employment services if you are working twenty hours or more a week, unless you are in sanction status.
(6) What if I lose my job while I am receiving post employment services?
If you now receive TANF or SFA, help is available to you so that you can find another job and continue in your approved post employment services.
(a) The employment security department will provide you with reemployment services.
(b) At the same time, your case manager can approve support services and childcare for you.
AMENDATORY SECTION (Amending WSR 05-08-124, filed 4/5/05, effective 6/1/05)
WAC 388-410-0001 What is a cash((/medical)) assistance overpayment? (1) An overpayment is any cash ((or medical)) assistance paid that is more than the assistance unit was eligible to receive.
(2) There are two types of cash((/medical)) overpayments:
(a) Intentional overpayments, presumed to exist if you willfully or knowingly:
(i) Fail to report a change you must tell us about under WAC 388-418-0005 within the time frames under WAC 388-418-0007; or
(ii) Misstate or fail to reveal a fact affecting eligibility as specified in WAC 388-446-0001.
(b) Unintentional overpayments, which includes all other client-caused and all department-caused overpayments.
(3) If you request a fair hearing and the fair hearing decision is in favor of the department, then:
(a) Some or all of the continued assistance you get before the fair hearing decision must be paid back to the department (see WAC 388-418-0020); and
(b) The amount of assistance you must pay back will be limited to sixty days of assistance, starting with the day after the department receives your hearing request.
(4) If you receive child support payments directly from the noncustodial parent, you must turn these payments over to the division of child support (DCS). These payments are not cash assistance overpayments.
AMENDATORY SECTION (Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)
WAC 388-410-0005 Cash ((and medical)) assistance overpayment amount and liability. (1) The amount of overpayment for cash ((and medical)) assistance households is determined by the amount of assistance received to which the assistance unit was not entitled.
(2) Cash ((and medical assistance)) overpayments are recovered from:
(a) Any individual member of an overpaid assistance unit, whether or not the member is currently a recipient; or
(b) Any assistance unit of which a member of the overpaid assistance unit has subsequently become a member.
(3) A cash ((or medical)) assistance overpayment is not recovered from:
(a) A nonneedy caretaker relative or guardian who received no financial benefit from the payment of assistance; or
(b) A person not receiving assistance when an unintentional overpayment of less than thirty-five dollars is discovered and/or computed.
(4) Overpayments resulting from incorrectly received cash assistance are reduced by:
(a) Cash assistance a household would have been eligible to receive from any other category of cash assistance during the period of ineligibility; and
(b) Child support the department collected for the month of overpayment in excess of the amount specified in (a) of this subsection; or
(c) Any existing grant underpayments.
(5) A cash assistance overpayment cannot be reduced by a ((medical or)) food assistance underpayment.
(6) ((A medical assistance overpayment cannot be reduced by a cash or food assistance underpayment.
(7))) An underpayment from one assistance unit cannot be credited to another assistance unit to offset an overpayment.
(((8))) (7) All overpayments occurring after January 1, 1982 are required to be repaid by mandatory grant deduction except where recovery is inequitable as specified in WAC 388-410-0010.
AMENDATORY SECTION (Amending WSR 10-24-064, filed 11/30/10, effective 12/31/10)
WAC 388-432-0005 Can I get help from DSHS for a family emergency without receiving monthly cash assistance? DSHS has a program called diversion cash assistance (DCA). If your family needs an emergency cash payment but does not need ongoing monthly cash assistance, you may be eligible for this program.
(1) To get DCA, you must:
(a) Meet all the eligibility rules for temporary assistance for needy families (TANF)/state family assistance (SFA) except:
(i) You do not have to participate in WorkFirst requirements as defined in chapter 388-310 WAC; and
(ii) You do not have to assign child support rights or cooperate with division of child support as defined in chapter 388-422 WAC.
(b) Have a current bona fide or approved need for living expenses;
(c) Provide proof that your need exists; and
(d) Have or expect to get enough income or resources to support yourselves for at least twelve months.
(2) You may get DCA to help pay for one or more of the following needs:
(a) Child care;
(b) Housing;
(c) Transportation;
(d) Expenses to get or keep a job;
(e) Food costs, but not if an adult member of your family has been disqualified for food stamps; or
(f) Medical costs, except when an adult member of your family is not eligible because of failure to provide third party liability (TPL) information as defined in WAC ((388-505-0540)) 182-503-0540.
(3) DCA payments are limited to:
(a) One thousand two hundred fifty dollars once in a twelve-month period which starts with the month the DCA benefits begin; and
(b) The cost of your need.
(4) We do not budget your income or make you use your resources to lower the amount of DCA payments you can receive.
(5) DCA payments can be paid:
(a) All at once; or
(b) As separate payments over a thirty-day period. The thirty-day period starts with the date of your first DCA payment.
(6) When it is possible, we pay your DCA benefit directly to the service provider.
(7) You are not eligible for DCA if:
(a) Any adult member of your assistance unit got DCA within the last twelve months;
(b) Any adult member of your assistance unit gets TANF/SFA;
(c) Any adult member of your assistance unit is not eligible for cash assistance for any reason unless one parent in a two-parent-assistance unit is receiving SSI; or
(d) Your assistance unit does not have a needy adult (such as when you do not receive TANF/SFA payment for yourself but receive it for the children only).
(8) If you apply for DCA after your TANF/SFA grant has been terminated, we consider you an applicant for DCA.
(9) If you apply for TANF/SFA and you received DCA less than twelve months ago:
(a) We set up a DCA loan.
(i) The amount of the loan is one-twelfth of the total DCA benefit times the number of months that are left in the twelve-month period.
(ii) The first month begins with the month DCA benefits began.
(b) We collect the loan only by reducing your grant. We take five percent of your TANF/SFA grant each month.
(10) If you stop getting TANF/SFA before you have repaid the loan, we stop collecting the loan unless you get back on TANF/SFA.
AMENDATORY SECTION (Amending WSR 00-22-085, filed 10/31/00, effective 12/1/00)
WAC 388-466-0150 Refugee employment and training services. (1) What are refugee employment and training services?
Refugee employment and training services provided to eligible refugees may include information and referral, employment oriented case management, job development, job placement, job retention, wage progression, skills training, on-the-job training, counseling and orientation, English as a second language, and vocational English training.
(2) Am I required to participate in refugee employment and training services?
If you are receiving refugee cash assistance (RCA) you are required to participate in refugee employment and training services, unless you are exempt.
(3) How do I know if I am exempt from mandatory employment and training requirements?
(a) You may be exempt from participation in employment and training requirements if:
(i) You are needed in the home to personally provide care for your child under three months of age (see WAC 388-310-0300);
(ii) You are sixty years of age or older.
(b) You can not be exempt from work and training requirements solely because of an inability to communicate in English.
(4) If I am required to participate, what do I have to do?
You are required to:
(a) Register with your employment service provider;
(b) Accept and participate in all employment opportunities, training or referrals, determined appropriate by the department.
(5) What happens if I do not follow these requirements?
If you refuse without good reason to cooperate with the requirements, you are subject to the following penalties:
(a) If you are applying for refugee cash ((and medical)) assistance, you will be ineligible for thirty days from the date of your refusal to accept work or training opportunity; or
(b) If you are already receiving refugee cash ((and medical)) assistance, your cash benefits will be subject to financial penalties.
(c) The department will notify your voluntary agency (VOLAG) if financial penalties take place.
(6) What are the penalties to my grant?
The penalties to your grant are:
(a) If the assistance unit includes other individuals as well as yourself, the cash grant is reduced by the sanctioned refugee's amount for three months after the first occurrence. For the second occurrence the financial penalty continues for the remainder of the sanctioned refugee's eight-month eligibility period.
(b) If you are the only person in the assistance unit your cash grant is terminated for three months after the first occurrence. For the second occurrence, your grant is terminated for the remainder of your eight-month eligibility period.
(7) How can I avoid the penalties?
You can avoid the penalties, if you accept employment or training before the last day of the month in which your cash grant is closed.
(8) What is considered a good reason for not being able to follow the requirements?
You have a good reason for not following the requirements if it was not possible for you to stay on the job or to follow through on a required activity due to an event outside of your control. See WAC 388-310-1600(3) for examples.
AMENDATORY SECTION (Amending WSR 01-10-104, filed 5/1/01, effective 6/1/01)
WAC 388-472-0040 What are the department's responsibilities in giving NSA services to me? (1) All of our staff are continually responsible to identify you as possibly NSA eligible and assist you with NSA services.
(2) We provide a grace period to continue your financial((,)) or food ((or medical)) assistance when:
(a) We stop a benefit because we are unable to tell if you continue to qualify; and
(b) You provide proof you still qualify for the benefit within the twenty days right after the benefit stops. We restore lost benefits ((as follows:
(i) We reopen your medical assistance from the first of the month; and
(ii) We)), recalculate your cash and food assistance, and issue you the correct amount without taking away any benefits as long as you were eligible to receive them.