Purpose: These amendments change income levels to reflect the new federal poverty level. These changes will increase the number of children and pregnant women who are eligible for medical assistance.

Citation of Existing Rules Affected by this Order: Amending WAC 388-508-0805, 388-509-0920, and 388-509-0960.

Statutory Authority for Adoption: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, and poverty guidelines updated each year under authority of Section 673(2) of the Omnibus Budget Reconciliation Act of 1981 (42 USC 9902(2)).

Under RCW 34.05.350 the agency for good cause finds that state or federal law or federal rule or a federal deadline for state receipt of federal funds requires immediate adoption of a rule.

Reasons for this Finding: The rules are implemented to comply with federal requirements and to maintain federal funding of these programs. The public hearing on these rules is scheduled for August 25, 1998. The existing emergency adoption will expire July 31, 1998.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, amended 3, repealed 0; Federal Rules or Standards: New 0, amended 0, repealed 0; or Recently Enacted State Statutes: New 0, amended 0, repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, amended 0, repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, amended 0, repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, amended 0, repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, amended 0, repealed 0; Pilot Rule Making: New 0, amended 0, repealed 0; or Other Alternative Rule Making: New 0, amended 3, repealed 0.

Effective Date of Rule: Immediately.

July 29, 1998

Marie Myerchin-Redifer, Manager

Rules and Policies Assistance Unit

AMENDATORY SECTION (Amending WSR 97-16-008, filed 7/24/97, effective 7/24/97)

WAC 388-508-0805  Pregnant woman--Income standards. (((1) The department shall find)) This chapter describes the income standards used to determine the eligibility of a pregnant woman for a medical program. A pregnant woman is eligible for categorically needy Medicaid ((as categorically needy)) when the ((pregnant woman meets the income requirements of this section.

(2) The department shall ensure total family income will)) countable family income does not exceed one hundred eighty-five percent of the Federal Poverty Level (FPL). One hundred eighty-five percent of the ((current)) FPL is:

(((k))) (11) For ((family)) assistance units with more than ten members, add $((420)) 432 to the monthly income for each additional member.

[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530 and Social Security Act, Federal Register, March 10, 1997, pgs. 10856 - 10859, 42 U.S.C. 1396 (a)(l)(m). 97-16-008, § 388-508-0805, filed 7/24/97, effective 7/24/97. Statutory Authority: RCW 74.08.090. 96-15-029, § 388-508-0805, filed 7/10/96, effective 7/10/96; 95-11-045 (Order 3848), § 388-508-0805, filed 5/10/95, effective 6/10/95; 94-10-065 (Order 3732), § 388-508-0805, filed 5/3/94, effective 6/3/94. Formerly WAC 388-83-032 (part).]

AMENDATORY SECTION (Amending WSR 97-16-008, filed 7/24/97, effective 7/24/97)

WAC 388-509-0920  Children's health program. This section describes the children's health program for children who are ineligible for Medicaid. (1) ((The department shall consider)) A child ((seventeen years of)) under age ((or younger,)) eighteen is eligible for state-funded medical services, with the same coverage as categorically needy, when((:

(a))) the child is not eligible for a federally-funded Medicaid program((; and

(b) The child's nonexempt family income does not exceed one hundred percent of the current federal poverty level (FPL). See income guidelines as described under subsection (4) of this section.

(2) The department shall determine nonexempt family income by:

(a) Following AFDC methodology; and

(b) Applying the medical income rules as described under WAC 388-506-0610.

(3) The department shall not require a child to meet the following eligibility factors:

(a) Citizenship;

(b) Social Security number; or

(c) Resources limits.

(4) The department shall find that)) and meets the income standards described in subsection (4).

(2) Citizenship, Social Security number, and resource standards are not eligibility factors for the children's health program.

(3) Countable family income is determined using TANF methodology and the medical income rules as described under WAC 388-506-0610.

(4) The countable income in the child's assistance unit may not exceed one hundred percent of the federal poverty level (FPL). One hundred percent of the current FPL equals:

(k) For ((family)) assistance units with more than ten members, add $((227)) 234 to the monthly income for each additional member.

(5) ((For a child determined eligible under this section, the department shall not consider)) A change in family income during the certification period does not affect eligibility for a child determined eligible under this section.

[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530 and Social Security Act, Federal Register, March 10, 1997, pgs. 10856 - 10859, 42 U.S.C. 1396 (a)(l)(m). 97-16-008, § 388-509-0920, filed 7/24/97, effective 7/24/97. Statutory Authority: RCW 74.08.090. 96-15-029, § 388-509-0920, filed 7/10/96, effective 7/10/96; 95-11-056 (Order 3848A), § 388-509-0920, filed 5/11/95, effective 6/11/95; 94-17-036 (Order 3769), § 388-509-0920, filed 8/10/94, effective 9/10/94; 94-10-065 (Order 3732), § 388-509-0920, filed 5/3/94, effective 6/3/94. Formerly WAC 388-83-033 (part).]

AMENDATORY SECTION (Amending WSR 97-16-008, filed 7/24/97, effective 7/24/97)

WAC 388-509-0960  Children's income standards. This section describes income standards used to determine a child's Medicaid eligibility. (1) ((The department shall determine)) A child meeting the eligibility requirements under WAC 388-509-0910 is eligible as categorically needy when the ((total family)) countable income in the child's assistance unit does not exceed two hundred percent of the federal poverty level (FPL). ((The department shall find that)) Two hundred percent of the ((current)) FPL equals:

(k) For ((family)) assistance units with more than ten members, add $((454)) 467 to the monthly income for each additional member.

(2) ((For a child determined eligible under WAC 388-509-0910, the department shall not consider)) A change in ((family)) the assistance unit's income during the certification period does not affect eligibility for a child determined eligible under WAC 388-509-0910.

[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530 and Social Security Act, Federal Register, March 10, 1997, pgs. 10856 - 10859, 42 U.S.C. 1396 (a)(l)(m). 97-16-008, § 388-509-0960, filed 7/24/97, effective 7/24/97. Statutory Authority: RCW 74.08.090. 96-15-029, § 388-509-0960, filed 7/10/96, effective 7/10/96; 95-11-056 (Order 3848A), § 388-509-0960, filed 5/11/95, effective 6/11/95. Statutory Authority: RCW 74.08.090 and Letter from HCFA approving State Plan Transmittal 94-21. 95-05-023 (Order 3833), § 388-509-0960, filed 2/8/95, effective 3/11/95. Statutory Authority: RCW 74.08.090. 94-17-036 (Order 3769), § 388-509-0960, filed 8/10/94, effective 9/10/94; 94-10-065 (Order 3732), § 388-509-0960, filed 5/3/94, effective 6/3/94. Formerly WAC 388-83-033 (part).]