WSR 04-15-053

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Economic Services Administration)

[ Filed July 13, 2004, 4:45 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 03-17-085.

Title of Rule and Other Identifying Information: WAC 388-418-0005 What types of changes must I report for cash, Basic Food, and medical assistance?

Hearing Location(s): Blake Office Park East (behind Goodyear Courtesy Tire), 4500 10th Avenue S.E., Rose Room, Lacey, WA, on August 24, 2004, at 10:00 a.m.

Date of Intended Adoption: Not earlier than August 25, 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 fernaax@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m., August 24, 2004.

Assistance for Persons with Disabilities: Contact Fred Swenson, DSHS Rules Consultant, by August 16, 2004, TTY (360) 664-6178 or (360) 664-6097.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: This rule filing will update department rules for cash assistance, medical, and Basic Food to reflect reporting requirements under 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. SB 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, SB 6411 (chapter 54, Laws of 2004).

Statute Being Implemented: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510, SB 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, Economic Services Administration, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: John Camp, Policy Analyst, 1009 College S.E., Lacey, WA 98504, (360) 413-3232.

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; they only affect 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 states 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 [as] well as requirements under Title 45 of the Code of Federal Regulations and the TANF (temporary assistance to needy families) state plan for benefits under the TANF program. The department also applies these requirements to the general assistance and refugee cash assistance programs.

July 1, 2004

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3430.3
AMENDATORY SECTION(Amending WSR 04-06-026, filed 2/23/04, effective 3/25/04)

WAC 388-418-0005   How will I know what ((type of)) changes I must ((I)) report ((for cash, Basic Food, and medical assistance))?   ((For purposes of this section, an "assistance unit" or "AU" is a group of people who live together and whose income or resources we count to decide what benefits the AU gets. Even if someone in your AU is not eligible to get a benefit, we still count that person's income or resources if they are financially responsible for you or someone in your AU, such as a common child. If you are a parent of a child who gets long-term care benefits, you need only report changes in income or resources that are actually contributed to the child. Tables one, two and three below show the types of changes you must report based on the type of assistance you get. Use table one to see if you must report a change for cash or Basic Food. Use table two to see if you must report a change for children's, pregnant women's, or family medical assistance. Use table three to see if you must report a change for SSI-related medical or long-term care medical assistance.


Table 1 - Cash Assistance and Basic Food
Type of change to report when you or anyone in your assistance unit (AU): Do I have to report this change for cash assistance? Do I have to report this change for Basic Food?
(1) Starts to get money from a new source; Yes Yes, but only if the change causes a change in the person's income.
(2) Has unearned income that changed by more than fifty dollars from amount we budgeted; Yes Yes
(3) Moves into or out of your home, including newborns or if an AU member dies. This also includes when someone temporarily moves in or out; Yes Yes
(4) Moves to a new residence; Yes Yes
(5) Has a change in shelter costs; Yes, but only if you went from having no shelter costs to having a shelter cost, or from having shelter costs to not having to pay anything. You don't have to report a change in the amount you pay. Yes, report the change at your recertification. If your shelter costs go up, you could get more benefits. Report the change sooner to see if you will get more benefits.
(6) Gets married, divorced, or separated; Yes Yes
(7) Gets a vehicle; Yes Yes
(8) Has a disability that ends; Yes Yes
(9) Has countable resources that are more than the resource limits under WAC 388-470-0005; Yes Yes
(10) Gets a job or changes employers; Yes Yes, but only if it causes a change in the person's income.
(11) Changes from part-time to full-time or full-time to part-time work. We use your employer's definition of part-time and full-time work; Yes Yes
(12) Has a change in hourly wage rate or salary; Yes Yes
(13) Stops working; Yes Yes
(14) Has a pregnancy that begins or ends; Yes No
(15) Has a change in uncovered medical expenses; No Yes, report this change only at your next eligibility review. If you are elderly or disabled and you have an increase in uncovered medical expenses, report this change sooner as you may be eligible to get more benefits.
(16) A change in work hours to below 20 hours per week averaged monthly. No Yes, but only if there are no children in your AU and the person is a nonexempt ABAWD under WAC 388-444-0030 and 388-444-0035.
(17) A change in legal obligation to pay child support. No Yes


Table 2 - Medical Assistance
Type of change to report when you or anyone in your assistance unit (AU): Do I have to report this change for family medical assistance (i.e., TANF-related) or Children's Medical? Do I have to report this change for Pregnancy Medical?
(18) Starts to get money from a new source; Yes No
(19) Has unearned income that changed; Yes No
(20) Moves into or out of your home, including newborns or if an AU member dies. This also includes when someone temporarily moves in or out; Yes Yes
(21) Moves to a new residence; Yes Yes
(22) Has a change in shelter costs; No No
(23) Gets married, divorced, or separated; Yes No
(24) Gets a vehicle; No No
(25) Has a disability that ends; No No
(26) Has countable resources that are more than the resource limits under WAC 388-470-0005; No No
(27) Gets a job or changes employers; Yes No
(28) Changes from part-time to full-time or full-time to part-time work. We use your employer's definition of part-time and full-time work; Yes No
(29) Has a change in hourly wage rate or salary; Yes No
(30) Stops working; Yes No
(31) Has a pregnancy that begins or ends; Yes Yes
(32) Has a change in uncovered medical expenses. Yes, but only if an AU member has a spenddown. Yes, but only if an AU member has a spenddown.


Table 3 - SSI-Related Medical Assistance and Long-Term Care
Type of change to report when you or anyone in your assistance unit (AU): Do I have to report this change for SSI-related medical assistance? Do I have to report this change for long-term care (i.e., COPES, CAP, or nursing home)
(33) Starts to get money from a new source; Yes Yes
(34) Has unearned income that changed; Yes Yes
(35) Has a change in earnings or stops working Yes Yes
(36) Moves into or out of your home, including newborns or if an AU member dies. This also includes when someone temporarily moves in or out; Yes Yes
(37) Moves to a new residence; Yes Yes
(38) Has a change in shelter costs; No, unless you went from paying rent to not paying any rent. You do not need to report if your rent amount changes. Yes, if client or community spouse live in their own home
(39) Gets married, divorced, or separated; Yes Yes
(40) Gets a vehicle; Yes, but only if that person or their spouse gets SSI-related medical Yes, but only if that person gets long-term care
(41) Has a disability that ends; Yes Yes
(42) Has countable resources that are more than the resource limits, under WAC 388-470-0005 or 388-513-1350; Yes, but only if that person or their spouse get SSI-related medical Yes, but only if that person gets long-term care
(43) Has a change in uncovered medical expenses. Yes, but only if an AU member has a spenddown. Yes.
))

You must report changes to the department based on the kinds of assistance you receive. The set of changes you must report for people in your assistance unit under chapter 388-408 WAC is based on the benefits you receive that require you to report the most changes. It is the first program that you receive benefits from in the list below.

For example:

If you receive Long Term Care and Basic Food benefits, you tell us about changes based on the Long Term Care requirements because it is the first program in the list below you receive benefits from.

(1) If you receive Long Term Care benefits such as COPES, CAP, or nursing home, you must tell us if you have a change of:

(a) Address;

(b) Marital status;

(c) Living arrangement;

(d) Income;

(e) Resources;

(f) Medical expenses; and

(g) If we allow you expenses for your spouse or dependents, you must report changes in their income or shelter cost.

(2) If you receive medical benefits based on age, blindness, or disability (SSI-related medical), you need to tell us if:

(a) You move;

(b) Someone moves into or out of your home;

(c) Your resources change; or

(d) Your income changes. This includes the income of you, your spouse or your child living with you.

(3) If you receive Basic Food and all adults in your assistance unit are elderly or disabled and have no earned income, you need to tell us if:

(a) You move;

(b) You start getting money from a new source;

(c) Your income changes by more than fifty dollars;

(d) Your liquid resources, such as your cash on hand or bank accounts, are more than two thousand dollars; or

(e) Someone moves into or out of your home.

(4) If you receive Basic Food, benefits and do not meet the conditions described in section (3) above, you must tell us about the following changes unless we have processed your application or recertification after October 16, 2004:

(a) Income or employment changes:

(i) You start or stop working and this changes your income;

(ii) You change from part-time to full-time or full-time to part-time work. We use your employer's definition of part-time and full-time work;

(iii) Your wage rate or salary changes;

(iv) You start getting money from a new source; or

(v) Your unearned income changes by more than fifty dollars.

(b) Personal or household changes:

(i) You move;

(ii) Someone moves into or out of your home;

(iii) You get married, divorced, or separated;

(iv)You have a change in your legal obligation to pay child support; or

(v) You have a disability that ends.

(c) Resource changes:

(i) You go over the countable resource limit under WAC 388-470-0005 and your household is not CE under WAC 388-441-0001; or

(ii) You get a vehicle.

(5) If you receive cash benefits, you must tell us about the following changes unless we have processed your application or eligibility review after October 16, 2004:

(a) Income or employment changes:

(i) You start or stop working and this changes your income;

(ii) You change from part-time to full-time or full-time to part-time work. We use your employer's definition of part-time and full-time work;

(iii)Your wage rate or salary changes;

(iv) You start getting money from a new source; or

(v) Your unearned income changes by more than fifty dollars.

(b) Personal or household changes:

(i) You move;

(ii) Someone moves into or out of your home;

(iii) You get married, divorced, or separated;

(iv) You have a pregnancy start or end; or

(v) You have a disability that ends.

(c) Resource changes:

(i) You go over the countable resource limit under WAC 388-470-0005; or

(ii) You get a vehicle.

(6) If you receive cash benefits, and we processed your application or eligibility review on or after October 17, 2004 you need to tell us if:

(a) You move;

(b) Someone moves out of your home;

(c) Your total gross monthly income goes over the:

(i) Payment standard under WAC 388-478-0030 if you receive general assistance or ADATSA benefits; or

(ii) Earned income limit under WAC 388-450-0165 for all other programs;

(d) You have liquid resources more than four thousand dollars; or

(e) You have a change in employment. Tell us if you:

(i) Get a job or change employers;

(ii) Change from part-time to full-time or full-time to part-time;

(iii) Have a change in your hourly wage rate or salary; or

(iv) Stop working.

(7) If you receive Children's Medical or Family Medical benefits, you need to tell us if:

(a) You move;

(b) Someone moves out of your home; or

(c) If your income goes up or down by one hundred dollars or more a month and you expect this income change will continue for at least two months.

(8) If you receive Basic Food benefits and we processed your application or recertification on or after October 17, 2004, you need to tell us if:

(a) You move; or

(b) Your total gross monthly income is more than the gross monthly income limit under WAC 388-478-0060.

(9) If you receive Pregnancy Medical benefits, you need to tell us if:

(a) You move;

(b) Someone moves out of the home; or

(c) You have a change in your pregnancy.

(10) If you receive other medical benefits, you need to tell us if:

(a) You move; or

(b) Someone moves out of the home.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510. 04-06-026, 388-418-0005, filed 2/23/04, effective 3/25/04; 03-21-028, 388-418-0005, filed 10/7/03, effective 11/1/03. Statutory Authority: RCW 74.08.090 and 74.04.510. 01-11-109, 388-418-0005, filed 5/21/01, effective 7/1/01; 99-23-034, 388-418-0005, filed 11/10/99, effective 1/1/00. 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.]

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