WSR 02-11-033

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Economic Services Administration)

[ Filed May 7, 2002, 4:22 p.m. ]

     Date of Adoption: May 2, 2002.

     Purpose: The rules have been amended to simplify and to clarify existing requirements governing state supplemental payments.

     Citation of Existing Rules Affected by this Order: Amending WAC 388-474-0001, 388-474-0005, 388-474-0010, 388-474-0015, and 388-474-0020.

     Statutory Authority for Adoption: RCW 74.04.050, 74.04.055, 74.04.057, 74.08.090.

     Other Authority: RCW 74.04.630.

      Adopted under notice filed as WSR 02-07-115 on March 20, 2002.

     Changes Other than Editing from Proposed to Adopted Version: WAC 388-478-0055 and 388-474-0012 were withdrawn from proposed rules filed as WSR 02-07-115. The changes were made because the state legislature changed the direction of policy for budgetary reasons before the filing was complete.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 5, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 5, Repealed 0.
     Effective Date of Rule: Thirty-one days after filing.

May 2, 2002

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3050.4
AMENDATORY SECTION(Amending WSR 01-06-042, filed 3/5/01, effective 4/5/01)

WAC 388-474-0001   ((General information--)) What is Supplemental Security Income((.)) (SSI) and who can get it?    (1) ((Persons with limited income and resources who are aged, blind, or disabled may qualify for)) SSI is a federal cash benefit((s under the Supplemental Security Income program (SSI))) program administered by the Social Security Administration (SSA) under Title XVI of the Social Security Act.

     (2) You can get SSI if you have limited income and resources and if you are:

     (a) Aged (sixty-five and older);

     (b) Blind; or

     (c) Disabled.

     (3) The SSI program replaced state programs for aged, blind and disabled persons beginning in January 1974. ((Persons who)) If you received state assistance in December 1973((, as aged, blind or disabled or were needed in the home to care for an eligible person, automatically)) and you became eligible for SSI in January 1974((. The blind or disabled)), you are called a grandfathered ((clients)) client by the state and a mandatory income level (MIL) client by SSI. You must continue to meet the definition of blind or disabled that was in effect under the state plan in December 1973. These definitions can be found in the SSA program operations manual system (POMS), see http://policy.ssa.gov/poms.nsf. ((A person designated in January 1974 as essential to the care of a grandfathered SSI client will continue to be included in the SSI payment as long as the essential person continuously resides with the SSI client.

     (3) The spouse of an SSI recipient who does not qualify for SSI in their own right may be included in the state supplement payment but is not considered an SSI recipient for purposes of medical assistance eligibility))

     (4) If you are needed in the home to care for an eligible person, you are called an essential person. You are also called a grandfathered client.

     (5) If you are an essential person you must have lived continuously with the eligible person since January 1974.

     (6) If you are an SSI recipient and you have a spouse who does not qualify for SSI in their own right, you may be eligible for a state supplemental payment for your spouse (also referred to as an ineligible spouse).

[Statutory Authority: RCW 74.04.050, 74.08.090, and 74.09.055. 01-06-042, § 388-474-0001, filed 3/5/01, effective 4/5/01. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-474-0001, filed 7/31/98, effective 9/1/98.]


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

WAC 388-474-0005   What medical coverage((.)) does a Supplemental Security Income client, essential person, and an ineligible spouse get?   (1) If you are an SSI ((recipient qualifies for)) client you automatically get categorically needy (CN) medical coverage ((without a medical determination, except when the SSI recipient)) (WAC 388-505-0110) unless you:

     (a) ((Refuses)) Refuse to provide private medical insurance information; or

     (b) Refuse to assign the right to recover insurance funds to the department((;

     (b) Disposes of resources for less than fair market value and then applies for Medicaid coverage of nursing home care within thirty months of the date of transfer; or

     (c) Has a Medicaid qualifying trust)) (WAC 388-505-0540).

     (2) ((A person designated as)) If you are an essential person as described in ((January, 1974, qualifies for)) WAC 388-474-0001 you get CN medical coverage as long as ((they)) you continue to ((reside)) live with the SSI ((recipient)) client.

     (3) ((The spouse of an SSI recipient designated as an)) If you are an ineligible spouse ((must have medical eligibility separately determined when:

     (a) They do not automatically qualify for medical coverage in subsection (2) above; or

     (b) They are not eligible for SSI in their own right.

     (4) Persons who are not receiving SSI, but are SSI-related and qualify for CN medical assistance are described in WAC 388-505-0110)) you are not considered an SSI recipient. You must have your medical assistance determined separately.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-474-0005, filed 7/31/98, effective 9/1/98.]


AMENDATORY SECTION(Amending WSR 01-19-023, filed 9/12/01, effective 11/1/01)

WAC 388-474-0010   How does being a Supplemental Security Income (SSI) client affect ((eligibility for)) your cash assistance ((programs?)) eligibility?   ((A person who is)) (1) If you are married to an SSI recipient but ((cannot)) do not get SSI in ((their own right is)) your own right, you are called an "ineligible spouse."

     (((1))) (2) If you are an ineligible spouse((,)) you cannot get the SSI state supplement (((see WAC 388-478-0055) if)) when you are:

     (a) The caretaker relative of a child who receives TANF or SFA; and

     (b) Required to be included in the TANF or SFA assistance unit with the child ((under WAC 388-408-0015.

     (2))) (see WAC 388-408-0015; or

     (c) Receiving refugee assistance.

     (3) If you are an ineligible spouse and ((are eligible for the)) get an SSI state supplement (WAC 388-474-0012), you ((are not eligible for)) cannot get general assistance ((benefits)) (GA).

[Statutory Authority: RCW 74.08.090, 74.04.057, 74.04.050. 01-19-023, § 388-474-0010, filed 9/12/01, effective 11/1/01. Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-474-0010, filed 7/31/98, effective 9/1/98.]


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

WAC 388-474-0015   ((Termination of)) What happens to my categorically needy (CN) medical coverage when my Supplemental Security Income (SSI((.))) cash payment is terminated?   (1) ((A person terminated from SSI cash assistance will have)) Your CN medical coverage ((continued)) (WAC 388-505-0110) continues after an SSI cash payment ends when:

     (a) Countable income exceeds the SSI income standard due solely to the annual cost-of-living adjustment (COLA); or

     (b) A timely request for a hearing has been filed. ((Categorically needy)) CN medical coverage is continued until Social Security Administration (SSA) makes a final decision on the hearing request and on any subsequent timely appeals.

     (2) ((A person terminated from SSI is eligible for continued CN)) If your SSI ends your CN medical coverage continues for a period of up to one hundred twenty days ((from the date of termination of SSI cash benefits)) while the department reviews your eligibility for other cash or medical programs ((is being determined)).

     (3) If you are a terminated SSI or SSI-related client, the department will ((have their)) your disability ((redetermined under certain conditions. These conditions are:

     (a) The person presents)) status when:

     (a) You present new medical evidence;

     (b) ((The person's)) Your medical condition changes significantly; or

     (c) ((The)) Your termination from SSI was not based on a review of current medical evidence.

     (4) Children terminated from SSI due to loss of disabled status ((as a disabled person)) may be eligible for medical benefits under WAC 388-505-0210.

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-474-0015, filed 7/31/98, effective 9/1/98. Formerly WAC 388-524-2405.]


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

WAC 388-474-0020   ((Duplicate)) What can a general assistance ((and overpayments.))-unemployable (GA-U) client expect when Supplemental Security Income (SSI) benefits begin?   (((1) Persons receiving cash benefits under the general assistance program who receive advance, emergency or retroactive SSI cash assistance for the same time period are considered to have received duplicate assistance. The amount of general assistance paid during this time period must be repaid to the department.

     (2) Applicants for general assistance-unemployable (GA-U) are required to)) You can only get assistance to meet your basic needs from one government source at a time (WAC 388-448-0210). If you are a GA-U client who begins setting SSI, you should know that:

     (1) If you got advance, emergency or retroactive SSI cash assistance for any period where you got GA-U, you must repay the department the amount of GA-U paid to you for the matching time period.

     (2) When you apply for GA-U you must sign DSHS 18-235(X), interim assistance reimbursement agreement (IARA) ((as a condition of eligibility for)) to get GA-U assistance.

     (3) You cannot use your GA-U ((funds cannot be used)) money to replace money deducted from ((a person's)) your SSI check ((by SSA)) to repay an SSI overpayment ((of SSI benefits)).

[Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090. 98-16-044, § 388-474-0020, filed 7/31/98, effective 9/1/98.]

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