HEALTH CARE AUTHORITY

[Filed July 14, 2020, 4:17 p.m.]

Preproposal statement of inquiry was filed as WSR 20-03-109.

Title of Rule and Other Identifying Information: WAC 182-506-0015 Medical assistance units for non-MAGI-based Washington apple health programs, and 182-512-0950 SSI-related medical—Child-related resource exclusions and allocations.

Hearing Location(s): On August 25, 2020, at 10:00 a.m.

As the Governor's Safe Start plan progresses, it is yet unknown whether by the date of this public hearing restrictions of meeting in public places will be eased. To continue to be safe, this hearing is being scheduled as a virtual only hearing. This will not be an in-person hearing and there is not a physical location available.

To attend the virtual public hearing, please register prior to the event at https://attendee.gotowebinar.com/register/3388771111368337931.

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Date of Intended Adoption: Not sooner than August 26, 2020.

Submit Written Comments to: HCA Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email arc@hca.wa.gov, fax 360-586-9727, by August 25, 2020.

Assistance for Persons with Disabilities: Contact Amber Lougheed, phone 360-725-1349, fax 360-586-9727, telecommunication[s] relay services 711, email amber.lougheed@hca.wa.gov, by August 7, 2020.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The agency is amending these rules to include resource standard requirements and to add a new subsection that identifies rules used to determine the allocation of resources. These requirements are defined under the supplemental security income (SSI) methodology used to determine eligibility. The agency anticipates no impact to eligibility or the amount of income or resources a client must pay or may keep. These rules:

Reasons Supporting Proposal: See purpose of proposal.


•	Add the requirement that SSI-related rules already test for resources in addition to income when determining eligibility.
•	State that financial responsibility also applies when one or both spouses receive home and community-based services to the extent described in WAC 182-512-0960 and chapters 182-513 and 182-515 WAC.
•	Remove income deeming and allocation rules already described in sections of chapter 182-512 WAC and not necessary for rules regarding medical assistance units.

Statutory Authority for Adoption: RCW 41.05.021, 41.05.160.

Statute Being Implemented: RCW 41.05.021, 41.05.160.

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

Name of Proponent: Health care authority, governmental.

Name of Agency Personnel Responsible for Drafting: Melinda Froud, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-1408; Implementation and Enforcement: Steve Kozak, P.O. Box 45534, Olympia, WA 98504-5534, 360-725-1343.

A school district fiscal impact statement is not required under RCW 28A.305.135.

A cost-benefit analysis is not required under RCW 34.05.328. RCW 34.05.328 does not apply to health care authority rules unless requested by the joint administrative rules review committee or applied voluntarily.

The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. This rule making does not impose any costs on businesses.

AMENDATORY SECTION(Amending WSR 14-20-094, filed 9/29/14, effective 10/30/14)

WAC 182-506-0015Medical assistance units for non-MAGI-based Washington apple health programs.

This section explains how medical assistance units (MAUs) are constructed for programs not based on modified adjusted gross income (MAGI) methodologies. (MAGI-based programs are described in WAC 182-503-0510.)

(1) An MAU is a person or group of people who must be included together when determining eligibility. MAUs are established based on each person's relationship to other family members and the person's financial responsibility for the other family members. MAUs for non-MAGI-based programs include an applicant and persons financially responsible for the applicant as described in subsection (2) of this section (as limited by subsection (3) of this section).

(2) Financial responsibility applies ((only to spouses and to parents,)) as follows:

(a) Married persons((,)) living together are financially responsible for each other;

(b) Natural, adoptive, or step-parents are financially responsible for their unmarried, minor children living in the same household;

(d) Married persons((' financial responsibility))not living together are financially responsible for each other to the extent described in WAC 182-512-0960 and chapters 182-513 and 182-515 WAC when ((not living together because one or both are residing in a medical institution is described in chapter 182-513 WAC))one or both are residing in a medical institution, or one or both are applying for or receiving home and community-based services.

(3) The number of persons in the MAU is increased by one for each verified unborn child for each pregnant ((woman))person already included in the MAU under this section.

(4) A separate SSI-related MAU is required for:

(a) SSI recipients, except for spouses who both receive SSI;

(b) SSI-related persons, except spouses whose eligibility is determined as a couple in chapters 182-511, 182-512, and 182-513 WAC;

(d) The purpose of applying medical income and resource standards for an:

(i) SSI-related applicant whose spouse is not relatable to SSI or is not applying for SSI-related medical; and

(ii) Ineligible spouse of an SSI recipient.

(((5) When determining eligibility for an SSI-related medical program, the agency determines how household income is allocated and deemed to the SSI-related person according to the rules described in WAC 182-512-0820 and 182-512-0900 through 182-512-0960.))

WAC 182-512-0950SSI-related medical—Child-related resource exclusions and allocations.

The agency considers resources of financially responsible people to determine if a portion of the resources must be regarded as available to other household members.

(1) A portion of the resources of a parent or parents is available to the SSI-related child when the child is age seventeen or younger and the parent or parents are:

(a) Financially responsible for the SSI-related child as described in WAC 182-506-0015;

(b) The natural, adoptive, or step-parent of the child;

(d) Not receiving a needs-based payment such as temporary assistance to needy families (TANF), state-funded cash assistance (SFA) or SSI; and

(e) Not related to SSI or not applying for medical assistance.

(2) Resources that are deemed to the child are that child's resources.

(3) When determining whether a parent's resources are countable, the agency:

(a) Follows the resource rules described in WAC 182-512-0200 through 182-512-0300; and

(b) Excludes resources described in WAC 182-512-0350 through 182-512-0550, except for WAC 182-512-0550(16), where instead, the pension funds excluded are those owned by either parent.

(4) In determining eligibility of an SSI-related child, the child's resources include the value of the countable resources of the parent or parents that exceed the resource limit in WAC 182-512-0010 for:

(a) A person, if one parent lives in the household; or

(b) A couple, if two parents (or one parent and the spouse of that parent) live in the household.

(5) The SSI-related child is allowed all applicable resource exclusions and disregards described in this chapter from their own resources.

(6) If there is more than one child living in the household, the value of the deemed resources is divided equally among the children.

(7) An SSI-related child's total countable resources are the combination of the value of the deemed resources and the nonexcluded resources of the child.

(8) A child's countable resources are compared with the one-person resource standard under WAC 182-512-0010.