WSR 05-23-078

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

[ Filed November 15, 2005, 4:24 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 05-13-135 on June 20, 2005.

Title of Rule and Other Identifying Information: WAC 388-478-0075 Medical programs -- Monthly income standards based on federal poverty level (FPL).

Hearing Location(s): Blake Office Park East, Rose Room, 4500 10th Avenue S.E., Lacey, WA 98503 (one block north of the intersection of Pacific Avenue S.E. and Alhadeff Lane, behind Goodyear Tire. A map or directions are available at http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6097), on December 27, 2005, at 10:00 a.m.

Date of Intended Adoption: Not earlier than December 28, 2005.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail fernaax@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m. December 27, 2005.

Assistance for Persons with Disabilities: Contact Stephanie Schiller, DSHS Rules Consultant, by December 23, 2005, TTY (360) 664-6178 or (360) 664-6097 or by e-mail at schilse@dshs.wa.gov.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The department is revising these rules to reinstate the children's health program for noncitizen children under age eighteen with income at or below 100% federal poverty level who are not otherwise eligible for Medicaid.

Reasons Supporting Proposal: These changes are legislatively required by E2SHB 1441 (chapter 279, Laws of 2005) and are made according to the governor's directive.

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

Statute Being Implemented: E2SHB 1441 (chapter 279, Laws of 2005).

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: Kathy Johansen, P.O. Box 45534, Olympia, WA 98504-5534, (360) 725-1321.

No small business economic impact statement has been prepared under chapter 19.85 RCW. This change does not affect small businesses.

A cost-benefit analysis is not required under RCW 34.05.328. Client eligibility rules for medical assistance are exempt from the provisions of RCW 34.05.328 per RCW 34.05.328 (5)(b)(vii).

November 3, 2005

Andy Fernando, Manager

Rules and Policies Assistance Unit

3612.1
AMENDATORY SECTION(Amending WSR 05-17-157, filed 8/22/05, effective 9/22/05)

WAC 388-478-0075   Medical programs--Monthly income standards based on the federal poverty level (FPL).   (1) The department bases the income standard upon the Federal Poverty Level (FPL) for the following medical programs:

(a) Children's health program is one hundred percent of FPL;

(b) Pregnant women's program up to one hundred eighty-five percent of FPL;

(((b))) (c) Children's categorically needy program up to two hundred percent of FPL;

(((c))) (d) Healthcare for workers with disabilities (HWD) up to two hundred twenty percent of FPL; and

(((d))) (e) The state children's health insurance program (SCHIP) is over two hundred percent of FPL but not over two hundred fifty percent of FPL.

(2) The department uses the FPL income standards to determine:

(a) The mandatory or optional Medicaid status of an individual; and

(b) Premium amount, if any, for a Medicaid child.

(3) There are no resource limits for the programs under this section.

(4) Beginning April 1, 2005, the monthly FPL standards are:


FAMILY SIZE 100% FPL ((Benchmark)) 133% FPL 150% FPL 185% FPL 200% FPL 220% FPL 250% FPL
1 $798 $1061 $1197 $1476 $1595 $1755 $1994
2 $1070 $1422 $1604 $1978 $2139 $2353 $2673
3 $1341 $1784 $2012 $2481 $2682 $2950 $3353
4 $1613 $2145 $2419 $2984 $3225 $3548 $4032
5 $1885 $2506 $2827 $3486 $3769 $4146 $4711
6 $2156 $2868 $3234 $3989 $4312 $4743 $5390
7 $2428 $3229 $3642 $4491 $4855 $5341 $6069
8 $2700 $3590 $4049 $4994 $5399 $5939 $6748
9 $2971 $3952 $4457 $5497 $5942 $6536 $7428
10 $3243 $4313 $4864 $5999 $6485 $7134 $8107
Add to the ten person standard for each person over ten:
$272 $362 $408 $503 $544 $598 $680

[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.500, and 42 U.S.C. 9902(2). 05-17-157, 388-478-0075, filed 8/22/05, effective 9/22/05. Statutory Authority: RCW 74.08.090, 74.04.057, 74.04.050, and 74.09.530. 04-15-092, 388-478-0075, filed 7/16/04, effective 8/16/04. Statutory Authority: RCW 74.08.090, 74.04.050, 74.04.057, 74.09.530, and 42 U.S.C. 9902(2). 03-15-088, 388-478-0075, filed 7/17/03, effective 7/17/03. Statutory Authority: RCW 74.08.090, 74.08A.100, 74.09.080, and 74.09.415. 02-17-030, 388-478-0075, filed 8/12/02, effective 9/12/02. Statutory Authority: RCW 74.04.050, 74.08.090, 74.09.500, 74.09.510, and Section 1902 (a)(10)(A)(ii)(XV) and (XVI) of the Social Security Act. 02-07-090, 388-478-0075, filed 3/19/02, effective 4/1/02. Statutory Authority: RCW 74.08.090, 74.04.050, 74.04.057, 74.09.530, and Section 673(2) (42 U.S.C. 9902(2)). 01-18-056, 388-478-0075, filed 8/30/01, effective 9/30/01; 00-17-085, 388-478-0075, filed 8/14/00, effective 9/14/00; 99-19-005, 388-478-0075, filed 9/3/99, effective 10/4/99. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, 388-478-0075, filed 7/31/98, effective 9/1/98. Formerly WAC 388-507-0805, 388-508-0810, 388-509-0910, 388-509-0920, 388-509-0940 and 388-509-0960.]