WSR 08-09-111

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

[ Filed April 21, 2008, 2:47 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 08-03-093.

Title of Rule and Other Identifying Information: The department is amending WAC 388-475-0300 SSI-Related medical -- Resources eligibility.

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. A map or directions are available at http://www1.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6094), on May 27, 2008, at 10:00 a.m.

Date of Intended Adoption: Not sooner than May 28, 2008.

Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504-5850, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5 p.m. on May 27, 2008.

Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS Rules Consultant, by May 20, 2008, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at johnsjl4@dshs.wa.gov.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: DSHS is updating this WAC to comply with federal rules which govern how the department considers retroactive lump sum payments from any Title II or Title XVI payment, and to clarify that these resources are now excluded for nine months, not six. DSHS is also correcting WAC references which are no longer correct.

Reasons Supporting Proposal: The department of social and health services (DSHS) is authorized to comply with the federal requirements for the medical assistance program provided in the Social Security Act and particularly Title XIX of Public Law (89-97) in order to secure federal matching funds for such program.

Statutory Authority for Adoption: RCW 74.04.057, 74.08.090.

Statute Being Implemented: RCW 74.04.050, 74.09.500.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Department of social and health services, health and recovery services administration, governmental.

Name of Agency Personnel Responsible for Drafting: Jonell O. Blatt, 626 8th Avenue, Olympia, WA 98504-5504, (360) 725-1571; Implementation and Enforcement: Catherine Fisher, P.O. Box 45502, Olympia, WA 98504-98501 [98504-5502], (360) 725-1357.

No small business economic impact statement has been prepared under chapter 19.85 RCW. Under RCW 19.85.025(3), the department is not required to prepare a small business economic impact statement (SBEIS) for rules adopting or incorporating, by reference without material change, federal statutes or regulations.

A cost-benefit analysis is not required under RCW 34.05.328. Under RCW 34.05.328 (5)(b)(vii), a cost-benefit analysis is not required for DSHS rules that relate only to client medical or financial eligibility.

April 11, 2008

Stephanie E. Schiller

Rules Coordinator

3967.1
AMENDATORY SECTION(Amending WSR 04-09-002, filed 4/7/04, effective 6/1/04)

WAC 388-475-0300   SSI-related medical -- Resources eligibility.   (1) ((A client must be resource eligible on the first moment of the first day of the month, and is then eligible for the entire month)) At 12:00 a.m. on the first day of the month a client's countable resources must be at or below the resource standard to be eligible for noninstitutional medical benefits for that month. If the total of the client's countable resources is above the resource standard at 12:00 a.m. on the first ((moment of the first)) day of the month, the client is ineligible for noninstitutional medical benefits for that entire month regardless of resource status at the time of application during that month. For resource eligibility relating to long-term care eligibility see chapter 388-513 WAC.

(2) An excluded resource converted to another excluded resource remains excluded.

(3) Cash received from the sale of an excluded resource becomes a countable resource the first of the month following conversion unless the cash is;

(a) Used to replace the excluded resource; or

(b) Invested in another excluded resource in the same month or within the longer time allowed for home sales under WAC 388-475-0350; or

(c) Spent.

(4) The unspent portion of a nonrecurring lump sum payment is counted as a resource on the first of the month following its receipt with the following exception: The unspent portion of any Title II (SSA) or Title XVI (SSI) retroactive payment is excluded as a resource for ((six)) nine months following the month of receipt. These exclusions apply to lump sums received by the client, client's spouse or other any other person who is financially responsible for the client.

(5) Clients applying for SSI-related medical coverage for long-term care (LTC) services must meet different resource rules. See chapter 388-513 WAC for LTC resource rules.

(6) The transfer of a resource without adequate consideration does not affect medical program eligibility except for LTC and home and community based waiver services programs. In those programs, the transfer may make a client ineligible for medical benefits for a period of time. See WAC 388-513-1364 through 388-513-1366 for LTC rules.

[Statutory Authority: RCW 74.04.050, 74.08.090. 04-09-002, 388-475-0300, filed 4/7/04, effective 6/1/04.]

Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.

Washington State Code Reviser's Office