WSR 01-14-079

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)

[ Filed July 3, 2001, 3:41 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 01-08-027.

Title of Rule: WAC 388-478-0065, 388-478-0075 and 388-478-0085, income standards based on the federal poverty level.

Purpose: Implements the increased federal standards for the federal poverty level, which was effective April 1, 2000.

Statutory Authority for Adoption: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.530.

Statute Being Implemented: Poverty guidelines updated annually in the Federal Register under the authority of Section 673(2) of the Omnibus Budget Reconciliation Act of 1981 (42 U.S.C. 9902(2)).

Summary: These amendments increase the monthly income standards for children, pregnant women and for people participating in the Medicare cost-sharing programs.

Reasons Supporting Proposal: To amend state rules to implement the increased standards for the federal poverty level.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Joanie Scotson, Medical Assistance Administration, Mailstop 45534, Olympia, Washington 98504-5534, (360) 725-1330.

Name of Proponent: Department of Social and Health Services, governmental.

Rule is necessary because of federal law, Section 673(2) of the Omnibus Budget Reconciliation Act of 1981 (42 U.S.C. 9902(2)).

Explanation of Rule, its Purpose, and Anticipated Effects: See Purpose above.

Proposal Changes the Following Existing Rules: See Purpose above.

No small business economic impact statement has been prepared under chapter 19.85 RCW. This proposed rule does not impact small businesses. It affects eligibility for medical assistance programs.

RCW 34.05.328 does not apply to this rule adoption. These proposed rules implement federal standards increases. RCW 34.05.328 (5)(b)(vii) exempts DSHS rules that apply to eligibility.

Hearing Location: Blake Office Park (East), 4500 10th Avenue S.E., Rose Room, Lacey, WA 98503, on August 8, 2001, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact Kelly Cooper by August 1, 2001, phone (360) 664-6094, TTY (360) 664-6178, e-mail coopekd@dshs.wa.gov.

Submit Written Comments to: Identify WAC Numbers, Kelly Cooper, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, by August 8, 2001.

Date of Intended Adoption: No sooner than August 9, 2001.

July 3, 2001

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

2924.2
AMENDATORY SECTION(Amending WSR 98-16-044, filed 7/31/98, effective 9/1/98)

WAC 388-478-0065   ((TANF/SFA-related)) Categorically needy income level (CNIL) and resource standards for families.   (1) The categorically needy income level (CNIL) standard for ((TANF-related)) family medical is the same as the grant payment standards for the TANF cash program as stated in WAC 388-478-0020.

(2) The countable resource standards for ((TANF/SFA-related categorically needy (CN))) family medical are the same as those of the TANF/SFA cash program as stated in WAC 388-470-0005.

(3) For all medical programs an unborn child is counted as a household member when determining household size.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, 388-478-0065, filed 7/31/98, effective 9/1/98. Formerly WAC 388-507-0710 and 388-508-0820.]


AMENDATORY SECTION(Amending WSR 00-17-085, filed 8/14/00, effective 9/14/00)

WAC 388-478-0075   Medical programs--Monthly income standards based on the federal poverty level (FPL).   (1) The department bases the income standard upon the Federal Poverty Level (FPL) for the following medical programs:

(a) Children's health program up to one hundred percent of FPL;

(b) Pregnant women's program up to one hundred eighty-five percent of FPL;

(c) Children's categorically needy program up to two hundred percent of FPL; and

(d) The children's health insurance program (CHIP) is over two hundred percent of FPL but under two hundred fifty percent of FPL.

(2) Beginning April 1, ((2000)) 2001, the monthly FPL standards are:


FAMILY

SIZE

 100%

FPL

 185%

FPL

 200%

FPL

 250%

FPL
1 $(( 696)) 716 $ ((1288)) 1325 $ ((1392)) 1432 $ ((1740)) 1790
2 $(( 938)) 968 $ ((1735)) 1790 $ ((1875)) 1935 $ ((2344)) 2419
3 $ ((1180)) 1220 $ ((2182)) 2256 $ ((2359)) 2439 $ ((2948)) 3048
4 $ ((1421)) 1471 $ ((2629)) 2722 $ ((2842)) 2942 $ ((3553)) 3678
5 $ ((1663)) 1723 $ ((3076)) 3187 $ ((3325)) 3445 $ ((4157)) 4307
6 $ ((1905)) 1975 $ ((3523)) 3653 $ ((3809)) 3949 $ ((4761)) 4936
7 $ ((2146)) 2226 $ ((3970)) 4118 $ ((4292)) 4452 $ ((5365)) 5565
8 $ ((2388)) 2478 $ ((4417)) 4584 $ ((4775)) 4955 $ ((5969)) 6194
9 $ ((2630)) 2730 $ ((4864)) 5094 $ ((5259)) 5459 $ ((6573)) 6823
10 $ ((2871)) 2981 $ ((5312)) 5515 $ ((5742)) 5962 $ ((7178)) 7453
Add to the ten person standard for each person over ten:
$ ((242)) 252 $ ((448)) 466 $ ((484)) 504 $ ((605)) 630

(3) There are no resource limits for the programs under this section.

[Statutory Authority: RCW 74.08.090, 74.04.050, 74.04.057, 74.09.530 and the poverty guidelines updated annually in the Federal Register by the United States Department of Health and Human Services under authority of Section 673(2) of the Omnibus Budget Reconciliation Act (42 U.S.C. 9902(2)). 00-17-085, 388-478-0075, filed 8/14/00, effective 9/14/00; 99-19-005, 388-478-0075, filed 9/3/99, effective 10/4/99. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, 388-478-0075, filed 7/31/98, effective 9/1/98. Formerly WAC 388-507-0805, 388-508-0810, 388-509-0910, 388-509-0920, 388-509-0940 and 388-509-0960.]


AMENDATORY SECTION(Amending WSR 00-17-085, filed 8/14/00, effective 9/14/00)

WAC 388-478-0085   Medicare cost sharing programs--Monthly income and countable resources standards.   (1) The qualified Medicare beneficiary (QMB) program income standard is up to one hundred percent of the Federal Poverty Level (FPL). Beginning April 1, ((2000)) 2001, the QMB program's income standards are:


(a) One person $ ((696)) 716
(b) Two persons $ ((938)) 968

(2) The special low-income Medicare beneficiary (SLMB) program income standard is over one hundred percent of FPL, but under one hundred twenty percent of FPL. Beginning April 1, ((2000)) 2001, the SLMB program's income standards are:


Minimum Maximum
(a) One person $ ((696.01)) 716.01 $ ((835)) 859
(b) Two persons $ ((938.01)) 968.01 $ ((1125)) 1161

(3) The expanded special low-income Medicare beneficiary (ESLMB) program income standard is over one hundred twenty percent of FPL, but under one hundred thirty-five percent of FPL. Beginning April 1, ((2000)) 2001, the ESLMB program's income standards are:

Minimum Maximum
(a) One person $ ((835.01)) 859.01 $ ((940)) 967
(b) Two persons $ ((1125.01)) 1161.01 $ ((1266)) 1307

(4) The qualified disabled working individual (QDWI) program income standard is up to two hundred percent of FPL. Beginning April 1, ((2000)) 2001, the QDWI program's income standards are:


(a) One person $ ((1392)) 1432
(b) Two persons $ ((1875)) 1935

(5) The qualified individual (QI) program income standard is over one hundred thirty-five percent of FPL, but under one hundred seventy-five percent of FPL. Beginning April 1, ((2000)) 2001, the QI program's income standards are:


Minimum Maximum
(a) One person $ ((940.01)) 967.01 $ ((1218)) 1253
(b) Two persons $ ((1266.01)) 1307.01 $ ((1641)) 1694

(6) The resource standard for the Medicare cost sharing programs in this section is:


(a) One person $ 4000
(b) Two persons $ 6000

[Statutory Authority: RCW 74.08.090, 74.04.050, 74.04.057, 74.09.530 and the poverty guidelines updated annually in the Federal Register by the United States Department of Health and Human Services under authority of Section 673(2) of the Omnibus Budget Reconciliation Act (42 U.S.C. 9902(2)). 00-17-085, 388-478-0085, filed 8/14/00, effective 9/14/00; 99-19-005, 388-478-0085, filed 9/3/99, effective 10/4/99. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, 388-478-0085, filed 7/31/98, effective 9/1/98. Formerly WAC 388-517-1715, 388-517-1730, 388-517-1750 and 388-517-1770.]

Washington State Code Reviser's Office