Wash. Admin. Code § 182-515-1507 – 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:
1. (a) Is receiving coverage under one of the following categorically needy (CN) medicaid programs:
  1. (i) SSI program under WAC 182-510-0001. This includes SSI clients under Section 1619(b) of the Social Security Act;
  2. (ii) SSI-related noninstitutional CN program under chapter 182-512 WAC; or
  3. (iii) Health care for workers with disabilities program (HWD) under chapter 182-511 WAC.
2. (b) Does not have a penalty period of ineligibility for the transfer of an asset under WAC 182-513-1363; and
3. (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:
1. (a) Keeps a personal needs allowance (PNA) under WAC 182-513-1105; and
2. (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/i-help-others-apply-and-access-apple-health/program-standard-income-and-resources.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 23-04-034, § 182-515-1507, filed 1/25/23, effective 2/25/23. 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.]