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182-513-1317  <<  182-513-1318 >>   182-513-1319

PDFWAC 182-513-1318

Income and resource criteria for home and community based (HCB) waiver programs and hospice.

(1) This section provides an overview of the income and resource eligibility rules for a person to be eligible for a categorically needy (CN) home and community based (HCB) waiver program under chapter 182-515 WAC or the hospice program under WAC 182-513-1240 and 182-513-1245.
(2) To determine income eligibility for an SSI-related long-term care (LTC) HCB waiver, the agency or its designee:
(a) Determines income available under WAC 182-513-1325 and 182-513-1330;
(b) Excludes income under WAC 182-513-1340;
(c) Compares remaining gross nonexcluded income to:
(i) The special income level (SIL) defined under WAC 182-513-1100; or
(ii) For HCB service programs authorized by the aging and long-term supports administration (ALTSA), a higher standard is determined following the rules under WAC 182-515-1508 if a client's income is above the SIL but net income is below the medically needy income level (MNIL).
(3) A person who receives MAGI-based coverage is not eligible for HCB waiver services unless found eligible based on program rules in chapter 182-515 WAC.
(4) To be resource eligible under the HCB waiver program, the person must:
(a) Meet the resource eligibility requirements and standards under WAC 182-513-1350;
(b) Not be in a period of ineligibility due to a transfer of asset penalty under WAC 182-513-1363;
(c) Disclose to the state any interest the person or that person's spouse has in an annuity and meet the annuity requirements under chapter 182-516 WAC.
(5) The agency or its designee determines a person's responsibility to pay toward the cost of care for LTC services as follows:
(a) For people receiving HCS HCB waiver services, see WAC 182-515-1509;
(b) For people receiving DDA HCB waiver services, see WAC 182-515-1514.
(6) To be eligible for the CN hospice program, see WAC 182-513-1240.
(7) To be eligible for the MN hospice program in a medical institution, see WAC 182-513-1245.
[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, § 182-513-1318, filed 1/17/17, effective 2/17/17.]
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