Programs Administered by the Department of Social and Health Services.
The Department of Social and Health Services (DSHS) Economic Services Administration (ESA) administers numerous assistance programs for the state, including the Aged, Blind, or Disabled (ABD) cash assistance program. The ABD program provides cash assistance, a referral to the Essential Needs and Housing Support (HEN) program, and help accessing federal disability benefits to eligible low-income adults who are age 65 or older, blind, or determined likely to meet federal Supplemental Security Income criteria.
The DSHS also administers federally and state-funded programs through the Aging and Long-Term Support Administration (ALTSA) and the Developmental Disabilities Administration (DDA) for persons who meet functional and financial eligibility criteria. The ALTSA supports long-term care programs for seniors and people with disabilities. The DDA assists individuals with developmental disabilities and their families to obtain services and supports. Clients of the ALTSA and the DDA may receive services through the Community First Choice program under the Medicaid State Plan or through community-based services waivers, or a combination of both.
Collection of Overpayments.
An overpayment is any cash assistance paid that is more than the recipient was eligible to receive or any payment made on a client's behalf in excess of that to which the client is legally entitled. Intentional overpayments result from a willful or knowing failure to report a change or misstating a fact affecting benefit eligibility or amount. Unintentional overpayments are any other client-caused and all agency-caused overpayments.
When a person is overpaid benefits administered by the DSHS, the DSHS generally recovers funds through mandatory reduction of the client's future assistance payments or through billing for overpaid services. All adult members of an overpaid assistance unit are responsible for repayment of an overpayment. A person who disagrees with a claim that the person owes a debt for an overpayment has the right to an adjudicative proceeding. The DSHS may not collect overpayments after six years from the date of notice of the overpayment absent a recovery action in court, which may extend the time for collection to 10 years. In addition, the DSHS may, at any time, accept offers of compromise of disputed claims, or may grant a partial or total write off of amounts due that are no longer cost effective to pursue.
Federal regulations require states administering Medicaid-funded programs to remit the federal portion of overpayments to the Centers for Medicare and Medicaid Services.
Beginning July 1, 2025, the Department of Social and Health Services (DSHS) may waive all efforts to collect unintentional overpayments made under the Aged, Blind, or Disabled program and unintentional overpayments made to functionally disabled clients receiving long-term support services and developmental disabilities services.
The DSHS must adopt rules establishing the circumstances under which it will waive collection efforts.
The striking amendment specifies that the authority granted to the Department of Social and Health Services to waive overpayments pertains only to "unintentional" overpayments, and otherwise maintains the provisions of the underlying bill.
(In support) This bill concerns some of the most vulnerable adults in society. Currently, when a mistake is made in issuing benefits, the state must recover that amount. Recovery is very difficult and efforts to recover funds often exceed the amount of the overpayment itself. Reducing the very small benefit that a person is receiving in order to recover an overpayment makes it very hard for that person to meet their basic needs. The changes in the bill will help better support people and will remove administrative burdens. This is an uncommon occurrence affecting about 73 people on a monthly basis, which is approximately 1 percent of the monthly caseload.
(Opposed) None.
Senator Ron Muzzall, prime sponsor; Carla Reyes, DSHS, Economic Services Administration, Assistant Secretary; and Brice Montgomery, DSHS, Economic Services Administration, Community Services Division Director.
No new changes were recommended.
(In support) People served by the Aged, Blind, or Disabled (ABD) program, long-term services and supports, and waiver programs for people with developmental disabilities have very limited means to meet their basic daily needs. The state's recovery of unintentional overpayments creates additional hardships for these individuals.
We have all felt the impact of rising costs. The average amount of ABD assistance is only $13 a day and that is very challenging to meet all of someone's basic needs. Losing out on some of that $13 a day because it is recovered as an overpayment makes it even more difficult.
(Opposed) None.
Carla Reyes, DSHS, Economic Services Administration, Assistant Secretary; and Brice Montgomery, DSHS, Economic Services Administration, Community Services Division, Director.