WAC 182-515-1512

Effective January 1, 2013

WAC 182-515-1512 What are the financial requirements for the DDA waiver services if I am eligible for Medicaid under the noninstitutional categorically needy program (CN)

Emergency WAC effective 1-1-2014

  1. You  meet income and resource eligibility for DDA Waiver services if you are eligible for Medicaid under a categorically needy program (CN)under one of the following programs:
    1. Supplemental security income (SSI) eligibility described in WAC 388-474-0001 and chapter 182-510 WAC.  This includes SSI clients under 1619B status. ;
    2. Healthcare for workers with disabilities (HWD) described in WAC 182-5511-1000 through 182-511-1250;   
    3. SSI-related (CN) Medicaid described in WAC 182-512-0100 (2) (a) and (b) or meets the requirements in WAC 182-512-0880  and is CN-P eligible after the income disregards have been applied;
  2. If you are eligible for a CN-P Medicaid program listed in subsection (1) of this section, you do not have to pay (participate) toward the cost of your personal care and/or habilitation services. You are responsible to pay room and board if residing in a residential setting.
  3. If you are eligible for a CN Medicaid program listed in subsection (1) of this section, you do not need to meet the initial eligibility income test of gross income at or below the special income level(SIL), which is three hundred percent of the federal benefit rate (FBR).
  4. If you are eligible for a CN Medicaid program listed in subsection (1) of this section, you pay up to the aging and disability services (ADS)  room and board standard based on the medically needy income level (MNIL) minus the sixty-two dollars and seventy-nine cents personal needs allowance (PNA). Room and board and long-term care standards are located at http://www.hca.wa.gov/medicaid/Eligibility/Pages/index.aspx.  If you live in an ARC, AFH or DDA group home, you keep a personal needs allowance (PNA) and use your income to pay up to the ADS room and board standard.  Effective January 1, 2009 the PNA is sixty-two dollars and seventy-nine cents.
  5. If you are eligible for the premium based Medicaid program, healthcare for workers with disabilities (HWD), you must continue to pay the Medicaid premium to remain eligible for that CN program and pay the ADS room and board rate if residing in a residential ALF setting.
  6. If you are eligible for a CN medicaid program listed in subsection (1) of this section you are subject to equity interest in primary residence, annuity disclosure requirements and are not subject to a penalty period of ineligibility described in WAC 182-513-1315

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.