WSR 10-06-059

EMERGENCY RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Health and Recovery Services Administration)

[ Filed February 25, 2010, 10:02 a.m. , effective March 1, 2010 ]


     Effective Date of Rule: March 1, 2010.

     Purpose: To implement necessary language regarding:

     (1) Exemption of certain property from resources for medicaid and children's health insurance program (CHIP) eligibility for Native Americans, as required under the American Recovery and Reinvestment Act (ARRA) of 2009 (Recovery Act); and

     (2) Payments or interest accrued on payments made under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) listed as excluded resources for SSI-related medical programs.

     Citation of Existing Rules Affected by this Order: Amending WAC 388-450-0040, 388-450-0080, 388-455-0005, 388-455-0015, 388-470-0045, 388-475-0350, 388-475-0550, and 388-475-0600.

     Statutory Authority for Adoption: RCW 74.08.090.

     Other Authority: ARRA of 2009 (Recovery Act), Public Law 111-5, Section 5006(b); 42 C.F.R. 435.601, EEOICPA of 2000, Public Law 106398, Sec. 1, app., Title XXXVI (October 30, 2000) (Section 1 adopting as Appendix H.R. 5408), Section 3646 of the Appendix.

     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: Amendments to these WAC sections are needed to be in compliance with federal requirements of the ARRA of 2009 (Recovery Act), which provides protections for American Natives in medicaid and CHIP, and the EEOICPA of 2000 which provides exemption of payments or interest accrued on payments received under the EEOICPA as countable resources for SSI-related medical programs.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 8, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 8, Repealed 0.

     Date Adopted: February 23, 2010.

Don Goldsby, Manager

Rules and Policies Assistance Unit

4181.2
AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-450-0040   Native American benefits and payments.   This section applies to TANF/SFA, RCA, GA medical and food assistance programs.

     (1) The following types of income are not counted when a client's benefits are computed:

     (a) Up to two thousand dollars per individual per calendar year received under the Alaska Native Claims Settlement Act, P.L. 92-203 and 100-241;

     (b) Income received from Indian trust funds or lands held in trust by the Secretary of the Interior for an Indian tribe or individual tribal member. Income includes:

     (i) Interest; and

     (ii) Investment income accrued while such funds are held in trust.

     (c) Income received from Indian judgement funds or funds held in trust by the Secretary of the Interior distributed per capita under P.L. 93-134 as amended by P.L. 97-458 and 98-64. Income includes:

     (i) Interest; and

     (ii) Investment income accrued while such funds are held in trust.

     (d) Up to two thousand dollars per individual per calendar year received from leases or other uses of individually owned trust or restricted lands, P.L. 103-66;

     (e) Payments from an annuity fund established by the Puyallup Tribe of Indians Settlement Act of 1989, P.L. 101-41, made to a Puyallup Tribe member upon reaching twenty-one years of age; and

     (f) Payments from the trust fund established by the P.L. 101-41 made to a Puyallup Tribe member.

     (2) Other Native American payments and benefits that are excluded by federal law are not counted when determining a client's benefits. Examples include but are not limited to:

     (a) White Earth Reservation Land Settlement Act of 1985, P.L. 99-264, Section 16;

     (b) Payments made from submarginal land held in trust for certain Indian tribes as designated by P.L. 94-114 and P.L. 94-540; ((and))

     (c) Payments under the Seneca Nation Settlement Act, P.L. 101-503; and

     (d) For medical assistance, receipt of money by a member of a federally recognized tribe from exercising Native American treaty rights or extraction of protected resources, such as fishing, shell-fishing, or selling timber, is considered conversion of an exempt resource during the month of receipt. Any amounts remaining from the conversion of this exempt resource on the first of the month after the month of receipt will remain exempt if the funds were used to purchase another exempt resource. Any amounts remaining in the form of countable resources (such as in checking or savings accounts) on the first of the month after receipt, will be added to other countable resources for eligibility determinations.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-450-0040, filed 7/31/98, effective 9/1/98. Formerly WAC 388-511-1140.]


AMENDATORY SECTION(Amending WSR 06-15-049, filed 7/12/06, effective 9/1/06)

WAC 388-450-0080   What is self-employment income?   This section applies to cash assistance, Basic Food, and medical programs for children, pregnant women and families.

     (1) Self-employment income is income you earn from running a business, performing a service, selling items you make, or reselling items to make a profit.

     (2) You are self-employed if you earn income without having an employer/employee relationship with the person who pays you. This includes, but is not limited to, when:

     (a) You have primary control of the way you do your work; or

     (b) You report your income using IRS Schedule C, Schedule C-EZ, Schedule K-1, or Schedule SE.

     (3) You usually have an employer/employee relationship when:

     (a) The person you provide services for has primary control of how you do your work; or

     (b) You get an IRS form W-2 to report your income.

     (4) Your self-employment does not have to be a licensed business for your business or activity to qualify as self-employment. Some examples of self-employment include:

     (a) Child care that requires a license under chapter 74.15 RCW;

     (b) Driving a taxi cab;

     (c) Farming/fishing;

     (d) Odd jobs such as mowing lawns, house painting, gutter cleaning, or car care;

     (e) Running a lodging for roomers and/or boarders. Roomer income includes money paid to you for shelter costs by someone not in your assistance unit who lives with you when:

     (i) You own or are buying your residence; or

     (ii) You rent all or a part of your residence and the total rent you charge all others in your home is more than your total rent.

     (f) Running an adult family home;

     (g) Providing services such as a massage therapist or a professional escort;

     (h) Retainer fees to reserve a bed for a foster child;

     (i) Selling items you make or items that are supplied to you;

     (j) Selling or donating your own biological products such as providing blood or reproductive material for profit;

     (k) Working as an independent contractor; and

     (l) Running a business or trade either on your own or in a partnership.

     (5) For medical programs, we do not count a member of a federally-recognized Native American tribe's receipt of money from exercising treaty rights as self-employment income (such as fishing, shell-fishing, or selling timber from protected tribal land). We count this as conversion of a resource. See WAC 388-540-0040.

     (6) If you are an employee of a company or person who does the activities listed in subsection (2) above as a part of your job, we do not count the work you do as self-employment.

     (((6))) (7) Self-employment income is counted as earned income as described in WAC 388-450-0030 except as described in subsection (((7))) (8).

     (((7))) (8) For cash assistance and Basic Food there are special rules about renting or leasing out property or real estate that you own.

     (a) We count the income you get as unearned income unless you spend at least twenty hours per week managing the property.

     (b) For TANF/SFA, we count the income as unearned income unless the use of the property is a part of your approved individual responsibility plan.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510, 74.08.090. 06-15-049, § 388-450-0080, filed 7/12/06, effective 9/1/06. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, and 74.04.510. 03-13-045, § 388-450-0080, filed 6/11/03, effective 8/1/03. Statutory Authority: RCW 74.08.090 and 74.04.510. 01-19-020, § 388-450-0080, filed 9/11/01, effective 10/1/01; 99-16-024, § 388-450-0080, filed 7/26/99, effective 9/1/99. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-450-0080, filed 7/31/98, effective 9/1/98.]


AMENDATORY SECTION(Amending WSR 08-11-105, filed 5/20/08, effective 7/1/08)

WAC 388-455-0005   How do lump sum payments affect benefits?   (1) A lump sum payment is money that someone receives but does not expect to receive on a continuing basis.

     (2) For cash assistance and family medical programs, we count a lump sum payment:

     (a) As a resource, under WAC 388-455-0010, if it was awarded for wrongful death, personal injury, damage, or loss of property.

     (b) As income, under WAC 388-455-0015, if it was received for any other reason, with the exception of subsection (3) of this section.

     (3) For medical programs, receipt of a lump sum by a member of a federally-recognized Native American tribe due to extraction of resources is considered an exempt resource in the month of receipt. Any amounts remaining on the first of the next month will be counted if they remain in the form of a countable resource. Any amounts remaining the first of the month after conversion will remain exempt if they are in the form of an exempt resource.

     (4) For Basic Food, we count lump sum payments for a previous period as a resource under WAC 388-470-0055. We count any amount for current or future months as income to your assistance unit.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510, and 74.08.090. 08-11-105, § 388-455-0005, filed 5/20/08, effective 7/1/08. Statutory Authority: RCW 74.08.090 and 74.04.510. 99-24-008, § 388-455-0005, filed 11/19/99, effective 1/1/00.]


AMENDATORY SECTION(Amending WSR 08-11-105, filed 5/20/08, effective 7/1/08)

WAC 388-455-0015   When and how does the department treat lump sum payments as income for cash assistance and family medical programs.   This section applies to cash and family medical programs.

     (1) If you receive a lump sum payment that is not awarded for wrongful death, personal injury, damage, or loss of property, we count this payment as income to your assistance unit. We budget this income according to effective date rules under WAC 388-418-0020.

     (2) For cash assistance, if you cannot access some or all of your lump sum payment for reasons beyond your control, we will adjust the amount we count as income to your assistance unit as described under WAC 388-450-0005.

     (3) To decide the amount of your lump sum we count as income, we take the following steps:

     (a) First, we subtract the value of your current resources from the resource limit under WAC 388-470-0005;

     (b) Then, we subtract the difference in (3)(a) from the total amount of the lump sum; and

     (c) The amount left over is what we count as income, as specified in WAC 388-450-0025 and 388-450-0030.

     (4) When the countable amount of the lump sum payment is:

     (a) Less than your payment standard plus additional requirements, we count it as income in the month it is received.

     (b) More than one month's payment standard plus additional requirements but less than two months:

     (i) We count the portion equal to one month's payment standard plus additional requirements as income in the month it is received; and

     (ii) We count the remainder as income the following month.

     (c) Equal to or greater than the total of the payment standard plus additional requirements for the month of receipt and the following month, we count the payment as income for those months.

     (5) If you receive a one-time lump sum payment, and you are ineligible or disqualified from receiving cash benefits:

     (a) We allocate the payment to meet your needs as described under WAC 388-450-0105; and

     (b) Count the remainder as a lump sum payment available to eligible members of your assistance unit according to the rules of this section.

     (6) For family medical programs:

     (a) We count lump sum payments as income in the month you receive the payment.

     (b) We count lump sums received by a member of a federally-recognized tribe for extraction of exempt resources as an exempt resource in the month of receipt. Any amount remaining the first of the next month in the form of an exempt resource will remain exempt. Any amount remaining the first of the month will be countable if in the form of a countable resource.

     (c) If you cannot access some or all of your lump sum payment for reasons beyond your control, will adjust the amount we count as income to your assistance unit as described under WAC 388-450-0005.

     (((c))) (d) We count any money that remains on the first of the next month as a resource except for recipients as described in WAC 388-470-0026 (1) and (2).

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510, and 74.08.090. 08-11-105, § 388-455-0015, filed 5/20/08, effective 7/1/08. Statutory Authority: RCW 74.08.090 and 74.04.510. 99-24-008, § 388-455-0015, filed 11/19/99, effective 1/1/00.]


AMENDATORY SECTION(Amending WSR 09-09-103, filed 4/20/09, effective 4/21/09)

WAC 388-470-0045   How do my resources count toward the resource limits for cash assistance and family medical programs?   (1) We count the following resources toward your assistance unit's resource limits for cash assistance and family medical programs to decide if you are eligible for benefits under WAC 388-470-0005:

     (a) Liquid resources not specifically excluded in subsection (2) below. These are resources that are easily changed into cash. Some examples of liquid resources are:

     (i) Cash on hand;

     (ii) Money in checking or savings accounts;

     (iii) Money market accounts or certificates of deposit (CDs) less any withdrawal penalty;

     (iv) Available retirement funds or pension benefits, less any withdrawal penalty;

     (v) Stocks, bonds, annuities, or mutual funds less any early withdrawal penalty;

     (vi) Available trusts or trust accounts; ((or))

     (vii) Lump sum payments as described in chapter 388-455 WAC; or

     (viii) Any funds retained beyond the month of receipt from conversion of exempt resources by members of a federally-recognized Native American tribe that are in the form of countable resources.

     (b) The cash surrender value (CSV) of whole life insurance policies.

     (c) The CSV over fifteen hundred dollars of revocable burial insurance policies or funeral agreements.

     (d) The amount of a child's irrevocable educational trust fund that is over four thousand dollars per child.

     (e) Funds withdrawn from an individual development account (IDA) if they were removed for a purpose other than those specified in RCW 74.08A.220.

     (f) Any real property like a home, land or buildings not specifically excluded in subsection (3) below.

     (g) The equity value of vehicles as described in WAC 388-470-0070.

     (h) Personal property that is not:

     (i) A household good;

     (ii) Needed for self-employment; or

     (iii) Of "great sentimental value," due to personal attachment or hobby interest.

     (i) Resources of a sponsor as described in WAC 388-470-0060.

     (j) For cash assistance only, sales contracts.

     (2) The following types of liquid resources do not count when we determine your eligibility:

     (a) Bona fide loans, including student loans;

     (b) Basic Food benefits;

     (c) Income tax refunds in the month of receipt;

     (d) Earned income tax credit (EITC) in the month received and the following month;

     (e) Advance earned income tax credit payments;

     (f) Federal economic stimulus payments that are excluded for federal and federally assisted state programs;

     (g) Individual development accounts (IDAS) established under RCW 74.08A.220;

     (h) Retroactive cash benefits or TANF/SFA benefits resulting from a court order modifying a decision of the department;

     (i) Underpayments received under chapter 388-410 WAC;

     (j) Educational benefits that are excluded as income under WAC 388-450-0035;

     (k) The income and resources of an SSI recipient;

     (l) A bank account jointly owned with an SSI recipient if SSA already counted the money for SSI purposes;

     (m) Foster care payments provided under Title IV-E and/or state foster care maintenance payments;

     (n) Adoption support payments;

     (o) Self-employment accounts receivable that the client has billed to the customer but has been unable to collect; ((and))

     (p) Resources specifically excluded by federal law; and

     (q) For medical benefits, receipts from extracted exempt resources (fishing, shell-fishing, timber sales, etc.) during the month of receipt for a member of a federally-recognized tribe.

     (3) The following types of real property do not count when we determine your eligibility:

     (a) Your home and the surrounding property that you, your spouse, or your dependents live in;

     (b) A house you do not live in, if you plan on returning to the home and you are out of the home because of:

     (i) Employment;

     (ii) Training for future employment;

     (iii) Illness; or

     (iv) Natural disaster or casualty.

     (c) Property that:

     (i) You are making a good faith effort to sell;

     (ii) You intend to build a home on, if you do not already own a home;

     (iii) Produces income consistent with its fair market value, even if used only on a seasonal basis; or

     (iv) A household member needs for employment or self-employment. Property excluded under this section and used by a self-employed farmer or fisher retains its exclusion for one year after the household member stops farming or fishing.

     (d) Indian lands held jointly with the Tribe, or land that can be sold only with the approval of the Bureau of Indian Affairs.

     (4) If you deposit excluded liquid resources into a bank account with countable liquid resources, we do not count the excluded liquid resources for six months from the date of deposit.

     (5) If you sell your home, you have ninety days to reinvest the proceeds from the sale of a home into an exempt resource.

     (a) If you do not reinvest within ninety days, we will determine whether there is good cause to allow more time. Some examples of good cause are:

     (i) Closing on your new home is taking longer than anticipated;

     (ii) You are unable to find a new home that you can afford;

     (iii) Someone in your household is receiving emergent medical care; or

     (iv) Your children are in school and moving would require them to change schools.

     (b) If you have good cause, we will give you more time based on your circumstances.

     (c) If you do not have good cause, we count the money you got from the sale as a resource.

[Statutory Authority: RCW 74.04.005, 74.04.050, 74.04.055, 74.04.057, 74.04.510 and 74.08.090. 09-09-103, § 388-470-0045, filed 4/20/09, effective 4/21/09. Statutory Authority: RCW 74.08.090 and 74.04.510. 03-05-015, § 388-470-0045, filed 2/7/03, effective 3/1/03; 99-16-024, § 388-470-0045, filed 7/26/99, effective 9/1/99. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-470-0045, filed 7/31/98, effective 9/1/98.]


AMENDATORY SECTION(Amending WSR 04-09-003, filed 4/7/04, effective 6/1/04)

WAC 388-475-0350   SSI-related medical -- Property and contracts excluded as resources.   (1) The department does not count the following resources when determining eligibility for SSI-related medical assistance:

     (a) A client's household goods and personal effects;

     (b) One home (which can be any shelter), including the land on which the dwelling is located and all contiguous property and related out-buildings in which the client has ownership interest, when:

     (i) The client uses the home as his or her primary residence; or

     (ii) The client's spouse lives in the home; or

     (iii) The client does not currently live in the home but the client or his/her representative has stated the client intends to return to the home; or

     (iv) A relative, who is financially or medically dependent on the client, lives in the home and the client, client's representative, or dependent relative has provided a written statement to that effect.

     (c) The value of ownership interest in jointly owned real property is an excluded resource for as long as sale of the property would cause undue hardship to a co-owner due to loss of housing. Undue hardship would result if the co-owner:

     (i) Uses the property as his or her principal place of residence;

     (ii) Would have to move if the property were sold; and

     (iii) Has no other readily available housing.

     (2) Cash proceeds from the sale of the home described in subsection (1)(b) above are not considered if the client uses them to purchase another home by the end of the third month after receiving the proceeds from the sale.

     (3) An installment contract from the sale of the home described in subsection (1)(b) above is not a resource as long as the person plans to use the entire down payment and the entire principal portion of a given installment payment to buy another excluded home, and does so within three full calendar months after the month of receiving such down payment or installment payment.

     (4) The value of sales contracts is excluded when the:

     (a) Current market value of the contract is zero,

     (b) Contract cannot be sold, or

     (c) Current market value of the sales contract combined with other resources does not exceed the resource limits.

     (5) Sales contracts executed before December 1, 1993, are exempt resources as long as they are not transferred to someone other than a spouse.

     (6) A sales contract for the sale of the client's principal place of residence executed between December 1, 1993 and May 31, 2004 is considered an exempt resource unless it has been transferred to someone other than a spouse and it:

     (a) Provides interest income within the prevailing interest rate at the time of the sale;

     (b) Requires the repayment of a principal amount equal to the fair market value of the property; and

     (c) The term of the contract does not exceed thirty years.

     (7) A sales contract executed on or after June 1, 2004 on a home that was the principal place of residence for the client at the time of institutionalization is considered exempt as long as it is not transferred to someone other than a spouse and it:

     (a) Provides interest income within the prevailing interest rate at the time of the sale;

     (b) Requires the repayment of a principal amount equal to the fair market value of the property within the anticipated life expectancy of the client; and

     (c) The term of the contract does not exceed thirty years.

     (8) Payments received on sales contracts of the home described in subsection (1)(b) above are treated as follows:

     (a) The interest portion of the payment is treated as unearned income in the month of receipt of the payment;

     (b) The principal portion of the payment is treated as an excluded resource if reinvested in the purchase of a new home within three months after the month of receipt;

     (c) If the principal portion of the payment is not reinvested in the purchase of a new home within three months after the month of receipt, that portion of the payment is considered a liquid resource as of the date of receipt.

     (9) Payments received on sales contracts described in subsection (4) are treated as follows:

     (a) The principal portion of the payment on the contract is treated as a resource and counted toward the resource limit to the extent retained at the first moment of the month following the month of receipt of the payment; and

     (b) The interest portion is treated as unearned income the month of receipt of the payment.

     (10) For sales contracts that meet the criteria in subsections (5), (6), or (7) but do not meet the criteria in subsections (3) or (4), both the principal and interest portions of the payment are treated as unearned income in the month of receipt.

     (11) Property essential to self-support is not considered a resource within certain limits. The department places property essential to self-support in several categories:

     (a) Real and personal property used in a trade or business (income-producing property), such as:

     (i) Land,

     (ii) Buildings,

     (iii) Equipment,

     (iv) Supplies,

     (v) Motor vehicles, and

     (vi) Tools.

     (b) Nonbusiness income-producing property, such as:

     (i) Houses or apartments for rent, or

     (ii) Land, other than home property.

     (c) Property used to produce goods or services essential to an individual's daily activities, such as land used to produce vegetables or livestock, which is only used for personal consumption in the individual's household. This includes personal property necessary to perform daily functions including vehicles such as boats for subsistence fishing and garden tractors for subsistence farming, but does not include other vehicles such as those that qualify as automobiles (cars, trucks).

     (12) The department will exclude an individual's equity in real and personal property used in a trade or business (income producing property listed in subsection (11)(a) above) regardless of value as long as it is currently in use in the trade or business and remains used in the trade or business.

     (13) The department excludes up to six thousand dollars of an individual's equity in nonbusiness income-producing property listed in subsection (11)(b) above, if it produces a net annual income to the individual of at least six percent of the excluded equity.

     (a) If a person's equity in the property is over six thousand dollars, only the amount over six thousand dollars is counted toward the resource limit, as long as the net annual income requirement of six percent is met on the excluded equity.

     (b) If the six percent requirement is not met due to circumstances beyond the person's control, and there is a reasonable expectation that the activities will again meet the six percent rule, the same exclusions as in subsection (13)(a) above apply.

     (c) If a person has more than one piece of property in this category, each is looked at to see if it meets the six percent return and the total equities of all those properties are added to see if the total is over six thousand dollars. If the total is over the six thousand dollars limit, the amount exceeding the limit is counted toward the resource limit.

     (d) The equity in each property that does not meet the six percent annual net income limit is counted toward the resource limit, with the exception of property that represents the authority granted by a governmental agency to engage in an income-producing activity if it is:

     (i) Used in a trade or business or nonbusiness income-producing activity; or

     (ii) Not used due to circumstances beyond the individual's control, e.g., illness, and there is a reasonable expectation that the use will resume.

     (14) Property used to produce goods or services essential to an individual's daily activities is excluded if the individual's equity in the property does not exceed six thousand dollars.

     (15) Personal property used by an individual for work is not counted, regardless of value, while in current use, or if the required use for work is reasonably expected to resume.

     (16) Interests in trust or in restricted Indian land owned by an individual who is of Indian descent from a federally recognized Indian tribe or held by the spouse or widow/er of that individual, is not counted if permission of the other individuals, the tribe, or an agency of the federal government must be received in order to dispose of the land.

     (17) Receipt of money by a member of a federally-recognized tribe from exercising Native American treaty rights and extraction of protected resources, such as fishing, shell-fishing, or selling timber from protected land, is considered conversion of an exempt resource during the month of receipt. Any amount remaining from the conversion of this exempt resource on the first of the month after the month of receipt will remain exempt if it is used to purchase another exempt resource. Any amount remaining in the form of a countable resource (such as in a checking or savings account) on the first of the month after receipt, will be added to other countable resources for eligibility determinations.

[Statutory Authority: RCW 74.04.050, 74.08.090. 04-09-003, § 388-475-0350, filed 4/7/04, effective 6/1/04.]


AMENDATORY SECTION(Amending WSR 06-04-046, filed 1/26/06, effective 2/26/06)

WAC 388-475-0550   SSI-related medical -- All other excluded resources.   All resources described in this section are excluded resources for SSI-related medical programs. Unless otherwise stated, interest earned on the resource amount is counted as unearned income.

     (1) Resources necessary for a client who is blind or disabled to fulfill a department approved self-sufficiency plan.

     (2) Retroactive payments from SSI or RSDI, including benefits a client receives under the interim assistance reimbursement agreement with the Social Security Administration, are excluded for nine months following the month of receipt. This exclusion applies to:

     (a) Payments received by the client, spouse, or any other person financially responsible for the client;

     (b) SSI payments for benefits due for the month(s) before the month of continuing payment;

     (c) RSDI payments for benefits due for a month that is two or more months before the month of continuing payment; and

     (d) Proceeds from these payments as long as they are held as cash, or in a checking or savings account. The funds may be commingled with other funds, but must remain identifiable from the other funds for this exclusion to apply. This exclusion does not apply once the payments have been converted to any other type of resource.

     (3) All resources specifically excluded by federal law, such as those described in subsections (4) through (((11))) 12 as long as such funds are identifiable.

     (4) Payments made under Title II of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970.

     (5) Payments made to Native Americans as listed in 20 CFR 416.1182, Appendix to subpart K, section IV, paragraphs (b) and (c), and in 20 CFR 416.1236.

     (6) The following Native American/Alaska Native funds are excluded resources:

     (a) Resources received from a Native Corporation under the Alaska Native Claims Settlement Act, including:

     (i) Shares of stock held in a regional or village corporation;

     (ii) Cash or dividends on stock received from the Native Corporation up to two thousand dollars per person per year;

     (iii) Stock issued by a native corporation as a dividend or distribution on stock;

     (iv) A partnership interest;

     (v) Land or an interest in land; and

     (vi) An interest in a settlement trust.

     (b) All funds contained in a restricted Individual Indian Money (IIM) account.

     (7) Exercise of Native American treaty rights, including extraction of exempt resources by a member of a federally-recognized tribe during the month of receipt. Any funds from the conversion of the exempt resource which are retained on the first of the month after the month of receipt will be considered exempt if they are in the form of an exempt resource, and will be countable if retained in the form of a countable resource.

     (8) Restitution payment and any interest earned from this payment to persons of Japanese or Aleut ancestry who were relocated and interned during war time under the Civil Liberties Act of 1988 and the Aleutian and Pribilof Islands Restitution Act.

     (((8))) (9) Funds received from the Agent Orange Settlement Fund or any other funds established to settle Agent Orange liability claims.

     (((9))) (10) Payments or interest accrued on payments received under the Radiation Exposure Compensation Act received by the injured person, the surviving spouse, children, grandchildren, or grandparents.

     (11) Payments or interest accrued on payments received under the Energy Employees Occupational Illness Compensation Act of 2000 (EEOICA) received by the injured person, the surviving spouse, children, grandchildren, or grandparents.

     (((10))) (12) Payments from:

     (a) The Dutch government under the Netherlands' Act on Benefits for Victims of Persecution (WUV).

     (b) The Victims of Nazi Persecution Act of 1994 to survivors of the Holocaust.

     (c) Susan Walker vs. Bayer Corporation, et al., 96-C-5024 (N.D. Ill.) (May 8, 1997) settlement funds.

     (d) Ricky Ray Hemophilia Relief Fund Act of 1998 P.L. 105-369.

     (((11))) (13) The unspent social insurance payments received due to wage credits granted under sections 500 through 506 of the Austrian General Social Insurance Act.

     (((12))) (14) Earned income tax credit refunds and payments are excluded as resources for nine months after the month of receipt.

     (((13))) (15) Payments from a state administered victim's compensation program for a period of nine calendar months after the month of receipt.

     (((14))) (16) Cash or in-kind items received as a settlement for the purpose of repairing or replacing a specific excluded resource are excluded:

     (a) For nine months. This includes relocation assistance provided by state or local government.

     (b) Up to a maximum of thirty months, when:

     (i) The client intends to repair or replace the excluded resource; and

     (ii) Circumstances beyond the control of the settlement recipient prevented the repair or replacement of the excluded resource within the first or second nine months of receipt of the settlement.

     (c) For an indefinite period, if the settlement is from federal relocation assistance.

     (d) Permanently, if the settlement is assistance received under the Disaster Relief and Emergency Assistance Act or other assistance provided under a federal statute because of a catastrophe which is declared to be a major disaster by the President of the United States, or is comparable assistance received from a state or local government or from a disaster assistance organization. Interest earned on this assistance is also excluded from resources. Any cash or in-kind items received as a settlement and excluded under this subsection are considered as available resources when not used within the allowable time periods.

     (((15))) (17) Insurance proceeds or other assets recovered by a Holocaust survivor as defined in WAC 388-470-0026(4).

     (((16))) (18) Pension funds owned by an ineligible spouse. Pension funds are defined as funds held in a(n):

     (a) Individual retirement account (IRA) as described by the IRS code; or

     (b) Work-related pension plan (including plans for self-employed individuals, known as Keogh plans).

     (((17))) (19) Cash payments received from a medical or social service agency to pay for medical or social services are excluded for one calendar month following the month of receipt.

     (((18))) (20) SSA- or DVR-approved plans for achieving self-support (PASS) accounts, allowing blind or disabled individuals to set aside resources necessary for the achievement of the plan's goals, are excluded.

     (((19))) (21) Food and nutrition programs with federal involvement. This includes Washington Basic Food, school reduced and free meals and milk programs and WIC.

     (((20))) (22) Gifts to, or for the benefit of, a person under eighteen years old who has a life-threatening condition, from an organization described in section 501 (c)(3) of the Internal Revenue Code of 1986 which is exempt from taxation under section 501(a) of that Code, as follows:

     (a) In-kind gifts that are not converted to cash; or

     (b) Cash gifts up to a total of two thousand dollars in a calendar year.

     (((21))) (23) Veteran's payments made to, or on behalf of, natural children of Vietnam veterans regardless of their age or marital status, for any disability resulting from spina bifida suffered by these children.

     (((22))) (24) The following are among assets that are not considered resources and as such are neither excluded nor counted:

     (a) Home energy assistance/support and maintenance assistance;

     (b) Retroactive in-home supportive services payments to ineligible spouses and parents; and

     (c) Gifts of domestic travel tickets. For a more complete list please see POMS @ http://policy.ssa.gov/poms.nsf/lnx/0501130050.

[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.500, and Social Security Act as amended by P.L. 108-203. 06-04-046, § 388-475-0550, filed 1/26/06, effective 2/26/06. Statutory Authority: RCW 74.04.050, 74.08.090. 04-09-004, § 388-475-0550, filed 4/7/04, effective 6/1/04.]


AMENDATORY SECTION(Amending WSR 04-09-004, filed 4/7/04, effective 6/1/04)

WAC 388-475-0600   SSI-related medical -- Definition of income.   (1) Income is anything an individual receives in cash or in-kind that can be used to meet his/her needs for food, clothing, or shelter. Income can be earned or unearned.

     (2) Some receipts are not income because they do not meet the definition of income above, including:

     (a) Cash or in-kind assistance from federal, state, or local government programs whose purpose is to provide medical care or services;

     (b) Some in-kind payments that are not food, clothing or shelter coming from nongovernmental programs whose purposes are to provide medical care or medical services;

     (c) Payments for repair or replacement of an exempt resource;

     (d) Refunds or rebates for money already paid;

     (e) Receipts from sale of a resource; ((and))

     (f) Replacement of income already received. See 20 CFR 416.1103 for a more complete list of receipts that are not income; and

     (g) Receipts from extraction of exempt resources for a member of a federally-recognized tribe.

     (3) Earned income includes the following types of payments:

     (a) Gross wages and salaries, including garnished amounts;

     (b) Commissions and bonuses;

     (c) Severance pay;

     (d) Other special payments received because of employment;

     (e) Net earnings from self-employment (WAC 388-475-0840 describes net earnings);

     (f) Self-employment income of tribal members unless the income is specifically exempted by treaty;

     (g) Payments for services performed in a sheltered workshop or work activities center;

     (h) Royalties earned by an individual in connection with any publication of his/her work and any honoraria received for services rendered; or

     (i) In-kind payments made in lieu of cash wages, including the value of food, clothing or shelter.

     (4) Unearned income is all income that is not earned income. Some types of unearned income are:

     (a) Annuities, pensions, and other periodic payments;

     (b) Alimony and support payments;

     (c) Dividends and interest;

     (d) Royalties (except for royalties earned by an individual in connection with any publication of his/her work and any honoraria received for services rendered which would be earned income);

     (e) Capital gains;

     (f) Rents;

     (g) Benefits received as the result of another's death to the extent that the total amount exceeds the expenses of the deceased person's last illness and burial paid by the recipient;

     (h) Gifts;

     (i) Inheritances; ((or))

     (j) Prizes and awards; or

     (k) Amounts received by Native American tribal members from gaming revenues.

     (5) Some items which may be withheld from income, but the department considers as received income are:

     (a) Federal, state, or local income taxes;

     (b) Health or life insurance premiums;

     (c) SMI premiums;

     (d) Union dues;

     (e) Penalty deductions for failure to report changes;

     (f) Loan payments;

     (g) Garnishments;

     (h) Child support payments, court ordered or voluntary (WAC 388-475-0900 has an exception for deemors);

     (i) Service fees charged on interest-bearing checking accounts;

     (j) Inheritance taxes;

     (k) Guardianship fees if presence of a guardian is not a requirement for receiving the income.

     (6) Countable income, for the purposes of this chapter, means all income that is available to the individual:

     (a) If it cannot be excluded, and

     (b) After deducting all allowable disregards and deductions.

[Statutory Authority: RCW 74.04.050, 74.08.090. 04-09-004, § 388-475-0600, filed 4/7/04, effective 6/1/04.]

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