WSR 97-07-023
PROPOSED RULES
DEPARTMENT OF
SOCIAL AND HEALTH SERVICES
(Public Assistance)
[Filed March 12, 1997, 3:08 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 97-01-091.
Title of Rule: WAC 388-507-0710 AFDC-related medical income standards and 388-513-1350 Institutional--Available resources.
Purpose: Adopt new standards for the medically needy income level and community spouse resource level. Corrects a cross-reference.
Statutory Authority for Adoption: RCW 74.04.050, 74.04.057, 74.08.090; for WAC 388-513-1350 also add RCW 74.09.575.
Statute Being Implemented: RCW 74.04.057.
Summary: See Purpose above.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Joanie Scotson, Medical Assistance Administration, 617 8th S.E., Olympia, WA, (360) 753-7462.
Name of Proponent: Department of Social and Health Services, governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: See Purpose above.
Proposal Changes the Following Existing Rules: See Purpose above.
No small business economic impact statement has been prepared under chapter 19.85 RCW. This proposed rule does not have an economic impact on small businesses. It concerns eligibility policy and affects only clients and staff.
Section 201, chapter 403, Laws of 1995, does not apply to this rule adoption. RCW 34.05.328 does not apply to the Department of Social and Health Services.
Hearing Location: Lacey Government Center (behind Tokyo Bento restaurant), 1009 College Street S.E., Room 104-A, Lacey, WA 98503, on April 22, 1997, at 10:00 a.m.
Assistance for Persons with Disabilities: Contact Leslie Baldwin by April 8, 1997, TTY (360) 902-8324, voice (360) 902-7540.
Submit Written Comments to: Leslie Baldwin, Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, FAX (360) 902-8292, by April 22, 1997.
Date of Intended Adoption: No sooner than April 23, 1997.
March 12, 1997
Merry A. Kogut, Manager
Rules and Policies Assistance Unit
AMENDATORY SECTION (Amending Order 3963, filed 4/10/96, effective 5/11/96 WAC 388-507-0710 AFDC-related medical income standards. (1) The department shall determine income standards for AFDC-related clients as described under WAC 388-505-0590 (2) and (4).
(2) Effective January 1, ((1996)) 1997, the department shall set the
medically needy income level (MNIL) at:
(a) One person $ ((496)) 512
(b) Two persons $ 592
(c) Three persons $ 667
(d) Four persons $ 742
(e) Five persons $ 858
(f) Six persons $ 975
(g) Seven persons $1,125
(h) Eight persons $1,242
(i) Nine persons $1,358
(j) Ten persons and above $1,483
[Statutory Authority: RCW 74.08.090 and Title XIX State Agency Letter
95-44. 96-09-033 (Order 3963), 388-507-0710, filed 4/10/96, effective
5/11/96. Statutory Authority: RCW 74.08.090 and Title XIX State Agency
Letter 94-49, notice of increase in SSI level. 95-05-022 (Order 3832),
388-507-0710, filed 2/8/95, effective 3/11/95. Statutory Authority:
RCW 74.08.090. 94-10-065 (Order 3732), 388-507-0710, filed 5/3/94,
effective 6/3/94.]
AMENDATORY SECTION (Amending Order 3963, filed 4/10/96, effective 5/11/96 WAC 388-513-1350 Institutional--Available resources. (1) Resources are defined under chapter 388-511 WAC for an SSI-related client and under WAC 388-22-030 for an AFDC-related client.
(2) The methodology and standards for determining and evaluating resources are under WAC 388-513-1310, 388-513-1330, 388-513-1340, and 388-513-1360. Transfers of resources are evaluated under WAC 388-513-1365.
(3) The department shall determine ownership of resources following Washington state community property principles for a person:
(a) Whose most recent period of institutionalization began on or before September 30, 1989; and
(b) Who remains continuously institutionalized.
(4) For purposes of Medicaid eligibility, the department shall consider resources are:
(a) Community resources when jointly held in the:
(i) Names of both the institutionalized and community spouse; or
(ii) Name of the institutionalized spouse only.
(b) The separate property of the community spouse when:
(i) Held in the separate name of the community spouse; or
(ii) Transferred between spouses as described under WAC ((388-513-1370(6))) 388-513-1350(7).
(5) The department shall:
(a) Divide by two, the total value of the community resources the spouses own; and
(b) Assign one-half of the total value of the community resources to each spouse.
(6) The department shall not consider a person continuously institutionalized if, for thirty consecutive days, the person:
(a) Is absent from an institution; or
(b) Does not receive home-based or community-based waivered services.
(7) For the purpose of determining Medicaid eligibility of a person, whose most recent continuous period of institutionalization starts on or after October 1, 1989, the department shall:
(a) Exclude resources as described under WAC 388-511-1160; except, the department shall exempt one vehicle without regard to use or value when the institutionalized person has a community spouse;
(b) Consider available to the community spouse, resources in the name of either the community spouse or the institutionalized spouse, except resources exceeding the greater of:
(i) Seventy-((six)) nine thousand ((seven hundred forty)) twenty
dollars effective January 1, ((1996)) 1997;
(ii) An amount established by a fair hearing under chapter 388-08 WAC when the community spouse's resource allowance is inadequate to provide a minimum monthly maintenance needs allowance; or
(iii) An amount ordered transferred to the community spouse by the court.
(c) Ensure resources available to the community spouse are in the name of the community spouse or transferred to the community spouse or to another person for the sole benefit of the community spouse:
(i) Before the first regularly scheduled eligibility review; or
(ii) As soon as practicable thereafter, taking into account such time as may be necessary to obtain a court order for the support of the community spouse.
(d) Consider resources greater than such resources described under subsection (7)(b) of this section available to the institutional spouse.
(8) The department shall consider resources of the community spouse:
(a) Unavailable to the institutionalized spouse:
(i) The month after the institutionalized spouse is determined eligible for institutional benefits; and
(ii) While the institutionalized spouse remains in a continuous period of institutionalization.
(b) Available to the institutionalized spouse when the institutionalized spouse:
(i) Acquires resources which, when added to resources held by the institutionalized spouse, exceed the one-person resource maximum, if the most recent period of institutionalization began on or after October 1, 1989; or
(ii) Has a break of thirty days or more in a period of institutionalization.
[Statutory Authority: RCW 74.08.090 and Title XIX State Agency Letter 95-44. 96-09-033 (Order 3963), 388-513-1350, filed 4/10/96, effective 5/11/96. Statutory Authority: RCW 74.08.090 and Title XIX State Agency Letter 94-49, notice of increase in SSI level. 95-05-022 (Order 3832), 388-513-1350, filed 2/8/95, effective 3/11/95. Statutory Authority: RCW 74.08.090. 94-23-129 (Order 3808), 388-513-1350, filed 11/23/94, effective 12/24/94; 94-10-065 (Order 3732), 388-513-1350, filed 5/3/94, effective 6/3/94. Formerly parts of WAC 388-95-337 and 388-95-340.]