WSR 02-10-093

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Economic Services Administration)

[ Filed April 29, 2002, 3:35 p.m. ]

Original Notice.

Exempt from preproposal statement of inquiry under RCW 34.05.310(4).

Title of Rule: Amending WAC 388-418-0020 How does the department determine the date a change affects my benefits? and 388-458-0030 We send you a termination letter when your benefits stop.

Purpose: WAC 388-418-0020, describes when changes affect benefits. The affect the change has determines when the benefits will be changed. WAC 388-458-0030, describes what is included in the termination letter and how much warning the department must give before terminating benefits.

Statutory Authority for Adoption: RCW 74.08.090 and 74.04.510.

Statute Being Implemented: RCW 74.08.090 and 74.04.510.

Summary: Federal regulations now require the department to send a letter requesting information from the client when we learn about a change and are not sure what impact that change will have on benefits. An example of this would be receiving returned mail. The request letter must give the client ten days to respond. If we do not hear from the client or the mail is returned again, then we can terminate benefits. If the second letter is returned with a notation from the post office that the client has moved and has not provided a forwarding address, we can terminate benefits without giving advance notice.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Veronica Barnes, DEAP, 1009 College Street S.E., Lacey, WA 98509, (360) 413-3071.

Name of Proponent: Department of Social and Health Services, governmental.

Rule is necessary because of federal law, 7 C.F.R. 237.12.

Explanation of Rule, its Purpose, and Anticipated Effects: These WACs are being modified to reflect new federal regulations. The department cannot immediately terminate benefits if we are not sure how a change affects the benefits. We must first send a letter to the client to request additional information. Return mail is an example of a change that has an unclear impact on benefits.

Proposal Changes the Following Existing Rules: WAC 388-418-0020, now requires the department to send a letter to the client if we find out about a change and are not sure what impact the change will have on benefits. WAC 388-458-0030, now allows the department to terminate benefits without ten day advance notice if we get returned mail from the post office that states the client has moved and has not provided a forwarding address.

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 only affects DSHS clients.

RCW 34.05.328 does not apply to this rule adoption. This rule does not fit the definition of a significant legislative rule per RCW 34.05.328 (5)(b)(vii).

Hearing Location: Office Building 2 Auditorium (DSHS Headquarters) (parking entrance at 12th and Washington), 1115 Washington, Olympia, WA, on June 4, 2002, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator, by May 31, 2002, phone (360) 664-6094, TTY (360) 664-6178, e-mail fernaax@dshs.wa.gov.

Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, e-mail fernaax@dshs.wa.gov, by 5:00 p.m. June 4, 2002.

Date of Intended Adoption: No earlier than June 5, 2002.

April 25, 2002

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3083.2
AMENDATORY SECTION(Amending WSR 99-23-034, filed 11/10/99, effective 1/1/00)

WAC 388-418-0020   How does the department ((determines)) determine the date a change affects ((the benefit amount.)) my benefits?   (1) Unless otherwise specified, the rules in this chapter refer to cash, food and medical assistance benefits.

(2) When a change causes an increase in benefits, the client must provide proof of the change before we adjust the benefit amount.

(a) ((The change affects the next month after the change is reported if the client provides verification)) If you give us the proof within ten days from the date we ((request verification)) requested it, we increase your benefits starting the month after the month you reported the change.

(b) ((The change affects the next month after the verification is received if the client provides verification after)) If you give us the proof more than ten days ((from)) after the date we ((request verification)) requested it, we increase your benefits starting the month after the month we got the proof.

(c) ((When the client is)) If you are entitled to ((receive additional)) get more benefits((, the department)) and we have already sent you benefits for that month, we must send ((the additional amount)) them to you within ten days of the day ((the client provides requested verification)) we got the proof.

(3) When a change causes a decrease in benefits, we change your benefit amount before we ask for proof:

(a) If ((the client reports)) you report the change within the time limits in WAC ((388-418-0005, the change affects)) 388-418-0007, we decrease your benefits starting the first month following the advance notice period. The advance notice period:

(i) Begins on the day we send ((the client a notice )) you a letter about the change, and

(ii) Is determined according to the rules in WAC 388-458-0010.

(b) If ((the client fails to)) you do not report the change within the time limits in WAC ((388-418-0005)) 388-418-0007:

(i) ((The change affects the first month following the day the advance notice period would end if the client)) We figure out the effective date as if you had reported ((the change)) it on time((, allowing)). This includes:

(A) Ten days for ((the client)) you to report the change, and

(B) Ten days for the advance notice period to begin, if required under chapter 388-458 WAC.

(ii) ((We continue assistance unchanged through the advance notice period when the advance notice period ends later than)) If the effective date((.

(iii))) should have been a past month:

(A) We establish an overpayment claim according to the rules in chapter 388-410 WAC ((when benefits continue beyond the effective date.

(4))) for all the appropriate months; and

(B) Decrease your benefits starting the following month.

(iii) We establish an overpayment claim and decrease your benefits starting the month after next when:

(A) The effective date should have been next month; and

(B) It is less than ten days away; and

(C) We were supposed to give you ten days notice.

(iv) If the effective date should have been next month or the following month and we have time to give you ten-days notice, we decrease your benefits starting that month.

(c) We have until your next recertification/eligibility review to ask for proof.

(4) If we are not sure how the change will affect your benefits, we send you a letter as described in WAC 388-458-0020 requesting information from you.

(a) We give you ten days to provide the information. If you need more time, you can ask for it.

(b) If you do not give us the information in time, we will stop your benefits after giving you advance notice, if required, as described in WAC 388-458-0030.

(5) Within ten days of the day we learn about a change, ((the department)) we:

(a) ((Sends)) Send advance notice according to the rules in chapter 388-458 WAC; and

(b) ((Takes)) Take necessary action to correct the benefit. We wait to take action on a change ((is delayed when the client requests)) if you request a hearing about a proposed decrease in benefits before the effective date or within the advance notice period as described in WAC 388-458-0040.

(((5))) (6) When ((the client requests)) you request a hearing and get continued benefits:

(a) ((The department continues)) We keep giving you the same benefits ((received prior to)) you got before the advance notice of reduction until the earliest of the following events occur:

(i) For food assistance only, ((the client's )) your certification period expires;

(ii) The end of the month the fair hearing decision is mailed;

(iii) ((The client states)) You state in writing that ((the assistance unit does)) you do not want continued benefits;

(iv) ((The client withdraws the)) You withdraw your fair hearing request in writing; or

(v) ((The client abandons the)) You abandon your fair hearing request; or

(vi) An administrative law judge issues a written order that ends continued benefits prior to the fair hearing.

(b) ((The department establishes)) We establish an overpayment claim according to the rules in chapter 388-410 WAC when the hearing decision agrees with the ((department's)) action we took.

(((6))) (7) Some changes have a specific effective date as follows:

(a) When cash assistance benefits increase because a person is added to ((the)) your assistance unit, we use the effective date rules for applications in WAC 388-406-0055.

(b) When cash assistance benefits increase because ((the household becomes eligible for a higher payment standard)) you start paying shelter costs, we use the date the change occurred.

(c) When a change in law or regulation changes the benefit amount, we use the date specified by the law or regulation.

(d) When institutional medical assistance participation changes, we calculate the new participation amount beginning with the month ((the)) your income or allowable expense changes.

[Statutory Authority: RCW 74.08.090 and 74.04.510. 99-23-034, 388-418-0020, filed 11/10/99, effective 1/1/00. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, 388-418-0020, filed 7/31/98, effective 9/1/98.]

3084.1
AMENDATORY SECTION(Amending WSR 01-16-087, filed 7/25/01, effective 9/1/01)

WAC 388-458-0030   We send you a termination letter when your benefits stop.   (1) We send you a termination letter when your benefits stop.

(2) On the letter, we tell you:

(a) When your benefits are going to end;

(b) The reason they are ending;

(c) The rules that support our decision; and

(d) Your right to have your case reviewed or ask for a fair hearing.

(3) We tell you at least ten days before your benefits end unless;

(a) You asked us to stop your benefits;

(b) We have proof that everyone in your assistance unit has moved to another state or will move to another state before the next benefits are issued;

(c) We have proof that everyone in your assistance unit has died;

(d) We have to change benefits for a lot of people at once because of a law change; ((or))

(e) We got returned mail from the post office that says you have moved and we do not have a forwarding address; or

(f) For food assistance, your certification period is ending.

(4) The ten-day count starts on the day we mail or give you the letter and ends on the tenth day.

(5) If we don't have to give you ten days notice, we send the letter to you:

(a) For cash and medical, by the date of the action.

(b) For food assistance, by the date you normally get your benefits.

[Statutory Authority: RCW 74.08.090 and 74.04.510. 01-16-087, 388-458-0030, filed 7/25/01, effective 9/1/01.]

Washington State Code Reviser's Office