SOCIAL AND HEALTH SERVICES
(Economic Services Administration)
Date of Adoption: October 16, 2000.
Purpose: New rule is to implement federal rules in order to continue to meet federal refugee funding requirements.
Statutory Authority for Adoption: RCW 74.08.090, 74.08A.320.
Adopted under notice filed as WSR 00-18-111 on September 6, 2000.
Changes Other than Editing from Proposed to Adopted Version: Editing changes only.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 1, Amended 0, Repealed 1; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 1.
Other Findings Required by Other Provisions of Law as Precondition to Adoption or Effectiveness of Rule: Refugee medical assistance, WAC 388-466-0007, emergency filing on July 18, 2000, as WSR 00-15-071 expires on November 14, 2000.Effective Date of Rule: November 1, 2000.
October 16, 2000
Edith M. Rice
for Marie Myerchin-Redifer, Manager
Rules and Policies Assistance Unit2788.6
(1) Who can apply for refugee medical assistance?
Any individual can apply for refugee medical assistance (RMA) and have eligibility determined by the department of social and health services (DSHS).
(2) Who is eligible for refugee medical assistance?
(a) You are eligible for RMA if you meet all of the following conditions:
(i) Immigration status requirements of WAC 388-466-0005;
(ii) Income and resource requirements of WAC 388-466-0010;
(iii) Monthly income standards up to two hundred percent of the federal poverty level (FPL). Spenddown is available for applicants whose income exceeds two hundred percent of FPL (see WAC 388-519-0110); and
(iv) Provide the name of the voluntary agency (VOLAG) which helped bring you to this country, so that DSHS can promptly notify the agency (or sponsor) about your application for RMA.
(b) You are eligible for RMA if you meet one of the following conditions:
(i) Receive refugee cash assistance (RCA) and are not eligible for Medicaid or children's health insurance program (CHIP); or
(ii) Choose not to apply for or receive RCA and are not eligible for Medicaid or CHIP, but still meet RMA eligibility requirements.
(3) Who is not eligible for refugee medical assistance?
You are not eligible to receive RMA if you are:
(a) Already eligible for Medicaid or CHIP;
(b) A full-time student in an institution of higher education unless the educational activity is part of a department-approved individual responsibility plan (IRP);
(c) A nonrefugee spouse of a refugee.
(4) If I have already received a cash assistance grant from voluntary agency (VOLAG), will it affect my eligibility for RMA?
No. A cash assistance payment provided to you by your VOLAG is not counted in determining eligibility for RMA.
(5) If I get a job after I have applied but before I have been approved for RMA, will my new income be counted in determining my eligibility?
No. Your RMA eligibility is determined on the basis of your income and resources on the date of the application.
(6) Will my sponsor's income and resources be considered in determining my eligibility for RMA?
Your sponsor's income and resources are not considered in determining your eligibility for RMA unless your sponsor is a member of your assistance unit.
(7) How do I find out if I am eligible for RMA?
DSHS will send you a letter in both English and your primary language informing you about your eligibility. DSHS will also let you know in writing every time there are any changes or actions taken on your case.
(8) Will RMA cover my medical expenses that occurred after I arrived in the U.S. but before I applied for RMA?
You may be eligible for RMA coverage of your medical expenses for three months prior to the first day of the month of your application. Eligibility determination will be made according to Medicaid rules.
(9) If I am an asylee, what date will be used as an entry date?
If you are an asylee, your entry date will be the date that your asylum status is granted. For example, if you entered the United States on December 1, 1999 as a tourist, then applied for asylum on April 1, 2000, interviewed with the asylum office on July 1, 2000 and granted asylum on September 1, 2000, your date of entry is September 1, 2000. On September 1, 2000 you may be eligible for refugee medical assistance.
(10) When does my RMA end?
Your refugee medical assistance will end on the last day of the eighth month from the month of your entry into the United States. Start counting the eight months from the first day of the month of your entry into the U.S. For example, if you entered the U.S. on May 28, 2000, your last month is December 2000.
(11) What happens if my earned income goes above the income standards?
(a) If you are getting RMA, your medical eligibility will not be effected by the amount of your earnings;
(b) If you were getting Medicaid and it was terminated because of your earnings, we will transfer you to RMA for the rest of your RMA eligibility period. You will not need to apply.
(12) Will my spouse also be eligible for RMA, if he/she arrives into the U.S. after me?
When your spouse arrives in the U.S., we will determine his/her eligibility for Medicaid and other medical programs. Your spouse may be eligible for RMA; if so, he/she would have a maximum of eight months of RMA starting on the first day of the month of his/her arrival.
(13) What do I do if I disagree with a decision or action that has been taken by DSHS on my case?
If you disagree with the decision or action taken on your case by department you have the right to request a review of your case or request a fair hearing (see WAC 388-02-0090). Your request must be made within ninety days of the decision or action).
(14) What happens to my medical coverage after my eligibility period is over?
We will determine your eligibility for other medical programs. You may have to complete an application for another program.