HEALTH CARE AUTHORITY
[Filed July 26, 2018, 3:44 p.m., effective August 26, 2018]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The agency is modifying WAC 182-513-1330 to add WAC references for sponsored immigrants and how to determine if sponsors' income counts in determining benefits.
Citation of Rules Affected by this Order: Amending WAC 182-513-1330.
Adopted under notice filed as WSR 18-13-021 on June 8, 2018.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 1, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.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: July 26, 2018.
AMENDATORY SECTION(Amending WSR 17-03-116, filed 1/17/17, effective 2/17/17)
WAC 182-513-1330Determining available income for legally married couples for long-term care (LTC) services.
This section describes income the agency or its designee determines available when evaluating a legally married person's eligibility for long-term care (LTC) services.
(1) The agency or ((its)) the agency's designee applies the following rules when determining income eligibility for LTC services:
(a) WAC 182-512-0600 SSI-related medical—Definition of income;
(b) WAC 182-512-0650 SSI-related medical—Available income;
(c) WAC 182-512-0700 SSI-related medical—Income eligibility;
(d) WAC 182-512-0750 SSI-related medical—Countable unearned income;
(e) WAC 182-512-0840(3), self-employment income-allowance expenses;
(f) WAC 182-512-0960 SSI-related medical—Allocating income—Determining eligibility for a spouse when the other spouse receives long-term services and supports (LTSS);
(g) WAC 182-512-0785, 182-512-0790, and 182-512-0795 for sponsored immigrants and how to determine if the sponsors' income counts in determining benefits.
(2) In initial categorically needy income eligibility for LTC, the agency does not allow any deductions listed in 1612(b) of the Social Security Act, for example:
(a) Twenty dollars per month income exclusion under WAC 182-512-0800;
(b) The first $65 and the remaining one-half earned income work incentive under WAC 182-512-0840; and
(c) Impairment related work expense or blind work expense under WAC 182-512-0840.
(3) The following income is available to an institutionalized spouse, unless subsections (5) and (6) apply:
(a) Income received in the institutionalized spouse's name;
(b) Income paid to a representative on the institutionalized spouse's behalf; and
(c) One-half of the income received in the names of both spouses.
(4) The following income is unavailable to an institutionalized spouse:
(a) Separate income received in the name of the community spouse; and
(b) Income established as unavailable through a court order.
(5) For the determination of eligibility only, if available income under subsection (3)(a) through (c) of this section, minus income exclusions under WAC 182-513-1340, exceeds the special income level (SIL), defined under WAC 182-513-1100, the agency or its designee:
(a) Follows Washington state community property law when determining ownership of income;
(b) Presumes all income received after the marriage by either spouse to be community income;
(c) Considers one-half of all community income available to the institutionalized spouse.
(6) If the total of subsection (5)(c) of this section plus the institutionalized spouse's separate income is over the SIL, determine available income using subsection (3) of this section.
(7) A stream of income, not generated by a transferred resource, is available to the institutionalized spouse, even if the institutionalized spouse transfers or assigns the rights to the stream of income to one of the following:
(a) The community spouse; or
(b) A trust for the benefit of the community spouse.