Medical care services - Resources
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Medical care services - Resources

Revised December 7, 2011

WAC 182-509-0200MCS resources--How resources affect eligibility for medical care services (MCS). (Emergency rule effective 11/1/11.)
WAC 182-509-0205MCS resources--How resources count toward the resource limits for medical care services (MCS). (Emergency rule effective 11/1/11.)
WAC 182-509-0210MCS resources--How vehicles count toward the resource limit for medical care services (MCS). (Emergency rule effective 11/1/11.)

WAC 182-509-0200

WAC 182-509-0200

Effective October 14, 2012

WAC 182-509-0200 MCS resources--How resources affect eligibility for medical care services (MCS).

This section applies to medical care services (MCS).

1.  The following definitions apply to this chapter:

a. "Equity value" means the fair market value (FMV) minus any amount you owe on the resource.

b.  "Community property" means a resource in the name of the husband, wife, or both.

c.  "Separate property" means a resource of a married person that one of the spouses:

i.  Had possession of and paid for before they were married;

ii.  Acquired and paid for entirely out of income from separate property; or

iii.  Received as a gift or inheritance.

2.  A resource is counted towards the resource limit described in subsection (6) of this section when:

a.  It is a resource that must be counted under WAC 182-509-0205;

b.  The individual owns the resource.  Ownership means:

i.  The individual's name is on the title to the property; or

ii.  The individual has property that doesn't have a title; and

c.  The individual has control over the resource, which means the resource is actually available to the individual; and

d.  The individual could legally sell the resource or convert it into cash within twenty days.

3.  The individual must try to make their resources available even if it will take more than twenty days to do so, unless:

a.  There is a legal barrier; or

b.  A court  must be petitioned to release part or all of a resource.

4.  Resources are counted as of the date of application for MCS coverage.

5.  If total countable resources are over the resource limit in subsection (6) of this section, the individual is not eligible for MCS.

6.  Countable resources must be below the standards listed below based on the equity value of all countable resources.

a.  Applicants can have countable resources up to one thousand dollars.

b.  Recipients can have an additional three thousand dollars in a savings account.

7.  If the individual owns a countable resource with someone who is not included in the assistance unit (AU), only the portion of the resource that is owned by the individual is counted.  If ownership of the funds cannot be determined, an equal portion of the resource is presumed to be owned by the individual and all other joint owners.

8.  It is assumed an individual has control of community property and is legally able to sell the property or convert it to cash unless evidence is provided to show the individual does not have control of the property.

9.  An item may not be considered separate property if the individual used both separate and community funds to buy or improve it.

10.  The resources of victims of family violence are not counted when:

a.  The resource is owned jointly with member of the former household;

b.  Availability of the resource depends on an agreement of the joint owner; or

c.  Making the resource available would place the individual at risk of harm.

11.  An individual may provide proof about a resource anytime, including when asked for proof by the agency or the agency's designee, or if the individual disagrees with a decision made about:

a.  Who owns a resource;

b.  Who has legal control of the resource;

c.  The value of a resource;

d.  The availability of a resource; or

e.  The portion of a property owned by the individual or another person(s).

12.  Resources of certain people who live in the home with the individual are countable, even if they are not getting assistance.  Resources that count toward the resource limit in subsection (6) of this section include the resources of ineligible or financially responsible people as defined in WAC 182-509-0100.

 

 

 

 

 

 

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

CLARIFYING INFORMATION

  1. Legal Barriers: A resource is unavailable if there is a legal barrier to its sale. Examples of legal barriers include:
    1. Property that is tied up in a divorce proceeding.
    2. Jointly owned property that the client cannot sell because the other owners do not agree to sell it.
    3. Property for which the client cannot get a clear title.
    4. The client does not have the necessary funds to retain an attorney.
  2. If the legal barrier can be overcome, require the client to take reasonable steps to do so unless the cost of legal action would be more than the client would gain or the legal action is not likely to succeed.
    1. Exempt the property permanently if the client cannot overcome the barrier.
    2. Treat the property as unavailable and exclude it for the period of time the client attempts to make a resource available. Review the status at each recertification/eligibility review.
    3. If the client overcomes the barrier, count the property to determine the client's eligibility unless the client makes a bona fide effort to dispose of the property as described in 7 below.
  3. If a client must petition the court to release part or all of a resource, including funds in blocked accounts or trusts, it is unavailable. Review the status at each recertification/eligibility review.
  4. Community property is all property held in the name of either the husband or wife or both. We consider community property as a resource potentially available to the assistance unit.
  5. We consider property to be separate property when:
    1. The property was acquired by either spouse before marriage;
    2. The property was acquired as a gift or inheritance by either spouse; or
    3. The property was acquired and paid for entirely out of income from separate property.
  6. Commingling of income from separate property and community income in the purchase, maintenance, or improvement of property may destroy the status of separate property. If you are unable to determine what income paid for what, then the separate property designation is destroyed.
  7. If the client has available nonexempt real property, exclude the property while the client makes a good faith effort to sell it. The client must accept any reasonable offer on the property for this exemption. Good faith efforts include:

a.  Listing the property with a real estate company;

b.  Actively showing the property; and

c.  Placing signs on the property and ads in the newspaper.

d.  Asking a price that is at or under fair market value (FMV).

8. Exclude any non-liquid assets if a creditor placed a lien on the property to secure a business loan and does not allow the AU to sell the property. Examples of non-liquid assets include land, crops, buildings, farm equipment and machinery.

9.  If a resource is currently unavailable, but you are reasonably certain that it will become available, create a tickler to review its status.

10.  When a client owns a resource with someone outside of the AU, such as a joint bank account, we count an equal portion of the resource that belongs to each person who owns it.

WORKER RESPONSIBILITIES

  1. Follow these steps for assistance units (AU) with resources:
    1. Determine whether the AU owns resources, and whether they are available.
    2. Separate the excluded from the countable resources. See WAC 182-509-0205 .
    3. Add the values of all countable resources.
    4. Compare the total countable resources to the appropriate limit.
    5. Set ticklers to review unavailable resources that might become available.
  2. Accept the client’s statement as verification unless it is questionable. This means we use:

a.  What the client enters on the application / eligibility review form. 

b.  What the client tells you during the interview.

3.  When an AU reports receipt of a resource that exceeds the applicable resource limit (by itself or in addition to other countable resources):

a.  Allow the AU 10 days to update the CSO information about the resources it owns and their current value.

     b.  Stop benefits when the AU fails to update its declared resources or its resources exceed the applicable resource limit. See: Letters A. - Related WAC -  WAC 388-458-0030.

4.  When a recipient converts a resource to a new type:

a.  Allow the AU 10 days to update the CSO information about the resources it owns and their current value.

b. Determine whether the new resource is excluded or countable.

c. If the total of all countable resources is over the limit, stop the benefits and provide the AU with advance and adequate notice. See: Letters A. - Related WAC WAC 388-458-0030.


WAC 182-509-0205

WAC 182-509-0205

Effective October 14, 2012

WAC 182-509-0205 MCS resources--How resources count toward the resource limits for medical care services (MCS).

This section applies to medical care services (MCS).

1.  The following resources count toward the resource limit described in WAC 182-509-0200:

a.      Liquid resources not specifically excluded in subsection (2) of this section. These are resources that are easily changed into cash. Some examples of liquid resources are: 

                                i.      Cash on hand;

                              ii.      Money in checking or savings accounts;

                            iii.      Money market accounts or certificates of deposit (CDs) less any withdrawal penalty;

                             iv.      Available retirement funds or pension benefits, less any withdrawal penalty;

                               v.      Stocks, bonds, annuities, or mutual funds less any early withdrawal penalty;

                             vi.      Available trusts or trust accounts;

                           vii.      Lump sum payments as described in this section; or

              viii.   Any funds retained beyond the month of receipt from conversion of federally protected rights or extraction of exempt resources by members of a federally recognized tribe that are in the form of countable resources.

b.      The cash surrender value (CSV) of whole life insurance policies.

c.      The CSV over fifteen hundred dollars of revocable burial insurance policies or funeral agreements.

d.     Funds withdrawn from an individual development account (IDA) if they were removed for a purpose other than those specified in RCW 74.08A.220.

e.      Any real property like a home, land or buildings not specifically excluded in subsection (3) of this section.

f.      The equity value of vehicles as described in WAC 182-509-0210.

g.      Personal property that is not:

                                i.      A household good;

                              ii.      Needed for self-employment; or

                            iii.      Of "great sentimental value," due to personal attachment or hobby interest.

h.        Resources of a sponsor as described in WAC 388-470-0060.

i.         Sales contracts.

2.      The following types of liquid resources are not counted toward the resource limit described in WAC 182-509-0200 when determining eligibility for MCS:

a.      Bona fide loans, including student loans;

b.      Basic food benefits;

c.      Income tax refunds for twelve months from the date of receipt;

d.      Earned income tax credit (EITC) in the month received and for up to twelve months;

e.      Advance earned income tax credit payments;

f.        Federal economic stimulus payments that are excluded for federal and federally-assisted state programs;

g.      Individual development accounts (IDAs) established under RCW 74.08A.220;

h.      Retroactive cash benefits or TANF/SFA benefits resulting from a court order modifying a decision of the department;

i.        Underpayments received under chapter 388-410 WAC;

j.         Educational benefits that are excluded as income under WAC 182-509-0035;

k.    The income and resources of an SSI recipient;

l.     A bank account jointly owned with an SSI recipient if SSA already counted the money for SSI purposes;

m.    Foster care payments provided under Title IV-E and/or state foster care maintenance payments;

n.      Adoption support payments;

o.      Self-employment accounts receivable that the individual has billed to the customer but has been unable to collect;

p.      Resources specifically excluded by federal law; and

q.    Receipts from exercising federally protected rights or extracted exempt resources (fishing, shell-fishing, timber sales, etc.) during the month of receipt for a member of a federally-recognized tribe.

3.      The following types of real property are not counted when determining eligibility for MCS coverage:

a.      A home where the individual, their spouse, or their dependents live, including the surrounding property;

b.      A house the individual does not live in but plans to return to, and the individual is out of the home because of:

                                i.      Employment;

                              ii.      Training for future employment;

                            iii.      Illness; or

                             iv.      Natural disaster or casualty.

c.      Property that:

                                i.     The individual is making a good faith effort to sell;

                              ii.      The individual intends to build a home on, if they do not already own a home;

                            iii.      Produces income consistent with its fair market value (FMV), even if used only on a seasonal basis; or

                             iv.      A household member needs for employment or self-employment. Property excluded under this section and used by a self-employed farmer or fisher retains its exclusion for one year after the household member stops farming or fishing.

d.      Indian lands held jointly with the Tribe, or land that can be sold only with the approval of the Bureau of Indian Affairs.

4.      If the individual deposits excluded liquid resources into a bank account with countable liquid resources, the excluded liquid resources are not counted for six months from the date of deposit.

5.      If the individual sells their home, the individual has ninety days to reinvest the proceeds from the sale of a home into an exempt resource.

a.      If the individual does not reinvest within ninety days, the agency or the agency's designee will determine whether there is good cause to allow more time. Some examples of good cause are:

                                i.      Closing on a new home is taking longer than anticipated;

                              ii.       The individual is unable to find a new home that is affordable;

                            iii.      Someone in the household is receiving emergent medical care; or

                             iv.      The individual has children or dependents that are in school and moving would require them to change schools.

b.      If good cause is determined, more time will be allowed based on the individual's circumstances.

c.      If good cause is not determined, the money received from the sale of the home is considered a countable resource.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

CLARIFYING INFORMATION

  1. Some examples of resources that are excluded for MCS are:
    1. Personal effects;
    2. Benefits from the Basic Food Program;
    3. LIHEAP payments;
    4. One burial plot for each AU member; and
    5. The income and resources of an SSI recipient.
  2. Some examples of lump sums for cash assistance are:
    1. Cash prizes;
    2. Awards;
    3. Lottery winnings;
    4. Refunds of cleaning, damage, security, or utility deposits; and
    5. Insurance or damage settlements, some or all of which may be excluded. See LUMP SUM PAYMENTS for more information.
  3. Sentimental Value Exemption

The exemption of a resource due to “great sentimental value” is limited to personal property. Vehicles are counted or exempted as defined in WAC 182-509-0210.

  1. A trust fund is considered unavailable for MCS when:
    1. A household member cannot revoke the trust or change the beneficiary;
    2. The trustee administering the funds is not under the direction of a household member or is appointed by the court with court-imposed limitations on the use of the funds;
    3. The funds are used solely to make investments on behalf of the trust or pay for medical or educational expenses for a specific household member; and
    4. The investments made on behalf of the trust do not directly involve or assist any business or corporation under the control, direction, or influence of a household member.
    5. The client must petition the court to release part or all of a resource, including funds in blocked accounts or trusts. Review the status at each recertification/eligibility review.
  2. Real Property
    1. Public rights of way, such as roads that run through the surrounding property and separate it from the home, will not affect the exemption of the property.
    2. Definition of a “good faith effort to sell” real property:
      1. Listing the property with a real estate company;
      2. Actively showing the property;
      3. Placing signs on the property and ads in the newspaper; and
      4. Asking a price that is at or under fair market value (FMV).

Real and Personal Property Used for Self-Employment

  1. For MCS, real and personal property used for self-employment are excluded if:
    1. The property is necessary to restore the client's independence or will aid in rehabilitating the client or the client's dependents; and
    2. The client has an approved self-employment plan for when they return to work. 
  2. Examples of real or personal property used in a self-employment business include:
    1. Farm Land;
    2. Farm Machinery;
    3. Livestock;
    4. Business Equipment; and
    5. Business Inventory.
  3. For MCS, an approved self-employment plan must include the following:
    1. A time frame that the client's business will produce enough income to reduce the assistance unit's need for MCS.
    2. A requirement for the client to give the department adequate verification to verify the business' assets and expenses on a monthly basis. See: Income - Special Income Types  (MCS)
    3. A statement of understanding between the client and the department that the real and personal property of the business will be excluded as long as there is an agreed plan.
    4. If the client does not sign an agreed plan, the value of all real and personal property of the business will count toward the assistance unit's resource limit.

WAC 182-509-0210

WAC 182-509-0210

Effective October 14, 2012

WAC 182-509-0210 MCS resources--How vehicles count toward the resource limit for medical care services (MCS).

This rule applies to medical care services (MCS).

  1. A vehicle is any device for carrying persons and objects by land, water, or air. 

  2. The entire value of a licensed vehicle needed to transport a physically disabled assistance unit member is excluded.

  3. The equity value of one vehicle up to five thousand dollars is excluded when the vehicle is used by the AU or household as a means of transportation.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

CLARIFYING INFORMATION

1.      To be considered a vehicle, the transportation device must have a motor. If it does not have a motor, it is considered personal property.

2.      To determine the fair market value of a vehicle, check the current value as listed in the Kelley Blue Book @ http://www.kbb.com/ or N. A. D. A. guides @  http://www.nadaguides.com/.  The amount owed on the vehicle is subtracted from the value to determine the amount of equity the person has in the vehicle.  The amount of the resource is the equity value. 

3.      Even though motor homes are vehicles, we do not treat them like vehicles for MCS assistance. We treat motor homes the same way we treat real property. See WAC 182-509-0205  for how to treat real property.

4.      To determine if a vehicle should be considered a motor home, use this definition:

A motor home is a vehicle that is designed to provide temporary living quarters for recreational, camping, or travel use. It is built on or permanently attached to a self-propelled motor vehicle chassis or on a chassis cab or van that is an integral part of the completed vehicle.

Modification Date: December 7, 2011