WSR 08-14-048

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

[ Filed June 24, 2008, 11:34 a.m. , effective July 25, 2008 ]


Effective Date of Rule: Thirty-one days after filing.

Purpose: 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.

Citation of Existing Rules Affected by this Order: Amending WAC 388-475-0300.

Statutory Authority for Adoption: RCW 74.04.057, 74.08.090.

Other Authority: RCW 74.04.050, 74.09.500.

Adopted under notice filed as WSR 08-09-111 on April 21, 2008.

Changes Other than Editing from Proposed to Adopted Version: Subsection (6) The transfer of a resource without adequate consideration does not affect medical program eligibility except for LTC ((and waiver services programs)) services described in chapters 388-531 and 388-515 WAC. In those programs, the transfer may make a client ineligible for medical benefits for a period of time. See WAC ((388-513-1364)) 388-513-1363 through 388-513-1366 for LTC rules.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 1, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.

Date Adopted: June 19, 2008.

Stephanie E. Schiller

Rules Coordinator

3967.2
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 waiver services programs)) services described in chapters 388-531 and 388-515 WAC. In those programs, the transfer may make a client ineligible for medical benefits for a period of time. See WAC ((388-513-1364)) 388-513-1363 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