WSR 01-10-104

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Economic Services Administration)

[ Filed May 1, 2001, 3:37 p.m. ]

Date of Adoption: May 1, 2001.

Purpose: Chapter 388-472 WAC, Client rights and responsibilities and necessary supplemental accommodations, this revision is being done to meet the requirements of the WAC migration of Title 388 WAC. WAC 388-200-1050, 388-200-1300 and 388-200-1350 are being repealed and were rewritten as a part of the client rights and responsibilities chapter, chapter 388-472 WAC. WAC 388-472-0005 was rewritten in the same writing style as the remainder of the chapter. All of chapter 388-472 WAC meets the standards of Executive Order No. 97-02, for regulatory improvement.

Citation of Existing Rules Affected by this Order: Repealing WAC 388-200-1050, 388-200-1300 and 388-200-1350; and amending WAC 388-472-0005.

Statutory Authority for Adoption: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510, and 74.08.090.

Adopted under notice filed as WSR 01-07-051 on April [March] 16, 2001.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 5, Amended 1, Repealed 3.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 5, Amended 1, Repealed 3. Effective Date of Rule: Thirty-one days after filing.

April 30, 2001

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

2925.3
AMENDATORY SECTION(Amending WSR 99-17-025, filed 8/10/99, effective 10/1/99)

WAC 388-472-0005   ((Client)) What are my rights and responsibilities((.))?   ((Unless specifically stated,)) For the purposes of this chapter, "we" and "us" refer to the administrations within the department of social and health services that provide cash and medical assistance benefits. "You" refers to the head of the household applicant or recipient.

The following rules apply to cash, food and medical assistance programs unless stated otherwise.

(1) ((A person who applies for or receives public assistance has)) If you apply for or receive benefits you have the right to:

(a) Be fully informed, in writing, of all legal rights and responsibilities in connection with benefits;

(b) Be treated politely and fairly without regard to race, color, ((creed,)) political ((affiliation)) beliefs, national origin, religion, age, gender, disability or birthplace;

(((b) File an application on the same day, during regular business hours, that the person contacts the department. A client has the right to get a receipt when leaving an application or other materials with the department;

(c) Have an application promptly accepted and promptly acted upon;

(d) Ask that the application be processed without delay if the person is pregnant, in need of immediate medical care, experiencing an emergency such as having no money for food, or facing an eviction. If a pregnant client requests an interview, she has the right to have one within five working days;

(e) Get a written decision in most cases within thirty days.

(i) Medical and some disability cases may take forty-five to sixty days. Pregnancy medical will be authorized within fifteen working days.

(ii) Food stamps will be authorized within thirty days if the person is eligible. If the person is eligible and has little or no money, food stamps will be authorized within five days;

(f) Be fully informed, in writing, of all legal rights and responsibilities in connection with public assistance;

(g) Have information kept private. The department may share some facts with other agencies for efficient management of federal and state programs;

(h) For cash and medical assistance programs, ask the department not to collect child support if the absent parent may harm the person or person's child;

(i) For cash assistance programs, ask for extra money to help in an emergency, such as an eviction or a utility shutoff;

(j) Get a written notice, in most cases, at least ten days before the department makes changes to lower or stop benefits;

(k) Ask for a fair hearing if the person does not agree with the department about a decision. Without affecting the right to a fair hearing, the person can also ask a supervisor or administrator to review an employee decision or action;

(l) Have interpreter or translator services at no cost or undue delay;

(m) Refuse to speak to a fraud early detection (FRED) investigator from the division of fraud investigations. The person does not have to let an investigator into the home. The person may ask the investigator to come back at another time. Such a request will not affect the person's eligibility for benefits;

(n) For medical assistance programs only: A person applying for or receiving medical assistance, limited casualty programs, medical care services, or children's health services has the same rights as cash assistance clients; and

(o) Receive help from the department to register to vote.

(2) A client is responsible for:

(a) Reporting any changes to the department within ten days for all cash and food assistance programs and twenty days for all medical assistance programs;

(b) Giving all the facts needed to determine eligibility;

(c) Giving the department proof of any facts for which proof is needed;

(d) For most cash or medical assistance programs related to children, cooperating with the department to get child support or medical care support unless it can be shown that harm to the person or child may occur;

(e) For cash or medical assistance programs, applying for and taking any benefits from other programs, if eligible;

(f) Completing reports and reviews when asked to do so;

(g) Seeking and taking a job or training if required; and

(h) For medical assistance programs only, showing the medical identification card or other adequate department generated notification of eligibility to the medical care provider.

(3) Clients will be screened and provided with necessary supplemental accommodation as specified under WAC 388-200-1300))

(c) Give us a written request for benefits using a form or alternative method designated by us. You have the right to get a receipt when leaving an application or other materials with us;

(d) Ask that the application be processed without delay if you are pregnant, in need of immediate medical care, experiencing an emergency such as having no money for food, or facing an eviction. If you are pregnant and request an interview, you have the right to have one within five working days;

(e) Get a written decision in most cases within thirty days.

(i) Medical and some disability decisions may take forty-five to sixty days. Pregnancy medical will be authorized within fifteen working days.

(ii) Food assistance will be authorized within thirty days if you are eligible. If you are eligible and have little or no money, food assistance will be authorized within five days.

(f) Have information you give us kept private. We share some facts with other agencies for efficient management of federal and state programs;

(g) For cash and medical assistance programs, ask us not to collect child support if the absent parent may harm you or your child;

(h) For some cash assistance programs, ask for extra money to help in an emergency, such as an eviction or a utility shutoff;

(i) Get a written notice, in most cases, at least ten days before we make changes to reduce or end your benefits;

(j) Ask for a fair hearing if you do not agree with us about a decision. You can also ask a supervisor or administrator to review our decision or action without affecting your right to a fair hearing;

(k) Have interpreter or translator services provided at no cost to you and without delay;

(l) Refuse to speak to a fraud investigator. You do not have to let an investigator into your home. You may ask the investigator to come back at another time. Such a request will not affect your eligibility for benefits;

(m) If you are applying for or receiving medical assistance, limited casualty programs, medical care services, or children's health services you have the same rights as cash assistance clients; and

(n) Receive help from us to register to vote.

(2) You are responsible to:

(a) Report any changes to us within:

(i) Ten days for all cash and food assistance programs; and

(ii) Twenty days for all medical assistance programs.

(b) Give all the facts needed to determine eligibility;

(c) Give us proof of any facts for which proof is needed;

(d) For most cash or medical assistance programs related to children, cooperate with us to get child support or medical care support unless you show that cooperation may harm you or your child;

(e) Apply for and get any benefits from other agencies or programs prior to getting cash or medical assistance from us;

(f) Complete reports and reviews when asked to do so;

(g) Get a job or training if required;

(h) Show your medical identification card or other notification of eligibility from us to your medical care provider; and

(i) Cooperate with the quality assurance review process.

(3) You will be screened for and provided necessary supplemental accommodation services as described in this chapter.

[Statutory Authority: RCW 74.08.090 and 74.04.510. 99-17-025, 388-472-0005, filed 8/10/99, effective 10/1/99. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, 388-472-0005, filed 7/31/98, effective 9/1/98. Formerly WAC 388-504-0430, 388-504-0440, 388-504-0450 and 388-505-0560.]


NEW SECTION
WAC 388-472-0010   What are necessary supplemental accommodation services?   Necessary supplemental accommodation (NSA) services are services provided to you if you have a mental, neurological, physical or sensory impairment or other problems that prevent you from getting program benefits in the same way that an unimpaired person would get them.

NSA services include but are not limited to:

(1) Arranging for or providing help to complete and submit forms to us;

(2) Helping you give or get the information we need to decide or continue eligibility;

(3) Helping you request continuing benefits;

(4) If you miss an appointment or deadline, contacting you about the reason before we reduce or end your benefits;

(5) Explaining to you the reduction in or ending of your benefits (see WAC 388-418-0020);

(6) If we know you have a person who helps you with your applications, notifying them when we need information or when we are about to reduce or end your benefits;

(7) Assisting you with requests for fair hearings;

(8) Providing protective payments if needed, according to WAC 388-265-1250; and

(9) On request, reviewing our decision to terminate, suspend or reduce your benefits.

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NEW SECTION
WAC 388-472-0020   How does the department decide if I am eligible for NSA services?   When you, as head of household, apply for benefits either in person or by phone, we screen you to decide if you meet NSA requirements. We explain NSA services to you during the screening.

(1) We identify you as NSA if you:

(a) Say you need NSA services in order to have equal access to our programs and services;

(b) Have or claim to have a mental impairment;

(c) Have a developmental disability;

(d) Are disabled by alcohol or drug addiction;

(e) Are unable to read or write in any language; or

(f) Are a minor not residing with your parents.

(2) We identify you as NSA if we observe you to have cognitive limitations, whether or not you have a disability, which may prevent you from understanding the nature of NSA services or affect your ability to access our programs. Cognitive limitations are limitations in your ability to communicate, understand, remember, process information, exercise judgement and make decisions, perform routine tasks or relate appropriately with others.

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NEW SECTION
WAC 388-472-0030   How can I get NSA services?   (1) After we screen you for NSA eligibility and initially identify your case as NSA, we mark your case file with a uniform NSA identifier.

(2) After you are initially identified as NSA, we complete an assessment to confirm your NSA designation.

(3) If the assessment confirms your NSA designation, we develop an accommodation plan that specifies the services we will provide to you to improve your access to our programs and services.

(4) If you are designated as NSA according to WAC 388-472-0020 (1) and (2), we include all the NSA services listed in WAC 388-472-0010 in your accommodation plan.

(5) Based on your request or a change in your needs, the NSA designation and the accommodation plan may be assessed and changed.

(6) Even if you are eligible to receive NSA services you may refuse NSA services.

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NEW SECTION
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, 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.

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NEW SECTION
WAC 388-472-0050   What if I don't accept or follow through the program requirements because I'm not able to or I don't understand them?   (1) We consider how your limitation or impairment affects your ability to accept and follow through on all program requirements. This can include, but is not limited to, your actions in failing to:

(a) Follow through with medical treatment;

(b) Follow through with referrals to other agencies;

(c) Provide timely income reports;

(d) Maintain employment;

(e) Participate in food assistance employment and training; or

(f) Participate in the WorkFirst program.

(2) If we decide your limitation was the cause of your refusal to accept or failure to follow through on these requirements, we will find that you have good cause and we will not take any adverse action.

(3) Following a finding of good cause not to have followed through with the requirement, we will review your accommodation plan to assure that all services necessary to enable you to meet the program requirements are being provided to you.

(4) If we are unable to accommodate your condition so that you are able to participate in program requirements, we will waive program requirements.

(5) If participation in program requirements is not waived, you must cooperate with program requirements.

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REPEALER

     The following sections of the Washington Administrative Code are repealed:
WAC 388-200-1050 Department and client responsibilities.
WAC 388-200-1300 Necessary supplemental accommodation services (NSA).
WAC 388-200-1350 Dispute resolution for clients needing supplemental accommodations.

Washington State Code Reviser's Office