Purpose: Amending WAC 388-400-0005 Who is eligible for temporary assistance for needy families?, 388-400-0025 General assistance-unemployable--General eligibility requirements, 388-400-0040 Am I eligible for benefits through the Washington Basic Food program?, and 388-416-0015 Certification periods for categorically needy (CN) medical and children's health insurance program (CHIP); which are rules related to simplified reporting for cash assistance, medical assistance, and Basic Food. These rules explain general eligibility requirements for department programs and certification periods for categorically needy medical and the children's health insurance program. The department has filed proposed rules as WSR 04-17-117 and 04-19-131.

     Citation of Existing Rules Affected by this Order: Amending WAC 388-400-0005, 388-400-0025, 388-400-0040, and 388-416-0015.

     Statutory Authority for Adoption: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510.

     Other Authority: SB 6411 (chapter 54, Laws of 2004).

     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: These rules are necessary to implement the department's simplified reporting initiative for cash assistance, medical assistance, and the Washington Basic Food program while the department completes the regular rule-making process. SB 6411 (chapter 54, Laws of 2004) requires the department to implement simplified reporting for food stamps by October 2004.

     The Farm Security and Rural Investment Act of 2002 and 7 C.F.R. 273.12 provide states the option to implement simplified reporting for the food stamp program. The department plans to implement simplified reporting for cash, medical, and the Basic Food program beginning in October 2004.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 4, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.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 4, Repealed 0.

     Date Adopted: September 27, 2004.

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

     (a) Can be in a TANF/SFA assistance unit as allowed under WAC 388-408-0015 through 388-408-0030;

     (b) Meet the citizenship/alien status requirements of WAC 388-424-0001;

     (c) Live in the state of Washington. A child must live with a caretaker relative, guardian, or custodian who meets the state residency requirements of WAC 388-468-0005;

     (d) Do not live in a public institution unless specifically allowed under RCW 74.08.025;

     (e) Meet TANF/SFA:

     (i) Income requirements under chapter 388-450 WAC;

     (ii) Resource requirements under chapter 388-470 WAC; and

     (iii) Transfer of property requirements under chapter 388-488 WAC.

     (f) Assign your rights to child support as required under WAC 388-422-0005;

     (g) Cooperate with the division of child support (DCS) as required under WAC 388-422-0010 by helping them:

     (i) Prove who is the father of children applying for or getting TANF or SFA; and

     (ii) Collect child support.

     (h) Tell us your Social Security number as required under WAC 388-476-0005;

     (i) Cooperate in a review of your eligibility as required under WAC 388-434-0005;

     (j) Cooperate in a quality assurance review as required under WAC 388-464-0001;

     (k) Participate in the WorkFirst program as required under chapter 388-310 WAC; ((and))

     (l) Report changes of circumstances as required under WAC 388-418-0005; and

     (m) Complete a six-month report and provide proof of any changes as required under WAC 388-418-0011.

     (2) If you are an adult and do not have a child living with you, you must be pregnant and meet the requirements of WAC 388-462-0010.

     (3) If you are an unmarried pregnant teen or teen parent:

     (a) Your living arrangements must meet the requirements of WAC 388-486-0005; and

     (b) You must attend school as required under WAC 388-486-0010.

     (4) In addition to rules listed in subsection (1) of this section, a child must meet the following rules to get TANF:

     (a) Meet the age requirements under WAC 388-404-0005; and

     (b) Live in the home of a relative, court-ordered guardian, court-ordered custodian, or other adult acting in loco parentis as required under WAC 388-454-0005; or

     (c) If the child lives with a parent or other adult relative that provides care for the child, that adult cannot have used up their sixty-month lifetime limit of TANF or SFA cash benefits as defined in WAC 388-484-0005.

     (5) You cannot get TANF if you have been:

     (a) Convicted of certain felonies and other crimes under WAC 388-442-0010; or

     (b) Convicted of unlawful practices to get public assistance under WAC 388-446-0005 or 388-446-0010.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.08.090. 04-15-057, § 388-400-0005, filed 7/13/04, effective 8/13/04. Statutory Authority: RCW 74.04.050, 74.04.057, 2000 2nd sp.s. c 1. 01-03-121, § 388-400-0005, filed 1/22/01, effective 3/1/01. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.08.090, and 74.04.510. 00-05-007, § 388-400-0005, filed 2/4/00, effective 3/6/00. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-400-0005, filed 7/31/98, effective 9/1/98.]

     (a) ((You)) Are incapacitated as required under WAC 388-448-0010 through 388-448-0120;

     (b) ((You)) Are at least eighteen years old or, if under eighteen, a member of a married couple;

     (c) ((You)) Are in financial need according to GAU income and resource rules in chapters 388-450, 388-470 and 388-488 WAC;

     (d) ((You)) Meet the general assistance citizenship/alien status requirements under WAC 388-424-0015(2);

     (e) ((You)) Provide a Social Security number as required under WAC 388-476-0005;

     (f) ((You)) Reside in the state of Washington as required under WAC 388-468-0005;

     (g) ((You)) Undergo a treatment and referral assessment as provided under WAC 388-448-0130 through 388-448-0150;

     (h) ((You)) Assign interim assistance as provided under WAC 388-448-0210;

     (i) Report changes of circumstances as required under WAC 388-418-0005; and

     (j) Complete a six-month report and provide proof of any changes as required under WAC 388-418-0011.

     (2) You cannot get GAU benefits if:

     (a) You are eligible for temporary assistance for needy families (TANF) benefits;

     (b) You are eligible for state family assistance (SFA) benefits unless you are not eligible under WAC 388-400-0010;

     (c) You have the ability to, but refuse to meet a TANF or SFA eligibility rule;

     (d) You are eligible for supplemental security income (SSI) benefits;

     (e) You are an ineligible spouse of an SSI recipient; or

     (f) You were denied benefits or your benefits were terminated by the Social Security Administration (SSA) for failing to follow a SSI program rule or application requirement.

     (3) The assistance unit will be established according to WAC 388-408-0010.

     (4) You may be eligible for GAU if you reside in a public institution. A "public institution" is an institution that is supported by public funds, and a governmental unit either is responsible for it or exercises administrative control over it. Your eligibility will depend upon the type of institution you are in.

     (a) If you reside in a public institution and are otherwise eligible for GAU, you may be eligible for general assistance if you are:

     (i) A patient in a public medical institution; or

     (ii) A patient in a public mental institution and are:

     (A) Sixty-five years of age or older; or

     (B) Twenty years of age or younger.

     (b) You are not eligible for GAU when you are in the custody of or confined in a public institution such as a state penitentiary or county jail including placement:

     (i) In a work release program; or

     (ii) Outside of the institution.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.08.090. 04-15-057, § 388-400-0025, filed 7/13/04, effective 8/13/04. Statutory Authority: RCW 74.04.057, 74.08.090. 00-15-017, § 388-400-0025, filed 7/10/00, effective 9/1/00. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-400-0025, filed 7/31/98, effective 9/1/98.]

     (1) When you apply for Basic Food, we decide who is in your assistance unit (AU) based on the requirements under WAC 388-408-0035.

     (2) To be eligible for Basic Food benefits, your AU must meet the eligibility requirements of the most current version of the Food Stamp Act of 1977.

     (3) To be eligible for federal Basic Food benefits, each AU member must meet the citizenship or alien status requirements for federal benefits as described under WAC 388-424-0020.

     (4) An AU member who is not eligible for federal benefits may be eligible for state-funded Basic Food benefits if they meet the requirements described under WAC 388-400-0045.

     (5) To be eligible for federal or state Basic Food benefits, each AU member must:

     (a) Be a resident of the state of Washington as required under WAC 388-468-0005;

     (b) Meet the citizenship or alien status requirements of either WAC 388-424-0020 or 388-424-0025;

     (c) Provide their Social Security number as required under WAC 388-476-0005;

     (d) Provide proof of identity as required under WAC 388-490-0005;

     (e) Participate in the food stamp employment and training program (FSE&T) as required under chapter 388-444 WAC; and

     (f) Meet the eligibility criteria for strikers as described under WAC 388-480-0001.

     (6) To be eligible for Basic Food, your AU must:

     (a) Have countable income at or below gross and net income standards as described under WAC 388-478-0060; ((and))

     (b) Have countable resources at or below your AU's resource limit under WAC 388-470-0005 unless your AU is categorically eligible under WAC 388-414-0001;

     (c) Report changes of circumstances as required under WAC 388-418-0005; and

     (d) Complete a six-month report and provide proof of any changes if required under WAC 388-418-0011.

     (7) If your AU has income under the gross income standard, we deduct certain expenses from your income under WAC 388-450-0200 before we calculate your Basic Food benefits.

     (8) If an eligible person in your AU is elderly or disabled, some rules may help your AU to be eligible for Basic Food or to get more Basic Food benefits. These include:

     (a) Resources limits and excluding certain resources under chapter 388-470 WAC;

     (b) An excess shelter deduction over the limit set for AUs without an elderly or disabled individual under WAC 388-450-0190;

     (c) A deduction for out-of-pocket medical expenses for the elderly or disabled individual if they are over thirty-five dollars a month under WAC 388-450-0200; and

     (d) Being exempt from the gross income standard under WAC 388-478-0060.

     (9) For Basic Food, elderly means a person who is age sixty or older;

     (10) For Basic Food, disabled means a person who:

     (a) Gets SSI;

     (b) Gets disability payments or blindness payments under Title I, II, XIV, or XVI of the Social Security Act;

     (c) Gets disability retirement benefits from a state, local or federal government agency because of a disability considered permanent under section 221(i) of the Social Security Act;

     (d) Gets disability benefits from the Railroad Retirement Act under sections 2 (a)(1)(iv) and (v) and:

     (i) Meets Title XIX disability requirements; or

     (ii) Is eligible for Medicare.

     (e) Receives disability-related medical assistance under Title XIX of the Social Security Act;

     (f) Is a veteran and receives disability payments based on one hundred percent disability;

     (g) Is a spouse of a veteran and:

     (i) Either needs an attendant or is permanently housebound; or

     (ii) Has a disability under section 221(i) of the Social Security Act and is eligible for death or pension payments under Title 38 of the USC.

     (11) If a person in your AU attends an institution of higher education and does not meet the requirements to be an eligible student under WAC 388-482-0005, we do not consider this person as a member of your AU.

     (12) If your AU lives on or near an Indian reservation and participates in a tribal food distribution program approved by Food and Nutrition Service (FNS), your AU is not eligible for Basic Food benefits.

     (13) If an AU member is ineligible for any of the following reasons, we count the ineligible person's income as described under WAC 388-450-0140:

     (a) Able-bodied adults without dependents who are no longer eligible under WAC 388-444-0030;

     (b) Persons (([convicted of a drug-related felony or])) fleeing a felony prosecution, conviction, or confinement under WAC 388-442-0010;

     (c) Persons who do not attest to citizenship or alien status as defined in WAC 388-424-0001;

     (d) Persons who are ineligible aliens under WAC 388-424-0020;

     (e) Persons disqualified for an intentional program violation under WAC 388-446-0015;

     (f) Persons who do not provide a Social Security number when required under WAC 388-476-0005; or

     (g) Persons who failed to meet work requirements under chapter 388-444 WAC.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.08.090. 04-15-057, § 388-400-0040, filed 7/13/04, effective 8/13/04. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.04.510, and 2004 c 54. 04-14-040, § 388-400-0040, filed 6/29/04, effective 7/30/04. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, and 74.04.510. 03-05-028, § 388-400-0040, filed 2/10/03, effective 4/1/03. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-400-0040, filed 7/31/98, effective 9/1/98.]

     (2) For a child eligible for the newborn medical program, the certification period begins on the child's date of birth and continues through the end of the month of the child's first birthday.

     (3) For a woman eligible for a medical program based on pregnancy, the certification period ends the last day of the month that includes the sixtieth day from the day the pregnancy ends.

     (4) For families and children the certification period is ((six)) twelve months with a six-month report required as a condition of eligibility as described in WAC 388-418-0011. When the medical assistance unit is also receiving benefits under a cash or food assistance program, the medical certification period is updated to begin anew at each:

     (a) Approved application for cash or food assistance; or

     (b) Completed eligibility review.

     (5) For an SSI-related person the certification period is twelve months.

     (6) When the child turns nineteen the certification period ends even if the ((six)) twelve-month period is not over. The certification period may be extended past the end of the month the child turns nineteen when:

     (a) The child is receiving inpatient services on the last day of the month the child turns nineteen;

     (b) The inpatient stay continues into the following month or months; and

     (c) The child remains eligible except for exceeding age nineteen.

     (7) A retroactive certification period can begin up to three months immediately before the month of application when:

     (a) The client would have been eligible for medical assistance if the client had applied; and

     (b) The client received covered medical services as described in WAC 388-529-0100.

     (8) If the client is eligible only during the three-month retroactive period, that period is the only period of certification.

     (9) Any months of a retroactive certification period are added to the designated certification periods described in this section.

     (10) For a child determined eligible for CHIP medical benefits as described in chapter 388-542 WAC:

     (a) The certification periods are described in subsections (1), (4), and (6) of this section;

     (b) There is not a retroactive eligibility period as described in subsections (7), (8), and (9); and

     (c) For a child who has creditable coverage at the time of application, the certification period begins on the first of the month after the child's creditable coverage is no longer in effect, if:

     (i) All other CHIP eligibility factors are met; and

     (ii) An eligibility decision is made per WAC 388-406-0035.

[Statutory Authority: RCW 74.08.090, 74.09.530, and 2003 c 10. 04-03-019, § 388-416-0015, filed 1/12/04, effective 2/12/04. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.08.090 and 74.09.450. 00-08-002, § 388-416-0015, filed 3/22/00, effective 5/1/00. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-416-0015, filed 7/31/98, effective 9/1/98. Formerly 388-509-0970, 388-521-2105, 388-522-2210 and 388-522-2230.]

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