HEALTH CARE AUTHORITY
[Filed May 22, 2019, 9:31 a.m., effective June 22, 2019]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The agency is amending the presumptive eligibility period from twelve to twenty-four months in subsection (7) to align with Title 388 WAC. The agency is also correcting a reference to the medicaid agency in subsection (8) and replacing it with the department of social and health services.
Citation of Rules Affected by this Order: Amending WAC 182-513-1620.
Adopted under notice filed as WSR 19-09-051 on April 12, 2019.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.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: May 22, 2019.
AMENDATORY SECTION(Amending WSR 17-12-019, filed 5/30/17, effective 7/1/17)
WAC 182-513-1620Tailored supports for older adults (TSOA)—Presumptive eligibility (PE).
(1) A person may be determined presumptively eligible for tailored supports for older adults (TSOA) services upon completion of a prescreening interview.
(2) The prescreening interview may be conducted by either:
(a) The area agency on aging (AAA); or
(b) A home and community services intake case manager or social worker.
(3) To receive services under presumptive eligibility (PE), the person must meet:
(a) Nursing facility level of care under WAC 388-106-0355;
(b) TSOA income limits under WAC 182-513-1635; and
(c) TSOA resource limits under WAC 182-513-1640.
(4) The PE period begins on the date the determination is made and:
(a) Ends on the last day of the month following the month of the PE determination if a full TSOA application is not completed and submitted by that date; or
(b) Continues through the date the final TSOA eligibility determination is made if a full TSOA application is submitted before the last day of the month following the month of the PE determination.
(5) If the person applies and is not determined financially eligible for TSOA, there is no overpayment or liability on the part of the applicant for services received during the PE period.
(6) The medicaid agency or the agency's designee sends written notice as described in WAC 182-518-0010 when PE for TSOA is approved or denied.
(7) A person may receive only one PE period within a ((twelve-consecutive-month))consecutive twenty-four-month period.
(8) If the ((agency))department of social and health services establishes a waitlist for TSOA services under WAC 388-106-1975, then PE does not apply.