WSR 16-06-098
(Economic Services Administration)
[Filed March 1, 2016, 9:36 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 16-01-153.
Title of Rule and Other Identifying Information: The department is proposing to amend WAC 388-450-0200 Will the medical expenses of elderly persons or individuals with disabilities in my assistance unit be used as an income deduction for Basic Food?
Hearing Location(s): Office Building 2, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at, on April 5, 2016, at 10:00 a.m.
Date of Intended Adoption: Not earlier than April 6, 2016.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, e-mail, fax (360) 664-6185, by 5:00 p.m., April 5, 2016.
Assistance for Persons with Disabilities: Contact Jeff Kildahl, DSHS rules consultant, by March 22, 2016, phone (360) 664-6092, TTY (360) 664-6178, or e-mail
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Changes proposed under this filing will amend WAC 388-450-0200 to clarify the acceptability of medical marijuana expenses as an excess medical expense deduction so it is applied consistently with federal regulations under Title 7 C.F.R. § 273.9 (d)(3)(B).
Reasons Supporting Proposal: The department of social and health services (DSHS) will clarify whether medical marijuana expenses are acceptable as a medical expense and allowable for supplemental nutrition assistance program recipients by modifying this WAC to reflect that medical marijuana is not allowable under the Code of Federal Regulations.
Statutory Authority for Adoption: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510, 74.08.090, and 7 C.F.R. 273.9.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: DSHS, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Ezra Paskus, 712 Pear Street S.E., Olympia, WA 98501, (360) 725-4611.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rule does not have an economic impact on small businesses. It only impacts DSHS clients.
A cost-benefit analysis is not required under RCW 34.05.328. The proposed rule is exempt as allowed under RCW 34.05.328 (5)(b)(vii) which states in part, "this section does not apply to … Rules of the department of social and health services relating only to client medical or financial eligibility and rules concerning liability for care of dependents."
February 25, 2016
Katherine I. Vasquez
Rules Coordinator
AMENDATORY SECTION (Amending WSR 13-18-007, filed 8/22/13, effective 10/1/13)
WAC 388-450-0200 Will the medical expenses of elderly persons or individuals with disabilities in my assistance unit be used as an income deduction for Basic Food?
(1) If your basic food assistance unit (AU) includes an elderly person or individual with a disability as defined in WAC 388-400-0040, your AU may be eligible for an income deduction for that person's out-of-pocket medical expenses. We allow the deduction for medical expenses over thirty-five dollars each month.
(2) You can use an out-of-pocket medical expense toward this deduction if the expense covers services, supplies, medication, or other medically needed items prescribed by a state-licensed practitioner or other state-certified, qualified, health professional. Examples of expenses you can use for this deduction include those for:
(a) Medical, psychiatric, naturopathic physician, dental, or chiropractic care;
(b) Prescribed alternative therapy such as massage or acupuncture;
(c) Prescription drugs except medical marijuana;
(d) Over the counter drugs;
(e) Eye glasses;
(f) Medical supplies other than special diets;
(g) Medical equipment or medically needed changes to your home;
(h) Shipping and handling charges for an allowable medical item. This includes shipping and handling charges for items purchased through mail order or the internet;
(i) Long distance calls to a medical provider;
(j) Hospital and outpatient treatment including:
(i) Nursing care; or
(ii) Nursing home care including payments made for a person who was an assistance unit member at the time of placement.
(k) Health insurance premiums paid by the person including:
(i) Medicare premiums; and
(ii) Insurance deductibles and copayments.
(l) Out-of-pocket expenses used to meet a spenddown as defined in WAC 182-519-0010. We do not allow your entire spenddown obligation as a deduction. We allow the expense as a deduction as it is estimated to occur or as the expense becomes due;
(m) Dentures, hearing aids, and prosthetics;
(n) Cost to obtain and care for a seeing eye, hearing, or other specially trained service animal. This includes the cost of food and veterinarian bills. We do not allow the expense of food for a service animal as a deduction if you receive ongoing additional requirements under WAC 388-473-0040 to pay for this need;
(o) Reasonable costs of transportation and lodging to obtain medical treatment or services; and
(p) Attendant care necessary due to age, infirmity, or illness. If your AU provides most of the attendant's meals, we allow an additional deduction equal to a one-person allotment.
(3) There are two types of deductions for out-of-pocket expenses:
(a) One-time expenses are expenses that cannot be estimated to occur on a regular basis. You can choose to have us:
(i) Allow the one-time expense as a deduction when it is billed or due;
(ii) Average the expense through the remainder of your certification period; or
(iii) If your AU has a twenty-four-month certification period, you can choose to use the expense as a one-time deduction, average the expense for the first twelve months of your certification period, or average it for the remainder of our certification period.
(b) Recurring expenses are expenses that happen on a regular basis. We estimate your monthly expenses for the certification period.
(4) We do not allow a medical expense as an income deduction if:
(a) The expense was paid before you applied for benefits or in a previous certification period;
(b) The expense was paid or will be paid by someone else;
(c) The expense was paid or will be paid by the department or another agency;
(d) The expense is covered by health care insurance;
(e) We previously allowed the expense, and you did not pay it. We do not allow the expense again even if it is part of a repayment agreement;
(f) You included the expense in a repayment agreement after failing to meet a previous agreement for the same expense; or
(g) You claim the expense after you have been denied for presumptive SSI; and you are not considered disabled by any other criteria.