WAC 388-515-1512 What are the financial requirements for the DDD waiver services if I am eligible for Medicaid under the noninstitutional categorically needy program (CN)



1. You automatically meet income and resource eligibility for DDD 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.  This includes SSI clients under 1619B status. These clients have Medicaid eligibility determined and maintained by the Social Security Administration;
   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;
   4. CN Medicaid for a child as described in WAC 182-505-0210  (1), (2), (7) or (8); or
   5. Aged, blind or disabled (ABD) cash assistance described in WAC 388-400-0060.
2. If you are eligible for a CN-P Medicaid program listed in subsection (1) above, you do not have to pay (participate) toward the cost of your personal care and/or habilitation services.
3. If you are eligible for a CN Medicaid program listed in subsection (1) above, 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), you pay up to the ADSA room and board standard described in WAC 388-515-1507. Room and board and long-term care standards are located at http://www.dshs.wa.gov/manuals/eaz/sections/LongTermCare/LTCstandardspna.shtml.
   1. If you live in an ARC, AFH or DDD group home, you keep a personal needs allowance (PNA) and use your income to pay up to the ADSA room and board standard.  Effective January 1, 2009 the PNA is sixty-two dollars and seventy-nine cents. 
5. If you are eligible for a premium based Medicaid program such as healthcare for workers with disabilities (HWD), you must continue to pay the Medicaid premium to remain eligible for that CN-P program.