WSR 15-20-107 PROPOSED RULES
DEPARTMENT OF
SOCIAL AND HEALTH SERVICES
(Economic Services Administration)
[Filed October 6, 2015, 1:42 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 15-17-111.
Title of Rule and Other Identifying Information: The department is amending WAC 388-310-0350 WorkFirst—Other exemptions from mandatory participation and 388-484-0006 TANF/SFA time limit extensions.
Hearing Location(s): Office Building 2, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at http://www1.dshs.wa.gov/msa/rpau/RPAU-OB-2directions.html), on November 10, 2015, at 10:00 a.m.
Date of Intended Adoption: Not earlier than November 11, 2015.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m., November 10, 2015.
Assistance for Persons with Disabilities: Contact Jeff Kildahl, DSHS rules consultant, by October 27, 2015, phone (360) 664-6092, TTY (360) 664-6178, or e-mail KildaJA@dshs.wa.gov.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The department is proposing to amend these rules to clarify WorkFirst exemption medical evidence and treatment requirements, and to create a new type of TANF/SFA time limit extension for adults who are aged, blind, or disabled.
Reasons Supporting Proposal: The department is proposing to amend these rules to ensure statewide consistency and a clear understanding of the exemption criteria.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of social and health services, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Miranda Adams, P.O. Box 45470, Olympia, WA 98504-5470, (360) 725-4769.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has analyzed the proposed rules and concluded that no new costs will be imposed on affected small businesses or small nonprofit organizations.
A cost-benefit analysis is not required under RCW 34.05.328. The proposed rules are exempt under RCW 34.05.328 (5)(b)(vii) and relate only to client medical or financial eligibility.
October 1, 2015
Katherine I. Vasquez
Rules Coordinator
AMENDATORY SECTION (Amending WSR 10-24-013, filed 11/18/10, effective 12/19/10)
WAC 388-310-0350 WorkFirst—Other exemptions from mandatory participation.
(1) When am I exempt from mandatory participation?
Except as provided in subsection (4) of this section, you are exempt from mandatory participation if you are:
(a) A caretaker relative as defined by WAC ((388-484-0010)) 388-454-0010, included in the assistance unit and:
(i) You are fifty-five years of age or older and caring for a child and you are not the child's parent; and
(ii) Your age is verified by any reliable documentation (such as a birth certificate or a driver's license).
(b) An adult with a severe and chronic disability as defined below ((and)):
(i) You have been assessed by a DSHS SSI facilitator as likely to be approved for SSI or other benefits and are required to apply for SSI or another type of federal disability benefit (such as railroad retirement or Social Security disability) in your individual responsibility plan. Your SSI application status may be verified through the SSI facilitator and/or state data exchange; ((and/))or
(ii) Your disability is a severe and chronic mental, physical, emotional, or cognitive impairment that prevents you from participating in work activities for more than ten hours a week and is expected to last at least twelve months((; and
(iii))). Your disability and ability to participate ((is)) must be verified by documentation from the division of developmental disabilities (DDD), division of vocational rehabilitation (DVR), home and community services division (HCS), division of mental health (MHD), ((and/or regional support network (RSN))) behavioral health organization (BHO), and/or regional service area (RSA), or evidence from ((another)) one of the medical or mental health professionals listed in subsection (2) of this section.((; and
(iv) Your SSI application status may be verified through the SSI facilitator and/or state data exchange.))
(c) Required in the home to care for a child with special needs when:
(i) The child has a special medical, developmental, mental, or behavioral condition; and
(ii) The child is determined by a public health nurse, ((physician, mental health provider,)) school professional, ((other)) one of the medical or mental health professionals listed in subsection (2) of this section, HCS, MHD, BHO, and/or a ((RSN)) RSA to require specialized care or treatment that prevents you from participating in work activities for more than ten hours per week.
(d) Required to be in the home to care for another adult with disabilities when:
(i) The adult with disabilities cannot be left alone for significant periods of time; and
(ii) No adult other than yourself is available and able to provide the care; and
(iii) The adult with the disability is related to you; and
(iv) You are unable to participate in work activities for more than ten hours per week because you are required to be in the home to provide care; and
(v) The disability and your need to care for your disabled adult relative is verified by documentation from DDD, DVR, HCS, MHD, BHO and/or a ((RSN)) RSA, or evidence from ((another)) one of the medical or mental health professionals listed in subsection (2) of this section.
(2) What types of medical or mental health professionals can provide medical evidence when I have a disability?
We accept medical evidence from the following sources when considering disability:
(a) For a physical impairment:
(i) A physician, which includes:
(A) Medical doctor (M.D.); and
(B) Doctor of osteopathy (D.O.);
(ii) An advanced registered nurse practitioner (ARNP) for physical impairments;
(iii) A Physician's assistant (P.A.);
(iv) A Doctor of optometry (O.D.) for visual acuity impairments; or
(v) Doctor of podiatry (D.P.) for foot disorders;
(b) For a mental impairment:
(i) A psychiatrist;
(ii) A psychologist;
(iii) An ARNP certified in psychiatric nursing;
(iv) A mental health professional provided the person's training and qualifications at a minimum include a master's degree; or
(v) A physician who is currently treating you for a mental impairment.
(c) We do not accept medical evidence from the medical professionals listed in subsections (2)(a) and (b), unless they are licensed in Washington state or the state where the examination was performed.
(3) Who reviews and approves an exemption from participation?
(a) If it appears that you may qualify for an exemption or you ask for an exemption, your case manager or social worker will review the information and we may use the case staffing process to determine whether the exemption will be approved. Case staffing is a process to bring together a team of multidisciplinary experts including relevant professionals and the client to identify participant issues, review case history and information, and recommend solutions.
(b) If additional medical or other documentation is needed to determine if you are exempt, your IRP will allow between thirty days and up to ninety if approved to gather the necessary documentation.
(c) Information needed to verify your exemption should meet the standards for verification described in WAC 388-490-0005. If you need help gathering information to verify your exemption, you can ask us for help. If you have been identified as needing NSA services, under chapter 388-472 WAC, your accommodation plan should include information on how we will assist you with getting the verification needed.
(d) After a case staffing, we will send you a notice that tells you whether your exemption was approved, how to request a fair hearing if you disagree with the decision, and any changes to your IRP that were made as a result of the case staffing.
(((3))) (4) If I am an adult who is exempt due to my severe and chronic disability, can I still be required to participate in the WorkFirst program?
When you are exempt due to your severe and chronic disability, you may be required to:
(a) Pursue SSI or another type of federal disability benefit; and/or
(b)Participate in available treatment that is recommended by your treating medical or mental health provider or by a chemical dependency professional.
(5) Can I participate in WorkFirst while I am exempt?
(a) You may choose to fully participate in WorkFirst while you are exempt.
(b) Your WorkFirst case manager may refer you to other service providers who may help you improve your skills and move into employment.
(c) If you decide later to stop participating, and you still qualify for an exemption, you will be put back into exempt status with no financial penalty.
(((4))) (6) Does an exemption from participation affect my sixty-month time limit for receiving TANF/SFA benefits?
Even if exempt from participation, each month you receive a TANF/SFA grant counts toward your sixty-month limit as described in WAC 388-484-0005.
(((5))) (7) How long will my exemption last?
Unless you are an older caretaker relative, your exemption will be reviewed at least every twelve months to make sure that you still meet the criteria for an exemption. Your exemption will continue as long as you continue to meet the criteria for an exemption.
(((6))) (8) What happens when I am no longer exempt?
If you are no longer exempt, then:
(a) You will become a mandatory participant under WAC 388-310-0400; and
(b) If you have received sixty or more months of TANF/SFA, your case will be reviewed for an extension. (See WAC 388-484-0006 for a description of TANF/SFA time limit extensions.)
(((7))) (9) For time-limited extensions, see WAC 388-484-0006.
AMENDATORY SECTION (Amending WSR 12-05-039, filed 2/10/12, effective 3/12/12)
WAC 388-484-0006 TANF/SFA time limit extensions.
(1) What happens after I receive sixty or more months of TANF/SFA cash assistance?
After you receive sixty or more months of TANF/SFA cash assistance according to WAC 388-484-0005, you may qualify for additional months of cash assistance. We call these additional months of TANF/SFA cash assistance a hardship TANF/SFA time limit extension.
(2) Who is eligible for a hardship TANF/SFA time limit extension?
You are eligible for a hardship TANF/SFA time limit extension if you are on TANF, are otherwise eligible for TANF, or are an ineligible parent, and you have received sixty cumulative months of TANF and:
(a) You are approved for one of the exemptions from mandatory participation according to WAC 388-310-0350 (1)(a) through (d) or you are an ineligible parent who meets the criteria for an exemption from mandatory WorkFirst participation; or
(b) You:
(i) Are a supplemental security income recipient or a Social Security disability insurance recipient; or
(ii) Are at least sixty-five years old, blind as defined by the Social Security Administration or disabled as determined under chapter 388-449 WAC; or
(iii) Have an open child welfare case with a state or tribal government and this is the first time you have had a child dependent under RCW 13.34.030 in this or another state or had a child a ward of a tribal court; or
(((iii))) (iv) Are working in unsubsidized employment for thirty-two hours or more per week; or
(((iv))) (v) Document that you meet the family violence option criteria in WAC 388-61-001 and are participating satisfactorily in specialized activities needed to address your family violence according to a service plan developed by a person trained in family violence or have a good reason, as described in WAC 388-310-1600(3) for failure to participate satisfactorily in specialized activities.
(3) Who reviews and approves a hardship time limit extension?
(a) Your case manager or social worker will review your case and determine whether a hardship time limit extension type will be approved.
(b) This review will not happen until after you have received at least fifty-two months of assistance but before you reach your time limit or lose cash assistance due to the time limit.
(c) Before you reach your time limit or lose cash assistance due to the time limit, the department will send you a notice that tells you whether a hardship time limit extension will be approved when your time limit expires and how to request an administrative hearing if you disagree with the decision.
(4) When I have an individual responsibility plan, do my WorkFirst participation requirements change when I receive a hardship TANF/SFA time limit extension?
(a) Even if you qualify for a hardship TANF/SFA time limit extension you will still be required to participate as required in your individual responsibility plan (WAC 388-310-0500). You must still meet all of the WorkFirst participation requirements listed in chapter 388-310 WAC while you receive a hardship TANF/SFA time limit extension.
(b) If you do not participate in the WorkFirst activities required by your individual responsibility plan, and you do not have a good reason under WAC 388-310-1600, the department will follow the sanction rules in WAC 388-310-1600.
(5) Do my benefits change if I receive a hardship TANF/SFA time limit extension?
(a) You are still a TANF/SFA recipient or an ineligible parent who is receiving TANF/SFA cash assistance on behalf of your child and your cash assistance, services, or supports will not change as long as you continue to meet all other TANF/SFA eligibility requirements.
(b) During the hardship TANF/SFA time limit extension, you must continue to meet all other TANF/SFA eligibility requirements. If you no longer meet TANF/SFA eligibility criteria during your hardship time limit extension, your benefits will end.
(6) How long will a hardship TANF/SFA time limit extension last?
(a) We will review your hardship TANF/SFA time limit extension and your case periodically for changes in family circumstances:
(i) If you are extended under WAC 388-484-0006 (2)(a), (2)(b)(i) or (2)(b)(ii) then we will review your extension at least every twelve months;
(ii) If you are extended under WAC 388-484-0006 (2)(b)(iii), (iv), or (v) then we will review your extension at least every six months.
(b) Your hardship TANF/SFA time limit extension may be renewed for as long as you continue to meet the criteria to qualify for a hardship time limit extension.
(c) If during the extension period we get proof that your circumstances have changed, we may review your case and determine if you continue to qualify for a hardship TANF/SFA time limit extension. When you no longer qualify for a hardship TANF/SFA time limit extension we will stop your TANF/SFA cash assistance. You will be notified of your case closing and will be given the opportunity to request an administrative hearing before your benefits will stop.
|