The Eligibility A-Z (EA-Z) Manual provides administrative rules and procedures for staff to determine initial and ongoing eligibility for people applying for and receiving cash and food assistance in Washington State and provides links to medical assistance eligibility information.
The Economic Services Administration (ESA) Community Services Division (CSD) provides periodic newsletters and bulletins about our activities. You can subscribe to any or all of these by going to https://public.govdelivery.com/accounts/WAESA/subscriber/new and entering your email address. Once you submit your email address, you’ll see a list of these newsletters and bulletins and you can choose which ones you want to subscribe to. Please note: Your privacy is important to us. Your email will not be shared and you can unsubscribe to any of these at any time.
Community Services Division (CSD)
Draft Rule (WAC) Changes – When State or Federal law changes, we update the Washington Administrative Code (WACs). Drafts of the changes are available for your comments and ideas. Your ideas matter to us.
Rule (WAC) Filings – When we update the Washington Administrative Code (WACs), they are published by the Code Revisers Office but we can send these directly to you. You’ll find CR-101s (notice of an intent to change a rule), CR-102s (drafts of our changes) and CR-103s (notice that the change is being implemented).
This page lists the Washington Administrative Codes (WACs) used throughout the Eligibility A-Z Manual. Use the "Find on this Page" (Ctrl+F) feature to quickly search for a WAC number or title.
Revised on: October 15, 2024
Eastern or Western State Hospital
Individuals residing in Eastern or Western State Hospital are potentially eligible for the Aged, Blind, or Disabled (ABD) program if they meet all other eligibility criteria per WAC 388-400-0060. If ABD is approved, individuals are eligible for a clothing, personal maintenance, and necessary incidentals (CPI) monthly grant up to $41.62.
At Admission/ABD application: Eastern and Western State Hospital staff help patients submit ABD cash applications after their admission. Hospital staff will only submit ABD applications for patients who are civilly committed or “not guilty by reason of insanity.” Home and Community Services (HCS) and Developmental Disabilities Administration (DDA) staff process ABD applications (and recertifications) for patients age 20 or under and age 65 and over (Title 19). CSD staff process applications (and recertifications) for patients age 21-64.
At Discharge: Eastern and Western State Hospital staff help patients submit food/cash applications at discharge. HCS and DDA staff process discharge applications (and ABD recertifications) for patients discharging to their services/care. Remaining discharge applications (and ABD recertifications) are processed by CSD staff.
Civilly Committed to a Community-Based Facility
At ABD Application: Patients who are civilly committed to a treatment facility managed by the Behavioral Health Administration, such as Maple Lane, Oak Cottage, or Olympic Heritage, will need to complete a financial interview and provide medical evidence. These facilities do not have an interview waiver or presumptive eligibility per WAC 388-449-0001 and WAC 388-434-0005.
If ABD is approved, individuals are eligible for a clothing, personal maintenance, and necessary incidentals (CPI) monthly grant up to $41.62.
NOTE: For ABD recipients who are discharged from Eastern and Western State Hospital to a community-based facility, see Clarifying Information #1 for WAC 388-449-0150.
Interview and Medical Evidence Requirements
Facility Name |
Public Institution? |
Financial Interview Required? |
Medical Evidence Required? |
Eastern/Western State Hospital |
Yes |
No |
No |
Oak Cottage |
No |
Yes |
Yes |
Maple Lane |
No |
Yes |
Yes |
Olympic Heritage |
No |
Yes |
Yes |
See the following WACs for additional information:
WAC 388-400-0060: Who is eligible for aged, blind, or disabled (ABD) cash assistance?
You may be eligible for ABD if you reside in Eastern or Western State Hospital or are civilly committed to a community-based facility and meet all other eligibility requirements.
You are not eligible for ABD if you are in the custody of or confined in a public correctional facility such as a state prison, or city, county or tribal jail, including placement in a work release program.
Forensic patients are individuals who have been admitted to Eastern or Western State Hospitals through the criminal justice system.
Patients who have been determined “not guilty by reason of insanity” (NGRI) have had their competency restored, completed their court process, pleaded NGRI and have been adjudicated. These patients are potentially eligible for ABD.
Competency evaluation and restoration patients are committed under RCW 10.77. Competency is the ability of the person to understand and participate in the court process. This population have not had their crimes adjudicated and are considered in custody of or confined to a public correctional facility. These individuals are not eligible for ABD.
WAC 388-434-0005: How often does the department review my eligibility for benefits?
Specialized eligibility staff review financial eligibility for ABD recipients residing in Eastern or Western State Hospital every 24 months and at discharge.
WAC 388-449-0001: What are the disability requirements for the aged, blind, or disabled (ABD) program?
We consider civilly committed Eastern or Western State Hospital patients as likely to be disabled. Specialized eligibility staff finalize applications for these patients without a disability determination from social services staff.
We consider Eastern or Western State Hospital patients who have been determined “not guilty by reason of insanity” (NGRI) as likely to be disabled. NGRI patients have had their competency restored, completed their court process, pleaded NGRI and have been adjudicated.
A disability determination is required for applicants who are civilly committed to a community-based facility.
WAC 388-449-0150: When does my eligibility for aged, blind, or disabled (ABD) cash benefits end?
We review eligibility for ABD recipients discharging from Eastern or Western State Hospital. This applies whether the recipient is discharged to the community or to a community-based facility such as Oak Cottage, Olympic Heritage or Maple Lane.
Specialized eligibility staff must complete an early eligibility review (ER). Completing the ER changes the certification period from 24 months back to 12 months.
An interview is not required in this situation since the recipient is residing in a public institution when they submit the eligibility review form. An ABD desk review should be completed. An interview is required if the recipient is applying for food at discharge.
Social Services staff must complete a disability determination based on medical evidence.
ABD recipients who are civilly committed to a community-based facility and are discharged to the community during the certification period don’t need to complete a new application or early review. Since they were approved for ABD based on financial eligibility and medical evidence, discharge from a facility is treated as a change of circumstance. See Worker Responsibilities #2 - WAC 388-418-0020.
WAC 388-449-0200: Am I eligible for cash assistance for aged, blind, or disabled (ABD) while waiting for supplemental security income (SSI)?
ABD recipients who reside in Eastern or Western State Hospital are not required to sign an interim assistance reimbursement authorization.
ABD recipients who reside in Eastern or Western State Hospital are not required to file an application for SSI.
WAC 388-452-0005: Do I have to be interviewed in order to get cash and basic food benefits?
Interviews for ABD cash applicants and recipients who reside in Eastern or Western State Hospital at application and eligibility review (ER) are not required. These applications and reviews are worked by specialized staff only.
Interviews are required for ABD cash applicants who are civilly committed to a community-based facility.
Specialized eligibility staff complete an ABD desk review at discharge from Eastern or Western State Hospital. An interview is not required since the recipient is residing in a public institution.
*Visit the ABD Clients Residing in Eastern or Western State Hospital page in the Social Services Manual for clarifying information about medical evidence.*
Revised: April 11, 2023
1. An Intentional Program Violation (IPV) of the Food Assistance program can be determined by a decision in an Administrative Disqualification Hearing (ADH) or by a decision of the court in a criminal prosecution.
2. A person suspected of an IPV can choose to waive their right to an ADH by signing a Waiver of Administrative Disqualification Hearing (Form 12-212) to accept the IPV penalty under WAC 388-446-0020.
3. The department must decide whether to refer an IPV instance for prosecution or for an ADH; both procedures shall not be pursued at the same time. Upon completion of an ADH, the department may choose to then refer the case for prosecution.
4. Separate instances of suspected IPV may be combined into one complaint that totals more than $85 for current recipients, or $125 or more for inactive recipients. See FRAUD
5. The department must prove the IPV with "clear and convincing evidence". This means that the evidence must establish that it is highly probable the actions that resulted in the overpayment were intentional.
This category will provide an explanation of the following elements regarding Administrative Hearings.
Revised April 6, 2023
Clients have the right to receive written notice of their administrative hearing rights at the time of application, denial, termination, suspension, grant reduction or notification of overpayment. [see RCW 74.08.080].
Clients have the right to be represented or to represent themselves at an administrative hearing.
The client who requests an administrative hearing is called the appellant. However, in an Administrative Disqualification Hearing food assistance case the department requests the hearing and the client is called the respondent.
Administrative Hearing Coordinators (AHCs) with the Community Services Division (CSD), Home and Community Services Division (HCS), and Developmental Disabilities Administration (DDA) manage hearing requests related to their programs. CSO Administrators (CSOAs) have the authority to resolve issues with clients prior to an administrative hearing.
Not every complaint received about a department action is a request for an administrative hearing. Refer to information in WAC 388-426-0005 for complaints that aren’t appropriate for an administrative hearing.
Administrative Law Judges (ALJs), employed by the Office of Administrative Hearings (OAH), conduct Administrative hearings. OAH is a separate agency from DSHS. Administrative hearings are held in person or by teleconference call. OAH is responsible for scheduling administrative hearings and sending a notice of the date and time for the administrative hearing to all participants.
The DSHS Board of Appeals (BOA) is responsible for reviewing the initial hearing decisions when reconsideration is requested by either the department or the appellant.
Exception: The department can’t request reconsideration on Basic Food decisions.
The client has the right to request judicial review of a final DSHS hearing decision.
Revised May 22, 2023
The following is a summary of general duties assigned to an Administrative Hearing Coordinator (AHC).
To find out the name of the Administrative Hearing Coordinator (AHC) in Community Services Division (CSD) regions / offices, please contact:
Danielle LeMier, Administrative Hearings Program Coordinator
Operations, Community Services Division
360-338-2721
Email: Danielle.LeMier@dshs.wa.gov
The AHC acts as the liaison, in cases involving Administrative Hearings, between the CSO and:
The AHC must maintain the appearance of fairness in the Administrative Hearing process. The following guidelines apply:
Exception: The department cannot request BOA reconsideration for Basic Food hearing decisions. See 7 CFR 273.15(q)(2).
Revised October 28, 2015
If a client meets continued benefits eligibility requirements, the client receives the level of benefits they were receiving prior to the administrative hearing request until the hearing decision is issued.
If the hearing decision affirms the department action (i.e. reduction, suspension, or termination of benefits) the continued benefits paid to the client pending the administrative hearing may become an overpayment for the client. See WAC 388-458-0040.
1. Review each administrative hearing request to determine eligibility for continued benefits.
Note: A client is eligible for continued benefits at the level of benefits they were receiving before the department took the action that reduced, suspended, or terminated their benefits, until the end of the month when the hearing decision was issued, unless:
a) The client failed to request the administrative hearing within the 10 day period after the change letter was mailed by the department.
b) The client’s Basic Food certification has ended.
c) The client’s Medical Certification Period has ended.
d) The client requested in writing that the department not give them continued benefits.
e) The client withdrew their administrative hearing request.
2. When the AHC determines the client is eligible for continued benefits.
a) Reinstate terminated benefits or make changes to the ACES record to cancel a reduction or suspension of benefits.
b) Send notice of eligibility to client which includes the following information:
i) Benefits have been continued based on your hearing request;
ii) Some or all of the continued benefits may be considered an overpayment if the department action is affirmed; and
iii) If you do not wish to receive continued benefits, you must make that request to the department in writing.
2. If the AHC determines that the client is not eligible for continued benefits, send an ACES letter general correspondence letter (0050-01). The following information should be included:
a) Why continued benefits cannot be authorized, citing the regulation; and
b) The information regarding Administrative Hearing rights.
3. Call the Office of Administrative Hearings (OAH) to schedule an expedited administrative hearing when clients appeal the hearing decision regarding continued benefits.
4. Notify the Social Service Specialist /Case Manager when continued benefits terminate.
5. AHC will establish overpayments that result from the payment of continued benefits to clients, if appropriate.
1. Continue to process all case actions or changes that do not apply specifically to the administrative hearing issue.
2. Notify the AHC of any case actions or changes that result in a reduction, suspension or termination of cash, food, or medical benefits.
Revised October 28, 2015
Equitable Estoppel is a legal principle which means that, in certain cases, the Administrative Law Judge (ALJ) can order the department to stop doing something because it is not fair to a client i.e. overpayment. See WAC 388-02-0495.
In 2012, the department, in consultation with Legal Services, the Office of the Attorney General and the Office of Administrative Hearings, developed a stipulation and agreed order of dismissal to be used to take the place of a formal administrative hearing and written decision by an Administrative Law Judge (ALJ), in cases where the client raises the equitable estoppel defense to eliminate an overpayment.
Appellants may raise the equitable estoppel as a defense in administrative hearings.
Exception: The equitable estoppel defense cannot be applied for overpayments related to the Supplemental Nutrition Assistance Program (SNAP), Food Assistance Program (FAP) or the Washington Combined Application Program (WASHCAP) as the principle of equitable estoppel is considered contrary to federal law. Because FAP and WASHCAP are required to mirror federal law it cannot be used for these programs. See WAC 388-410-0025.
The Stipulation and Agreed Order of Dismissal should be considered for cases which meet all of the following conditions:
Cases must be determined individually based on each unique set of facts. The purpose of the stipulation is to avoid unnecessary administrative hearings. An administrative hearing is unnecessary only when the department agrees that the appellant has established the case for equitable estoppel and the appellant agrees to the facts of the overpayment. If either party, the AHC (or other department representative) or the appellant, disputes any fact affecting the outcome of the case, an administrative hearing should be held and a formal decision made by the ALJ.
Review each hearing request, consulting with supervisors as appropriate, to determine if equitable estoppel is a factor. If yes, apply the following guidelines to determine if the case is appropriate for use of the stipulation and agreed order.
Guidelines for Establishment of Equitable Estoppel:
An admission, statement, or act by the department, which is inconsistent with a later claim. The department makes a statement, takes an action, or fails to act and later finds that they were incorrect. The client is informed after the fact that the error was made.
Factors which may be used as evidence of element #1:
An action by the client on the faith of the department's admission, statement or act. The client must have taken some action that was reasonable given the circumstances; e.g. cashed the check and spent the money.
Factors which may be used as evidence of element #2:
EXAMPLE:
Client receives a letter informing him that his check will be $400. Client has reported income correctly and has no reason to suspect that the amount might be an error.
The benefit is no longer available. Document the facts using the best verification obtainable, including the client's statements when necessary.
An injury to the client arising from permitting the department to contradict or repudiate such admission, statement or act.The client experiences either a loss or a detrimental change in their position because the department reverses a decision regarding eligibility. Depending on the specific circumstances of the case, the imposition of a debt that could not be anticipated or avoided by the client may establish injury.
Factors which may be used as evidence of injury:
The client made financial decisions or plans based on a reasonable belief that the benefits they received were correct:
Spent the money on items they would not have otherwise bought and which are not an available resource.
Paid outstanding debts they would not otherwise have paid
Failed to use an available family or community resource due to the receipt of the benefits. Food Banks, help from relatives, the Salvation Army.
EXAMPLE:
The client receives TANF medical benefits for several months before the department discovers the family is ineligible. The client acted in good faith and is without fault. The family used private medical providers during the period in question based on a reasonable belief that they were entitled to medical assistance. The family did not use the free medical clinic in their town that was available and could have met their medical needs. Injury can be established based on the failure to use an available community resource.
When determining injury, the effects of non-cash benefits, such as training and childcare can and should be considered.
The appellant and the department must be in agreement regarding the establishment of injury. If the appellant and the department cannot agree on the nature or extent of the injury, the case should go to hearing.
Equitable estoppel is necessary to prevent a manifest injustice.The overpayment is clearly unfair to the client based on the way that it occurred and repayment would compromise the client's ability to meet basic needs.
Factors which can be used as evidence of element #4:
The client cannot repay the overpayment without drawing on funds needed for basic requirements. Document income and expenditures. Verify only questionable amounts.
It is clear that the client acted in good faith by following the rules required to maintain eligibility for public assistance.
a) The client reported income timely and accurately
b) The overpayment was solely due to department error; and
c) The client has "clean hands". That is, without fault. The client fulfilled all their responsibility to inform the department of changes in their circumstances.
Applying equitable estoppel will not impair the exercise of governmental powers. Element #5 will be considered to be met unless there is an extraordinary circumstance. This element must be considered on a case by case basis. The cumulative effect of equitable estoppel applied to many cases is not permitted.
When the appellant and the department (AHC and their supervisor) agree that equitable estoppel should be applied, the AHC:
Although it is best to obtain agreement for the stipulation before the administrative hearing, it is not always be possible. The order can be done either in pre-hearing meeting with the appellant (and representative) on the day of the administrative hearing or on the record with the ALJ presiding. It still saves time required for administrative hearing and written decision.
When the signed order is received from the ALJ, the AHC must forward a copy to the Office of Financial Recovery (OFR).
Revised May 22, 2023
A Pre-Hearing Conference is a formal proceeding conducted on the record by an Administrative Law Judge (ALJ) to prepare for an administrative hearing.
1. The pre-hearing conference (PHC) may be required by an ALJ or requested by any party. It is an essential step in the administrative hearing process. See WAC 388-02-0200 – What Happens During a Pre-Hearing Conference.
2. Attendance at the pre-hearing conference is mandatory for the parties. If clients do not attend the pre-hearing conference, the ALJ may dismiss the hearing request or enter a default order against the client.
3. An ALJ may conduct the pre-hearing conference in person, by telephone conference call, or in any other manner acceptable to the parties.
Note: Mandatory Pre-Hearing Conferences do not apply to Basic Food cases. See 7 CFR 273.15(d).
Notify all staff who are scheduled to participate in the pre-hearing conference of the date and time of the PHC.
When participating in a pre-hearing conference:
1. Explain the facts on which the decision is based.
2. Discuss the rules, which the department relied on when making the decision the client is appealing. Make copies of the cited rules available on request.
3. Review the evidence that the department relied on and how it relates to the client's situation.
The Administrative Law Judge enters a written pre-hearing conference order describes actions taken, changes to documents, any agreements reached, and any ruling of ALJ. The pre-hearing order determines if and how the administrative hearing is conducted, whether it will be in person, by telephone conference, or other means.
Revised October 29, 2015
The Pre-Hearing Meeting is an informal, voluntary meeting conducted by the DSHS Representative and the Client and/or Representative prior to an Administrative Hearing to attempt to resolve the issues at the lowest possible level.
1. The pre-hearing meeting (PHM) ensures that hearings are held only in cases that cannot be resolved under current policy.
2. The (PHM) is not designed to take the place of an administrative hearing. It is an opportunity for the client and/or their representative and the Administrative Hearing Coordinator (AHC) to clarify the issue for hearing, correct errors and make agreements.
3. The PHM is not mandatory and does not need to be lengthy or formal.
4. The PHC can be held by telephone or in person.
5. The client has a right to decline a PHM.
1. Attempt telephone contact immediately with the client for a PHM as soon as possible after receiving the request for an administrative hearing; or
2. Use the DSHS 02-527(x) Pre-hearing Meeting Letter, ACES letter FHC2 Pre-hearing Meeting Notification or local CSO letter to schedule pre-hearing meeting when the telephone attempt is unsuccessful.
3. Arrange for interpreter services or other accommodation as required.
4. Document on the ACES narrative when a client declines a PHM.
The AHC should be prepared to meet at least once, either in person or by telephone, with the client and/or the representative before the administrative hearing. Additional contacts should be scheduled as needed.
1. When conducting a pre-hearing meeting:
a. Attempt to identify and define the issues.
b. Explain the facts on which the decision is based.
c. Discuss the result the client expects from the administrative hearing.
d. Explain the client's right to representation and the local contact for free legal services.
e. Discuss the rules, which the department relied on when making the decision the client is appealing. Make copies of the cited rules available on request.
f. Review the evidence that the department relied on and how it relates to the client's situation.
g. Attempt to resolve areas of factual dispute by reviewing the case record, ACES record or other documentation.
h. Allow the client an opportunity to provide additional information and/or documents that were not considered in the original decision.
i. Correct any CSO errors that are identified.
j. Coordinate with Regional staff for clarification of regulations, policies or procedures as needed.
k. Review alternative methods for helping the client, including community resources and the possibility of an Exception to Rule.
l. Review the hearing procedures, including testimony, swearing of witnesses and presentation of evidence.
m. Answer any general questions the client has regarding the hearing process.
n. Submit new or additional evidence provided by the appellant to the original decision maker or their supervisor for an amended decision, if appropriate. (See WAC 388-406-0060 (3) for application denials.)
2. If a resolution is reached and the client wishes to withdraw the hearing request:
a. Have the client complete a DSHS 02-528(X) Withdrawal of Administrative Hearing which specifies the reason for the withdrawal and any agreements made by the AHC or other CSO staff which resulted in the withdrawal:
b. For verbal withdrawals:
1) Have the client complete a DSHS 02-528(X) as in (a) above or send the form to the client with instructions to complete as in (a) above.
2) Notify the Office of Administrative Hearings (OAH) immediately if the written withdrawal will not be received by OAH before the hearing is scheduled.
3. Forward the original copy of the withdrawal to the OAH. Give one copy to the client and put one copy in the CSO hearing file.
Revised October 28, 2015
Effective preparation for an administrative hearing includes a complete review of the department record. Documents are identified for their potential use as exhibits at the administrative hearing. Witnesses should be interviewed and prepared for their testimony. Errors in the record should be corrected. Client notices that are incomplete or do not meet advance or adequate requirements must be corrected and reissued before the administrative hearing.
The administrative hearing preparation is the responsibility of the Administrative Hearing Coordinator (AHC).
The Administrative Hearing report and proposed exhibits (Administrative Hearing Packet) should be made available to the client and their representative as soon as possible before the administrative hearing. The client may have seen the documents. However, the documents will be in a different format and may not look familiar to the client.
If an interpreter is involved, the Administrative Hearing Packet should be given to the interpreter in advance of the administrative hearing, if possible.
a) Letters/notes provided by the client or others.
b) Applications, MSR, or other forms signed by the client.
c) Medical reports, employer statements, collateral statements or other documents provided by a third party and used by the department in the eligibility decision.
d) Financial computations, ACES screen prints including CAFI, MAFI and FSFI, Progressive Evaluation Process worksheets
e) Notices or letters sent by the department to the client either through ACES or manual notes.
f) Verification documents provided by the client (landlord statement, wage stubs).
3. Testimony is provided by witnesses who have direct knowledge of facts related to the issue for hearing. It is appropriate to use a witness when the witness can testify:
a) That a document is authentic because the witness either prepared the document or observed the preparation;
b) About the source of a document because the witness either received the document or observed its receipt;
c) About his or her own actions;
d) About the actions of others; or
e) About statements made by the appellant to the witness.
Revised October 28, 2015
a) Opening statement
b) Presentation of the evidence
c) Closing statement
3. The ALJ's decision can only consider documents that have been formally entered into the record of the hearing.
4. Either the client or the department may object to the admission of any document into the record. The ALJ will usually rule immediately regarding an objection.
5. An objection should be raised if a document:
a) Has been altered, or
b) Is not what it is purported to be, or
c) Is not relevant to the issue for hearing e.g. a medical report, which is not current.
a) Identify the action or department decision being contested;
b) Explain the circumstances which led to the action or department decision;
c) Cite the specific regulation or statute which was applied in the department decision; and
d) Explain how the documents and the witnesses if any will provide evidence to support the departments' position.
2. Present the evidence:
a) Introduce documentary evidence; explain how it relates to the facts of the case.
b) Introduce and question witnesses. Ask questions that allow the witness to explain what he or she knows about the case.
c) Present material in an orderly, logical manner. Consider if it is best to present the case in chronological sequence.
d) Explain how the department came to know the facts of the case.
e) Explain the reasons for the department decision and the regulations and/or statutes which support the decision.
f) Show the steps taken to comply with regulations and notice requirements.
g) Explain the actions taken by the department after the administrative hearing was requested, including whether or not a pre-hearing meeting was held. If a pre-hearing meeting was not held, be prepared to tell and document to the ALJ the number times the department attempted to contact the client before the administrative hearing.
3. Closing statement:
a) Briefly summarize the department's view of the case and review the regulations/statutes which support the department actions
b) Explain why the ALJ should rule in favor of the department.
Note: If new information is raised by the client during the administrative hearing, it is appropriate for the AHC to respond to the new information. In addition, the AHC may ask that the department be allowed additional time to respond to the new evidence if it is extensive or it raises issues which were not presented in the original client hearing request.
Revised October 28, 2015
Effective July 1, 2011, the Health Care Authority (HCA) became the single state Medicaid agency responsible for all medical assistance programs (Title XIX of the federal Social Security Act), State Children’s Health Insurance (S-CHIP) program (Title XXI of the federal Social Security Act), and Medical Care Services (MCS) programs. These programs are collectively known as the “Medical Services Programs.” Through an interagency agreement between HCA and DSHS, DSHS continues to provide all the services it previously provided in managing these cases. However, the legal jurisdiction for the Medical Services Programs moved from RCW 74.08.080 to RCW 74.09.741. The AHC who previously represented the Department in these cases now represents the Health Care Authority as the HCA Hearing Representative. The Office of Administrative Hearings schedules these hearings as an HCA Hearing and will send a notice of the hearing to the DSHS AHC. If you have questions, please call the HCA Appeals Administrator at (360) 725-1254.
There are some hearings that are scheduled on the CSO docket but involve decisions made by other divisions, agencies or administrations, including:
a) Medical equipment and services, or
b) Managed care eligibility or services, or
c) Restricted use of medical care, or
d) Coordination of Benefits or Third Party Liability issues.
In some cases, someone may represent the department from the agency or office that made the decision (e.g. issue related to denial of a medical service or choice of a managed care plan).
In some cases, the AHC will act as the agency representative, and the other office or agency will provide a witness to testify regarding the decision.
2. Transfer of administrative hearing rules for medical services programs from WAC 388-02 to WAC 182-526:
HCA now has its own hearing rules separate from DSHS hearing rules. Any hearing involving a medical services program will fall under the hearing rules listed in WAC 182-526. These rules are effective February 1, 2013. This means any hearing held on or after that date is subject to the rules listed in WAC 182-526.
Other important changes to the WACs include the following:
There are several offices within the Health Care Authority (HCA) that make decisions that are subject to administrative hearings. It is important to contact the appropriate office as soon as a notice of hearing is received to coordinate representation
A. Medical assistance hearings:
B. Non-grant medical assistance (NGMA) hearings:
The AHC acts as the agency representative, and a DDDS employee provides testimony to support the decision. Clients have up to 90 days to request a hearing on a NGMA decision. As soon as the hearing request is received:
NOTE: A hearing request is not always needed for the Department to review a NGMA decision. Clients may ask for a review within 30 days of the initial denial if medical evidence exists that was not used to make the original decision. Please follow the above steps and note on the referral that it is a reconsideration of denial.
Michael Magill
Disability Hearings Manager
(360) 664-7394
MS 45550
Revised October 28, 2015
Once a hearing request has been scheduled, a decision must be issued by the ALJ.
When a hearing decision is received by the department:
Document the AHCS with the docket number, the type of decision, and the date of mailing.
Include any other information necessary for a complete record.
Summarize the hearing decision in the ACES narrative.
1. Order of dismissal: Issued when an appellant withdraws the hearing request or does not appear at the scheduled time for the administrative hearing. An appellant can request that an Order of Dismissal be vacated or canceled. If the Order of Dismissal is vacated, the administrative hearing will be reinstated. Document the circumstances that led to the dismissal so that the department can respond in those cases.
a. Default/no show: If the administrative hearing notice was correctly addressed and the appellant failed to appear, document the AHCS and ACES narrative and file the hearing decision with any related documents in the case record.
If the notice of hearing was not correctly addressed or there is some other reason that the notice of hearing was not properly delivered, contact the Office of Administrative Hearings (OAH) and provide them with the correct address or other information needed to deliver the notice of hearing.
b. Withdrawal: Document the AHCS, ACES narrative and file the hearing decision, with the request for withdrawal and any other related documents attached in the case record.
2. Initial decision: The initial decision is issued by the Administrative Law Judge (ALJ) who presided at the administrative hearing. The initial hearing decision becomes the final hearing decision if it is not appealed by either party within 21 days of the date that it is mailed.
The ALJ who conducted the administrative hearing is responsible for writing the initial hearing decision and mailing a copy to all parties. It is appropriate to follow up with the ALJ if the decision is delayed. No details of the case can be discussed before the hearing decision is issued.
The Health Care Authority (HCA) is responsible for administrative hearings involving medical equipment or medical services. Refer questions about these hearing decisions to the HCA Appeals Manager, MS 45503. (See Special Procedures in this category.)
HCA shall not implement hearing decisions concerning medical procedures, medical equipment, or dental services until a final order is issued. The HCA Appeals Manager will coordinate these cases
3. Reversed decisions: When the department decision is reversed, immediately:
a. Authorize benefits for an applicant effective with the date of eligibility determined in the hearing decision.
b. Reinstate benefits for a recipient at the level paid prior to the hearing request, if the benefits are not already being continued, or at the level determined correct by the initial hearing decision.
c. Adjust overpayments or take any other action addressed in the initial hearing decision.
4. Stay: When the department disagrees with the initial hearing decision, request a stay of the action per the initial hearing decision.
5. Affirmed decisions: When the department decision is affirmed, immediately:
a. Terminate the continued benefits. Adequate notice must be provided to the appellant. Advance notice is not required.
b. Review the period of continued benefits, and establish an overpayment, as appropriate.
c. Distribute the hearing decision to other offices or divisions (OFR, WorkFirst Division, etc.), as appropriate.
6. Petition for review of initial decision: The AHC is responsible for filing a petition to review in cases involving public assistance cash and eligibility for medical assistance.
The Health Care Authority (HCA) is responsible for filing petitions for review in cases involving medical equipment, medical services, or MAGI medical cases. The HCA Appeals Manager at: MS 45503 coordinates the cases.
6. AHC petitions for review to the DSHS Board of Appeals (BOA):
a. After implementing the initial hearing decision, determine if a review is appropriate:
b. If the department decides to petition the BOA fir a review of the initial hearing decision, prepare a memorandum for the BOA Board of Appeals, MS 45803 which includes:
7. Appellant petition for review:
a. Do not reinstate continued benefits pending a review of the initial hearing decision requested by the appellant.
b. Review the appellant's petition to determine if a response is appropriate. A response may not be required if the appellant raises issues which are irrelevant or which are outside the authority of the ALJ, e.g., issues relating to the behavior of department workers.
c. If a response is required, prepare a memorandum to the Board of Appeals, MS 45803, which includes:
d. Refer to chapter 388-02 WAC for complete instructions regarding distribution and time frames for a response to a petition for review.
8. Receipt of review decision from BOA:
a. Implement the BOA review decision immediately.
b. See chapter 388-02 WAC to determine if a request for reconsideration is appropriate.
c. If a request for reconsideration is appropriate, prepare a memorandum to the Board of Appeals, MS 45803 including the specific reason why the department does not agree with the BOA review decision.
9. Judicial Review: The appellant has the right to request judicial review of the final agency decision in superior court. Instructions regarding requesting judicial review are attached to the BOA review decision. If an appellant asks about judicial review, they should be advised to seek legal counsel and referred to the local legal services office.
This chapter explains age and school requirements for a child to be eligible for TANF or SFA and the definition of "elderly" for food assistance programs.
When a child turns 18:
They are considered an adult and can receive assistance for themselves and their children.
They must participate full-time in a secondary education program or an equal level of vocational training to be eligible for assistance.
The child's eligibility for TANF/SFA ends on the last day of the month in which the child turns 18 if the child:
Is not participating in their education on a full-time basis.
Has met the basic requirements to complete the education or training program even if they haven't gone though the official graduation ceremony.
Needy caretaker relative of a child receiving SSI:
If the only child that meets the TANF/SFA age requirement gets SSI, the child parent or needy caretaker relative can get TANF or SFA for their own needs as long as the child meets the requirements of WAC 388-404-0005.
Education:
See VERIFICATION for information on how to verify a child's age or school attendance.
See TEEN PARENTS for the school attendance requirements for TANF and SFA AUs that have an unmarried parent under the age of 18.
Verify the child's age, school attendance, and the date the child is expected to complete school as needed.
If the child will have their 18th birthday during a summer vacation month, contact the school before the end of the school year to find out when the child will complete the program. Update ACES based on the information provided by the school.
Verify that the child:
Is in a program that will lead to getting their diploma, GED, or equal level of vocational or technical training;
Is making satisfactory progress toward completing the program; and
Meets the institution's attendance requirement for a full-time student.
Set an alert in ACES to follow up with the school as needed if:
The school is not certain about the date they expect the child to complete their education; or
Based on case history, you expect the child may not participate through the entire review period.
See WAC 388-408-0035 to decide if an elderly and disabled person can be in a separate food assistance unit.
See WAC 388-416-0005 to decide how long to certify an AU when all members are elderly.
See WAC 388-450-0190 for information on the food assistance shelter deduction for AUs with an elderly or disabled member.
See WAC 388-450-0200 to decide if an elderly food assistance client can have an income deduction for their out-of-pocket medical expenses over $35.
See WAC 388-470-0005 for the maximum resource limit for AUs with an elderly member.
This chapter includes rules and procedures for processing applications for cash, medical and food assistance. It includes the following sections and rules:
Created on: March 11, 2020
Revised February 12, 2024
This section explains 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.
1. Applications by others:
For cash 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:
2. Authorized representative:
An authorized representative can be any adult who isn’t a member of the AU and has sufficient knowledge of the applicant's circumstances to act on the their behalf. In general, the applicant chooses who will be their authorized representative. For more information, see Authorized Representative – Food Assistance and Authorized Representative - Food, Cash and Medical Benefit Issuances | DSHS (wa.gov)
3. Applications while in a public institution:
4. Program Options for Justice Involved Individuals
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 Program Options for Inmates Matrix, accessed from the staff desk aids page, is intended to clarify how placement in a correctional options program affects a person's eligibility for public assistance benefits.
FOR NON-COMPLIANCE SANCTION (NCS) APPLICATIONS:
See WorkFirst Sanctions-Participation
The following topics related to the above WAC are discussed below:
We can't require applicants to use a specific form to request benefits. Examples of typical requests for benefits include:
3. Adding a request for assistance to a pending application or eligibility review for another program:
4. Handling multiple applications from the same household:
5) This applied to additional applications received after we determine eligibility on the first application:
NOTE: When denying additional applications as described in (c.) above, avoid creating a new AU if an old AU is available.
An application is received without a name or address, make a reasonable effort to contact the applicant. If the applicant is in the office, we ask for an address where they can be contacted.
Applications Marked “Homeless”:
If we receive an application that includes a name and signature, but is marked "homeless" and doesn’t 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 applicant. Do this can by searching the electronic case record, case narrative or remarks, online directories, etc. Even if contact information isn’t available, an appointment letter must be sent to the applicant. Address the letter in the applicant's name to General Delivery for the town indicated on the application. If no town is indicated, send the appointment letter to the applicant by General Delivery for the nearest town. The application must be processed in accordance with the Standards of Promptness guidelines in WAC 388-406-0035.
For Medical applications, please refer to the application section of the Apple Health Manual.
Application Received |
Online - for cash or Basic Food |
In-person, mailed, emailed, faxed, dropped off, or scanned |
Interactive Interview Declaration (IID) in person or by phone (telephonic signature) |
---|---|---|---|
Application Signed? |
Yes |
May or may not be signed. If not signed, see “Action to Take.” |
Yes, when the client signs the printed IID or when both attestation scripts have been read and the client has verbally attested to the accuracy of IID content by phone. |
Date of Application |
Date received or next business day if received after business hours |
If signed, date received or next business day if received after business hours.
If not signed, see "Action to Take".
For cash and food assistance, the signature on the front page of the application after the applicant's name counts as a signature for the purpose of establishing a date of application.
If two-parent household applying for cash, at least one parent's signature is required to establish the date of application. |
The date the client verbally attests to the first script by phone. For cash and food assistance, the first attestation after collecting the applicant’s name and address counts as a signature for purpose of establishing a date of application. If only the first attestation script is obtained during a call, see “Action to Take”. If a two-adult household is applying for cash, at least one adult’s signature is required to establish the date of application.
|
Action to Take |
Interview if required or conduct desk review. If applying for cash and a 2-parent household with minor children, obtain other parent's signature at interview or mail back for signature. |
If not signed, have client sign at interview (if the client is in the office) or mail back for signature. The date we receive the signature is the date of application for food assistance. If applying for cash and a 2-parent household, obtain the other parent's signatures. |
If only the first verbal attestation is obtained prior to the interview, the second attestation is required to complete the telephonic signature after review of the IID. If applying for cash and a 2-adult household, obtain the other adult’s signature during the telephonic attestation or pend, mailing the IID back for the second signature. |
Other requirements |
For cash, both adult signatures are required in a two adult household.
|
For cash, both adult signatures are required in a two adult household.
|
For cash, both adults must sign the IID in a two adult household. For cash, both adults must attest to the second signature script in a two adult household. |
See EMERGENCY ASSISTANCE - Additional Requirements for Emergent Needs (AREN)or EMERGENCY ASSISTANCE - Consolidated Emergency Assistance Program - CEAP for forms needed when the applicant applies for benefits from these programs.
Interview
See INTERVIEW REQUIREMENTS and Documentation.
Special Situations
See APPLICATIONS FOR ASSISTANCE – Special Situations for the following situations:
Forms that must be reviewed with the household at the time of interview:
Rights and Responsibilities
Review form DSHS 14-113(X), Client Rights and Responsibilities with the household:
When conducting a face-to-face interview, explain the rights and responsibilities to the applicant and ask them to sign form DSHS 14-113 to acknowledge that they understand them. Send the document as file only to be scanned into the client’s Electronic Case Record (ECR).
2. Phone Interviews:
When conducting phone interviews, explain the rights and responsibilities to the applicant, send them a copy of form DSHS 14-113, and request them to sign and return the document (do not hold up benefit issuance waiting for this form).
Your DSHS Cash or Food Assistance Benefits
For cash or food assistance benefits, review form DSHS 14-520, Your DSHS Cash or Food Assistance Benefits with the household:
1. Face to Face Interviews:
When conducting a face-to-face interview, explain the allowable use of benefits to the applicant and ask them to sign DSHS 14-520 to acknowledge that they understand the restrictions and penalties for illegal use. Send the document as file only to be scanned into the client’s Electronic Case Record (ECR).
2. Phone Interviews:
When conducting phone interviews, explain the allowable use of benefits to the applicant, send them a copy of form DSHS 14-520, and request them to sign and return the document (do not hold up benefit issuance waiting for this form).
Processing Basic Food and Cash Applications for Applicants Receiving Benefits from Another State during Month of Application
When applicants apply for Basic Food or Cash and they received benefits from another state during the application month, this doesn’t change the date of application:
If the applicant has a pending application for one of our programs and requests Basic Food, use the application the applicant provided for the other program. The date the applicant requested food benefits is the date of application for Basic Food.
This section lists the emergent conditions needed to get benefits under the Washington Basic Food Program (Basic Food) within seven calendar days. This section also includes Basic Food expedited service requirements and certification procedures.
If an ABAWD does have non-qualifying months available they can be considered for expedited services.
Clients who have been disqualified for Basic Food due to not meeting ABAWD participation requirements aren't eligible for expedited services until they have requalified.
Expedited cases can be approved with postponed verification for proof of out of state non-qualifying months.
Applicants who meet expedited criteria and are eligible for Basic Food can get benefits even if they don't have all the necessary verification to determine eligibility. We must attempt to verify as much information as possible at the interview prior to postponing verification (see Verification).
See Process Application Month
See Finalize Application
See Basic Food Program - Expedited Services
This section includes rules and procedures related to application processing time limits and processing delays.
If an applicant for food assistance completes their interview late in the application process and we still need some information to determine eligibility, take the following steps:
ACES will deny a food program application by the 30th day, or next business day if the 30th day falls on a weekend or holiday, even if the household requests additional time to provide information. See WAC 388-406-0040, #4.
Applications processed after the 30-day standard of promptness are considered untimely even if the household had the interview before the 30th day and we needed verification to determine eligibility for benefits.
For cash and medical assistance applications, good cause exists only when the local office meets all processing requirements and the client causes a delay in the process.
See:
Revised August 28, 2018
This section contains applications procedures for special situations, including when an applicant is temporarily out of state and the Trial Visit Program.
This section contains rules and procedures related to application approvals, denials and withdrawals, including notification requirements, eligibility effective dates for approved applications, limits on denial actions, and when we may reconsider a denied application.
Basic Food and Transitional Food Assistance:
Transitional Food Assistance (TFA) provides five months of basic food benefits as a fixed benefit amount for families leaving TANF or Tribal TANF. When someone moves out of a TFA household, they aren't automatically removed from the TFA assistance unit.
Federal rules don't allow people to receive benefits under the Food Stamp program in more than one household at the same time. This includes basic food and TFA.
Processing an NCS Application:
See WORKER RESPONSIBILITIES Non-Compliance Sanctions (NCS) Re-Applicants
For basic food, when the thirty-day period ends on a weekend or a holiday the denial notice is sent the first working day after the thirtieth day.
If a basic food applicant doesn't show for the required eligibility interview within the 7-day interview window:
Processing Basic Food Applications for Individuals Ineligible Due to Duplicate Participation
When applicants apply for basic food and are ineligible for benefits during the month of application because they received benefits from another state:
Top of Page
Revised September 11, 2019
This section includes rules and procedures on what happens when a client applies for benefits and the department needs other information to determine eligibility.
Revised December 8, 2011
To describe what an assistance unit is and how it is formed for cash, medical and food assistance programs. The following sections are contained in this chapter.
This section shows who must be in an assistance unit (AU) for the Washington Basic Food Program and explains how certain living arrangements impact a client's AU and eligibility for Basic Food.
Persons sharing a residence must be one Basic Food household when they:
When a mandatory member as described in WAC 388-408-0035 moves into the home of an AU already receiving benefits under TFA, this person cannot be added to the TFA AU unless the household opts out of TFA to apply for regular Basic Food. The new member cannot receive benefits separately if they are required to be in the AU under the WAC. Refer to WAC 388-489-0015 for more information.
If a client does not currently buy and prepare food separately from others in the home **only** because they have no food or money to buy food, they may be a separate AU from the others in the home if they are not required to be in the same AU under WAC 388-408-0035 (2) **and** they intend to buy and prepare food separately from the others.
If a minor is homeless and is temporarily living at the residence of an adult who is not their parent and does not provide for them financially, they are not considered to be under parental control and can be their own assistance unit.
Examples of when a minor is not under parental control include, but are not limited to, when the minor is:
A minor is not required to have a residence or income to be eligible for Basic Food. A child should not be considered "financially dependent" unless the child receives significant and sustained financial or other in-kind support from a non-parental adult.
If the minor regularly buys and prepares food with others, everyone who does must be in the same assistance unit for Basic Food.
While there are no special eligibility requirements for homeless youth, they must be provided the same rights, protection, and accommodations as homeless individuals, including the exception to the requirement to verify residency. Other important considerations include:
If a minor child doesn't live with an adult, we decide whom to include in the AU as if the minor child was an adult. A minor child who lives alone is independent of an adult even if they have been assigned a payee.
If a minor has a payee, but they get and have control of income of at least the TANF payment standard in WAC 388-478-0060 (2), we consider them as financially independent from unrelated adults in the home.
If the payee has control of the minor’s income such as deciding which bills to pay and shopping for the minor, the child is not financially independent and must be in the adult’s AU.
An individual can only be in one AU during a given month. A child may get Basic Food in the AU where they are "living". We do not use a set number of hours or days someone must sleep in the home to decide if a child is living in the home. If a child stays with their parents who do not live together, we decide where the child lives based on the actual living arrangements.
If a child lives with both parents, both parents must be in the AU regardless of whether or not the parents buy and cook food together. An unmarried parent cannot choose to be excluded from the AU if the other parent has applied for Basic Food for the child.
If a person age 18 through 21 lives at the same address as their parents, this person can be a separate AU from the parents only if they have separate living, cooking, and sanitation facilities.
Also see WASHCAP rules (WAC 388-492-0030, (1)(c)(ii)) for SSI recipients, ages 18 through 21 living with a parent.
If someone lives at the same address as their spouse, this person can be a separate AU from their spouse only if they have separate living, cooking, and sanitation facilities.
11. Same-Sex Legally Married Couples:
As of July 28, 2014, legally married same-sex couples are treated the same as heterosexual married couples and fall under the definition of "spouses" for the purposes of determining who buys and prepares food together and are in the same food assistance AU.
12. Child living with biological parent:
Adoption ends a biological parent's parental rights as well as their legal and financial responsibilities to the child. If a child who has been adopted lives in the same home as one of their biological parents, we do not consider it any different than if they were living with an unrelated adult.
We determine if the child is in the same AU as their biological parent based whether or not the child is financially independent from their biological parent, and the arrangements for buying and preparing food.
13. Live-in attendants:
a. A client does not have to be a paid employee to be a live-in attendant.
b. Someone who must be in a client's AU under WAC 388-408-0035 (2) cannot be in a separate AU even if this person is a live-in attendant.
14. Income of an elderly and disabled AU member's spouse:
a. If an elderly and disabled person can't buy and cook their own food, but they want to be a separate AU, we compare the income of the other people who live in the home to the 165% standard.
b. We don't count the income of the elderly and disabled person's spouse in the above step because spouses who live in the same home must always be in the same AU.
15. Home-monitored AU members:
For Basic Food, AU members who live at home and are being monitored by the court or the Department of Corrections are not considered as living in an institution. They can get Basic Food benefits if they meet all other eligibility requirements.
16. Clients living in a group home:
Clients who live in certain group homes may be eligible for Basic Food even though they are living in an institution. See WAC 388-408-0040 to determine if a client living in a group home can receive Basic Food.
17. State-Funded Basic Food AUs:
We use the same rules to build an AU for state-funded Basic Food as we do for federally funded benefits.
Deciding if a Boarder Pays a Reasonable Amount for Meals
For someone to be eligible for Basic Food based on living in federally subsidized housing for the elderly, the housing must meet both of the following two conditions:
The facility must be expressly for the elderly; and
The facility must be federally subsidized.
If a residence offers an optional meal plan as a part of their normal services, we only consider a resident to be living in an institution for Basic Food if they choose to get their meals through the optional plan.
If someone chooses to get the majority of their meals through an optional meal plan, the person is living in an institution. For this person to be eligible for Basic Food benefits, the institution must meet the requirements of WAC 388-408-0040 .
A person who lives in an institution that provides meals may be eligible for Basic Food benefits when:
The person living in the institution can't eat the institution's meals because they need a special diet; and
The institution is unable or unwilling to provide the special diet.
Some group living arrangements are not qualified group homes, but we don’t consider them institutions, because the facility doesn’t prepare the majority of meals for the persons living there. In this case, we look at the client’s living arrangements and whether or not they buy and fix food together to determine who must be in the AU under WAC 388-408-0035.
A Supported Living Provider (formerly Intensive Tenant Support Services or ITS Home) provides services to DDA clients and is licensed by DDA.
Drug or alcohol treatment centers certified by FNS as eligible for Basic Food: (Nonprofit facility authorized as a retailer under 7 CFR §278.1(e))
A facility's status as "DOH licensed and certified" in this section only refers to the facility having a Supplemental Nutrition Assistance Program (SNAP) / Basic Food endorsement.
Drug and alcohol treatment centers endorsed by DOH as eligible for Basic Food:
(Nonprofit facility authorized as a retailer under 7 CFR §237.11(e))
According to the Washington Department of Commerce's Housing Division/ Homeless Programs and the Washington State Coalition for the Homeless, there are no "for-profit" shelters for the homeless in the state of Washington. We can assume that all the homeless shelters in Washington are non-profit for the purposes of determining eligibility for homeless applicants.
The rules for women and children living in domestic violence shelters (shelters for battered women and children) should be interpreted to include men and their children who are victims of domestic violence. The term "shelters for battered women and children" can be interpreted to mean "shelters for battered persons and their children".
If the AU is homeless at the time of application or recertification, we consider the AU homeless for the entire certification period.
The 90-Day Period for Temporary Living Arrangements
This section contains rules and procedures on how to decide who is in an assistance unit for TANF, SFA, PWA, ABD cash and HEN referral.
For more complete details see these EA-Z Manual chapters: APPLICATION and INTERVIEW REQUIREMENTS OTHER HELPFUL INFORMATION
For cash programs, we decide who is in the AU at application and when someone moves in or out of the home. We make this decision before we look at financial eligibility requirements.
In general, we decide who to include in the AU based on the relationship of people living in the home and whether they meet eligibility requirements other than income or resources. We may allocate the income of someone in the home excluded from the AU to people in the AU if the excluded person is financially responsible for someone in the AU.
A client that lives in the home but is under home monitoring or home detention ordered by the courts or the Department of Corrections is living in the home. We do not consider them as inmates of a public institution. Clients that live in a public institution aren't eligible for TANF under WAC 388-400-0005.
Adoption ends the legal relationship between biological siblings.
EXAMPLE Blessica is applying for TANF for her granddaughter Mahalia. Blessica provides documentation she has temporary custody of Mahalia while her dad is incarcerated. Since Blessica is not Mahalia’s parent and she isn’t legally or financially responsible for Mahalia, she can apply for a non-needy TANF grant for Mahalia.
EXAMPLE Six months later Blessica reports Mahalia won’t be going back to her parents’ home and provides a document verifying she’s now receiving the Guardianship Assistance Program (GAP) subsidy and has accepted legal and financial responsibility for Mahalia. Since Blessica is now financially responsible for Mahalia, we can’t exclude her from the TANF AU.
NOTE: If Blessica wanted assistance for Mahalia, she would need to apply for benefits for both of them.
If a financially responsible person cannot be in the AU under WAC 388-408-0020, we allocate the income of this person to the AU. How we allocate this income varies based on why the person is ineligible. See INCOME - Allocation and Deeming.
If a minor parent gets Title IV-E foster care, the minor parent's child is not eligible for TANF or SFA. The foster care payment includes the child's needs.
Adoption support
Adoption support is money given to families that adopt children with special needs. This money is intended to help the family with the special expenses that these children have.
For cash, this money is excluded because it is assistance from another agency that does not cover ongoing living expenses. See WAC 388-450-0055 for more information.
For Basic Food, this money is budgeted as countable unearned income.
Guardianship Assistance Program (GAP)
Guardianship Assistance GAP, also known as guardianship income, is money given to caregivers who accept permanent guardianship of a child. These caregivers have accepted permanent legal and financial responsibility for the child in their care and therefore must be included in the TANF AU. The Department of Children, Youth and Families (DCYF) determined these children have special needs. This money is intended to help the family with the special expenses for the children. The income is considered the children’s income.
For cash, this money is excluded because it is assistance from another agency that does not cover ongoing living expenses. See WAC 388-450-0055 for more information.
For Basic Food, this money is budgeted as countable unearned income.
EXAMPLE A child, Mohammad is living with their half-sibling, Liam and Liam's mother, Astrid, who is not the parent of Mohammad and has no financial responsibility for this child. Astrid is working and has income. Astrid can choose to apply for non-needy TANF for Mohammad and not include Liam in the needs, since including herself and Liam would cause the assistance unit to be over income for TANF.
NOTE: In this example, if Artem and common child Ana are added to the TANF assistance unit, they are all recipients. If Artem gains employment, the household may choose to exclude Artem and Ana from the TANF assistance unit, while Olivia and her other two children, Sofia and Luka continue receiving a TANF grant.
NOTE: In this example, if the entire household is eligible when we include Alex's income, the household can choose to exclude Alex and Kimani, as we can consider this a recipient assistance unit. If the family is eligible in the month of application, you can consider them as recipients and exclude the child, Kimani and co-parent, Alex before you issue benefits.
Families can always change the status of optional TANF AU members. In some cases, removing the optional AU member from the TANF AU may increase the benefits to the family.
See Assistance Unit (AU)
This section explains authorized representative rules specific for Basic Food and describes when an authorized representative is required for someone in a treatment center or group home.
Authorized Representatives on Multiple Accounts:
ACES does not monitor or create reports on individuals who are authorized representatives for multiple cases. If you learn that a person is an authorized representative for multiple AUs and suspect the representative is misusing the client's benefits, refer the case to the Office of Fraud Accountability. See FRAUD.
Persons currently disqualified for an Intentional Program Violation (IPV) may not be an authorized representative for Basic Food.
The head of household for the food assistance AU may request an administrative hearing when the person they have named as their authorized representative is disqualified from being an authorized representative. See ADMINISTRATIVE HEARINGS.
For additional information on Authorized Representatives, see AUTHORIZED REPRESENTATIVE - FOOD, CASH, AND MEDICAL BENEFIT ISSUANCES.
This chapter defines an authorized representative (AREP) and provides instruction on: What form to use in order to code someone in ACES or the ECR as an AREP. When to require the DSHS 14-012(x) consent form. When to require the DSHS 17-063 authorization form or HCA 80-020 authorization for the release of information form. When it's permissible to share information without consent. How to identify and code an AREP in our automated systems.
An AREP can be any adult who is not a member of the AU who is sufficiently aware of the household circumstances and is authorized by the household to act on behalf of the client for eligibility purposes. If an individual AREP is representing an organization, other individuals from that organization within the same department may also act as an AREP. An AREP assists the client with the application, recertification, and general eligibility processes.
An AREP is not authorized to receive health information about clients unless they have power of attorney or have been named on the completed and signed DSHS 14-012(x) consent form.
An AREP can share any information relevant to eligibility; however, the department can only share information with the AREP that is necessary for the purposes of determining financial eligibility.
An AREP can receive letters, including the income computation sheet, renewal forms, and ProviderOne services cards if the client has authorized the sharing of such correspondence.
The client can identify an AREP on the application, eligibility review form, or DSHS 14-532 authorized representative form. The DSHS 14-532 authorized representative form shall be used when a client is authorizing an AREP at a time other than at application or eligibility review. The AREP information shall be reviewed at recertification. See WORKER RESPONSIBILITIES.
AREPs are not automatically eligible to be an EBT Alternate Card Holder for Basic Food or cash benefits. Both the client and Alternate Card Holder must complete and sign the DSHS 27-130 form. Please refer to the EBT Manual for more information.
Please refer to the Payees on Benefit Issuances - Authorized Representatives chapter, WAC 388-460-0005 through 460-0015 for AREP rules specific to the Basic Food (SNAP) program.
Legal Guardianship is designated by coding the AREP screen Rep Type field in ACES with the following:
Power of Attorney for cash, medical, and basic food is designated by coding the AREP screen Rep Type field in ACES with AD or NA.
The DSHS 14-012(x) consent form is a Health Insurance Portability and Accountability Act (HIPAA) compliant form designed for use by the client to authorize an exchange of information outside of basic eligibility information shared with an AREP. See AREP definition above. The 14-012(x) is the correct form for authorizing the sharing of specified confidential information between specified parties for a specified period of time.
HIPAA restrictions prevent us from discussing the client's individual health information with an AREP unless a current signed DSHS 14-012(x) consent form is in the record.
The DSHS 17-063 authorization form and the HCA 80-020 authorization for release of information form are HIPAA compliant forms designed for use by the client to authorize the release of existing documents to a specified individual or agency. These forms allow the disclosure of a designated set of records from the individual's DSHS or HCA file. The Public Disclosure Unit is responsible for approving or denying requests for disclosure of confidential information.
For more information see Confidentiality and Public Disclosure.
There are times when we can share confidential client data without the client's permission:
To learn more about when it is permissible to share client information please refer to DSHS Administrative Policy 5.02, Section D;4.
For information regarding AREP for Long-Term Care cases see: Long-Term Care AREP or WAC - Long-Term Care for Families and Children.
An AREP may receive letters/notices/forms/warrants/EFT/ProviderOne service cards or they may have permission to only discuss the case and not receive any written correspondence. Record the representative's name and address on the AREP screen in ACES. The REP Type code on the AREP screen determines what forms, letters, etc. they receive. See the Authorized Representative Payee Chart.
Completing the DSHS 14-532 AREP form isn't required if the client is confirming or making changes to their current AREP.
4. Clients should make an initial designation of an AREP on the application, review, or DSHS 14-532 AREP form. Clients can make changes to an AREP's information, such as address or phone number verbally but we must clearly document these changes in the case record.
Authorized Representative/Protective Payee
Revised June 26, 2014
ACES is an acronym for the Automated Client Eligibility System. This system is used by the State of Washington's Department of Social and Health Services. ACES supports the operations of the department by integrating DSHS programs under a single, client-based, on-line system. The ACES system is a tool for determining eligibility, issuing benefits, management support, and sharing of data between agencies.
ACES Instruction in this Manual
The links to specific sections in the ACES User Manual are provided throughout the Eligibility A-Z Manual. See the ACES User Manual.
Basic Food Employment and Training (BFET) Program
WAC 388-444-0015 How can the Basic Food Employment and Training (BF E&T) program help me find work?
Clarifying Information - WAC 388-444-0015
What is BFET?
Basic Food Employment & Training (BFET) assist federally funded Basic Food (SNAP) participants gain skills, training or work experience to increase their ability to attain a living wage career. BFET services are available from all WA State community and technical colleges as well as many community-based organization (CBO) providers including the Employment Security Department (ESD). Additional information on the type of services and benefits is located on the BFET public website. www.dshs.wa.gov/bfet
Who can receive BFET services?
Most clients who receive federally funded Basic Food (SNAP) and are at least 16 years old can receive BFET services. Even clients with college education may benefit from retraining or job search services.
How can BFET help pay for college?
BFET students should utilize other forms of funding for tuition whenever possible. Typically, all students who attempt to enroll into BFET will be asked by the college to apply for Federal Student Aid (FAFSA) as part of the enrollment process for BFET.
Who can't receive BFET services?
Clients receiving the following programs:
* RCA recipients are not eligible for BFET, however there is one exception. In counties where there are no LEP Pathway providers, RCA recipients may receive BFET services from community colleges. RCA recipients may not receive services from college providers in counties in which there is at least one LEP Pathway provider, although exceptions may be made under extenuating circumstances. Extenuating circumstances may include limited provider capacity, distance from the provider, and/or client request for a particular provider.
BA (Bachelor of Arts or Science) educational degrees, also known as four year degrees are not eligible through the BFET program so clients seeking these degrees should not be referred to BFET.
Do clients have to participate in BFET?
No. BFET is voluntary and intended to focus resources on the most motivated individuals Services are available for exempt and non-exempt clients who are eligible for federal SNAP benefits living in Washington.
NOTE:
There are clients categorized as Able-Bodied Adults without Dependents (ABAWD) who do have additional work requirements in order to stay eligible for Basic Food benefits. BFET is an option to fulfill this requirement, though is not mandatory. To learn more about ABAWDs please see https://www.dshs.wa.gov/esa-1
How does a student become eligible for Basic Food through BFET?
If a client appears to be an ineligible student, give the client basic information about BFET to help decide if they could become eligible for Basic Food. Refer to WAC 388-482-0005 for student eligibility. BFET recipients who are college students are typically eligible students (pending other Basic Food eligibility factors).
How do I find a list of current BFET providers?
See our public web site for a list of BFET Providers and the counties in which they offer services.
BFET Processes and Procedures
How does a Basic Food client receive BFET services?
DSHS staff will provide the client with a referral to BFET provider(s) with their contact information... You can find a list of current BFET Providers at the following: BFET Brochures, EJAS BFET Referral tool, or the BFET public website.
Once the referral is received, the BFET Provider will determine if the perspective individual is SNAP eligible and will complete an intake to determine appropriate BFET services. The BFET Provider will address the referral with appropriate EJAS coding.
If the perspective individual is enrolling in a BFET college program and appears eligible for BFET, but is not yet on SNAP, then the college will complete the 10-501 Referral Form to be submitted to DSHS. This form tells DSHS the client will be accepted into BFET upon approval of SNAP benefits, so the client should be considered an eligible student. The college will open the BFET components in eJAS after SNAP is approved.
If client was closed for ABAWD requirements they must meet requalifying requirements as outlined in ABAWD participating in BFET. https://www.dshs.wa.gov/esa/basic-food-work-requirements/abawds-able-bodied-adults-without-dependents.
How do I know a client is participating in the BFET program?
Barcode has a BFET indicator in red at the top of the client’s ECR. If you have access, you can also review their information in their electronic case record in eJAS. The BFET program uses the FI component to distinguish BFET participants from other programs that use eJAS. Components are open based on the actual activity of the client, such as BK (supervised job search), BG (vocational education) or BR (job retention). Components reflect the scheduled hours per week for each activity and dates of participation.
Verification of participation from BFET provider: This can be a verbal verification or a provider document.
ACES Procedures
Work Registration
Purpose:
People participating in BFET may be able to receive support services through their provider to help them participate in the program including but not limited to:
The availability of these support services is depended on each BFET provider and the funding they have available.
2. Dependent care allowance - Non-ABAWD participants only:
https://www.dcyf.wa.gov/services/early-learning-providers/subsidy
This section provides rules and instructions for Basic Food work requirements and the Basic Food Employment and Training Program (BFE&T). BFE&T services are voluntary and apply to non-TANF clients receiving federal SNAP Benefits. Work Requirements for nonexempt ABAWDs are not voluntary.
A. BASIC FOOD WORK REQUIREMENTS - Work Registration |
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WAC 388-444-0005 | Am I required to work or look for work in order to be eligible for Basic Food? |
B. BASIC FOOD WORK REGISTRATION EXEMPTIONS |
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WAC 388-444-0010 | Who is exempt from work registration while receiving Basic Food? |
C. BASIC FOOD EMPLOYMENT AND TRAINING (BFET) |
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WAC 388-444-0015 | How can the Basic Food Employment and Training (BFET) program help me find work? |
D. BFET PAYMENTS FOR RELATED EXPENSES |
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WAC 388-444-0025 | What expenses will the department pay to help me participate in BFET? |
E. ABAWDs - Able-Bodied Adults Without Dependents |
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WAC 388-444-0030 | Do I have to work to be eligible for Basic Food benefits if I am an able-bodied adult without dependents (ABAWD)? |
WAC 388-444-0035 |
Who is exempt from ABAWD work requirements? |
WAC 388-444-0040 |
Can I volunteer for an unpaid work program in order to meet the work requirements under WAC 388-444-0030? |
WAC 388-444-0045 |
How does an ABAWD regain eligibility for Basic Food after being closed for the three-month limit? |
F. BASIC FOOD WORK REQUIREMENTS - GOOD CAUSE |
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WAC 388-444-0050 | What is good cause for failing to meet Basic Food work requirements? |
G. BASIC FOOD WORK REQUIREMENTS - DISQUALIFICATION |
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WAC 388-444-0055 | What are the penalties if I refuse or fail to meet Basic Food work requirements? |
H. BASIC FOOD WORK REQUIREMENTS - UNSUITABLE EMPLOYMENT AND QUITTING A JOB |
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WAC 388-444-0060 | What is unsuitable employment for Basic Food work requirements? |
WAC 388-444-0065 |
Am I eligible for Basic Food if I quit my job or reduce my work effort? |
WAC 388-444-0070 |
What is good cause for quitting my job or reducing my work effort? |
WAC 388-444-0075 |
What are the penalties if I quit my job or reduce my work effort without good cause? |
I. APPENDIX I - ABAWD participation requirements by location J. Current Partners - BFET Partner Colleges and Agencies |
Revised: September 1st, 2023
Exempt clients (per WAC 388-444-0010) are not required to register for work, so they are not work registrants.
Non-exempt clients are people who receive Basic Food and must be registered for work. They are considered work registrants, and further divided into two groups:
Work Registrants |
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Work Registrants Who are ABAWDs |
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Revised January 1, 2024
January 1, 2024
WAC 388-444-0030 What additional work requirements and time limits is an able-bodied adult without dependents (ABAWD) subject to in order to be eligible for Basic Food?
WAC 388-444-0035 Who is exempt from ABAWD time limits and minimum work requirements?
WAC 388-444-0040 Can I volunteer for an unpaid work program in order to meet the work requirements under WAC 388-444-0030?
WAC 388-444-0045 How does an ABAWD regain eligibility for Basic Food after being closed for the three-month limit?
Administrative Hearing Procedures
Countable Months
36-Month Period
Moving Between Non-Waived and Waived Areas
A waived area: |
A non-waived area: |
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State Funded Food Assistance Program (FAP) Clients
Activities to Meet Participation
WIOA Program (non-college) |
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Zachary is participating in the following activities:
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Non-WIOA Program (Non-College) |
Zachary is participating in the following activities:
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6. Proof of Participation
Identifying an ABAWD
Out of State Countable Months
Monitoring ABAWD Participation
Combining Work and/or Training to meet requirements
- Increase the number of hours she is working to 80 hours a month;
- Participate in an approved training program for at least ten hours a week average (to make a total of 80 hours a month in work and training) ;
- Participate in unpaid work for at least ten hours a week average (to make a total of 80 hours a month in work and training); or
- Volunteer at a Workfare agency for a specified number of hours per month based on local minimum wage. (If local minimum wage is $18.29/hr this would only be 5 hours, as $100 / $18.29/hr. = 5.68 or 5 hours rounded down)
- If Joanna becomes exempt or moves to a waived area, she also may be eligible to continue to receive food benefits.
Good Cause:
ABAWD Information
Children in the home
Temporary Assistance for Needy Families (TANF) Clients
TANF clients aren’t subject to ABAWD participation time limits because they have children or meet the pregnancy exemption for ABAWD participation. Do not code them as an ABAWD.
Waived Areas
ABAWD clients living in waived areas are exempt from participation. See more about this in the Moving Between Non-Waived and Waived Areas section.
Discretionary Exemptions
Participation Exceptions
ABAWD participation exceptions are reasons that an ABAWD client is not able to participate in work or work activities for 80 hours a month. When documenting, always select the exemption or exception that will last for the longest period of time. Exempt Area is only used when the individual lives in a waived county and doesn’t qualify for a different exemption or exception.
NOTE:
The following status’ are work registration exemptions:
Not able to Work 80 Hours a Month.
Questionable
Aged, Blind, Disabled (ABD)/ Housing Essential Needs (HEN)
We route communication about Workfare to the Workfare Unit who match clients up with appropriate Workfare agencies for their abilities and needs. Staff follow the referral instructions in the CSD Procedures Handbook. When determining the amount of hours a client must complete when requalifying, use the calculated prorated amount.
Ineligibility Due to Failure to Meet ABAWD Requirements
If a client exhausts the 3-out-of-36 months eligibility limit, we must terminate the person's Basic Food benefits as soon as we become aware of this information. We must also deny this person Basic Food at application or recertification if they do not have a personal exemption and they do not live in a waived area, unless they have requalified under Regaining Eligibility.
If a client is terminated for non-participation, the person is an ineligible household member. We include this person's income in the Basic Food Assistance Unit as described under WAC 388-450-0140 How does the income of an ineligible assistance unit member affect my eligibility and benefits for food assistance? More information in the Allocation & Deeming chapter.
Eligibility for a Second 3-month period for ABAWDs WAC 388-444-0045(1) & (3).
There are two three-month periods an ABAWD can receive Basic Food benefits without participation.
After Subsequent Months are used:
NOTE:
The department cannot consider the eligibility of an ABAWD client who has used the initial and subsequent months and does not regain eligibility by participating or becoming exempt until the next 36-month period.
Worker Responsibilities - WAC 388-444-0045
Monitoring ABAWD Participation information found in Worker Responsibilities-WAC 388-444-0030.
Adding an Ineligible ABAWD back into the Household
If an ABAWD client regains eligibility by meeting requirements in the Regaining Eligibility section, food benefits begin for this client effective the date:
NOTE:
Benefits must be prorated based on this date.
See more about how to add a client back onto a household in the Change of Circumstances: Effective Date Chapter.
ACES Procedures
The ACES Manual is housed on the internal network accessible by staff.
See Chapters Basic Food Assistance - Able Bodied Adults Without Dependents (ABAWD)
Revised January 1, 2024
Purpose:
When you are informed that a non-exempt Basic Food client has not complied with work requirements:
For Mandatory Work Registrants
For ABAWDs
EXAMPLE:
Rita is an ABAWD who lives a remote area in a non-waived county. She had a vehicle to get to her part time job, but it is in need of repairs and is not drivable. She calls to report that she will not be able to meet the required number of hours for ABAWD. The worker does not change the ABAWD Participation status but records the Good Cause decision in the case remarks and explains to Rita that Good Cause is limited. The worker refers Rita to a BFET provider in her area to explore options for aid to repair her vehicle.
EXAMPLE:
Sahar is an ABAWD who lives in a non-waived county. She is volunteering at a Workfare site in the next town over. She usually takes the bus to the location. There is a snowstorm which has caused the buses to not run in her neighborhood. She does not feel safe walking to a farther bus stop. Sahar calls to report that she will not be able to meet her volunteer hours for that month. The worker does not change the ABAWD Participation status but records the Good Cause decision in the case remarks..
EXAMPLE:
Parker is an ABAWD who lives in a non-waived county. He reports that he is not going to be able to work for a few months because he has broken his leg. This is not a case of Good Cause, instead, the worker should evaluate Parker for a personal exception for being unable to work.
Revised December 20, 2022
The disqualification rules and procedures are for Basic Food non-exempt work registrants only. Please see Section E, ABAWDS for disqualification rules and procedures for able-bodied adults without dependents.
Ending a Disqualification When a Client Becomes Exempt During the Penalty Period
A disqualification ends and the client may again receive benefits effective the first of the month following report of the change when the client becomes exempt during the penalty phase.
Examples for AUs receiving Basic Food while an adult is in a BF Work Registration penalty period:
Example 1: Tessa is in a BF work requirement penalty period and, begins attending school, becomes responsible for caring for a child under age six, or meets another Basic Food Work Registration exemption. Tessa can begin receiving Basic Food again, if otherwise eligible, effective the first of the month following the reported change. Update Tessa’s Work Registration Details in ACES Case Actions with the new status in the ongoing month.
Example 2: Ellery is in WorkFirst sanction. They agree to a new IRP and begin to participate during their second BF work requirement penalty period. This changes Ellery’s status to exempt due to participating in a cash program even if the full WF sanction period has not been served. The BF disqualification will end and, if otherwise eligible, Ellery may receive benefits effective the first of the month after the change.
When a person requests a fair hearing within 10 days of the issuance of the Notice of Adverse Action, and the certification period has not expired, benefits will continue.
See Interview (WORK) screen
See Disqualified or Sanctioned Assistance Unit or Client - Quitting a Job
Revised November 18, 2016
Purpose:
WAC 388-444-0060 What is unsuitable employment for Basic Food work requirements?
WAC 388-444-0065 Am I eligible for Basic Food if I quit my job or reduce my work effort?
WAC 388-444-0070 What is good cause for quitting my job or reducing my work effort?
WAC 388-444-0075 What are the penalties if I quit a job or reduce my work effort without good cause?
Clarifying Information - WAC 388-444-0075
The rules for quitting a job or reducing work effort below thirty hours per week apply to both Basic Food applicants and recipients.
General Requirements
3. We cannot disqualify a recipient or applicant for less than the penalty time period unless they become exempt from work registration as described in WAC 388-444-0075 (5).
The penalties for quitting a job or reducing hours are:
Worker Responsibilities -WAC 388-444-0075
Verifying and Documenting a Voluntary Job Quit or Reduction in Work Effort
NOTE:
Do not delay benefits to an otherwise eligible person beyond the normal processing time while awaiting a good cause determination.
ACES PROCEDURES
See Disqualified / Sanctioned Assistance Unit / Individual - Quitting a Job Without Good Cause
Revised August 4, 2011
This category is about how to identify incorrect benefit payments and how to establish and refer for collection cash, medical and food assistance overpayments. The rules and procedures for identifying and correcting underpayments are also in this category.
WAC 388-410-0001 What is a cash / medical assistance overpayment?
WAC 388-410-0005 Cash and medical assistance overpayment amount and liability
WAC 388-410-0010 Repayment of grant overpayment occurring prior to April 3, 1982, and resulting from department error
WAC 388-410-0015 Recovery of cash assistance overpayments by mandatory grant deduction
WAC 388-410-0020 What happens if I receive more Basic Food or WASHCAP benefits than I am supposed to receive?
WAC 388-410-0025 Am I responsible for an overpayment in my assistance unit?
WAC 388-410-0030 How does the department calculate and set up my Basic Food or WASHCAP overpayment?
WAC 388-410-0033 How and when does the department collect a Basic Food or WASHCAP overpayment?
WAC 388-410-0035 Are alien and alien sponsors jointly responsible for cash and food assistance overpayments?
WAC 388-410-0040 Cash and food assistance underpayments.
Revised June 3, 2011
If the department determines that an assistance unit’s overpayment amount needs to be modified because of an error, the worker should refer to the ACES manual Benefit Error Group, Modify a BEG – Underpayment or Overpayment.
See Benefit Error Group (BEG) – Modify a BEG – Underpayment or Overpayment
Didn’t act timely on a reported or known change in circumstances;
Made a mistake in determining the AU’s eligibility or benefits;
Incorrectly issued duplicate benefits;
Issued allotments after the end of the AU's certification period without redetermining the AU's eligibility;
Didn’t disqualify a client for an IPV on time as required under chapter 388-446 WAC;
Made an incorrect change to the case or failed to make a needed change that caused the department to make an incorrect decision on the AU's eligibility or benefit amount.
Understood what they were required to report; or
Failed to report a change or provided inaccurate and incomplete information, but without the intent to get more food assistance than they were eligible to receive.
Makes an oral or written false or misleading statement that affects their benefits;
Misrepresents, conceals, or withholds facts; or
Violates the Food Stamp Act, Basic Food regulations, or any state laws that cover:
How someone can get, have, and use Basic Food benefits or EBT cards; or
The transfer of Basic Food benefits or EBT cards; or
NOTE: See chapter 388-446 WAC for information and rules on IPV disqualification hearings and penalties. WAC 388-446-0015 explains that an administrative disqualification hearing (ADH) is a formal hearing to determine if a person committed an IPV. Eligibility staff can't write an overpayment as IPV until an ADH or court hearing is held and the outcome determines an IPV was committed and caused the overpayment. See Fraud chapter: Clarifying Information #6 under WAC 388-446-0001.
The Date of Discovery is the date we have adequate information to validate the AU has an overpayment, and determine the amount overpaid. It isn't the date of a system-generated (BEG), because these only give enough information to identify a potential overpayment.
The date we "open" the BEG in ACES is the official date of discovery. The exception to this rule is Basic Food errors discovered through the federal Quality Control review process. The official date of discovery for a QC error is the date the QC error report in a client’s electronic case record (ECR).
We must process at least 90% of all overpayments by the end of the calendar quarter after the quarter we discover an overpayment. A claim isn't timely if we sent the AU an overpayment letter later than the last day of the quarter after the quarter in which we "opened" the overpayment BEG. Even though we can set up a valid overpayment after the timely processing period, federal rules require the department to meet this timeframe.
NOTE: Potential overpayments discovered by the Basic Food quality assurance (QA) process must be "priority". Every attempt must be made to establish overpayments within federal time limits after the payment errors associated with these overpayments have been finalized by the Division of Program Integrity (DPI).
To ensure that staff review potential overpayments and promptly act on this information, the department monitors BEG lists.
Claims Establishment Timeline |
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1st Quarter |
2nd Quarter |
3rd Quarter |
4th Quarter |
If your date of discovery is in: |
January; |
April; |
July; |
October; |
You must establish the claim by: |
June 30th |
September 30th |
December 31st |
March 31st |
To measure if we are meeting federal timeliness standards for establishing overpayments, staff compares the dates an overpayment BEG was "opened" to the date we sent the overpayment letter.
EXAMPLE
If we discover an overpayment on February 6th (1st quarter) we must set up the overpayment by June 30th (end of the 2nd quarter).
If we discover an overpayment on June 28th (2nd quarter) we must set up the overpayment by September 30th (end of the 3rd quarter).
8. Other program reporting requirements and Basic Food overpayments:
If someone doesn't report a change in circumstances required under WAC 388-418-0005, we determine if there is an overpayment for each program based on that program’s reporting requirements.
For Basic Food, the household must report changes as required under WAC 388-418-0005(2).
If a Basic Food assistance unit wouldn't have to report the change based on the AU's circumstances, we don't set up an overpayment even if the household had to report a change for another department program.
EXAMPLE: Julie, Spencer, and their two children receive TANF and Basic Food. They fail to report that Spencer got a job earning $900 monthly. Spencer received his first paycheck on August 25th. We discover this information in November.
TANF: The family was required to report getting a job for TANF. We determine amount of TANF benefits the family was eligible for if they reported the change timely on September 10th and set up an overpayment for October and November.
Basic Food: The new job didn't cause the family to go over the income limit for a family of four. Since they didn't have to report this change for Basic Food, we don't set up an overpayment.
EXAMPLE: Diane receives TANF and Basic Food for herself and her daughter. Diane doesn't report she has switched to full-time status at work and now earns $2,500 monthly. Her paycheck on April 30th puts her over the income limit for Basic Food. We discover this information in July.
TANF: Diane was required to report the change in employment status and going over the earned income limit for TANF. We treat this change as if Diane had reported it timely on May 10th. We would set up an overpayment for the TANF benefits the AU received in June and July.
Basic Food: Diane’s $2,500 monthly income is over the income limit for a two-person AU. Since she was required to report this change for Basic Food, we set up a Basic Food overpayment for benefits the AU received in June and July.
Even though all adult members of an AU with an overpayment are liable for the full overpayment, OFR tracks payments to ensure that we don't collect more than the amount of the overpayment.
The overpayment amount is the difference between what the client received and what they were eligible to receive.
For Administrative Errors where the household has earned income, apply the earned income deduction to all earned income, reported or unreported.
For Inadvertent Household Errors with unreported earnings, don’t apply the earned income disregard to the portion of earnings that wasn’t reported timely.
iii. For trafficking, the overpayment amount will be provided by the court or in a signed agreement.
b. When determining an overpayment amount, subtract any outstanding underpayment from an overpayment to get the net overpayment amount.
Overpayments discovered outside the QC Review process: If we didn't discover the overpayment through the federal QC process, we set up an overpayment if:
The responsible household members still receive Basic Food or WASHCAP benefits and the overpayment is over $85; or
The overpayments total more than $125 and the responsible household members don’t receive Basic Food or WASHCAP.
The thresholds remain the same when the overpayment will be referred as IPV.
OFR collects on established debts regardless of the amount. The $85 and $125 thresholds related to QC findings apply to whether or not we establish an overpayment for Basic Food or WASHCAP. OFR collects on established overpayments regardless of the amount. This includes when we:
Set up an overpayment for an AU who no longer receives Basic Food; or
Modify an existing overpayment.
OFR is the point of contact for “compromising” (reducing) overpayment balances or making decisions on waiving overpayment collections. Clients must be referred to OFR for these requests.
When overpaid but still eligible, the emergency supplement isn’t increased to make up the overpaid amount.
Repaying an overpayment:
The Department collects from the client by reducing Basic Food benefits. Clients can also repay an overpayment by paying the OFR directly.
The adults in the overpayment assistance unit share the responsibility for repaying an overpayment even if they later belong to different assistance units.
We consider a person who receives Basic Food or WASHCAP benefits as having the ability to repay an overpayment.
When can an overpayment be reduced:
The CSO can reduce an overpayment debt only if the overpayment was incorrectly calculated for an amount larger than is actually owed.
An Administrative Law Judge (ALJ) can order an overpayment debt waived or reduced to correct an overpayment that was calculated in error. An ALJ doesn't have the authority to reduce or waive an overpayment based on hardship.
OFR can reduce an established overpayment:
A person responsible for an overpayment may be able to negotiate a reduction of the debt. OFR is the secretary's designee for the department under RCW 43.20A.110 and uses criteria under RCW 43.20B.030 to determine if an overpayment should be reduced or dismissed as allowed under Title 7 CFR §273.18(c)(7)
i. OFR OFR determines if a reduction of the debt would be cost effective for the department instead of continuing collections through other means.
ii. Normally, reducing the debt is cost effective only if the person is willing to pay the remaining debt off in full.
iii. People can contact OFR to negotiate a reduction in the overpayment by calling at 800-562-6114.
We don’t recover an existing overpayment from the first month's benefits of a newly-approved application for WASHCAP or Basic Food. We do recover an overpayment from the first month of an AU's certification period if we recertified the AU with no break in eligibility. How overpayments are collected:
NOTE: If we remove Basic Food benefits from a client's EBT account through the expungement process, OFR will reduce the client's overpayment by the amount we expunged from the client's EBT account.
Revised July 27, 2012
Effect of Underpayments on Resources: The unspent amount of a cash assistance underpayment is not included in computing the value of a household's nonexempt resources in the month the underpayment is reimbursed or in the following month.
Date of Discovery for Department Errors: When the underpayment is discovered by the department, the date of discovery is the date we have adequate information to validate the household has an underpayment and determine the amount the household was underpaid. It is not the date the department received information or verification.
1. Intentional Overpayment:
2. Unintentional Overpayment:
a. An unintentional client error overpayment is based on the condition that although caused by the client, there was no intent to obtain or retain assistance for which the client knew they were not eligible.
b. An unintentional department error overpayment is the direct result of omission, neglect, or error by the department in taking action on information affecting the amount of benefits for which a client is eligible.
c. An unintentional technical error is an overpayment not directly caused by department error or client error. These types of overpayments are due to effective dates and procedural requirements. Following are examples of technical errors:
3. Strikers:
Prior to July 1, 1999, an overpayment exists for any month in which a member of a TANF/SFA household is on strike on the last day of that month. Starting with July 1999 benefits, there are no overpayments based solely on a member of the TANF/SFA assistance unit being on strike.
4. Prospective Budgeting:
An overpayment exists when a client intentionally understates their estimated income for the first 2 months of eligibility. See WAC 388-450-0215.
5. When Someone Fails to Report a Change of Circumstances Required for Cash Only:
When someone doesn't report a change of circumstances required under WAC 388-418-0005, we determine if a client has an overpayment for each program based on that program’s reporting requirements.
If the person was not required to report a change for Basic Food or medical benefits, we do not set up an overpayment for these programs based on the unreported change. This is true even if we would have reduced benefits if the household reported the change.
6. Diaper Related Payments (DRP):
DRP is not pro-rated and all overpayments will be for the full amount issued in the ineligible month(s). DRP will only have an overpayment if the assistance unit was completely ineligible for DRP (i.e., no child under 3 in the household and/or the assistance unit wasn’t eligible for TANF)
All adult members of a cash assistance unit are responsible for overpayments incurred after January 1, 1982 provided they were members of the assistance unit at the time of the overpayment.
The amount of an overpayment can be reduced by the amount of any unpaid underpayments in any period prior to the month in which the overpayment is computed.
As of May 1, 2019 children will no longer be included when establishing an overpayment for cash.
On child-only TANF cases, the overpayment is established for the adult receiving the grant.
When a non-needy caretaker relative or guardian is assessed an overpayment for a child who isn't currently part of the assistance unit:
We'll no longer recoup the overpayment by means of mandatory grant reduction.
Alert the Office of Financial Recovery (OFR) when a caregiver is in this situation by sending an email to DSHS RE OFR Client Overpayment. This email must include the:
Caregivers name and client ID,
Date of the original overpayment letter and
Text explaining we must no longer recoup the overpayment from the cash grant.
Once OFR learns about this change, they will stop the automatic deductions from the TANF grant and pursue other means of collection.
Establishing Overpayments for vendors
If it is determined that a vendor has been overpaid, an overpayment must be established.Overpayments for vendors are processed by the Office of Financial Recovery (OFR).
Staff will complete form DSHS 18-398A and email the form to OFR at vendorop@dshs.wa.gov.
OFR will establish the overpayment in their system and mail a copy of the DSHS 18-398A to the vendor.
ACES Procedures
Revised March 25, 2011
Grant Deductions
Revised March 25, 2011
This section describes how the department issues benefits, requirements to endorse warrants, how and when the department provides benefits, the allowable use of cash and food assistance benefits, and the replacement of benefits and Electronic Benefits Transfer (EBT) cards.
Revised November 21, 2023
This section describes how the department issues benefits, requirements to endorse warrants, how and when the department provides benefits, the allowable use of cash and food assistance benefits, and the replacement of benefits.
1. Use of Cash and Food Assistance Checklist
a. Review the 'Your DSHS Cash or Food Benefits' form 14-520' with clients during the interview process at application and eligibility review to ensure that the household understands:
i. The allowable use of DSHS benefits;
ii. The illegal uses, including the purchase of marijuana and/or marijuana-based products with EBT cards or cash from the EBT cards; and
iii. The penalties for illegal use of benefits.
b. Request that the head of household or authorized representative sign the 14-520 and send the document as file only for the client's electronic case record (ECR).
If the client refuses to sign the form or fails to return the signed form, don't deny the application or terminate assistance. Signing the form isn't a condition of eligibility.
2. Referrals to the Office of Fraud and Accountability (OFA)
Refer allegations of reported misuse of cash or food assistance benefits to OFA utilizing the Barcode referral for FRED.
When a worker receives the DSHS-FRED form from OFA identifying use in a prohibited location, review the ECR for prior offenses (document type FR)
If there is a prior offense, a protective payee must be assigned.
The worker will:
Notify Social Services Specialists through Barcode tickle to @SOC
The Social Services Specialist will:
Assign a protective payee (see Payees on Benefit Issuances - Protective Payees)
Input a -COMM tickle to 900@FIN for input of protective payee information into ACES
The worker who receives the tickle will:
Input the Authorized Representative information under Contact Information in ACES 3G
Revised March 25, 2011
Subtract the date of application from 31 and divide the result by 30. Multiply the result by a full month benefit amount.Round down to the nearest dollar.
Revised March 25, 2011
The Office of Accounting Services (OAS) holds funds from cash benefits issued to someone in the form of a state warrant (check). Warrants are stale-dated at the 180 days from issuance based on the statute of limitations.
The DSHS Office of Financial Recovery automatically uses expunged Basic Food benefits to reduce a recipient's outstanding overpayment balance.
Normally we require the US Postal Service (USPS) to return DSHS mail if the post office knows that the client doesn't live at the residence. However, if a household requests USPS to hold their mail due to a temporary absence (i.e., vacation or hospital stay), the post office may hold mail that we send.
Clients may have their cash assistance deposited directly into a checking or savings account by completing the Direct Deposit Enrollment - DSHS 14-432 and returning the completed form to the address on page 2 of the form, along with a pre-printed voided check, pre-printed deposit slip, or a printout from the financial institution, as this is required to complete the enrollment process.
A client who wants another person to have access to their benefits must authorize the person to be an alternate card holder.
If a responsible member of the AU cannot access the benefits for the AU because the head of household cannot complete and sign the Alternate Card Holder Authorization due to incapacity or other circumstances, document the circumstances in the case record and authorize the issuance of a Quest card for the responsible member as an alternate card holder.
If a recipient contacts you about wanting to stop receiving their benefits through EFT (Direct Deposit), you have two options to assist the client. You may delete the banking information on the EFTR screen in ACES main-frame, or you may inform the client to call the toll free number at 1-888-235-2954.
Checks for cash benefits can be mailed to a Post Office box or the CSO when a payee meets WAC 388-412-0025(1)(c) and makes this request in writing. If a recipient requests that checks be mailed to an address other than their residence address:
See Issuances
Reported loss:
Redeemed warrants and affidavits of forged endorsement: If the department learns the original warrant that was replaced is redeemed, request a copy of the signed warrant from DFFR for the payee to examine.
Office of Accounting Services
Central Operations, SOL Desk
PO Box 45845
MS: 45845
Olympia, WA 98405-5845
Replacing Out-of-Date SSP Warrants
1. If a payee reports an out-of-date warrant, do not replace the warrant.
2. Ask the payee to sign a DSHS 07-008(X) Affidavit of Lost, Stolen, or Destroyed Warrant.
3. Send the notarized affidavit along with the warrant and a note asking to replace the warrant to OAS. Follow the instructions on the form.
Requesting Copies of Warrants:
WAC 388-412-0040 Can I get my benefits replaced?
Replace the amount of food destroyed up to the amount of the household's monthly allotment. Use the client's statement when considering the amount of benefits to replace. If the client's statement is questionable, consider when the client received benefits, when the food was destroyed, and the day of the month of the disaster;
Congress passed the Consolidated Appropriations Act, 2023, and extended it with the Continuing Appropriations and Extensions Act, 2025, which allows state agencies to use federal funds to replace SNAP benefits stolen between October 1, 2022, and December 20, 2024 via card skimming, card cloning, and other similar methods. Some provisions apply.
The department also received state funds to replace TANF, SFA, RCA, PWA and ABD cash benefits stolen between July 1, 2024, and December 20, 2024 via card skimming, card cloning, and other similar methods.
Benefits stolen via card skimming, card cloning and other similar fraudulent methods
EXAMPLES:
Revised April 1, 2024
This section explains which Basic Food assistance units (AUs) do not have to meet all of the eligibility requirements for Basic Food.
200 percent of Federal Poverty (FPL) based on Federal Poverty Guidelines published January 2024. April 1, 2024 – March 31, 2025 |
|||
---|---|---|---|
Persons in AU |
200 percent FPL |
Persons in AU |
200 percent FPL |
1 |
$2,510 |
6 |
$6,993 |
2 |
$3,407 |
7 |
$7,890 |
3 |
$4,303 |
8 |
$8,787 |
4 |
$5,200 |
9 |
$9,683 |
5 |
$6,097 |
10 |
$10,580 |
Add $897 for each person over 10 AU members. |
An AU that is CE doesn’t automatically receive Basic Food benefits. If the AU is ineligible for a reason other than income or resources, CE status doesn't make them eligible for benefits. Examples of eligibility requirements not met by CE include:
EXAMPLE: Basic Food AU consists of four eligible members and one member who is ineligible based on their undocumented status. The AU isn't CE based on receipt of TANF/SFA, DCA, SSI, or ABD benefits. The three eligible members of the AU have $4000 monthly earnings; the fourth is a child. The ineligible member has $1000 countable monthly income. Determine if the AU is CE as follows:
$750 Prorated share (¾ of $1,000) of countable income from ineligible member under WAC 388-450-0140
+ $4000 Gross countable income of eligible AU members
= $4,750 Income used to determine if AU meets 200% test.
Because the gross countable income of $4,750 isn’t over 200% of the federal poverty guidelines for three eligible AU members, the AU is CE for Basic Food.
Revised September 26, 2013
This category contains two sections which address the length of certification periods.
This section explains: What a certification period is for Basic Food, the longest certification period allowed based on their assistance unit's (AUs) situation, and when ACES sets a certification period to match the review end date of other programs.
AU Circumstances / Other Programs |
Default Certification |
---|---|
All non-WASHCAP or non-ESAP Basic Food AUs |
12 months |
WASHCAP or ESAP |
36 months |
Transitional Food Assistance |
5 months |
ESAP eligibility may only be determined at application and recertification. ACES is programmed with the ESAP requirements and will change a Basic Food Certification to ESAP when the assistance unit qualifies. See: Elderly Simplified Application Project (ESAP)
For changes related to ESAP cases, See: Elderly Simplified Application Project (ESAP)
This chapter describes what changes a client needs to report, how changes affect the monthly benefit level and what actions are needed. This chapter contains the following sections:
For Basic Food only cases:
If the household |
And the information |
And the change happened |
Then |
---|---|---|---|
Is required to report the change
|
Is verified upon receipt (information comes from the source: for example, SOLQ, UTAB, current employer or landlord) or a system match from the Social Security Admin (such as SDX), or National Directory of New Hires |
Less than 60 days before the current month |
Act on the change. |
Is not verified upon receipt or a system match |
Ask the household to verify the information and take appropriate action. |
||
Is a system match (SSA, NDNH) |
60 days or older |
Act on the change. |
|
Is not from one of those sources |
Hold the information until the next MCR or recertification. |
||
Is not required to report the change |
Is verified upon receipt |
Less than 60 days before |
Act on the change. |
Is not verified upon receipt |
(no timeframe) |
Hold the information until the next MCR or recertification. |
If the third-party report shows that we certified or recertified the case using significantly conflicting information, we must verify the report and make the necessary case corrections. This may involve creating overpayments or making a fraud referral.
Example of information that conflicts with, but doesn't significantly conflict with, information used at cert:
Examples of information changing after cert:
c. Changes Verified Upon Receipt:
d. A Lottery or Gambling Win:
e. Other Reports:
f. Department of Corrections Reports and Incarceration: We have to act on Department of Corrections match tickles. These matches are from a primary sources, however, because the tickles are based on data we receive once a month, we must verify the tickles data.
Use FORS to determine whether the client is still incarcerated. Remove the incarcerated client from the basic food or cash household with adequate notice if they are incarcerated more than 30 days.
When the department verifies a client is incarcerated over 30 days, we suspend EBT benefits to prevent fraudulent use. Take the following steps when receiving notification that someone is verified to be incarcerated over 30 days:
When a client contacts the department to report they are no longer incarcerated, request reactivation of benefits and document case action. Benefits will be available within 48 hours of notification they are no longer incarcerated. Contact to the department is also considered a request for reinstatement or application.
g. SSA Death Alerts
We must take action on alerts from SSA of a client's death. This information isn't considered verified upon receipt. Use DOH web portal to verify a client's death.
h. Information known to the department:
Information considered known to the department doesn't need verification to affect a household's benefits. The "department" is any agency under the Department of Social and Health Services including:
It also includes programs within ESA.
A household must report when a non-exempt ABAWD's hours of employment drop below 20 hours per week. This includes when the non-exempt ABAWD is the head of household for Basic Food. Only ABAWDs in King County are subject to this requirement.
The DMS E001 tickler uses EBT transaction data to identify EBT cash or food clients who may no longer be living in Washington because they are consistently using their benefits out of state. Out of state EBT transactions are defined as any EBT purchase, ATM withdrawal or manual voucher transaction at a non-Washington site that requires the use of an EBT card as part of the transaction. When this occurs, the residency may be questionable.
Follow the E001 tickler handling process described in the CSD Procedures Handbook.
Non-Income Changes
The date of a change is normally the date a change happens. Examples of this include the date:
Income Changes The date of an income related change is the date someone receives income based on the change. Examples of this include the date:
We ask for proof of a change if it increases a household's benefits. We only ask for proof of an increase in expenses if the expenses are questionable. We increase the AU's benefits based on the effective date rules under WAC 388-418-0020.
We don't close the case based on the household's failure to give proof of a change that would increase their benefits.
People may report a change in their circumstances on an eligibility review form or an application for benefits. If you receive an application or eligibility review form:
For Basic Food, follow the rules in WAC 388-408-0035 to determine if the person is still eligible for benefits.
Washington state residency is a requirement for most programs. If an AU member or the entire AU leaves the state, follow the rules in WAC 388-468-0005 to determine if they are still eligible for benefits.
For information on mid-certification reviews, please see the Mid-Certification Reviews section.
Top of Page
1. Advance notice:
2. Overpayments due to not reporting or reporting late
See BENEFIT ERRORS and BENEFIT ERRORS – BASIC FOOD OVERPAYMENTS for information on how to set up an overpayment when someone did not report a change timely or when we did not make the change timely.
If someone does not report a change in circumstances required under WAC 388-418-0005, we determine if a client has an overpayment for each program based on that program’s reporting requirements.
· For Basic Food, the household must report changes as required under WAC 388-418-0005(2).
· If a Basic Food assistance unit would not have to report the change based on the AU's circumstances, we do not set up an overpayment even if the household had to report a change for another department program.
3. Mass changes
Mass changes are changes to eligibility rules.
Examples of mass changes include:
Changes to allotments or payment standards |
Changes to income standards |
---|---|
Changes to the Basic Food maximum shelter deduction |
Cost of Living Adjustment (COLA) to SSI, Social Security, or VA benefits |
Changes to the standard deduction for Basic Food |
Changes to utility allowances for Basic Food |
When a client reports a change in income that we do not expect to last at least a month beyond the month they reported the change, do not change their benefits. This includes having income over the gross income limit for Basic Food. Instead, take the following steps:
If the client is an ABAWD, we must determine if participation is met for each month (see Worker Responsibilities WAC 388-444-0030- Verifying Participation).
2. Changes that cause an increase in benefits:
EXAMPLE: Billie is in an ARC (Adult Residential Care) facility and is receiving a CPI of $38.84 as an TANF recipient. Billie is released from the facility on April 10th and is eligible for a supplemental payment calculated as follows:
EXAMPLE: Charlie is an ABD recipient, who has been in an Adult Residential Treatment facility (ARTF) and receiving CPI $38.84. Charlie graduates and moved into clean and sober housing unit on October 13th and eligible for a supplemental payment calculated as follows:
3. Changes that reduce benefits:
When people report a change that will reduce their benefits, make the change to reduce their benefits (with advance notice). Do not require proof of the change. We will verify this information at the next eligibility review / recertification.
If the client is an ABAWD, consider how a change in their hours or income could impact their work registration status. If verification of participation is required, request it.
4. When someone reports multiple changes at one time:
When clients report multiple income-related changes at the same time, review each change separately to decide how the change impacts their eligibility and benefits.
EXAMPLE: Rico is returning to work after a temporary incapacity. Rico lives in a non-waived area and is now identified as a non-exempt ABAWD. Although we do not need income verification to decrease benefits, we do need work verification to determine if Rico will meet participation requirements.
5. For Basic Food: When a newborn's date of birth is between the application date and interview date:
The newborn is eligible for benefits in the month of application effective the date of birth. However, ACES does not correctly prorate benefits in the month of application when the newborn's application date is different than the rest of the household members. When finalizing the case, you will need to exclude the baby in the first month and manually create a supplement for the newborn's portion. The supplement amount is the difference between what the household is eligible to receive with and without the newborn, prorated from the date of birth.
To determine the supplement amount, take the following steps:
EXAMPLE: A husband and wife apply for Basic Food on 07/10/10. The wife gives birth on 07/20/10 and reported this information during their interview on 07/25/10. The worker screens the newborn onto the AU. After going through Steps 1 and 2, the worker determines that in the month of application, the household is eligible for $250 as a household of three (including the newborn) and $180 as a household of two (excluding the newborn). The worker finalizes the case and approves benefits as a household of two for the month of application, and a household of three for the rest of the certification period.
To figure out the BEG amount, the worker follows Step 3 and 4:
NOTE: For information on how to create a BEG, see Benefit Error Group (BEG) in the ACES User Manual.
6. For Basic Food: When someone (other than a newborn) moves into the household between the application date and interview date:
If someone moves into the household between the application date and interview date, that person is eligible for benefits effective the application date, along with the rest of the household members.
7. Requests to add a person to an open case:
Cash Assistance |
If someone asks to add an adult to their cash benefits, have the person complete an application or ER.
|
---|---|
Basic Food |
We do not need a new application / ER form to add someone to the AU, unless the applicant is an ABAWD attempting to requalify.
|
The client is eligible to receive a supplemental payment for the time they are eligible in application (requalifying) month. To process the supplement:
To figure out the supplement amount, the worker follows steps 4 and 5.
$355 - $194 = $161
$161 ÷ 30 days (from 04/01 through 04/30) = $5.3667 per day
$5.37 x 11 days (from 04/20 through 04/30) = $59.03
The worker creates a BEG for $59.
8. Changes that cause a cash program change:
When clients report changes that makes them ineligible for the active cash program but eligible for another cash program, verify the change and process the cash program change without a new application or ER form unless it is required for other reasons. See CSD Procedure Handbook – Change of Circumstances Processing (For staff only) for procedures.
9. Return Mail:
If you receive returned mail for someone and there is a new or forwarding address, take the following steps:
a. If the client's new address is in the State of Washington; refer to Worker Responsibility #5 for WAC 388-418-0007 in the Reporting Requirements section of the EAZ Manual.
b. If the client's new address is out of state, terminate benefits without advance notice as described in WAC 388-458-0030 (3)(b).
Note: When mail is returned by the post office, and there is no new or forwarding address, HIU will dispose of the envelope.
c. No other action is necessary until the household makes contact at the next eligibility, or mid-certification review.
ACES Procedures
See Interview | |
Add a Person: | See Add a Person |
Add a Program: | See Add a Program |
Update AU / Client Data: | See Update Assistance Unit / Client Data |
Terminating an AUs / Client's Benefits: | See Close Assistance Unit / Client |
Adverse Action: | See Update Assistance Unit / Client Data See Deny an Assistance Unit / Client |
To describe the services available to assist clients who are chemically dependent or abusing alcohol or drugs. This topic also describes the process for access to chemical dependency treatment for people who are on other public assistance programs and for those who are not eligible for any public assistance program.
TABLE OF CONTENTS - Chemical Dependency Treatment
To provide information to CSD staff when contacted by people who want substance use treatment services.
This section describes the chemical dependency treatment services available to Social Security Supplemental Security Income (SSI) beneficiaries.
When an SSI beneficiary is placed in a DBHR contracted residential chemical dependency treatment facility, see Chemical Dependency Treatment and Food Assistance to determine effect on eligibility. The client's SSI income is considered in determining eligibility for Food Assistance.
This section explains the availability of food assistance for an individual eligible for ALTSA Treatment Services.
Clients placed in a chemical dependency treatment facility but not in an ALTSA contracted treatment bed may be eligible to receive food assistance. For example, a person receiving involuntary treatment or a pregnant woman receiving treatment.
See Authorized Representative
Revised July 25, 2017
This section lists the procedures on how to report suspected child abuse, neglect, or the rape of a child. For purposes of this section, “Abuse and neglect” of children means the injury, sexual abuse, sexual exploitation, negligent treatment, or maltreatment of a child by any person under circumstances which indicate that the child’s health, welfare, and safety is harmed. The laws addressing child abuse and neglect are codified in RCW RCW 26.44.020(12) and RCW 26.44.030(1(d). The laws addressing child rape are codified in RCW 9A.44.073-079.
State law requires all DSHS employees to report to Child Protective Services (CPS) the suspected abuse or neglect of a child under the age of 18 whenever there is reasonable cause to believe abuse or neglect exists.
The term “reasonable cause” means that if we observe or learn that a child has been abused or neglected, then we must report the incident to CPS. We must report suspected abuse or neglect even if there is no proof that an incident occurred. The gender or sexual orientation of the parties involved does not matter. We are not required to tell the minor or adult about the report.
Examples of abuse or neglect include:
Always report suspected abuse at the first opportunity, but no later than 48 hours after you decide reasonable cause exists that an incident occurred. Report the abuse to CPS at 1-800-562-5624. Document in the case file that a report to CPS was made.
A report of child rape to law enforcement can be made only when the department knows the age of the alleged perpetrator. We do not have to ask the age of the alleged father. However, if the age of the father is known and it meets one of the child rape conditions above, a report of suspected child rape must be made to the law enforcement agency that has jurisdiction where the minor lives (either city police or county sheriff).
The gender or sexual orientation of the parties involved does not matter. If the incident meets the child rape criteria above, we must report it to the appropriate law enforcement agency (e.g. city policy or county sheriff).
An oral report can be made, but a written report must be sent upon request by the law enforcement agency. To find a law enforcement agency, click on: https://en.wikipedia.org/wiki/List_of_law_enforcement_agencies_in_Washington
Also, report to CPS at 1-800-562-5624 if abuse or neglect is a factor. There may be situations in which reports to both law enforcement for child rape and CPS for abuse or neglect are made.
This chapter provides information and instructions on the assignment of support rights to the State. It includes the requirement to cooperate with the Division of Child Support (DCS) as a condition of eligibility for TANF and SFA.
Child Support Requirements
Note: In some cases child support arrears “past due support” is not assigned to the state and is forwarded to the custodial parent while on TANF. Budget child support arrears income received by the custodial parent as unearned income “DP”.
Note: Effective February 1, 2021 Pass-through payments do not affect TANF/SFA grants. However, these payments must be budgeted for Basic Food. Workers must use SEMS for each active child support case to anticipate child support amounts. The SEMS Disbursement History (DH) screen shows the amount disbursed and passed through to the custodial parent/caregiver and the Case History (CH) screen shows how the payment is applied for current and arrears support. Using the CP valid value will budget this income correctly for Basic food and exempt it for TANF.
How do I complete child support referrals?
Cooperation
Good Cause
See instructions for explaining assignment of child support rights and completing the 18-334(s) in the Clarifying Information, Cooperation section above.
When the CP applying for or receiving TANF/SFA states it isn’t safe for DCS to provide full collection services (which may include collection of medical support), this is a request for a good cause determination.
Send a General Correspondence letter with instructions to complete and return the DSHS 18-334. Also let the parent or caregiver know they can access the DSHS 18-334 online. If a parent/caregiver already receiving TANF/SFA requests good cause over the telephone or in writing, do a referral to the SSS for the good cause determination while you wait for receipt of the form.
When a parent/caregiver requests good cause, enter an "N" in the IV-D cooperation field, a “Y” in the good cause indicator field, the appropriate code in the reason field, and a “CP” (claim pending) in the status field on the NCP page of the NCP that the CP (custodial parent) states may cause harm.
After entering the NCP page information, refer the parent/caregiver to the SSS who makes the good cause determination. Refer the good cause claim to the SSS immediately following the phone interview if the parent/caregiver claims good cause without waiting for the returned 18-334(s).
The SSS must complete the good cause determination even if the parent/caregiver terminates TANF/SFA during the good cause determination process.
The supervisor approves the DSHS 18-444(X) - Good Cause Decision by checking the 'reviewed by Supervisor' box in the Barcode Good Cause system.This is a requirement before generating the decision letter.
Replace the “CP” (claim pending) coding with the appropriate code when the SSS approves or denies good cause.
Begin the good cause process as detailed above if a parent/caregiver begins to cooperate with DCS and then requests good cause. Change the reason and status fields to the appropriate code when the determination is pending and again after approval or denial.
When a custodial parent requests good cause after a 25% DCS non-cooperation sanction has been entered, begin the good cause process as detailed above. Instead of coding “CP” (claim pending) enter a “NS” (Pending Non-Cooperation) in the status field. DCS is notified that the client has claimed good cause and they put a hold on the collection process for 30 days. DCS sends a Cooperation Notice, and staff must follow the lifting DCS non-cooperation sanction process.
The system notifies DCS in the overnight batch process (e-Referral) when the NCP page changes.
For more information see the Social Services Manual - Good Cause
A TANF grant will automatically close after the second consecutive month that child support collections exceed the grant payment amount unless there are optional members in a Consolidated Assistance Unit. For instruction about how to close these cases, go to ACES Procedures. See link below.
See Close an Assistance Unit / Client
This section provides basic definitions of various citizen and immigrant statuses relevant for determining eligibility for federal and state programs.
The Immigration and Nationality Act (INA) is the federal statutes that govern the entire immigration law. It is codified in Title 8 of the U.S. Code, starting with Section 1101.
For a list of typical citizenship/immigration documents see the:
CSD staff: For guidance on how to read a Visa, I-94 Class of Admission Codes, or I-551, Lawful Permanent Resident (LPR) Category Codes and ACES 3G Coding refer to information in the Training – CSD Desk Aids - Immigration Section of the CSD Internal SharePoint website.
Release of information regarding non-citizens is subject to the same confidentiality rules that govern release of all DSHS clients’ data to outside parties. For more information on confidentiality of individually identifiable data, please see RCW 74.04.060. The department is only obligated to report clients’ information to the federal government when a sponsored immigrant receives federally funded benefits under the "indigence exemption". See WAC 388-450-0156, (7) for a description of this reporting requirement.
When requesting information necessary to determine citizenship or immigration status, be mindful of client rights. DSHS does not discriminate based on race, color or national origin. All similarly, situated clients should be treated in the same manner.
Request immigration status information only when needed to determine an applicant’s eligibility for public benefits. Never ask undocumented immigrants to contact United States Citizenship and Immigration Services (USCIS) themselves.
Notify your supervisor if you believe a report to USCIS is necessary.
Eligibility for public benefits depends on an individual's citizenship or immigration status. All individuals fall into one of the following four groups for purposes of benefits eligibility. For more information, click the links for each category:
Additional Information
The links below provide additional information for determining immigration status for individuals applying for public benefits:
Consult the Decision Tree in Appendix I for an overview of citizenship and alien status eligibility rules.
Persons born in the United States or in U.S. territories, under the terms listed below, are U.S. citizens at birth. This includes persons born in:
U.S. Nationals are persons born in:
U.S. nationals have the same eligibility for public assistance benefits as U.S. citizens.
It is possible that a child or a grandchild of a U.S. citizen who was born abroad, may have acquired citizenship at birth. In such cases, citizenship may depend on:
If unable to verify, refer individuals to an immigration attorney at the Northwest Justice Project, or the Northwest Immigrant Rights Project (Western Washington - 206-587-4009; Eastern Washington - 509-854-2100).
To qualify for benefits they must provide verification of tribal enrollment showing they are:
American Indians, who do not meet the criteria above, are undocumented unless they have another immigration status with USCIS.
For persons who automatically become citizens under terms of the Child Citizenship Act of 2000 or previous legislation, USCIS does not issue documentation unless requested. Clients may not be aware they, or their children, are already citizens.
If the client is uncertain about whether they meet conditions for automatic citizenship, refer them to an immigration attorney at the Northwest Justice Project, or the Northwest Immigrant Rights Project (Western Washington - 206-587-4009; Eastern Washington - 509-854-2100).
Sec. 403 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) states that immigrants, who entered the U.S. on or after August 22, 1996, are not eligible to receive federally-funded benefits for five years from the date they entered the U.S. as a qualified alien. Once they have met the five-year bar, they may qualify for federal benefits, if they meet all other eligibility requirements.
The following categories of aliens, called humanitarian immigrants, are exempt from the five-year bar, regardless of their date of entry into the country:
The five-year bar does not apply to aliens, including undocumented, applying for emergency medical treatment, if they meet all other eligibility criteria for the state’s Medicaid program.
“I was a Hmong (or Highland Laotian) tribe member when the tribe assisted the U.S. military during Vietnam era (August 5,1964 to May 7, 1975).”
See Appendix III for a printable version of this statement.
Federal law does not limit the sponsor’s obligations to only the first 5 years of the sponsored immigrant being in the U.S. The sponsored immigrants’ eligibility for federal and state funded benefits do not terminate nor substitute for the sponsor’s obligations.
The I-864 Affidavit of Support commits the sponsor (or sponsors) to financial support of the sponsored immigrant, which ends only if the alien:
Divorce does not terminate a sponsor’s obligation to a spouse.
State and federal programs have different rules and eligibility requirements, and sponsored immigrants still may be eligible for some state-funded benefits. For more information, see WAC 388-450-0156 and EA-Z Manual, Income, Allocation and Deeming.
Non-qualified aliens may be eligible for some benefits. For more information, see WAC 388-424-0001, and EA-Z Manual Section - Citizenship and Alien Status Requirements Specific to Program.
All non-qualified aliens with expired documents and no application pending with USCIS are undocumented for eligibility purposes.
Applicants for asylum are lawfully present non-qualified aliens.
To enter the U.S. they are not required to have visas, but they must be lawfully admitted into the U.S. and have verification of admission. To confirm their citizenship and entry status they may provide:
An electronic I-94 can be accessed with client permission and printed at the U.S. Customs and Border Protection, I-94 website.
Most international students can obtain part-time on-campus jobs. Off campus work is allowed only with an Employment Authorization Document.
Under state and federal law, undocumented aliens are not eligible for ongoing food and/or cash assistance. They may qualify for assistance from the Consolidated Emergency Assistance Program (CEAP), Children’s Health Program, and Alien Emergency Medical (AEM) Program, if they meet eligibility requirements.
Additional Information
The “A” number stays with an alien much like a Social Security Number, until the alien naturalizes. USCIS, ICE, Customs and Border Protection, Immigration Courts, the Board of Immigration Appeals (BIA), the Systematic Alien Verification for Entitlements (SAVE) program - all track alien cases by the “A number”.
What is an Alien Registration Number Desk Aid has examples of immigration documents and correspondence with the “A” number.
Adjustment of Status is a procedure that changes (adjusts) a non-immigrant status to LPR status.
If the client does not have any verification of their current immigration status and refuses to obtain an EAD, the client is undocumented.
If USCIS approves the fee waiver request, they will notify an applicant by the I-797, Notice of Action.
Immigration questions should follow established procedures for submission through the Policy Clarification system, so that everyone can view the questions and responses.
Recording Citizenship / Alien Status
Completion of the (ALAS) Screen for Non-Citizens
Revised May 4, 2021
This section explains how to determine an alien’s “date of entry” into the United States. It describes which groups of aliens are subject to the five-year bar on receipt of federal means-tested benefits. Finally, it describes how to determine the date on which the five-year bar begins.
Determining whether a person has entered the U.S. before August 22, 1996.
For the majority of aliens the date they entered the U.S. and became a “qualified alien” is on their I-94 card or Customs and Border Protection (CBP) stamp in their passport, on a Refugee Transportation Letter as a “Date of Entry”, and on their Permanent Resident card as a “Resident Since” date.
A person is not subject to the five-year bar for TANF, or medical assistance if they entered the U.S. before August 22, 1996, even if they did not obtain a “qualified” immigration status until sometime after they entered. As long as the alien “continuously resided” in the U.S. from the earlier date, that date is considered the “date of entry”. “Continuously resided” means the alien only left the U.S. for short periods of time.
However, an applicant for federal Basic Food (SNAP) benefits, who became “qualified” on or after August 22, 1996, and who requires 5 years of residency for eligibility, can’t count time spent in the U.S. before they became a “qualified alien” toward the five-year bar requirement.
Aliens who have the five-year bar.
All aliens, who are lawfully present in the U.S. and aren’t included in the statuses named in WAC 388-424-0006, Citizenship and alien status—Date of entry have a five-year bar on receipt of Basic Food, TANF, and non-emergency Medicaid.
How to determine the date a Victim of Trafficking becomes a qualified alien.
A victim of human trafficking becomes a “qualified alien” on the certification date stated on a Certification Letter for adults, or a Letter of Eligibility for minors from the U.S. Department of Health and Human Services (HHS), Office of Refugee Resettlement (ORR). The “certification date” on the Letter is also the benefits eligibility date.
How to determine the date an asylee becomes a qualified alien.
The date an asylee becomes a “qualified alien” is the date -
Stated on an Asylum Approval Letter, from a USCIS Asylum Office, as the date asylum was granted under §208 of the Immigration and Nationality Act (INA);
How to determine the date a battered immigrant becomes a “qualified alien."
The date a battered alien becomes “qualified” is the date of the approval (or notice of prima facie case) of a Violence Against Women Act (VAWA) petition or the date that the U.S. citizen or lawful permanent resident spouse petitioned for the family visa application. These dates aren’t the same as the date the alien was granted lawful permanent residence and aren’t the date on the Permanent Resident card.
Aliens who are exempt from the five-year bar.
Aliens exempt from the five-year bar due to immigration status are listed in WAC 388-424-0006, Citizenship and alien status—Date of entry. Aliens with a status of refugee, asylee, withholding of deportation/removal, Cuban/Haitian entrant, Special Immigrants from Iraq and Afghanistan, and Amerasian remain exempt after they’ve adjusted to lawful permanent resident status. The “category” or “class” code on their Permanent Resident Alien (“green”) card identifies under which provision of law they came into the U.S. For more information on immigration documentation, status codes, benefit eligibility and step-by-step process, please see immigration desk aids located on the CSD website.
If you have questions regarding eligibility, or how to process a medical only case, please contact Dody McAlpine in the HCA Office of Medicaid, Medicare Eligibility & Policy at (360) 725-9964 or by e-mail at dody.mcalpine@hca.wa.gov
See the VERIFICATION chapter for further guidance.
For more information about verifying an asylee’s entry date, see “Asylum Documentation” under WAC 388-466-0005, Clarifying Information.
The purpose of this section is to explain the special situations that affect immigrants when there are requirements for a Social Security number (SSN) in federal and state benefit programs.
The rules and information below supplement information provided in the SSN Chapter (WAC 388-476-0005 ).
A veteran is a person who served in the active military, naval, or air service of the U.S., who fulfilled the minimum active duty service requirements or 24 months of continuous active service, whichever is less, and was honorably discharged or released. Veterans also include men and women who died while on active duty in the U.S. armed forces or forces under U.S. command. For purposes of determining a surviving spouse or dependent child's eligibility for benefits, a person who died after being released from active duty in the U.S. armed forces is also a veteran.
Obtain evidence of armed services or veteran status. For those veterans who are Hmong or Highland Lao who fought with the U.S. in Southeast Asia, have the veteran or family member sign the statement in Appendix III.
Revised March 26, 2021
Earnings Required for Work Quarters for Recent Years
This chart shows the amount of earnings needed to qualify for each SSA work quarter of coverage for 1978 through 2021.
Calendar Year |
Amount Needed for a Quarter of Coverage |
Amount Needed to Qualify for Four Quarters |
---|---|---|
1978 |
$250 |
$1000 |
1979 |
$260 |
$1040 |
1980 |
$290 |
$1160 |
1981 |
$310 |
$1240 |
1982 |
$340 |
$1360 |
1983 |
$370 |
$1480 |
1984 |
$390 |
$1560 |
1985 |
$410 |
$1640 |
1986 |
$440 |
$1760 |
1987 |
$460 |
$1840 |
1988 |
$470 |
$1880 |
1989 |
$500 |
$2000 |
1990 |
$520 |
$2080 |
1991 |
$540 |
$2160 |
1992 |
$570 |
$2280 |
1993 |
$590 |
$2360 |
1994 |
$620 |
$2480 |
1995 |
$630 |
$2520 |
1996 |
$640 |
$2560 |
1997 |
$670 |
$2680 |
1998 |
$700 |
$2800 |
1999 |
$740 |
$2960 |
2000 |
$780 |
$3120 |
2001 |
$830 |
$3320 |
2002 |
$870 |
$3480 |
2003 |
$890 |
$3560 |
2004 |
$900 |
$3600 |
2005 |
$920 |
$3680 |
2006 |
$970 |
$3880 |
2007 |
$1000 |
$4000 |
2008 |
$1050 |
$4200 |
2009 |
$1090 |
$4360 |
2010 |
$1120 |
$4480 |
2011 |
$1120 |
$4480 |
2012 |
$1130 |
$4520 |
2013 |
$1160 |
$4640 |
2014 |
$1200 |
$4800 |
2015 |
$1220 |
$4880 |
2016 |
$1260 |
$5040 |
2017 |
$1300 |
$5200 |
2018 |
$1320 |
$5280 |
2019 |
$1360 |
$5440 |
2020 |
$1410 |
$5640 |
2021 |
$1470 |
$5880 |
This section describes which immigrants are eligible for benefits through federally-funded Basic Food and state-funded Food Assistance Program.
If a client does not provide proof of the alien status of someone in the assistance unit (AU), the client can withdraw the application or apply for Basic Food without that person. That person is an ineligible AU member under WAC 388-408-0035. Please refer to the VERIFICATION chapter for general rules regarding documentation.
We must deem income to a sponsored immigrant who is not exempt from deeming requirements under WAC 388-450-0156. This includes a sponsored immigrant who is eligible for federal benefits based on being a qualified alien who has lived in the U. S. for five years, if they do not have 40 qualifying quarters of work or qualify for a different exemption.
4. When a “qualified alien” child turns 18 before being in the U.S. for five years:
5. "Lawfully residing"
6. Iraqi and Afghan Special Immigrants (SIVs): For more information on documentation, Immigration Status codes, benefit eligibility and step-by-step process, please see desk aid Iraqi and Afghan Special Immigrants Benefits
7. Haitian Entrants vs. Haitian Nationals Granted Temporary Protected Status:
This section provides information on how a person’s immigration status affects their eligibility for Temporary Assistance for Needy Families (TANF)
Provide clients who are Lawful Permanent Residents (LPR) with information about naturalization assistance services offered by local community agencies through the DSHS Office of Refugee and Immigrant Assistance. See the Social Services Manual, SSI Facilitation - Facilitation Process - SSI Facilitation Process for more information on the Department’s naturalization assistance program.
Take a client’s declaration of U.S. citizenship at face value. Don’t routinely request proof of citizenship unless there is a specific and substantive reason to, such as an inconsistency in a client's statements or in the information presented on their application for benefits.
Consider immigrants, who are not eligible for federal TANF because of the five-year bar on federal benefits, for the state funded benefits programs.
The following non-qualified aliens are lawfully present and aren’t eligible for TANF, but could be eligible for state funded benefits, if they meet all other eligibility criteria:
Pending applicants for Asylum, or Withholding of Deportation/Removal under the Convention Against Torture (CAT) if :
Aliens granted withholding of removal under the Convention Against Torture (CAT);
Aliens paroled into the U.S. for less than 1 year;
Aliens in current Temporary Protected Status (TPS) or Aliens granted deferred action status, with the exception of Deferred Action Childhood Arrivals (DACA);
Family Unity beneficiaries;
A child who has a pending application for Special Immigrant Juvenile status;
Citizens of the Marshall Islands, Micronesia and Palau. These persons have special rights under compacts of Free Association and are lawfully allowed to enter, reside and work in the U.S., but they aren’t U.S. citizens or nationals. They are lawfully present non-qualified aliens unless they have some other immigration status.
"U" visa holders;
Religious workers under section 101(a)(15)(R) of the INA;
An individual with a petition pending for 3 years or more, as permitted under section 101(a)(15)(V) of the INA;
A fiancé of a citizen, as permitted under section 101(a)(15)(K) of the INA;
Other aliens with a current nonimmigrant status
EXAMPLE A client applying for benefits has an I-94 (Arrival/Departure Record) stamp with a "B2" code that is not expired. According to the NILC Guide, "B2" signifies tourist status. A person with a tourist status is a lawfully present nonimmigrant and, if otherwise eligible may qualify for benefits. However, an alien with B2 visa is in the U.S. only temporary and doesn’t meet Washington state residency requirements,
EXAMPLE A five-person family applies for benefits. The father has a Lawful Permanent Resident card (I-551), but the mother and three children only have Employment Authorization Documents (EADs). All four EADs are coded "A15". According to the NILC Guide, the "A-15" code indicates "V" status. These are spouses and children of lawful permanent residents whose visa petitions have been pending for at least three years. Immigrants with "V" status are lawfully present non-qualified aliens. These immigrants may qualify for state benefits. The father may be eligible for federal benefits depending on other factors such as date of entry into the U.S.
EXAMPLE A mother and child applied for benefits. The mother has a valid I-94 Arrival/Departure form stamped with a "U" visa. The child would likely have been included as a dependent on the mother's U visa application. Both mother and child are considered "lawfully residing" and may be eligible for state benefits.
Immigrant children and pregnant women, who are:
lawfully present non-qualified aliens, as defined in WAC 388-424-0001; and
meet residency requirements of WAC 388-468-0005,
are eligible for federally funded medical benefits, unless they are approved under Deferred Action Childhood Arrivals (DACA).
Staff should check eligibility for State Family Assistance (SFA) and Food Assistance Program (FAP), when an applicant is a Deferred Action Childhood Arrivals (DACA) individual.
NOTE: An Employment Authorization Document (EAD, USCIS form I-765), known popularly as a work permit, is a document issued by the United States Citizenship and Immigration Services (USCIS) and it gives noncitizens a temporary authorization to work. EAD doesn’t confer immigration status, but for eligibility determination purposes, it indicates the client's current immigration status.
Aliens with a variety of statuses may be issued an EAD. Unless other current immigration document(s) are provided, an expired EAD means a person's immigration status has expired.
For more information about I-765 EAD Category Codes please see Employment Authorization Document, Category Codes
Alien Emergency Medical
Revised June 15, 2012
This section provides information on how an alien’s immigration status affects their eligibility for the State Family Assistance (SFA), Aged, Blind, or Disabled (ABD) cash, and Pregnant Women Assistance (PWA) programs. The purpose of SFA is to provide assistance to immigrants and others who are ineligible to receive TANF benefits because of the restrictions imposed under federal welfare reform. ABD provides assistance to disabled or aged individuals, including those who are ineligible for Supplemental Security Income (SSI) due to immigrant or other restrictions. Chemical dependency services are broadly available to legal immigrants.
Revised on: February 5, 2024
This section provides clarifying information to support benefit determination for survivors of certain crimes. Relevant WAC sections include:
Who are survivors of certain crimes?
Survivors of certain crimes are noncitizens and their qualifying family members, who have filed, or are preparing to file an application with U.S. Citizenship and Immigration Services (USCIS) for:
For full definitions, see WAC 388-424-0001.
“Preparing to file” means a survivor is preparing to request a T-Visa (for trafficking victims), a U-Visa (for victims of qualifying crimes), or asylum, but has not yet submitted an application to USCIS.This may be for a number of reasons, including the need to gather information for their application, or because the survivor needs to recover from physical, mental, and/or emotional abuse.
Human trafficking is a form of modern-day slavery in which traffickers force their victims into sexual slavery, commercial sexual exploitation, or forced labor through coercion, fraud, threats, psychological abuse, torture, or imprisonment. Trafficked noncitizens may be eligible for a T-Visa through USCIS.
Victims of qualifying crimes are noncitizens who suffered substantial mental or physical abuse as a result of a qualifying crime that happened in the U.S. or violated U.S. laws and may be eligible for a U visa through USCIS. To be eligible for a U-Visa, victims:
Applicants for asylum are persons who flee their country and are unable, or unwilling, to return due to persecution or a well-founded fear of persecution on the basis of their race, religion, nationality, political opinion, or membership in a particular social group. For the full definition, see EA-Z Manual - Definitions, Clarifying Information, #16.
Note: If a client is going through the asylum application process and provides proof of that process, they become non-qualified lawfully present aliens.
The only verification needed to meet the definition of a survivor of certain crimes is a verbal self-attestation by the applicant. Self-attestation must include the applicant stating:
If an individual states that they are applying for asylum and that the crime happened in their country of origin or they do not initially offer that the crime was one of the crimes described in WAC 388-424-0001(4)(c)(ii)(A)-(C), the individual is not a survivor of certain crimes. Do not ask for further details, but code the individual in ACES as a lawfully present non-qualified alien who is an asylum applicant.
No other documentation or evidence is necessary to verify that an applicant is a survivor of certain crimes. An applicant’s verbal self-attestation is sufficient for program eligibility determination.
Alternative evidence may also be provided in lieu of a verbal self-attestation, only if preferred by the applicant. This may include but isn’t limited to:
Qualifying family members are defined in WAC 388-424-0001. They don’t include a family member charged with or convicted of a crime committed against the survivor spouse or a child of the spouse.
A written or verbal statement from the survivor that speaks to how they are related to a qualified family member may be accepted as verification of relationship.
Survivors of certain crimes may be eligible for the following state-funded assistance programs, provided they meet all other eligibility requirements for those programs and are not already eligible under other citizenship and immigration rules:
All survivors of certain crimes (and their qualifying family members) who are eligible for SFA, ABD or HEN Referral, may be eligible for Medical Care Services (MCS) if not already eligible for federally funded medical programs.
Note: Pregnant women who are survivors of certain crimes may be eligible for Apple Health for Pregnant Women. See Apple Health for Pregnant Women | Washington State Health Care Authority for more information.
Survivors of certain crimes do not likely meet the minimum work requirements for a Working Family Support payment due to their immigration status (WAC 388-493-0010). As a reminder, staff are required to review each household to determine if Working Family Support benefits are an option.
All SFA recipients are required to participate in WorkFirst services. For survivors who are not eligible to work, these services may be geared towards preparing for future employment. This includes English language training, job skills development, job-specific training, etc. Please see WorkFirst Handbook 5.2 for more information.
10. Are survivors of certain crimes subject to the public charge rule if they receive public assistance benefits?
The receipt of public assistance is only one of several factors that USCIS considers to determine whether someone is likely to be a “public charge” and is therefore inadmissible. Any survivor of certain crimes assistance applicant or recipient should be directed to consult with an immigration attorney with questions regarding “public charge”. For more information: Public Charge Information | DSHS (wa.gov).
If an applicant asks questions regarding eligibility for specific immigration visas or statuses, staff are to advise them to seek advice from an immigration attorney.
Applications from survivors of certain crimes should be handled the same as all other applications for cash or food assistance, with the exception of the verification policy below.
Absence of these documents does not affect an applicant’s eligibility for benefits. Don’t run applicants’ information through SAVE because the majority of applicants don’t have an immigration status, or may have an expired immigration status.
What are the documentation requirements for staff?
When verifying an individual is a survivor or a qualifying family member, workers should document the following in the ACES case narrative:
The following ACES coding is used to issue benefits to survivors of certain crimes:
Only use this coding when an applicant qualified for assistance as a survivor of certain crimes is preparing to file an application with USCIS. If they have already filed an application for status with USCIS, they may be eligible for benefits as a non-qualified or qualified alien. Assess based on verification provided and proceed based on that information.
No, the only verification that is required in order to continue benefits is verbal self-attestation that the recipient is a survivor and is continuing to prepare to file, per WAC 388-424-0035.
If the recipient states that they applied for asylum, a T visa, or a U visa with USCIS, staff are to request e verification (a copy of receipt). The survivor may also provide their USCIS receipt number verbally, allowing staff to check the USCIS website directly to verify an application has been filed. In a scenario where verification was requested and the individual failed to provide the receipt and/or the worker cannot verify via the USCIS website that an application was filed, the individual would still be eligible for continued benefits, based solely on their self-attestation that they are continuing to prepare to file.
Once new verification is received from the recipient, workers should:
Update the client’s Citizenship status information in ACES; and
Establish eligibility for benefits.
T1 Documents (Only Tier 1 documents are considered by the federal government to document both citizenship and identity).
T2 Documents
***NOTE: A "hospital" birth certificate is considered by the federal government to be a souvenir and DOES NOT meet the federal requirement for any "T" level of verification.
T3 - Examples
The T3 tier of verification must be created 5 years before the date of initial application or eligibility review.
T4 - Examples
Identity - Examples
A child under the age of 16 (or 16-17 if they have no ID verification above) may present the following documents as evidence of identity:
Revised September 27, 2023
National Immigration Law Center (NILC) Guide
The National Immigration Law Center (NILC) publishes the "Guide to Immigrant Eligibility for Federal Programs, Fourth Edition". This appendix gives you access to sections of the NILC Guide, which contain descriptions and pictures of key citizenship and immigration documents, and information on how to decipher the coding on these documents.
Revised September 20, 2011
Click the following link to complete the SSN Request used to request a non-work SSN from the Social Security Administration on behalf of clients applying for benefits.
Revised March 25, 2011
I declare, under penalty of perjury, that I was a Hmong or Highland Laotian tribe member when the tribe assisted the U.S. military during the Vietnam era (8/5/64 to 5/7/75).
Signature
Date
Revised March 25, 2011
Revised February 12, 2024
This section describes civil rights rules and how to file a complaint.
Your civil rights when you do business with include:
We require annual staff training for civil rights.
In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), religious creed, disability, age, political beliefs, or reprisal or retaliation for prior civil rights activity.
Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the agency (state or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339.
To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/ad-3027.pdf, from any USDA office, by calling (833) 620-1071, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to:
This institution is an equal opportunity provider.
Department policy on equal opportunity and access:
The Washington state Department of Social and Health Services (DSHS) is an equal opportunity employer and does not discriminate on the basis of age, sex, sexual orientation, gender, gender identity/expression, marital status, race, creed, color, national origin, religion or beliefs, political affiliation, military status, honorably discharged veteran, Vietnam Era, recently separated or other protected veteran status, the presence of any sensory, mental, physical disability or the use of a trained dog guide or service animal by a person with a disability, equal pay or genetic information.
Discrimination complaints filed with the department:
The DSHS Human Resources Investigations Unit investigates complaints we receive on discrimination. Someone may file a complaint with the unit using one of the numbers below or by requesting a copy of either form listed below and sending the complaint to Human Resources.
HR Investigations Unit
1115 S. Washington, OB2 2nd Floor NE Wing
PO Box 45839
Olympia, WA 98504-5839
(360) 725-5821 or Toll Free
TTY (360) 586-4289 or Toll Free TDD
Hearings / Judicial review:
If we receive a complaint that a future hearing or judicial review covers, we can tell the person that the hearing or review will resolve the issue.
Equal Access (EA), previously known as Necessary Supplemental Accommodation (NSA):
When handling a complaint from an EA client, be sure to follow the client's EA Plan and applicable EA Policy.
Revised October 2, 2023
The Address Confidentiality Program (ACP) protects the address of persons attempting to escape from domestic violence, sexual assault, trafficking, or stalking situations. Criminal Justice Affiliates, Election Officials and Protected Health Care workers may also participate in the program. Participants may use a substitute address, issued by the Secretary of State, in place of their actual physical address. State and local agencies can then respond to public records requests without disclosing the actual location of the participant.
Rules for ACP are found in WAC 434-840-001 through WAC 434-840-310 and are governed by the Office of the Secretary of State.
The ACP provides the following services:
NOTE: ACP works best if the participant has relocated to a location not already in public record.
Participants are given an authorization card the size of a driver's license. The card has the participant's name, substitute address, birth date, expiration date, and a toll-free number to the ACP office for information. The toll-free number is 1-800-822-1065. The TTY number is 1-800-664-9677.
When a public assistance client requests use of the substitute address, the ACP authorization card must be presented to the worker. The worker may make a copy of the ACP authorization card.
When a client states they are in danger or fleeing an abuser but are not enrolled in ACP advise the client that, if they provide their physical address to the department or any state agency, they will not be able to remove the address if they later on enroll in ACP. They have the option to wait to provide the department their physical address until approved for enrollment in ACP.
When a client presents an ACP authorization card or states they are enrolled in ACP and have an assigned Private Mail Box (PMB) address:
NOTE: If the individual doesn't have their authorization card, government agencies may call the ACP office at 1-800- 822-1065, or (360) 753-2972 to verify that the individual is an active ACP participant.
If the client wants more information about ACP:
A trained advocate will assist individuals with the ACP application. The advocate will assist the individual with additional safety planning prior to enrolling in the program. For a current list of advocates trained in your community to sign up people for ACP, to to https://www.sos.wa.gov/statewide-programs/address-confidentiality-program-acp and click on the map for your location.
The department is responsible for ensuring that confidential information is not released to clients or third parties inappropriately or illegally. Confidential information can be disclosed only under the specific criteria in chapter 388-01 WAC.
Policies related to disclosure of confidential information are contained in chapter 388-01 WAC and in departmental administrative policies. The CSO Public Disclosure Coordinator is responsible for approving or denying requests for disclosure of confidential information.
Disclosing Information to Parents with Visitation Rights or Legal Custody
Revised March 25, 2011
To describe how the department receives information from other sources regarding a clients eligibility for program benefits.
ACES provides workers with information on a variety of interfaces including:
Created October 9, 2023
This section reviews the Diaper Related Payment (DRP), which provides a reoccurring cash payment for diapers and basic needs essential to early development for all TANF/SFA households with a qualifying child under 3 years old. This program begins in November 2023.
WAC 388-494-0010 – What is the diaper related payment (DRP)?
Clarifying Information - WAC 388-494-0010
DRP is issued under the same TANF AU ID and in the same manner as the payment method for the TANF (EBT, warrant or EFT).
When the DRP is approved, the client will be notified of the appropriate usage and availability of the benefits.
TANF/SFA households will be notified when they are no longer eligible for DRP.
The benefit amount is established annually by the department contingent on budget and available funding. The payment is subject to end if funds are exhausted.
This category describes an emergency cash benefit available to families that meet the eligibility criteria for TANF or SFA but do not need ongoing monthly cash assistance. Assistance under this program is limited to one 30-day period every 12 months.
Revised: October 31, 2024
This section explains how often we review an Assistance Unit’s (AU) eligibility based on the type of benefits they receive, their circumstances, and when ACES sets a review period to match the review end date or certification end date of other programs.