Purpose: This section includes rules and procedures on who can apply for benefits, how to apply for benefits and the minimum amount of information that must be provided to start the application process.
What is the date of my application and how does it affect my benefits?
WAC 388-406-0005
WAC 388-406-0005
Effective November 1, 2009
WAC 388-406-0005 Can I apply for cash, medical, or Basic Food?
You can apply for any benefit the department offers, including cash assistance, medical assistance, or Basic Food.
You must meet certain eligibility requirements in order to receive a program benefit.
You can apply for someone else if you are:
A legal guardian, caretaker, or authorized representative applying for:
A dependent child;
An incapacitated person; or
Someone who is deceased;
Applying for someone who cannot apply for some other reason. We may ask why the applicant is unable to apply on their own behalf.
If you get Supplemental Security Income (SSI), you do not need to apply for medical benefits. We automatically open medical benefits for you.
A person or agency may apply for GAU or medical assistance for you if:
You temporarily live out-of-state; and
You are a Washington state resident.
When you are confined or incarcerated in a Washington State public institution, you may apply for cash or medical assistance if you meet the following criteria:
You are confined by or in the following public institutions:
Department of Corrections;
City or county jail; or
Institution for Mental Diseases (IMD).
Staff at the public institution provide medical records including diagnosis by a mental health professional that you have a mental disorder (as defined in the Diagnostic and Statistical Manual of Psychiatric Disorders, most recent edition) that affects your thoughts, mood or behavior so severely that it prevents you from performing any kind of work.
We will make an eligibility determination for medical assistance prior to your release from confinement and will authorize medical benefits upon your release from confinement when you:
Meet the criteria of subsection (6) in this section; and
Were receiving Medicaid or General Assistance benefits immediately before confinement or within the five years prior to confinement.
If you meet the criteria in subsection (6) but did not receive Medicaid or General Assistance benefits within the five years prior to confinement, the department will process your request for medical assistance within the time frames in WAC 388-406-0035.
If you are applying for assistance for a youth leaving incarceration in a juvenile rehabilitation administration or county juvenile detention facility, you may apply for assistance within forty-five days prior to release. We will process your application for medical assistance when we receive it, and if eligible, we will authorize medical benefits upon the youth's release from confinement.
Medical applications of parents with joint custody of a minor dependent child:
Only one household may receive medical benefits for a child. The household that cares for the child the majority of time receives benefits for that child, but
Remember that medical benefits follow the child within the state, so when two households have joint custody of a child, the child may use the medical ID card while staying at either home in Washington.
Applications by others:
For cash, medical assistance, and Basic Food, third parties (i.e., persons not applying for themselves or their legal dependents) may apply for other persons. To apply on someone's behalf, third parties must:
Be familiar enough with the client's circumstances to complete the application accurately; and
If we ask, tell us why they are applying on behalf of the applicant to help us identify if the applicant should get Necessary Supplemental Accommodation (NSA) services under chapter 388-472 WAC. Examples of when someone might apply for another person include when the applicant is:
Mentally incompetent;
Physically or mentally ill or otherwise incapacitated;
A minor child;
Deceased;
Subjected to domestic violence;
For Basic Food, living in a qualified DDD group home or qualified Drug & Alcohol treatment facility; or
For GA-U and medical programs, temporarily residing outside the state.
NOTE:
While others can apply for benefits on behalf of clients, HIPPA restrictions prevent us from discussing the client's individual health information with the person making the application unless the representative has power of attorney for the client or the client has signed an Authorization form, DSHS 17-063.
Authorized Representative:
An authorized representative can be any adult who is not a member of the AU and has sufficient knowledge of the client's circumstances to act on the client's behalf. In general, the client chooses who will be their authorized representative. For more information, see PAYEES ON BENEFIT ISSUANCES – Authorized Representatives.
Applications while in a public institution:
Prior to release from a public institution, people may apply for public assistance. The CSO needs to accept these applications.
Expedited medical assistance for people with mental disorders before release from public institutions
The enactment of House Bill 1290 in 2005 requires the department to perform expedited eligibility determinations and provide timely access to medical assistance by persons with mental disorders being released from confinement. The goal is to provide eligible people with a medical assistance identification card on the date they are released, whenever possible.
Work flow procedures will be developed as part of local agreements between the CSO and the institutions.
Direct questions to the State 1290 Coordinator.
Instructions on tracking these applications will follow.
Dangerous Mentally Ill Offenders (DMIOs)
The department (DSHS) has a state law-required agreement with the Department of Corrections (DOC) to accept Medicaid applications (in practice these are requests for GAX benefits), from an inmate who is classified as a dangerous mentally ill offender (DMIO). The CSO that serves the catchment area in which the correctional facility releasing the DMIO is located or an alternate CSO as designated by the Region Office must accept applications from inmates of that facility.
Chemical Dependency Treatment
People may apply for a determination of financial eligibility to allow the institution to arrange for chemical dependency assessment and treatment placement.
Accept applications from a person whose situation is not described in a through c above, determine eligibility if possible or notify the person of necessary verification and schedule for follow-up after release.
Correctional Options programs
The Department of Corrections (DOC) and county and city jails have a variety of programs that may be used in placing offenders outside public institutions. The Options Program Appendix is intended to clarify how placement in a correctional options program affects a person's eligibility for public assistance benefits. A person who has been suspended from SSI for 12 months or less solely due to incarceration in a public institution is eligible to receive SSI medical (S01) on the date of his/her release from the institution.
In compliance with House Bill 1290 (2005), the CSO will open an S01 medical AU from an application for a person meeting the criteria in section 3a (above). A Medical ID card is sent to the facility so that the applicant can leave the institution with the ID card in hand.
WORKER RESPONSIBILITIES
FOR NON-COMPLIANCE SANCTION (NCS) APPLICATIONS:
See WORKER RESPONSIBILITIES Non-Compliance Sanctions (NCS) Re-Applicants in WAC 388-310-1600
WORKER RESPONSIBILITIES
FOR APPLICATIONS OF PERSONS LEAVING PUBLIC INSTITUTIONS:
When you receive an application for a person who is being released from a public institution or correctional facility, check the SDX interface (SDX1) for the client pay code status.
If the pay code status is N22, N02, or H10, open an S01 medical benefits AU beginning the month of release. The UNER screen in ACES should have SI income type coded with $0 benefit amount.
Make sure to change the living arrangement code on the ACES DEM1 screen so that it no longer shows IM, JL or PR.
If the SDX does not update the SSI amount in ACES within 60 days after release, the AU will be captured on the Terminated SSI AU Report sent to the CSOs each month. At that time, SSI status and/or income will need to be verified.
Electronic Home Monitoring
Eligible offenders reside in their home and are monitored electronically for movement. The offender pays a fee to be on the program and does not occupy a jail or prison bed while on this program.
No for GA
Yes for ADATSA
Yes
Yes
Yes
Day Jail / Day Reporting
Eligible offenders report at various assigned times throughout a 24 hour period OR offenders are placed on supervised work or community betterment programs during regular work hours. In either situation, the offender does not occupy a jail or prison bed while on this program.
Yes
Yes
Yes
Yes
Pre-Trial Supervision / Probation
Pre-Trial Supervision staff monitor defendants who are pending trial. The offender has been released from custody by the court pending the outcome of their trial and does not occupy a jail or prison bed.
Yes
Yes
Yes
Yes
District Court Probation
District Court Probation Officers monitor offenders who have been convicted of or are pending trial for misdemeanor charges. The offender does not occupy a jail or prison bed.
Yes
Yes
Yes
Yes
DOC Community Supervision
Community Corrections Officers monitor offenders who have been convicted of felony charges. The offender does not occupy a jail or prison bed.
Yes
Yes
Yes
Yes
Drug Court
A court-ordered program in which offenders with drug-related charges voluntarily choose to participate in chemical dependency treatment and counseling. Offenders may have their charges dismissed if they successfully complete the program. The offender does not occupy a jail or prison bed.
Yes
Yes
Yes
Yes
DOC Work Release
A correctional options program whereby eligible offenders are housed in a Work Release, jail or Corrections Facility and are authorized to leave the facility for purposes or employment, education, court ordered treatment or employment search. The offender does occupy a corrections bed while on this program.
No
No
No
No
Work Crews / Community Betterment
A program offered to selected minimum custody offenders for working in the community on various public entity or non-profit organization programs. There is no participation fee for this program. The offender does occupy a Corrections bed while on this program.
No
No
No
No
WAC 388-406-0010
WAC 388-406-0010
Effective March 14, 2008
WAC 388-406-0010 How do I apply for benefits?
You can apply for cash assistance, medical assistance, or Basic Food by giving us an application form in person, by mail, by fax, or by completing an online application.
If your entire Assistance Unit (AU) gets or is applying for Supplemental Security Income (SSI), your AU can file an application for Basic Food at the local Social Security Administration District Office (SSADO).
If you are incapacitated, a dependent child, or cannot apply for benefits on your own for some other reason, a legal guardian, caretaker, or authorized representative can apply for you.
You can apply for cash assistance, medical assistance, or Basic Food with just one application form.
If you apply for benefits at a local office, we accept your application on the same day you come in. If you apply at an office that does not serve the area where you live, we send your application to the appropriate office by the next business day so that office receives your application on the same day we send it.
We accept your application for benefits if it has at least:
For cash and medical assistance combined, the name, address, and signatures of the responsible adult AU members or person applying for you. A minor child may sign if there is no adult in the AU. Signatures must be handwritten, electronic or digital as defined by the department, or a mark if witnessed by another person.
For medical assistance only, the name, address, and signature of the applicant and applicant's spouse or other responsible adult person in the household, if any. In the case of an application for children's medical with caretaker adults in the hoousehold, the signature of a caretaker adult member of the household.
For Basic Food, the name, address, and signature of a responsible member of your AU or person applying for you as your authorized representative under WAC 388-460-0005.
As a part of the application process, we may require you to:
Complete an interview if one is required under WAC 388-452-0005;
Meet WorkFirst participation requirements for four weeks in a row if required under WAC 388-310-1600 (12).
Give us the information we need to decide if you are eligible as required under WAC 388-406-0030; and
Give us proof of information as required under WAC 388-490-0005 so we can determine if you are eligible.
If you are eligible for necessary supplemental accommodation (NSA) services under chapter 388-472 WAC, we help you meet the requirements of this section.
Local offices must make application forms readily available and provide a form to anyone requesting one. Applying for benefits is separate from any other program requirements. We cannot refuse to give an application form to a client because they are not meeting other program requirements or for any other reason.
NOTE:
We cannot require or ask that a TANF applicant participate in a WorkFirst activity before we give them an application form.
Application filing:
A client has filed an application when we receive a request for benefits in the local office. We can't require clients to use a specific form to request benefits. Examples of typical requests for benefits include:
Adding a request for assistance to a pending application for another program:
Clients can add a request for any benefits to an existing application without submitting a new 14-001. A person may make the request in writing by checking the appropriate boxes on the 14-001 form, dating and initialing the form, or they may make it verbally. A person may also add a request to an unprocessed eligibility review. Use the date the client added the new request as the date of application for the new program. See WAC 388-406-0012.
EXAMPLE
Jenny has a pending application for Basic Food. At her intake interview she requests TANF. Add the TANF application to the Basic Food and note the date of request prominently in the ACES narrative.
EXAMPLE
Sam has a pending application for GA-U. At his intake interview the worker makes him aware that he may be eligible for Basic Food. He decides to pursue Basic Food. Add the Basic Food application to the GA-U and note the date of request prominently in the ACES narrative.
EXAMPLE
Maria has a pending application for Basic Food. At her telephone intake interview the worker makes her aware that she may be eligible for medical benefits. She decides to add a medical request. Add the medical application to the Basic Food and note the date of request prominently in the ACES narrative.
If the application for the other program has already been processed, clients must submit a new application for Basic Food.
If we receive an application without a name or address to contact the client we make any reasonable effort we can to contact the client to find out who the client is and where they can be reached. If the client is in the office, we ask the client for an address where they can be reached.
a. Homeless applications:
If we receive an application that includes a name and signature, but is marked "homeless" and/or does not indicate a mailing address, it is still considered a valid application and must be screened. Make a reasonable attempt to locate an address or phone number for the client. This can be done by searching the electronic case record, case narrative or remarks, online directories, etc. Even if contact information is not available, an appointment letter must be sent to the applicant. Address the letter in the client's name to General Delivery for the municipality indicated on the application. If no municipality is indicated, send the appointment letter to the client by General Delivery for the nearest municipality. The application must be processed in accordance with the Standards of Promptness guidelines in WAC 388-406-0035.
Signatures:
For children's medical assistance, one parent of the minor children living in the home must sign the application.
For cash and medical programs other than children's medical, a responsible adult AU member must sign the application and if both parents of minor children are living in the home with the minor children, both parents must sign unless one is incapacitated and unable to sign the application;
For Basic Food, the signature of one responsible AU member is required.
For cash, medical, or Basic Food, a representative may sign an application if the applicant is unable to apply on their own behalf or is unable to sign the application.
A minor child may sign the application if there is no adult in the AU.
A mark is an acceptable signature if another person witnesses it.
Online applications for cash, medical, or Basic Food are electronically signed when transmitted. The password used to complete the online application is an electronic signature. For online medical and long-term care applications, the electronic signature is only for the person applying. A separate signature page for the application will be sent for any other adults in the household who are financially responsible for the applicant to sign and return.
Applications we receive without a signature must be signed either at the time of the interview or by mail.
Application Received
Online - for cash or Basic Food
Online - for medical assistance only or long-term care
In-person, mailed, emailed, faxed, dropped off, or scanned
Application Signed?
Yes
Always electronically signed when transmitted
Yes, for person applying. Need additional signature of any other financially responsible adult (such as a spouse) in the household
No
Date of Application
Date received or next business day if received after business hours
Date received or next business day if received after business hours
Date received or next business day if received after business hours
Action to Take
Interview if required or desk review
Mail back for signature. Desk review only.
Have client sign at interview or mail back for signature
NOTE:
If we receive an application without a name, address, or a signature to file, we accept the application and take whatever action we can to contact the client to get the information needed to officially file the application. We must take action on all applications, even if there is information missing that is needed to file the application such as a name, address, or a signature.
For pregnant women, family medical, and cash assistance for applicants with children:
EPSDT Information Brochure, DSHS 22-019(X);
Women, Infants and Children (WIC) pamphlet to applicants who are pregnant, postpartum, or who have children under age five. Pamphlets are available to local WIC offices.
Check the AU's alerts for possible computer matches made after screening. Compare match information with information provided by the client. Discuss and clarify any discrepancies during the interview.
If possible, have the applicant or applicant's representative make the changes by:
Drawing a line through the incorrect entry;
Writing the correct entry; and
Initialing and dating the change on the application.
If the applicant or applicant's representative is not available to make the changes, follow the above procedures and document on the ACES remarks screen related to the change being made.
WASHCAP clients who are opting out must apply for Basic Food. These applications from WASHCAP clients must be screened for Basic Food eligibility.
If the client meets the criteria under WAC 388-492-0040, request a case transfer from the WASHCAP Unit and treat the request as you would other applications for Basic Food benefits.
If the client fails to complete the application process, deny Basic Food and transfer their case back to the WASHCAP Unit.
If the client is found eligible, change them over to Basic Food as of the first of the month following the date that the application was received.
If the client does not meet the criteria under WAC 388-492-0040, forward the application to the WASHCAP Unit.
Screening:
Screening gathers preliminary information to determine what programs a client may be eligible for. We also screen for certain services such as:
NOTE: If we accept an application for assistance in accordance with the requirements of WAC 388-406-0010(6), it must be screened. When an applicant's date of birth (DOB) is not provided or otherwise available during the screening process, a DOB must be indicated to complete the process. In this situation, staff may screen the application using a fictitious DOB. However, an explanatory note for the intake worker should be placed in the client's ECR under the "Client#" tab.
When no Social Security Number (SSN) is provided or otherwise accessible to staff for a member of the applying household, the "SSA/SSN Referrl" field on the client's DEM1 screen in ACES must be coded appropriately to allow the client additional time to provide the information.
Appointments:
If the client must be interviewed and is applying for multiple programs, schedule one interview appointment. See Interview Requirements.
If an applicant is in the CSO and can’t wait for an appointment because of an emergent need, schedule the earliest possible appointment and send the client a letter to inform them of the appointment. Make sure that there is enough mailing time between the day the appointment letter is mailed to the day of the appointment.
Examples of an emergent need include when the applicant:
Is pregnant;
Has no money or food;
Is homeless or has received an eviction notice;
Has no heat or has received a utility shutoff notice;
Has no transportation;
Is a domestic violence victim; or
Is experiencing any other situation the CSO considers an emergency.
Applicant lives outside of the local office catchment area
Determine if the application is in the correct local office. If the application received is in the wrong local office, date stamp the application and fax it to the correct office no later than the next business day (see WAC 388-406-0010). The correct local office must get the application the same day we fax it.
Tell or notify the client that the application was forwarded and give the applicant the name, location, and contact information for the correct local office.
If the applicant lives outside the local office catchment area, but cannot return to his or her home for a temporary period, accept the application for processing in the local office. Such temporary absences from the home include the applicant's temporary stay in a:
Hospital or nursing home;
Shelter for victims of domestic violence; or
Emergency shelter or other living arrangement when the applicant is a victim of a natural disaster (e.g., flood).
WAC 388-406-0012 What is the date of my application and how does it affect my benefits?
The date of your application affects when your benefits start. The date of your application is the date any field office receives your application unless:
Your entire Assistance Unit gets or applies for Supplemental Security Income (SSI) and applies for Basic Food at the local Social Security office. The date of application is the date Social Security gets your application; or
You apply outside of normal business hours, including applications you submitted online, dropped off, or sent to us by fax. The date of your application is the next business day.
You request Basic Food benefits when you have applied for benefits through another department program, but we have not made a decision on the application. We call this a “pending application”. If you ask for Basic Food benefits when you have a pending application for another program:
We use your application for the other program, but we use the date you requested food benefits as your date of application for Basic Food; and
You must provide us the necessary information to determine if you are eligible for Basic Food, even if we did not need this information for the other program.
Date stamp the application, the same day we get the application, even if the application is sent to the wrong office; or
The next business day if we received the application outside of normal business hours.
NOTE:
If you received an application without a signature and the client has now signed the application, do not date stamp the form a second time.
Adding a request for Basic Food to a pending application:
If the client has a pending application for one of our programs and requests Basic Food, use the application the client provided for the other program. The date the client requested food benefits is the date of application for Basic Food.
Do not require the client to complete another application. If you need additional information to determine eligibility for Basic Food, request the necessary information;
Document the request for Basic Food and the date the client requested the benefits; and
Add a program for Basic Food.
NOTE:
If you have already processed the application for the other program(s), the client will need to apply for Basic Food separately.
