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WASHCAP

Revised February 26, 2009

Purpose: This section contains rules and procedures for the Washington Combined Application Program (WASHCAP). WASHCAP is a simplified food benefits program for certain SSI recipients. WASHCAP delivers food benefits through an automated interface between Social Security Administration (SSA) and the Department of Social and Health Services (DSHS). A client's application for SSI also acts as the application for food benefits. Clients who receive WASHCAP are certified for up to 36 months.

WAC 388-492-0020 What are WASHCAP food benefits? WAC 388-492-0030 Who can get WASHCAP? WAC 388-492-0040 Can I choose whether I get WASHCAP food benefits or Basic Food benefits? WAC 388-492-0050 How do I apply for WASHCAP? WAC 388-492-0060 How do I get my WASHCAP food benefits? WAC 388-492-0070 How are my WASHCAP food benefits calculated? WAC 388-492-0080 Where do I report changes? WAC 388-492-0090 How often do my WASHCAP food benefits need to be reviewed? WAC 388-492-0100 How is my eligibility for WASHCAP food benefits reviewed? WAC 388-492-0110 What happens if my WASHCAP food benefits end? WAC 388-492-0120 What happens to my WASHCAP benefits if I am disqualified? WAC 388-492-0130 What can I do if I disagree with a decision the department made about my WASHCAP benefits?

Call the WASHCAP Central Unit if you have processing questions at 1-877-380-5784.

WAC 388-492-0020 Effective December 9, 2004 WAC 388-492-0020 What are WASHCAP food benefits? WASHCAP means the Washington State Combined Application Program.   WASHCAP is a simplified food benefits program for certain Supplemental Security Income (SSI) recipients.  Unless specifically stated in this WAC chapter, WASHCAP food benefits follow all the program requirements of the Basic Food Program as described under WAC 388-400-0040. Social Security Administration (SSA) asks you if you want to get food benefits when you apply for SSI in Washington State. If you meet the requirements of WAC 388-492-0030, you will get WASHCAP food benefits unless you can choose Basic Food benefits under WAC 388-492-0040. If you are eligible for WASHCAP food benefits under WAC 388-492-0030, SSA electronically sends us the information we need to open your WASHCAP food benefits. WASHCAP food benefits begin the first month after the month you are eligible for ongoing SSI. You do not have to go to your local Community Services Office (CSO) to apply for WASHCAP. If you want Basic Food benefits before WASHCAP food benefits begin, you can apply for Basic Food at your local CSO, Home and Community Services Office (HCS), or SSA. While you get WASHCAP food benefits, you must report all changes to SSA. SSA shares the changes you report to them with your WASHCAP worker. You do not have to report changes to your WASHCAP worker. See 388-492-0080. 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 Who maintains WASHCAP food benefits? The WASHCAP centralized unit maintains the majority of WASHCAP AUs; Home and Community Services (HCS) maintains WASHCAP food AUs for clients receiving other services from HCS. Who has responsibility for SSI Medicaid cases? The WASHCAP centralized unit maintains SSI Medicaid AUs for WASHCAP food benefit clients; HCS maintains SSI Medicaid AUS for their WASHCAP clients. When do I receive WASHCAP food benefits? WASHCAP begins the first of the month following SSI approval for ongoing benefits.

WAC 388-492-0030 Effective December 9, 2004 WAC 388-492-0030 Who can get WASHCAP? You can get WASHCAP food benefits if: You are eligible to receive federal SSI benefits; and  You are eighteen years of age or older; and You live alone, or SSA considers you as a single household; or You live with others but buy and cook your food separately from them; and You do not have earned income when you apply for SSI; or You already get WASHCAP food benefits, become employed and receive earned income for less than three consecutive months; or You already get WASHCAP and move to an institution for ninety days or less. You are not eligible for WASHCAP food benefits if: You live in an institution; You are under age eighteen; You live with your spouse; You are under age twenty-two and you live with your parent(s) who are getting Basic Food benefits; You begin working after you have been approved for WASHCAP and have earned income for more than three consecutive months; You live with others and do not buy and cook your food separately from them; or You are ineligible for Basic Food benefits under WAC 388-400-0040 section 13(b) and (e). Editor's Note:  The correct reference is section 14 (b) and (e) of WAC 388-400-0040. We accept SSA information about your WASHCAP eligibility unless you prove the information is not accurate. 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 SSI clients living in institutions SSI clients who live in an institution are not eligible for WASHCAP. When we know that a client has moved to an institution, they are not eligible for WASHCAP. There is no overpayment or payment error when a WASHCAP client lives in an institution 90 days or less, continues to receive WASHCAP benefits, and we did not know the client was institutionalized. There is an overpayment and a payment error when a WASHCAP client lives in an institution for more than 90 days and continues to receive WASHCAP benefits. When clients must reapply for WASHCAP Clients institutionalized for more than 30 days must reapply for WASHCAP benefits. If the client needs food benefits before WASHCAP benefits become effective, they can apply for Basic Food benefits.

WORKER RESPONSIBILITIES When you know a client moved to an institution Update the living arrangement code on the DEM screen to close the food benefits; Update the INST screen with appropriate code; Transfer the medical AU to the CSO or HCS when appropriate; and If the client returns to their home in less than 30 days (full issuance month), reinstate their WASHCAP benefits.

WAC 388-492-0040 Effective March 1, 2007 WAC 388-492-0040 Can I choose whether I get WASHCAP food benefits or Basic Food benefits? You can choose to have Basic Food benefits instead of WASHCAP food benefits when: Your out-of pocket medical expenses are more than thirty-five dollars a month; You chose to have Basic Food benefits instead of WASHCAP benefits prior to April 25, 2005: or Your food benefits under Basic Food would be at least forty dollars more due to excess shelter costs under WAC 388-450-0190(1)(a) through (e) or legally obligated child support payments. 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 WASHCAP eligible clients may only opt-out of the program if they meet the specific criteria in the WAC, and request to apply for benefits under Basic Food. Opt-outs prior to April 25, 2005 Basic Food recipients who opted out or were not converted to WASHCAP prior to April 25, 2005 may elect to remain in the Basic Food program instead of WASHCAP as long as they remain continuously eligible for Basic Food. This includes individual who opted out under the Chamberlain court order. Field workers who think a client is WASHCAP eligible and no “alt” benefit amount appears on the FSFI should contact the WASHCAP central unit for a case review. When we look at child support costs to decide if a household can opt out of WASHCAP under WAC 388-492-0040 #3, the expense must be legally- obligated support for a child outside the home. We can only consider support being paid. Having a debt with DCS alone does not qualify a client for a child support deduction. We use the amount we can reasonably anticipate the person paying to determine if they would receive at least $40 more benefits under Basic Food.

NOTE: If a WASHCAP eligible client does not meet the opt-out criteria, they must receive their benefits through WASHCAP.

WORKER RESPONSIBILITIES When you opt clients out of WASHCAP If a WASHCAP client meets opt-out criteria, explain the differences between WASHCAP and Basic Food. Clients may choose to participate in WASHCAP even if they meet the opt-out criteria and would receive more benefits from Basic Food. Clients opting out of WASHCAP must complete the Basic Food application or review process in their local CSO. WASHCAP workers only transfer WASHCAP cases to the field when a client has filed a Basic Food application as defined in WAC 388-406-0010, and the local CSO requests the case. When you discover WASHCAP eligible clients If they do not meet one of the specific opt-out criteria, clients must be transferred to the WASHCAP unit. Be sure to review case notes for clients who opted out prior to 4/25/05 or were opted out as part of the Chamberlain court order. WASHCAP workers manually convert transferred-in cases.

WAC 388-492-0050 Effective December 9, 2004 WAC 388-492-0050 How do I apply for WASHCAP? You apply for WASHCAP food benefits at Social Security Administration (SSA) when you apply for Supplemental Security Income (SSI).  If you want food benefits, your SSA worker will ask you WASHCAP food eligibility questions when you have your SSI interview. If you are eligible for WASHCAP food benefits, your benefits will start the first of the month after the month you are eligible for ongoing SSI benefits. If you need food benefits in five days or less, you must apply for expedited services at: Your local community service office (CSO); Your local home and community services office (HCS) if you get long-term care services; or The SSA office if you give them an application for Basic Food expedited services when you apply for SSI.  SSA forwards the Basic Food application to the local CSO to process. If you want Basic Food benefits before you get SSI, you must apply at: SSA if you give them a Basic Food application when you apply for SSI; Your local CSO; or Your local HCS office if you get long-term care services. If you already receive SSI and want WASHCAP food benefits, you can apply at: Your SSA office; Your local CSO; Your local HCS office if you get long-term care services. By contacting the WASHCAP central unit with an application form request. If you get Basic Food benefits, these benefits will continue: Through the end of your certification period; or Through the month before your WASHCAP food benefits start. If your Basic Food benefits end before you are eligible for WASHCAP food benefits, you must reapply to continue these benefits. If you get Basic Food benefits and you become eligible for WASHCAP food benefits, we will automatically change your Basic Food benefits to WASHCAP food benefits. 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 Basic Food applications (DSHS 14-001) taken at SSA: SSA has the client complete page one of the application for Basic Food. SSA faxes the application to the local CSO for processing. WASHCAP application (DSHS 14-439): The WASHCAP application includes the following eligibility declarations: I live alone, or I buy and fix my food separately from other people in the house; I pay $_______(my share) for rent/mortgage each month. WASHCAP/HCS workers manually open WASHCAP benefits when we receive the application. WASHCAP brochure (DSHS 22-480): The WASHCAP brochure explains the client’s rights and responsibilities. Client’s get the brochure when: They have their SSI interview; or ACES auto-opens the WASHCAP AU; and At recertification for WASHCAP food benefits.. When clients want expedited service Expedited service is not available through WASHCAP. Clients must apply for Basic Food benefits to receive expedited services. How ACES decides a client is eligible for WASHCAP ACES receives a daily SDX file from SSA. ACES opens a WASHCAP AU when the SDX shows the client: Is eligible for federal SSI benefits; Has no earned income; Is in a SSA living arrangement “A” on the SDX; Is single or separated; and Is at least 18 years old. Automated WASHCAP approval ACES auto-opens WASHCAP when the SDX "Fs Appl Cd" indicator is "Y" or "N". WASHCAP approved clients receive the DSHS 02-28 approval letter explaining: The client’s current Basic Food benefit if applicable; and The client’s WASHCAP benefit. When do clients receive WASHCAP food benefits? WASHCAP begins the first of the month following SSI approval for ongoing benefits. Automated WASHCAP approval: An alert will be sent to the worker when WASHCAP does not auto-open. ACES will not automatically open WASHCAP when the: Client gets DO1 or DO2 medical; DEM screen marital status is “A” or “M”; Name or date of birth is mismatched; Client is FAP; Client already receives food benefits in another AU; Client has a current food stamp disqualification; or Client’s ACES living arrangement type for Basic Food is one of the following: AD Adoption Support Non IV-E IL Invalid Living Arrangement AE Adoption Support IV-E IM IMD AF Alternate Living Facility (ALF) IT Involuntary Treatment Act in IMD AS Alien Sponsor, Home w/Spouse JL City/County Jail BO Boarder JR Juvenile Rehabilitation BS Boarding School MR IMR CB Commercial Boarding Home NA Non-Adatsa Alcohol & Drug Treatment Center DC Assisted Living Dept Contract NF Nursing Facility FC Foster Care Non-Title IV-E PR State/Federal Prison FE Foster Care Title IV-E TA Temporary Absence FH Adult Family Home TF Temporary Absence - In Foster Care GH DDD Group Home (Large - 17+) VH Veteran Home HS Hospital

WORKER RESPONSIBILITIES When ACES doesn't auto-open WASHCAP The system sets an alert for the worker. If you get this alert, take the following actions: Decide if the client is WASHCAP eligible; Deny the AU if the client is not WASHCAP eligible; Resolve the discrepancy preventing the auto-open.

NOTE: If the client isn't eligible for WASHCAP, the WASHCAP worker at the central unit or HCS office will deny the client's application.  If the client wants to apply for Basic Food, send DSHS 14-001, Application for Benefits, to the client.

When a WASHCAP-eligible client applies for Basic Food at the CSO: Process the request for benefits using Basic Food application and verification procedures; Issue any benefits the client is eligible to receive for the application month; If an alternate amount appears on the FSFI screen, transfer the ongoing case to the WASHCAP unit unless: The client is an HCS client; or The client opts out of WASHCAP under WAC 388-492-0040. If the alternate amount does not appear on the FSFI screen, the client is not WASHCAP eligible, unless there is a coding mismatch in ACES. WASHCAP application (DSHS 14-439) received in the CSO Discuss with the client whether they want to pursue Basic Food; If yes, accept the application as filed and proceed with the Basic Food application process. Transfer ongoing months to the WASHCAP unit as appropriate. If the client wants WASHCAP benefits only, fax the application to the WASHCAP unit. If the client is unavailable, fax the WASHCAP application to the WASHCAP unit for processing at (866) 586-5499, or if the client is active with HCS, forward the application to the HCS office.

WAC 388-492-0060 Effective December 9, 2004 WAC 388-492-0060 How do I get my WASHCAP food benefits? If you are eligible for WASHCAP, you will get your food benefits through electronic benefits transfer (EBT).  The department issues your EBT food benefits according to WAC 388-412-0025. 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 Issuing an EBT / QUEST Card When ACES opens WASHCAP it triggers JP Morgan Chase (formerly Citibank) to mail an EBT card. Clients receive their WASHCAP EBT card within 7 days of the SDX interface showing WASHCAP approval. Clients are instructed to select their own PIN through the Personal PIN selection process by calling the 1-888-328-9271 toll-free number when they receive their EBT card in the mail.

WAC 388-492-0070 Effective October 1, 2009 WAC 388-492-0070 How are my WASHCAP food benefits calculated?  We calculate your food benefits as follows:    We begin with your gross income. We subtract one hundred forty-one dollars from your gross income to get your countable income. We figure your shelter cost based on information we receive from Social Security Administration (SSA), unless you report a change as described under WAC 388-492-0080. If you pay: Three hundred dollars or more a month for shelter, we use three hundred seventy-nine dollars as your shelter cost; or Less than three hundred dollars for shelter, we use one hundred eighty-two dollars as your shelter cost; and We add the current standard utility allowance under WAC 388-450-0195 to determine your total shelter cost. We figure your shelter deduction by subtracting one half of your countable income from your shelter cost. We figure your net income by subtracting your shelter deduction from your countable income and rounding the resulting figure up from fifty cents and down from forty-nine cents to the nearest whole dollar. We figure your WASHCAP food benefits (allotment) by: Multiplying your net income by thirty percent and rounding up to the next whole dollar; and Subtracting the result from the maximum allotment under WAC 388-478-0060. If you are eligible for WASHCAP, you will get at least the minimum monthly benefit for Basic Food under WAC 388-412-0015. 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 Calculating WASHCAP benefits 1.      We rely on the gross income as updated by the SDX from SSA as described in WAC 388-492-0030 Effective December 9, 2004 WAC 388-492-0030 Who can get WASHCAP? You can get WASHCAP food benefits if: You are eligible to receive federal SSI benefits; and  You are eighteen years of age or older; and You live alone, or SSA considers you as a single household; or You live with others but buy and cook your food separately from them; and You do not have earned income when you apply for SSI; or You already get WASHCAP food benefits, become employed and receive earned income for less than three consecutive months; or You already get WASHCAP and move to an institution for ninety days or less. You are not eligible for WASHCAP food benefits if: You live in an institution; You are under age eighteen; You live with your spouse; You are under age twenty-two and you live with your parent(s) who are getting Basic Food benefits; You begin working after you have been approved for WASHCAP and have earned income for more than three consecutive months; You live with others and do not buy and cook your food separately from them; or You are ineligible for Basic Food benefits under WAC 388-400-0040 section 13(b) and (e). Editor's Note:  The correct reference is section 14 (b) and (e) of WAC 388-400-0040. We accept SSA information about your WASHCAP eligibility unless you prove the information is not accurate. 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.

WORKER RESPONSIBILITIES When a client's shelter cost changes If you find out that a WASHCAP client’s shelter cost has changed, verify the change as appropriate and update the change on the ACES WCAP screen to inform SSA to allow the appropriate WASHCAP shelter cost.  See WASHCAP in the ACES User Manual .

WAC 388-492-0080 Effective December 9, 2004 WAC 388-492-0080 Where do I report changes? You report all changes to Social Security Administration (SSA) according to their reporting requirements. Social Security reports these changes to your WASHCAP worker.    SSA will not accept or report shelter cost changes to WASHCAP until SSA does its redetermination. You do not have to report any changes to your WASHCAP worker. You can choose to report the following changes to your WASHCAP worker to see if you will get more food benefits: A change in your address; An increase in your shelter costs; or An increase in your out-of-pocket medical expenses. If changes are reported to DSHS, proof may be required. If you report a change that could increase the amount of your food benefits, we will not increase the benefit amount if we have asked for proof and it has not been provided. 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 Reporting changes to SSA Clients must tell SSA when changes happen. Changes the client is required to report to SSA may differ from changes the client is normally required to report to DSHS. SSA also requires that the client report changes within 10 days after the month in which the change occurred. When SSA tells DSHS about changes SSA gives DSHS new information using the SDX interface. ACES will either automatically act on the change or set an alert for the worker to take action.

EXAMPLE Client moves on the 15th of January. The client must report this change to Social Security by February 10th.

When ACES automatically takes action When ACES opens WASHCAP for a new SSI client who has never received Basic Food, ACES will: Deny food benefits for the month that ongoing SSI was approved; and Open WASHCAP the first of the following month. An existing Basic Food AU will be converted to WASHCAP when ACES receives an SDX with WASHCAP codes “Y” or “N” on the SDX Fs Appl Cd field. ACES also: Transfers cases to the WASHCAP central unit # 130 when appropriate; Sends an application to WASHCAP clients 45 days prior to the end of the client’s certification period; and Closes WASHCAP when the client no longer meets WASHCAP eligibility criteria. ACES sends an alert to the worker when: The client has current ADATSA coding on the INST screen. The clients living arrangement on an active case prevents the case from auto-opening. Someone else is active on the client's current Basic Food AU. ACES shows earned income and the SDX does not. The demographics on the SDX and in ACES do not match. The client is a recipient on any AU with another member. The client is on a DO1 AU. The client is disqualified from food benefits. The client is pending on a Basic Food AU or pending on a Basic Food AU with another client.

WORKER RESPONSIBILITIES When WASHCAP clients report changes to you: CSO workers should forward the reported information and supporting documentation (if any) to the WASHCAP unit. WASHCAP and HCS workers should update ACES with changes of address and remind the client to report the change to SSA. WASHCAP and HCS workers may confirm reported changes in non-utility shelter costs.

EXAMPLE Jennifer, who is receiving the high shelter deduction, calls to report that she has been approved for HUD housing. Her rent amount will drop below the threshold. Workers should update the shelter amounts and change Jennifer’s WASHCAP shelter allowance.

3. WASHCAP and HCS workers must confirm reported changes above $35 in out-of-pocket medical expenses and give the client the choice to opt-out of WASHCAP under WAC 388-492-0040.

ACES PROCEDURES See  Washingtion State Combined Application Project (WASHCAP)

WAC 388-492-0090 Effective November 1, 2008 WAC 388-492-0090 How often do my WASHCAP food benefits need to be reviewed? Your eligibility for WASHCAP food benefits must be reviewed at least every thirty-six months.  Your certification period is the amount of time your assistance unit is eligible for WASHCAP food benefits. 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 When the WASHCAP certification period begins The certification period for clients not already receiving Basic Food is 36 months and begins the first of the month following SSI approval for on-going benefits. To determine the certification period for newly approved SSI clients already receiving Basic Food, ACES: Subtracts the number of months the client has already received Basic Food in their current certification period from the maximum 36-month WASHCAP certification period; The difference is the new WASHCAP certification period.

EXAMPLE Client was approved benefits from November through October (1 year). The client starts getting SSI and becomes a WASHCAP client effective with February benefits. The client received Basic Food benefits from November through January in the current certification (3 months). ACES will subtract 3 months from the 36-month certification. The client's first WASHCAP certification period is 33 months.

WAC 388-492-0100 Effective December 9, 2004 WAC 388-492-0100 How is my eligibility for WASHCAP food benefits reviewed? If Social Security Administration (SSA) reviews your Supplemental Security Income (SSI) eligibility, they will also complete your review for WASHCAP.  SSA sends us this information electronically and we will automatically extend your WASHCAP certification period.  If SSA does not review your SSI eligibility, we will mail you a one-page application two months before your WASHCAP food benefits end. You must complete and return this application to the WASHCAP unit or your local Home and Community Services office (HCS). We do WASHCAP reviews by mail.  If you bring your WASHCAP application to the local office, we will process the application as follows: If you get long-term case services, your local HCS office will process your application; or If you do not get long-term care services, the local office will forward your application to the WASHCAP central unit. If we get your completed one-page application after your WASHCAP food benefits end, we will reopen your benefits back to the first of the month if: We get your application form within thirty days from the end of your certification period; and You are still eligible for WASHCAP food benefits. If we get your completed one-page application form more than thirty days after your benefits end, your WASHCAP food benefits open the first of the next month after you turn in your application and SSA shows you are eligible for WASHCAP in their system. If your application is not complete, we will return it to you to complete. If you want Basic Food benefits while you are waiting for WASHCAP food benefits, you must apply for these benefits at the local CSO or HCS office. 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 Updating WASHCAP Certifications When SSA completes a SSI redetermination on a WASHCAP client, ACES automatically updates the WASHCAP case to: A new 36-month certification period; The new certification period starts the month after the month that SSA completed the SSI redetermination. When SSI does not complete a SSI redetermination prior to WASHCAP certification ending, ACES: Sends the client a review letter and a WASHCAP application (DSHS 14-439) forty-five days before the WASHCAP certification period ends; Sends a letter thirty days prior to the certification end date if the client has not returned a completed application; Closes WASHCAP if the case is not recertified by deadline. WASHCAP cases can be reopened back to the first of the month if the client returns the application within 30-days of the end of the certification period (See example below).

EXAMPLE On June 1st ACES sends the client a one-page application form. The recertification was not done because the client did not complete and return the application form. The case closes July 31st. On August 12th, the client returns the completed application. The worker reopens the WASHCAP case back to August 1st.

WAC 388-492-0110 Effective December 9, 2004 WAC 388-492-0110 What happens if my WASHCAP food benefits end? If your WASHCAP food benefits end because you did not have the review required under WAC 388-492-0100, you must finish the required review or apply for Basic Food benefits at: Your local community services office (CSO); or  Your Home and Community Services (HCS) office. If your WASHCAP benefits end because you are disqualified under WAC 388-400-0040 (13) (b) or (e), you are not eligible for Basic Food benefits and: If you get medical assistance, we will send your medical assistance case to your local office.  If you are a HCS client, your medical case will remain at HCS. If your WASHCAP benefits end for any other reason: We will send you an application for Basic Food benefits along with: Information about what you must verify in order to get benefits; and The address of your local CSO.  If you are an HCS client, your case will remain at your HCS office. For the local CSO to decide if you are eligible for Basic Food benefits, you must: Finish the application process for Basic Food benefits under chapter 388-406 WAC; and Have an interview for Basic Food benefits under WAC 388-452-0005. If you get medical assistance, we will send your medical assistance case to the local CSO unless you are an HCS client; If your WASHCAP case closed because SSA ended your SSI, you will receive the same medical benefits until we decide what medical programs you are eligible for under  WAC 388-418-0025. 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.

worker responsibilities When a client is terminated from WASHCAP and submits a WASHCAP Application (14-034) WASHCAP staff will deny WASHCAP benefits if the client is ineligible for WASHCAP. They will document their action and add notes in the ACES narrative to alert the local office to consider the 14-034 as a request for benefits under WAC 388-406-0010.

WAC 388-492-0120 Effective December 9, 2004 WAC 388-492-0120 What happens to my WASHCAP benefits if I am disqualified? If you are disqualified from receiving SSI for any reason, you will not be able to get WASHCAP food benefits. See WAC 388-492-0030, Who can get WASHCAP?  If you are disqualified from receiving Basic Food assistance for any reason, you will not get WASHCAP food benefits. This includes clients who: Are ineligible under WAC 388-400-0040 (13) (b) and (e) and WAC 388-442-0010; or Did not cooperate with quality assurance as required under WAC 388-464-0001. 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 When the WASHCAP client has an Intentional Program Violation (IPV), ACES: Runs a cross-match with the Disqualified Recipient System (DRS) file on every new WASHCAP case to identify IPV cases. Sends a letter to the client explaining the disqualification and when the disqualification ends. Sends a State Verification Exchange System (SVES) inquiry at the end of the disqualification period asking for a new SDX record. Monitors the SANC screen and on-going disqualification interface to: Check for disqualification extensions; Notify the client if their disqualification period has been extended; Take appropriate action if the disqualification period has been shortened. Sends an alert to the worker if the disqualification becomes a permanent disqualification.

WORKER RESPONSIBILITIES When ACES sends a disqualification alert Review the case to see if you should apply the disqualification: If applicable, close the case following adverse action rules. See WAC 388-458-0030  for advance notice rules. Send client a letter to inform them of the disqualification and the date the disqualification will end. See WAC 388-418-0020  for Effective Dates for Changes. Document your actions if the disqualification is not valid (i.e. the disqualification period is over). If the client is permanently disqualified: Update the (SANC) screen in ACES. Send a letter to the client about the disqualification; and Document in the record that the client is permanently disqualified from Basic Food and the reason for the disqualification. Cooperation with Quality Assurance: If you receive a notice that a client refused to cooperate with Quality Assurance, follow the Worker Responsibilities under WAC 388-464-0001.

WAC 388-492-0130 Effective December 9, 2004 WAC 388-492-0130 What can I do if I disagree with a decision the department made about my WASHCAP benefits? If you disagree with a decision about your benefits, you may ask for a fair hearing.  You can ask for a hearing by contacting the WASHCAP Central Unit, Home and Community Service Office or any responsible department or office of administrative hearings employee. See chapter 388-02 WAC  for information on the fair hearing process.  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 WASHCAP clients have the same fair hearing rights as other clients. This includes the right to continued benefits pending a hearing.

WORKER RESPONSIBILITIES When the client requests a hearing If a client requests a hearing, keep the WASHCAP case with the Central Unit or Home and Community Services office. See FAIR HEARING - Hearing Request. If you are waiting for a fair hearing decision on a terminated WASHCAP case: Open Basic Food for the continued benefits; Use the WASHCAP shelter costs and the client’s SSI income; Make certain the benefits issued are the same amount the client received under WASHCAP; Set an alert to check on the fair hearing decision. What to do when you get the results of the hearing If the department is affirmed, reduce or terminate the benefits; Set up an overpayment for any amount the client received in continued benefits.

How is WASHCAP different from Basic Food? Federal regulations set the rules for the Washington Basic Food Program (Basic Food). See the table below for some of the differences between WASHCAP and Basic Food: WASHCAP Basic Food The WASHCAP food assistance application is one page long. The interview for SSI is also the interview for WASHCAP. The application for Basic Food is longer, and clients must complete an additional interview. A client must be eligible for SSI to be eligible for WASHCAP. A client does not have to be eligible for get SSI to be eligible for Basic Food. A client is eligible for WASHCAP if they get SSI benefits and SSA determines that the client: Meets the definition of "Living arrangement A" (living alone); Purchases and prepares food separately; and Has no earned income. We decide if an assistance unit is eligible for Basic Food based on the client's living arrangements, who they purchase and prepare food with, and other eligibility factors under WAC 388-400-0040 and 388-400-0045. A client must complete an application for benefits every 36 months unless SSA has recertified their SSI benefits. When SSA has recertified a client's SSI benefits, their WASHCAP benefits are automatically extended for 36 months from the date SSA recertified the client's SSI. Depending on the client's age and other circumstances, a client may have to complete an application and have an interview for benefits every 6 to 12 months. A client does not have to give us proof of their circumstances. SSA gives us this information. A client must give us proof of their income, rent or mortgage, utilities, medical expenses, living, and eating arrangements. A client must tell SSA about changes within ten calendar days after the month the change happened. The client does not report this change to DSHS. A client must report certain changes to the local office.  The client may have to provide proof of the changes. If the client gets SSI, they must also tell SSA about the change within ten calendar days after the month the change happened. A client's WASHCAP benefits start the first of the month after the month SSA starts their ongoing SSI benefits. We do not prorate WASHCAP benefits. A client's Basic Food benefits usually start from the date the client applied for Basic Food benefits. We determine the exact date the client's benefits are effective under WAC 388-406-0055. We prorate the first month's benefits based on this date. We do not offer expedited service for WASHCAP benefits. A client that qualifies for expedited service can get Basic Food within five days of the date the client applied for benefits.

ACES PROCEDURES See  Washingtion State Combined Application Project (WASHCAP)

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Modification Date: February 26, 2009

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