SOCIAL AND HEALTH SERVICES
(Medicaid Purchasing Administration)
Effective Date of Rule: Thirty-one days after filing.
Purpose: This is not a policy change. Prior to February 1, 2011, the rule cross referenced to WAC 388-478-0020 because the income standards for both family medical programs and the temporary assistance for needy families (TANF) grant program were the same. Beginning February 1, 2011, the TANF income standard was reduced so the family medical programs income standard had to be listed out in WAC 388-478-0065, which in turn requires WAC 388-505-0220 to be amended.
Citation of Existing Rules Affected by this Order: Amending WAC 388-478-0065 and 388-505-0220.
Statutory Authority for Adoption: RCW 74.04.050, 74.04.057, and 74.08.090.
Adopted under notice filed as WSR 11-09-055 on April 18, 2011.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 2, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 2, Repealed 0.
Date Adopted: June 2, 2011.
Katherine I. Vasquez
(a) For assistance units with obligations to pay shelter costs:
|Assistance Unit Size||Payment Standard|
|10 or more||1,321|
|Assistance Unit Size||Payment Standard|
|10 or more||803|
(3) Each unborn child is counted as a household member when determining household size for:
(a) Family medical;
(b) Pregnancy medical; and
(c) Children's medical.
[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.530. 05-15-080, § 388-478-0065, filed 7/14/05, effective 8/14/05. 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, § 388-478-0065, filed 8/30/01, effective 9/30/01. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-478-0065, filed 7/31/98, effective 9/1/98. Formerly WAC 388-507-0710 and 388-508-0820.]-4275.1
(a) Receiving temporary assistance for needy families (TANF) cash benefits;
(b) Receiving Tribal TANF;
(c) Receiving cash diversion assistance, except SFA relatable families, described in WAC 388-400-0010(2);
(d) Eligible for TANF cash benefits but choose not to
(e) Over the TANF cash payment standard but under the family medical payment standard as described in WAC 388-478-0065; or
(f) Not eligible for or receiving TANF cash assistance, but meet the eligibility criteria for aid to families with dependent children (AFDC) in effect on July 16, 1996 except that:
(i) Earned income is treated as described in WAC 388-450-0210; and
(ii) Resources are treated as described in WAC 388-470-0005 for applicants and 388-470-0026 for recipients.
(2) An adult cannot receive a family medicaid program unless the household includes a child who is eligible for:
(a) Family medicaid;
(b) SSI; or
(c) Children's medicaid.
(3) A person is eligible for CN family medical coverage when the person is not eligible for or receiving cash benefits solely because the person:
(a) Received sixty months of TANF cash benefits or is a member of an assistance unit which has received sixty months of TANF cash benefits;
(b) Failed to meet the school attendance requirement in chapter 388-400 WAC;
(c) Is an unmarried minor parent who is not in a department-approved living situation;
(d) Is a parent or caretaker relative who fails to notify the department within five days of the date the child leaves the home and the child's absence will exceed one hundred eighty days;
(e) Is a fleeing felon or fleeing to avoid prosecution for a felony charge, or is a probation and parole violator;
(f) Was convicted of a drug related felony;
(g) Was convicted of receiving benefits unlawfully;
(h) Was convicted of misrepresenting residence to obtain assistance in two or more states;
(i) Has gross earnings exceeding the TANF gross income level; or
(j) Is not cooperating with WorkFirst requirements.
(4) An adult must cooperate with the division of child support in the identification, use, and collection of medical support from responsible third parties, unless the person meets the medical exemption criteria described in WAC 388-505-0540 or the medical good cause criteria described in chapter 388-422 WAC.
(5) Except for a client described in WAC 388-505-0210(6), a person who is an inmate of a public institution, as defined in WAC 388-500-0005, is not eligible for CN or MN medical coverage.
[Statutory Authority: RCW 74.04.050 and 74.08.090. 08-19-099 and 08-20-014, § 388-505-0220, filed 9/17/08 and 9/18/08, effective 10/18/08 and 10/19/08. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510, and 74.08.090. 08-14-105, § 388-505-0220, filed 6/30/08, effective 8/1/08. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.530. 05-16-127, § 388-505-0220, filed 8/3/05, effective 9/3/05. Statutory Authority: RCW 74.08.090, 74.08A.100, 74.09.080, and 74.09.415. 02-17-030, § 388-505-0220, filed 8/12/02, effective 9/12/02. Statutory Authority: RCW 74.08.090, 74.04.050, [74.04.]055, and [74.04.]057. 01-11-110, § 388-505-0220, filed 5/21/01, effective 6/21/01; 98-16-044, § 388-505-0220, filed 7/31/98, effective 9/1/98. Formerly WAC 388-507-0740 and 388-522-2210.]