Source: https://apps.leg.wa.gov/wac/default.aspx?cite=182-515&full=true
Timestamp: 2020-08-10 11:43:01
Document Index: 726583045

Matched Legal Cases: ['§ 431', '§ 155', '§ 182', '§ 209', '§ 388', '§ 388', '§ 182', '§ 431', '§ 155', '§ 182', '§ 209', '§ 388', '§ 388', '§ 388', '§ 431', '§ 155', '§ 182', '§ 209', '§ 388', '§ 388', '§ 182', '§ 431', '§ 155', '§ 182', '§ 209', '§ 388', '§ 388', '§ 388', '§ 431', '§ 155', '§ 182', '§ 182', '§ 209', '§ 388', '§ 388', '§ 182', '§ 182', '§ 431', '§ 155', '§ 182', '§ 182', '§ 209', '§ 388', '§ 388', '§ 388']

PDF182-515-1505
PDF182-515-1506
Home and community based (HCB) waiver services authorized by home and community services (HCS)—General eligibility.
(1) To be eligible for home and community based (HCB) waiver services a person must:
(i) Community options program entry system (COPES), under WAC 388-106-0310;
(ii) Residential support waiver (RSW), under WAC 388-106-0310; or
(iii) New Freedom, under WAC 388-106-0338.
(b) Meet the disability criteria for the supplemental security income (SSI) program under WAC 182-512-0050;
(c) Require the level of care provided in a nursing facility under WAC 388-106-0355;
(d) Reside in a medical institution as defined in WAC 182-500-0050, or be likely to be placed in one within the next thirty days without HCB waiver services provided under one of the programs listed in (a) of this subsection;
(e) Attain institutional status under WAC 182-513-1320;
(f) Assessed for HCB waiver services, be approved for a plan of care, and receiving an HCB waiver service under (a) of this subsection;
(g) Be able to live at home with community support services and choose to remain at home, or live in a department-contracted alternate living facility under WAC 182-513-1100.
(a) Is subject to a penalty period of ineligibility for the transfer of an asset under WAC 182-513-1363; or
(b) Has a home with equity in excess of the requirements under WAC 182-513-1350.
(3) See WAC 182-513-1315 for rules used to determine countable resources, income, and eligibility standards for long-term care (LTC) services.
(4) Current income and resource standards are found at http://www.hca.wa.gov/free-or-low-cost-health-care/program-administration/program-standard-income-and-resources.
[Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R § 155. WSR 17-03-116, § 182-515-1506, filed 1/17/17, effective 2/17/17. WSR 13-01-017, recodified as WAC 182-515-1506, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, section 6014 of the Deficit Reduction Act of 2005 (DRA), and 2010 1st sp.s. c 37 § 209(1). WSR 12-21-091, § 388-515-1506, filed 10/22/12, effective 11/22/12. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.500, and 74.09.530 and Washington state 2007-09 operating budget (SHB 1128). WSR 08-22-052, § 388-515-1506, filed 11/3/08, effective 12/4/08.]
PDF182-515-1507
Home and community based (HCB) waiver services authorized by home and community services (HCS)—Financial eligibility if a client is eligible for an SSI-related noninstitutional categorically needy (CN) medicaid program.
(1) A client is financially eligible for home and community based (HCB) waiver services if the client:
(a) Is receiving coverage under one of the following categorically needy (CN) medicaid programs:
(i) SSI program under WAC 182-510-0001. This includes SSI clients under Section 1619(b) of the Social Security Act;
(ii) SSI-related noninstitutional CN program under chapter 182-512 WAC; or
(iii) Health care for workers with disabilities program (HWD) under chapter 182-511 WAC.
(b) Does not have a penalty period of ineligibility for the transfer of an asset under WAC 182-513-1363; and
(c) Does not own a home with equity in excess of the requirements under WAC 182-513-1350.
(2) A client eligible under this section does not pay toward the cost of care, but must pay room and board if living in an alternate living facility (ALF) under WAC 182-513-1100.
(3) A client eligible under this section who lives in a department-contracted ALF described under WAC 182-513-1100:
(a) Keeps a personal needs allowance (PNA) under WAC 182-513-1105; and
(b) Pays towards room and board under WAC 182-513-1105.
(4) A client who is eligible under the HWD program must pay the HWD premium under WAC 182-511-1250, in addition to room and board, if residing in an ALF.
(5) Current resource, income, PNA, and room and board standards are found at www.hca.wa.gov/free-or-low-cost-health-care/program-administration/program-standard-income-and-resources.
[Statutory Authority: RCW 41.05.021, 41.05.160, 2017 c 270. WSR 17-23-039, § 182-515-1507, filed 11/8/17, effective 1/1/18. Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R § 155. WSR 17-03-116, § 182-515-1507, filed 1/17/17, effective 2/17/17. WSR 13-01-017, recodified as WAC 182-515-1507, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, section 6014 of the Deficit Reduction Act of 2005 (DRA), and 2010 1st sp.s. c 37 § 209(1). WSR 12-21-091, § 388-515-1507, filed 10/22/12, effective 11/22/12. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.500, 74.09.530, and section 1915(c) of the Social Security Act. WSR 09-14-043, § 388-515-1507, filed 6/24/09, effective 7/25/09. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.500, and 74.09.530 and Washington state 2007-09 operating budget (SHB 1128). WSR 08-22-052, § 388-515-1507, filed 11/3/08, effective 12/4/08.]
PDF182-515-1508
PDF182-515-1509
PDF182-515-1510
PDF182-515-1511
Home and community based (HCB) waiver services authorized by the developmental disabilities administration (DDA)—General eligibility.
(1) To be eligible for home and community based (HCB) waiver services authorized by the developmental disabilities administration (DDA), a person must:
(a) Meet specific program requirements under chapter 388-845 WAC;
(b) Be an eligible client of the DDA;
(c) Meet the disability criteria for the supplemental security income (SSI) program under WAC 182-512-0050;
(d) Need the level of care provided in an intermediate care facility for the intellectually disabled (ICF/ID);
(e) Have attained institutional status under WAC 182-513-1320;
(f) Be able to reside in the community and choose to do so as an alternative to living in an ICF/ID;
(g) Be assessed for HCB waiver services, be approved for a plan of care, and receive HCB waiver services under (a) of this subsection, and:
(ii) Live in a department-contracted facility with HCB waiver services, such as:
(B) A group training home;
(C) A child foster home, group home, or staffed residential facility;
(D) An adult family home (AFH); or
(E) An adult residential care (ARC) facility.
(iii) Live in the person's own home with supported living services from a certified residential provider; or
(iv) Live in the home of a contracted companion home provider.
(4) Current income and resource standard charts are found at http://www.hca.wa.gov/free-or-low-cost-health-care/program-administration/program-standard-income-and-resources.
[Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R § 155. WSR 17-03-116, § 182-515-1511, filed 1/17/17, effective 2/17/17. WSR 13-01-017, recodified as WAC 182-515-1511, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, section 6014 of the Deficit Reduction Act of 2005 (DRA), and 2010 1st sp.s. c 37 § 209(1). WSR 12-21-091, § 388-515-1511, filed 10/22/12, effective 11/22/12. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.500, 74.09.530, and Washington state 2007-09 operating budget (SHB 1128). WSR 08-11-083, § 388-515-1511, filed 5/20/08, effective 6/20/08.]
PDF182-515-1512
Home and community based (HCB) waiver services authorized by the developmental disabilities administration (DDA)—Financial eligibility if a client is eligible for a noninstitutional SSI-related categorically needy (CN) program.
(1) A client is financially eligible for home and community based (HCB) waiver services authorized by the developmental disabilities administration (DDA) if:
(a) The client is receiving coverage under one of the following categorically needy (CN) medicaid programs:
(i) Supplemental security income (SSI) program under WAC 182-510-0001. This includes SSI clients under 1619(b) status; or
(ii) Health care for workers with disabilities (HWD) under chapter 182-511 WAC; or
(iii) SSI-related noninstitutional (CN) program under chapter 182-512 WAC; or
(iv) The foster care program under WAC 182-505-0211 and the client meets disability requirements under WAC 182-512-0050.
(b) The client does not have a penalty period of ineligibility for the transfer of an asset as under WAC 182-513-1363; and
(c) The client does not own a home with equity in excess of the requirements under WAC 182-513-1350.
(b) Pays towards room and board up to the room and board standard under WAC 182-513-1105.
(4) A client who is eligible under the HWD program must pay the HWD premium under WAC 182-511-1250, in addition to room and board if residing in an ALF.
(5) Current resource, income, PNA and room and board standards are found at www.hca.wa.gov/free-or-low-cost-health-care/program-administration/program-standard-income-and-resources.
[Statutory Authority: RCW 41.05.021, 41.05.160, 2017 c 270. WSR 17-23-039, § 182-515-1512, filed 11/8/17, effective 1/1/18. Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R § 155. WSR 17-03-116, § 182-515-1512, filed 1/17/17, effective 2/17/17. WSR 13-01-017, recodified as WAC 182-515-1512, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, section 6014 of the Deficit Reduction Act of 2005 (DRA), and 2010 1st sp.s. c 37 § 209(1). WSR 12-21-091, § 388-515-1512, filed 10/22/12, effective 11/22/12. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.575, 74.09.500, 74.09.530. WSR 08-24-069, § 388-515-1512, filed 12/1/08, effective 1/1/09. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.500, 74.09.530, and Washington state 2007-09 operating budget (SHB 1128). WSR 08-11-083, § 388-515-1512, filed 5/20/08, effective 6/20/08.]
PDF182-515-1513
Home and community based (HCB) waiver services authorized by the developmental disabilities administration (DDA)—Financial eligibility using SSI-related institutional rules.
(1) If a person is not eligible for a categorically needy (CN) program under WAC 182-515-1512, the agency determines eligibility for home and community based (HCB) waiver services authorized by the developmental disabilities administration (DDA) using institutional medicaid rules. This section explains how a person may qualify using institutional rules.
(a) General eligibility requirements under WAC 182-513-1315 and 182-515-1511;
(b) Resource requirements under WAC 182-513-1350; and
(c) Have available income at or below the special income level (SIL) defined under WAC 182-513-1100.
(3) The agency determines available income and income exclusions according to WAC 182-513-1325, 182-513-1330, and 182-513-1340.
(4) A person eligible under this section is responsible to pay income toward the cost of care and room and board, as described under WAC 182-515-1514.
(5) Current resource, income standards are found at http://www.hca.wa.gov/free-or-low-cost-health-care/program-administration/program-standard-income-and-resources.
[Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R § 155. WSR 17-03-116, § 182-515-1513, filed 1/17/17, effective 2/17/17. WSR 13-01-017, recodified as § 182-515-1513, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, section 6014 of the Deficit Reduction Act of 2005 (DRA), and 2010 1st sp.s. c 37 § 209(1). WSR 12-21-091, § 388-515-1513, filed 10/22/12, effective 11/22/12. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.500, 74.09.530, and Washington state 2007-09 operating budget (SHB 1128). WSR 08-11-083, § 388-515-1513, filed 5/20/08, effective 6/20/08.]
PDF182-515-1514
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 20-08-082, § 182-515-1514, filed 3/27/20, effective 4/27/20. Statutory Authority: RCW 41.05.021, 41.05.160, 2017 c 270. WSR 17-23-039, § 182-515-1514, filed 11/8/17, effective 1/1/18. Statutory Authority: RCW 41.05.021, 41.05.160, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R § 155. WSR 17-03-116, § 182-515-1514, filed 1/17/17, effective 2/17/17. WSR 13-01-017, recodified as § 182-515-1514, filed 12/7/12, effective 1/1/13. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.530, section 6014 of the Deficit Reduction Act of 2005 (DRA), and 2010 1st sp.s. c 37 § 209(1). WSR 12-21-091, § 388-515-1514, filed 10/22/12, effective 11/22/12. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.575, 74.09.500, 74.09.530. WSR 08-24-069, § 388-515-1514, filed 12/1/08, effective 1/1/09. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.500, 74.09.530, and Washington state 2007-09 operating budget (SHB 1128). WSR 08-11-083, § 388-515-1514, filed 5/20/08, effective 6/20/08.]