WSR 99-23-034

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Economic Services Administration)

[ Filed November 10, 1999, 3:48 p.m. , effective January 1, 2000 ]

Date of Adoption: November 10, 1999.

Purpose: WAC 388-418-0005, 388-418-0020 and 388-458-0010 are amended to reflect the department's change to prospective budgeting as the sole method of budgeting income and deductions. Changes in reporting requirements are changed to reflect the requirements established by a federal waiver approved by the United States Department of Agriculture, Food and Nutrition Services. WAC 388-418-0010, 388-418-0015 and 388-418-0030 are repealed and incorporated into the new WAC 388-458-0001 and the revised WAC 388-458-0010.

Citation of Existing Rules Affected by this Order: Repealing WAC 388-418-0010, 388-418-0015 and 388-418-0030; and amending WAC 388-418-0005, 388-418-0020, and 388-458-0010.

Statutory Authority for Adoption: RCW 74.08.090, 74.04.510.

Adopted under notice filed as WSR 99-19-159 on September 22, 1999.

Changes Other than Editing from Proposed to Adopted Version: Additional text was added to WAC 388-458-0010 to define when adverse action notice periods begin and end. Text was removed from WAC 388-418-0020 that implied clients must request continued benefits pending a hearing decision.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 1, Amended 3, Repealed 3.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, Amended 3, Repealed 3.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 3, Repealed 3. Effective Date of Rule: January 1, 2000.

November 10, 1999

Marie Myerchin-Redifer, Manager

Rules and Policies Assistance Unit

2649.3
NEW SECTION
WAC 388-458-0001
How the department requests information or action needed when a client applies for assistance or reports a change.

(1) When the department needs additional information in order to determine the client's eligibility and benefit amount, we send a written request. The client has at least ten days from the date we send the request to respond.

(2) We send these kinds of request when:

(a) You must provide additional information, verification or participate in some activity to qualify for benefits.

(b) Additional information is necessary to determine how a change affects your benefit amount.

(c) Verification is required before we increase your benefit amount.

(3) The request must state:

(a) What information or action is needed, and

(b) The date the information or action is due, and

(c) That we may reduce or deny benefits if the client fails to provide the information or take the action.

(4) If the client fails to provide requested information or take an action within the ten days, we may deny, reduce or discontinue the client's benefits.

(5) If the client later provides the requested information or takes the requested action during the advance notice period:

(a) Assistance continues unchanged if the action or information does not result in a reduction of benefits.

(b) The information or action is treated as a newly reported change under chapter 388-418 WAC if the action or information results in a reduction of benefits.

[]


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

WAC 388-458-0010
Adequate notice of adverse action to recipients.

((An adequate written notice of a decision to terminate, suspend, reduce or restrict cash, medical or food assistance benefits includes a statement of:))

(1) ((The action the department intends to take;

(2) The reasons for the intended action;

(3) The specific rule, regulation or law supporting the action;

(4) The recipient's right to request a fair hearing, including the circumstances under which assistance may be continued if a hearing is requested;

(5) Timely notice of a decision to terminate, suspend, or reduce assistance must be provided as required under WAC 388-418-0030; and

(6) Notices to clients who qualify for necessary supplemental accommodation services will be provided as required under WAC 388-200-1300)) Before we change the benefits a client receives, we send a written notice that explains:

(a) When the benefit amount will change;

(b) If the change is an increase or decrease;

(c) The reasons for the intended action;

(d) The specific rule, regulation or law supporting the action;

(e) The recipient's right to request a fair hearing, including the circumstances under which assistance may be continued if a hearing is requested.

(2) For cash, medical and food assistance, a notice must be sent ten days in advance of an action to reduce, suspend, restrict or discontinue assistance benefits.

(a) The advance notice period begins the day we send the notice.

(b) The advance notice period ends:

(i) On the tenth day after we send the notice; or

(ii) On the next regular mail delivery day if the tenth day falls on a Sunday or holiday.

(3) For certain situations the advance notice period can be less than ten days. A shorter advance notice period is allowed when:

(a) The recipient asks the department to reduce or discontinue benefits.

(b) The department has documented information that the assistance unit has moved to another state or will move to another state before the next benefits are issued.

(c) The department has documented information that all members of the assistance unit have died.

(d) A change in law or regulation requires the department to change benefits for all clients in a certain group.

(4) When a shorter advance notice period is allowed, the notice must be mailed or given to the recipient:

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

(b) For food assistance, by the date the benefits are received or should have been received.

(5) A separate adverse action notice is not required:

(a) For cash and food assistance, when:

(i) The client was notified when benefits were approved that the amount of benefits for each month varied; or

(ii) The client 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.

(6) For clients who qualify for necessary supplemental accommodation services, we provide notices as required under WAC 388-200-1300.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.  98-16-044, 388-458-0010, filed 7/31/98, effective 9/1/98. Formerly WAC 388-525-2520.]

2650.4
AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-418-0005
((Reporting requirements)) Clients must report certain changes to the department within specified time limits.

(1) ((For)) Clients who receive cash ((and)) or food assistance ((:

(a) Clients must report changes within ten days of the date the change becomes known to the assistance unit.

(b) Clients who report changes on a monthly report as specified under chapter 388-456 WAC are not required to report within the ten-day period.

(2) For medical care services, clients must report changes within twenty days of the date the change becomes known to the client.

(3) Food assistance clients are required to report the following:

(a) A change in the amount of gross monthly income of more than twenty-five dollars except for changes in public assistance income;

(b) A change in the source of income;

(c) A change in household size such as addition or loss of a household member;

(d) A change in residence and the resulting change in shelter cost;

(e) Obtaining a licensed vehicle;

(f) The end of a temporary disability when the temporary disability is the reason for excluding a vehicle; and

(g) When a change in the assistance unit's countable liquid resources exceeds the applicable resource limit as described under WAC 388-470-0005.

(4) For TANF/SFA, a caretaker relative must report the absence of a child within five days of the date that it becomes reasonably clear that the absence will exceed ninety days.  If the relative fails to report timely, the relative:

(a) Is not eligible for one month; and

(b) The relative's countable income will be considered available to the remaining members of the assistance unit)) must report the following changes about everyone in the assistance unit. The client must report these changes within ten days of when they learn about the change. Clients must report:

(a) The gross monthly amount of unearned income they receive when:

(i) They start receiving money from any new source.

(ii) The amount received from a previously reported source changes by more than twenty-five dollars.

(b) When someone, including a newborn child, moves in or out, even if the change is temporary.

(c) The marriage or divorce of any assistance unit member.

(d) A new residence, including any change in shelter expenses because of the move.

(e) Obtaining a vehicle.

(f) The end of a temporary disability when the temporary disability is the reason for excluding a vehicle.

(g) When the assistance unit's countable resources exceed the resource limits described in chapter 388-470 WAC.

(h) Any of the following changes related to employment:

(i) A new job or different employer.

(ii) A change in wage rate or pay scale.

(iii) An employment status change from part-time to full time. The employer determines when an employee has full-time employment status.

(2) Clients who receive only children or pregnant women's medical assistance must report the following changes. The client must report these changes within twenty days of when they learn about the change. Clients must report:

(a) When someone, including a newborn child, moves in or out, even if the change is temporary.

(b) When a pregnancy begins or ends.

(c) A new residence.

(3) Clients who receive any other medical assistance must report the following changes. Clients must report these changes about themselves, their spouses or any dependents. The client must report these changes within twenty days of when they learn about the change. Clients must report:

(a) When someone, including a newborn child, moves in or out, even if the change is temporary.

(b) When an assistance unit member gets married, divorced or separated.

(c) When a pregnancy begins or ends.

(d) A new residence or address.

(e) Any change in the amount of income received from any new or previously reported source.

(f) Any change in the amount of expenses paid for shelter.

(g) Any change in the amount of expenses paid for medical care.

(h) Changes in resources.

(4) For TANF/SFA, a caretaker relative must report within five days when they learn that the temporary absence of a child will exceed ninety days. When the relative fails to report timely, the relative:

(a) Is not eligible for one month; and

(b) The relative's countable income is considered available to the remaining members of the assistance unit.

(5) When a change is reported late, the client may receive the wrong amount or the wrong type of assistance. When benefits are overpaid, the client must repay the assistance as described in chapter 388-410 WAC.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.  98-16-044, 388-418-0005, filed 7/31/98, effective 9/1/98.]


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

WAC 388-418-0020
((Effective dates for changes)) How the department determines the date a change affects the benefit amount.

((The following rules apply to recipients of all programs)) (1) Unless otherwise specified((.

(1) When a change causes a cash assistance recipient to become ineligible or results in a change in grant amount, the effective date of the change is the first day of the next month after the change occurred.  However, for the following types of changes, the effective date is:

(a) The date a person who is added to the assistance unit enters the household or is determined eligible, whichever is later;

(b) The date of a change in shelter arrangement which makes the assistance unit eligible for a higher payment standard;

(c) The first regular monthly issuance when a person changes from one cash assistance program to another;

(d) The first regular monthly issuance after the advance notice period when a grant deduction is imposed to collect an overpayment;

(e) The date of termination when child support or spousal support is increased as specified in WAC 388-422-0030.

(f) In accordance with:

(i) Chapter 388-450 WAC when budgeting income;

(ii) Chapter 388-480 WAC when an assistance unit member is on strike;

(iii) WAC 388-462-0005(2) when pregnant woman receives GA-S and then relinquishes the child for adoption; and

(iv) As specified by the department for changes in law or regulation.

(g) For TANF/SFA, the date a sanctioned WorkFirst participant complies with the requirements of their individual responsibility plan as specified under chapter 388-310 WAC.

(2) Eligibility for medical care services ends at the same time a recipient's general assistance or ADATSA eligibility is terminated.

(3) When a change makes a recipient ineligible or reduces the benefit amount, assistance will continue without change through the advance notice period even when the advance notice is beyond the effective date.

(4) When cash and food assistance benefits are continued beyond the effective date of a reduction or termination of such benefits, an overpayment will be established for the amount the recipient was not eligible to receive.

(5) For prospectively budgeted food assistance households:

(a) The effective date of the change for an increase in benefits is the next allotment after the change is:

(i) Reported when the change is verified within the ten day period; or

(ii) Verified when the assistance unit does not send the requested verification within the ten day period.

(b) The effective date of the change for a decrease in benefits is the first of the next month after the advance notice period expires.

(6) For retrospectively budgeted food assistance households, the effective date of a change reported in the budget month is the first of the payment month.

(7) Eligibility for the newborn medical program ends on the last day of the month the child is no longer living with the mother.  Eligibility is redetermined for other medical programs prior to the termination of newborn medical)), the rules in this chapter refer to cash, food and medical assistance benefits.

(2) When a change causes an increase in benefits, the client must provide proof of the change before we adjust the benefit amount.

(a) The change affects the next month after the change is reported if the client provides verification within ten days from the date we request verification.

(b) The change affects the next month after the verification is received if the client provides verification after ten days from the date we request verification.

(c) When the client is entitled to receive additional benefits, the department must send the additional amount within ten days of the day the client provides requested verification.

(3) When a change causes a decrease in benefits:

(a) If the client reports the change within the time limits in WAC 388-418-0005, the change affects the first month following the advance notice period. The advance notice period:

(i) Begins on the day we send the client a notice about the change, and

(ii) Is determined according to the rules in WAC 388-458-0010.

(b) If the client fails to report the change within the time limits in WAC 388-418-0005:

(i) The change affects the first month following the day the advance notice period would end if the client reported the change on time, allowing:

(A) Ten days for the client to report the change, and

(B) Ten days for the advance notice period to begin.

(ii) We continue assistance unchanged through the advance notice period when the advance notice period ends later than the effective date.

(iii) We establish an overpayment claim according to the rules in chapter 388-410 WAC when benefits continue beyond the effective date.

(4) Within ten days of the day we learn about a change, the department:

(a) Sends advance notice according to the rules in chapter 388-458 WAC; and

(b) Takes necessary action to correct the benefit. Action on a change is delayed when the client requests a hearing about a proposed decrease in benefits before the effective date or within the advance notice period.

(5) When the client requests a hearing and continued benefits:

(a) The department continues the same benefits received prior to the advance notice of reduction until the earliest of the following events occur:

(i) For food assistance only, the client's certification period expires;

(ii) The end of the month the fair hearing decision is mailed;

(iii) The client states in writing that the assistance unit does not want continued benefits;

(iv) The client withdraws the fair hearing request in writing; or

(v) The client abandons the fair hearing request; or

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

(b) The department establishes an overpayment claim according to the rules in chapter 388-410 WAC when the hearing decision agrees with the department's action.

(6) Some changes have a specific effective date as follows:

(a) When cash assistance benefits increase because a person is added to the assistance unit, we use the effective date rules for applications in WAC 388-406-0055.

(b) When cash assistance benefits increase because the household becomes eligible for a higher payment standard, we use the date the change occurred.

(c) When a change in law or regulation changes the benefit amount, we use the date specified by the law or regulation.

(d) When institutional medical assistance participation changes, we calculate the new participation amount beginning with the month the income or allowable expense changes.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.  98-16-044, 388-418-0020, filed 7/31/98, effective 9/1/98.]


REPEALER

     The following sections of the Washington Administrative Code are repealed:
WAC 388-418-0010 Requesting information or action needed.
WAC 388-418-0015 Recipient fails to provide requested information or take requested action.
WAC 388-418-0030 Notifying a recipient of intent to reduce, suspend or terminate assistance.

Washington State Code Reviser's Office