WSR 18-01-049

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES

(Aging and Long-Term Support Administration)

[Filed December 12, 2017, 1:06 p.m., effective January 12, 2018]

Effective Date of Rule: Thirty-one days after filing.

Purpose: The department is amending WAC 388-106-0225 How do I pay for medicaid personal care?, as a result of the passage of SB 5118 to reflect an increase in the personal needs allowance effective July 1, 2017, and each fiscal year thereafter. This adjustment is subject to legislative funding.

Citation of Rules Affected by this Order: Amending WAC 388-106-0225.

Statutory Authority for Adoption: RCW 74.08.090.

Adopted under notice filed as WSR 17-21-076 on October 16, 2017.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 1, Repealed 0.

Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.

Date Adopted: December 11, 2017.

Katherine I. Vasquez

Rules Coordinator

AMENDATORY SECTION (Amending WSR 15-11-049, filed 5/15/15, effective 7/1/15)

WAC 388-106-0225 How do I pay for ((MPC)) medicaid personal care?

You pay for medicaid personal care (MPC) as follows:

(1) If you live in your own home, you do not ((participate toward)) share in the cost of your personal care services.

(2) If you live in a residential facility ((and are:

(a) An SSI beneficiary who receives only SSI income, you only pay for board and room. You are allowed to)), you:

(a) Keep a personal needs allowance ((of sixty-two dollars and seventy-nine cents)) as described in WAC 182-513-1105;

(b) ((An SSI beneficiary who receives SSI and another source of income, you only)) Pay for ((board and)) room((. You are allowed to keep a personal needs allowance of sixty-two dollars and seventy-nine cents.)) and board as described in WAC 182-513-1105; and

(c) ((An SSI-related person under WAC 182-512-0050, you)) May be required to ((participate towards)) share in the cost of your personal care ((services in addition to your board and room if your financial eligibility is based on the facility's state contracted rate described in)) under WAC 182-513-1205. ((You are allowed to keep a personal needs allowance of sixty-two dollars and seventy-nine cents.

(d) An aged, blind, disabled (ABD) cash assistance client eligible for categorically needy medicaid coverage in an adult family home (AFH), you are allowed to keep a personal needs allowance (PNA) of thirty-eight dollars and eighty-four cents per month. The remainder of your income must be paid to the AFH as your room and board up to the ALTSA room and board standards; or

(e) An aged, blind, disabled (ABD) cash assistance client eligible for categorically needy medicaid coverage in an assisted living facility, you are authorized a personal needs grant of up to thirty-eight dollars and eighty-four cents per month;

(f) A Washington apple health MAGI-based client as determined by WAC 182-505-0250, you pay only for room and board. If your income is less than the ALTSA room and board standard, you are allowed to keep a personal needs allowance of sixty-two dollars and seventy-nine cents and the remainder of your income goes to the provider for room and board.))

(3) ((Personal needs allowance (PNA) standards and the ALTSA room and board standard can be found at http://www.hca.wa.gov/medicaid/eligibility/pages/standards.aspx.

(4))) The department pays the residential care facility from the first day of service through the:

(a) Last day of service when the medicaid resident dies in the facility; or

(b) Day of service before the day the medicaid resident is discharged.