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).

Revised April 6, 2023

DSHS Hearing Rules are found in chapter 388-02 WAC.  

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.

Clarifying Information:

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

DSHS Hearing Rules are found in chapter 388-02 WAC.

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

Clarifying Information: 

The AHC acts as the liaison, in cases involving Administrative Hearings, between the CSO and:

• The appellant
• The appellant's representative
• The Office of Administrative Hearings (OAH)
• The DSHS Board of Appeals (BOA)
• The Health Care Authority (HCA)
• The Community Services Division (CSD)
• The Office of the Assistant Attorney General (AAG)
• Children's Administration (CA)
• The Office of Fraud and Accountability (OFA)
• Other agencies or individuals involved in specific hearings.

The AHC must maintain the appearance of fairness in the Administrative Hearing process. The following guidelines apply:

1. Communication with Administrative Law Judge (ALJ), department witnesses, appellants their witnesses and representatives must be on a professional level.
2. Any communication between the AHC and an ALJ regarding a specific hearing must include the appellant and/or their representative. Private conversations with an ALJ about an administrative hearing (ex-parte communications) are strictly prohibited, unless it involves a safety issue. See RCW 34.05.455.

Administrative Hearing Coordinator (AHC) Responsibilities: 

1. Maintain the hearing case file to include the  following specific information:
   1. Name and client ID of appellant;
   2. Date of request for hearing;
   3. Hearing Issue;
   4. Name of appellant representative, if any;
   5. Pre-Hearing meeting (PHM) activities, if any;
   6. Scheduled date of hearing;
   7. Continuances requested;
   8. Date and result of hearing decision; and
   9. Date of request for review and/ or reconsideration.
2. Document hearing actions on ACES narrative.
3. Determine eligibility for continued benefits under WAC 388-458-0040.
4. Give notice to Office of Financial Recovery (OFR) to stop recovery when an administrative hearing about an overpayment has been requested.
5. Represent the Department at the voluntary Pre-Hearing Meeting, Pre-Hearing Conference, and the Administrative Hearing.
6. Contact the division program manager for Administrative Hearings to determine whether an AAG should be present at an administrative hearing. Notify the OAH of any accommodation needed due to client Equal Access (EA) status.
7. Notify the OAH if interpreter services are requested for Limited English Proficient (LEP) clients.
8. Prepare the DSHS 09-354(X), Administrative Hearing Report or similar document as an attachment to exhibits (Administrative Hearing Packet).
9. Provide copies of the Administrative Hearing Packet to all parties.
10. Coordinate and conduct pre-hearing meetings or pre-hearing conference activities.
11. Arrange for subpoenas to be issued by the AAG, when necessary.
12. Distribute copies of hearing decisions as necessary to program managers.
13. Coordinate implementation of hearing decisions.
14. Prepare petition for review or request for Board of Appeals (BOA) reconsideration of initial decision or response to appellant petition as appropriate.

Exception: The department cannot request BOA reconsideration for Basic Food hearing decisions.  See 7 CFR 273.15(q)(2).

Revised October 28, 2015

Purpose:

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.

Clarifying Information:

1. Continued benefits for clients are governed by WAC 388-458-0040.
2. Continued benefits are authorized at the benefit level the client was receiving before the action was taken by the department which resulted in the hearing request.
3. Clients must be notified in writing of their eligibility for continued benefits.

Administrative Hearing Coordinator (AHC) Responsibilities:

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.

Financial Services Specialist (FSS)/Case Manager Responsibilities:

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

Clarifying Information: 

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:

1. The sole issue for the administrative hearing is the fairness of the collection of an overpayment, and
2. Neither party (appellant or department) is disputing any fact affecting the outcome of the case. There is agreement about the amount and the facts of the overpayment; and
3. The department is satisfied that all elements of estoppel have been established by the appellant with "clear, cogent, and convincing" evidence. This means that the fact is proven by the evidence to be highly probable.

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.

Administrative Hearing Coordinator (AHC) Responsibilities:

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:

Element #1:

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:

1. The department had all the information available to correctly determine eligibility
2. The client received the benefits
3. The department has assessed an overpayment.

Element #2:

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:

• The client's belief in the department's action was reasonable.

Element #3:

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:

1. Spent the money on items they would not have otherwise bought and which are not an available resource.

2. Paid outstanding debts they would not otherwise have paid

3. 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.

Element #4:

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:

1. The client cannot repay the overpayment without drawing on funds needed for basic requirements. Document income and expenditures. Verify only questionable amounts.

2. 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.

Element #5: 

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. 

Administrative Hearing Coordinator (AHC) Procedures:

When the appellant and the department (AHC and their supervisor) agree that equitable estoppel should be applied, the AHC:

1. Completes and signs The Agreed Order and Stipulation, DSHS-EE ORDER 1/98 (currently available from CSD headquarters) and,
2. Contacts the appellant to review and sign the stipulation, and
3. Submits the stipulation to the ALJ for review and signature at least 3 days prior to the administrative hearing.

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

DSHS Hearing Rules are found in chapter 388-02 WAC. 

Clarifying Information:

1. The client or their representative may request an administrative hearing. The request should be made within in 90 days of the date of the notice of the department decision. After 90 days, a hearing request may only be accepted after an ALJ determines there was good cause for not requesting the hearing within 90 days.
2. Hearing requests don’t need to be in any particular form and can be made to any department employee or the Office of Administrative Hearings OAH.   Note: Provider hearing requests must be made in writing and submitted to the Office of Financial Recovery (OFR).
3. Hearing requests can be made by:
      a. Calling the Department of Social and Health Services (DSHS) at (877) 501-2233 or the OAH Call Center at (800) 583-8271;
      b. Writing to:
              Office of Administrative Hearings
              PO Box 42489
              Olympia, WA 98504-2489
      c. Requesting online at the OAH Website, https://oah.wa.gov, then click the How do I Request a hearing link to get started;
      d. Faxing your request to OAH at (360) 664-8721; or
      e. Visiting any DSHS office and making an oral request, completing a Request for Hearing form, or providing 
          any other written statement for a hearing. 
4. Hearing requests should include the department decision being appealed, the date the client was notified of the department decision, and why the client is dissatisfied with the department decision.
5. Any communication with the department indicating dissatisfaction with a department decision should be treated as a hearing request.
6. Hearing requests must be forwarded to the (OAH) for scheduling regardless of the date of the hearing request. See RCW 74.08.080

Public Benefits Specialist/Case Manager Responsibilities:

1. Respond to the client and document in the ACES narrative when a client contacts the department regarding an adverse department decision.
2. Explain the reasons for the department decision.
3. Describe what rules apply to the department decision.
4. Try to resolve the issue(s) with the client, but, if unable to resolve the issue(s) offer the client a supervisor conference, if appropriate.
5. Inform the client of their right to an administrative hearing.
6. Offer a Request for Hearing, DSHS 5-013(X) or take request over the phone
7. Offer to complete an electronic Administrative Hearing Request form for the customer or provide the paper Request for Hearing form DSHS 5-013(X), if the the client prefers. Document the client's decision in ACES. 

Administrative Hearing Coordinator (AHC) Responsibilities:

1. Maintain record of all hearing requests until scheduled.
2. Contact client to clarify the hearing request, if necessary.
3. Forward all hearing requests to the OAH for scheduling. 
   • If the client is Equal Access, include a copy of Accommodation plan with the hearing request.
   • If the client is Limited English Proficiency, include primary language information with the hearing request.
4.  Document the receipt of a hearing request in ACES narrative.

Purpose:

A Pre-Hearing Conference is a formal proceeding conducted on the record by an Administrative Law Judge (ALJ) to prepare for an administrative hearing.

Clarifying Information: 

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).  

Administrative Hearings Coordinator Responsibilities:

Notify all staff who are scheduled to participate in the pre-hearing conference of the date and time of the PHC.

Administrative Hearings Coordinator Procedures:

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. 

Post Pre-Hearing Conference:

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

Pre-Hearing Meeting With the DSHS Representative

Purpose: 

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. 

See WAC 388-02-0175 - What is a Pre-Hearing Meeting? 

Clarifying Information: 

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.

Administrative Hearings Coordinator Responsibilities: 

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.

Administrative Hearings Coordinator Procedures: 

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

DSHS Hearing Rules are found in chapter 388-02 WAC.

Clarifying Information:

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.

Evidence:

1. Evidence can be in the form of documents or testimony.
2. Documentary evidence can come from different sources. Documents which can be used as evidence in an administrative hearing include, but are not limited to:

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

Clarifying Information:

1. See WAC 388-02-0215  through WAC 388-02-0245 for the responsibilities of the Administrative Law Judge.
2. The case is presented to the ALJ and generally consists of the following sections:

          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.

Administrative Hearing Coordinator (AHC) Responsibilities: 

1. Prepare the opening statement:

         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

Clarifying Information:

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:

• Non Grant Medical Assistance decisions made by Division of Disability Determination Services (DDDS).
• Medical Assistance decisions made by the Health Care Authority regarding:

1. Creation of a single state Medicaid agency:

   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:

• Definition updates for Limited English Proficiency clients and interpreters (WAC 182-526-0010, 182-526-0120 through 182-526-0150);
• Clarification of the terms send (182-526-0040), serve (182-526-0045) and file (182-526-0070) in relation to documents for a hearing;
• Pre-hearing conferences must still be granted if requested at least 7 business days before the scheduled hearing. The rule changed so the pre-hearing conference order must be served at least fourteen calendar days before the hearing, which may prevent OAH from having the pre-hearing conference on the same day as the hearing, unless parties voluntarily waive the timeliness requirements.

Administrative Hearing Coordinator Responsibilities:

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:

1. For hearings involving medical services, equipment, transportation, managed care enrollment, and Patient Review and Coordination (PRC) program, contact the HCA’s Office of Hearings and Appeals at: MS 45504, 360-725-1254 or 1-800-351-6827.
2. The HCA staff may act as the agency’s representative for these cases, coordinate testimony of medical consultants, help you obtain additional medical information, and arrange medical examinations, if necessary.
3. The HCA Appeals Administrator will coordinate review and implementation of hearing decisions as required by HCA.
4. The DSHS AHC acts as liaison between HCA’s staff and the Appellant and their representative if required. For example, if the Appellant requests an in-person hearing and it is scheduled at the local CSO, the DSHS AHC may assist the ALJ and the Appellant during the hearing because HCA staff participates in the hearing telephonically from Olympia, WA.
5. For insurance issues, contact HCA’s Revenue, Recovery and Premium Payment Section or HCA’s Coordination of Benefits (COB) Section, as appropriate:
   • COB Health Units: 1-800-562-3022 ext # 16134
   • COB Casualty Unit: 1-800-562-3022 ext # 15462
   • RRPS Premium Payment: 1-800-562-3022 ext # 15473
6. For eligibility and policy issues, when clarification is required, contact the regional eligibility representative in the Office of Medicaid, Medicare, Eligibility & Policy (OMMEP), Eligibility Policy and Service Delivery (EPSD) - MS 45534.
7. For hearings involving SCHIP (F07), Take Charge (P06), BCCTP (S30) or other cases assigned to CSO 76 contact Susie Bahr 360-725-1724  MS 45531
8. For hearings involving a cash AND medical program, such as TANF or ABD, the AHC will need to cite the correct hearing rules when necessary, which may mean citing both the HCA hearing rules and the DSHS hearing rules. The administrative law judge will also need to use the correct rules when entering and serving an order. All ALJ decisions on HCA cases must be "initial orders", not "final orders."

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:

1. If the original denial is affirmed in the DDDS review process, consult with the DDDS hearing supervisor who will assign someone to testify in support of the denial.
2. Notify the appellant if the original DDDS decision is reversed in the DDDS review process.
3. Coordinate requested continuances from either the appellant or DDDS with the local OAH office. Continuances are often necessary in these cases to obtain additional medical information. It is important that the AHC keep all parties informed of the status of the case prior to the hearing.
4. Notify DDDS of the scheduled date and time of the hearing.
5. Forward the DSHS 14-144 and the DDDS original decision packet in hard copy to the appropriate DDDS office. Attach any new medical documentation and release of information authorizations, if appropriate.  (Do not use the automated BarCode referral process for administrative hearing reviews.)
6. Initiate reconsideration of the original decision by completing in hard copy a DSHS 14-144, Transmittal Summary, and check the box for the Administrative Hearing Review. The reconsideration is a required step in the DDDS process prior to hearing. Request continuances as appropriate to allow sufficient time for the reconsideration.

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.

DDDS Hearings Contact:

Michael Magill 
Disability Hearings Manager
(360) 664-7394

MS 45550

Revised October 28, 2015

DSHS Hearing Rules are found in chapter 388-02 WAC.

Clarifying Information:

Once a hearing request has been scheduled, a decision must be issued by the ALJ. 

Administrative Hearing Coordinator (AHC) Responsibilities: 

When a hearing decision is received by the department:

1. Document the AHCS with the docket number, the type of decision, and the date of mailing.

2. Include any other information necessary for a complete record.

3. 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:

1. Consult with CSO supervisors or administrator, as appropriate
2. Consult with regional trainers or program staff, if necessary
3. See chapter 388-02 WAC, which gives a full explanation of the BOA review judge's authority.

     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:

1. Appellant's name and docket number,
2. All areas in which the department believes the ALJ erred. See chapter 388-02 WAC for the review standard. The review judge usually only addresses areas that have been raised in the petition for review. Refer to findings of fact and conclusions of law by the number assigned in the hearing decision.
3. Cite WAC's, findings of fact or evidence in the record that support the department argument.
4. New evidence which affects the hearing decision, and could not have been provided by the AHC at the hearing with reasonable diligence.
5. A request asking the review judge to find in the department's favor.
6. Refer to chapter 388-02 WAC for complete instructions regarding distribution and time frames for a petition for reconsideration.

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:

1. The appellant's name and the docket number,
2. A response which speaks only to the issues raised by the appellant,
3. Argument(s) which supports the finding in the initial hearing decision.

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.

Created on: March 11, 2020
Revised February 12, 2024

Purpose: 

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.

WAC 388-406-0005  Can I apply for cash or Basic Food?

·Clarifying Information and Worker Responsibilities

WAC 388-406-0010  How do I apply for cash assistance or Basic Food benefits?

·Clarifying Information and Worker Responsibilities

WAC 388-406-0012  What is the date of my application and how does it affect my benefits?

·Clarifying Information and Worker Responsibilities

Clarifying Information - WAC 388-406-0005

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:

1. Be familiar enough with the applicant's circumstances to complete the application accurately; and
2. Tell us why they are applying on behalf of the applicant to help us identify if the applicant should receive Equal Access (EA) services under chapter 388-472 WAC. Examples of when someone might apply for another person include when the applicant is:
   
   1. Physically or mentally ill or otherwise incapacitated;
   2. A minor child;
   3. Subjected to domestic violence;
   4. For Basic Food, living in a qualified DDD group home or qualified Drug & Alcohol treatment facility; or
   5. For ABD cash temporarily residing outside the state.

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:​

1. Prior to release from a public institution, residents may apply for public assistance. Expedited eligibility -- determinations for food benefits and timely access to medical assistance is available for applicants with mental disorders before release from confinement. A Medical ID card is sent to the facility so that the client can leave the institution with the ID card in hand. The goal is to provide eligible people with a medical assistance identification card on the date they are released, whenever possible.
2. Transitional Outreach ABD Program (TOAP) applications must be tracked for reporting purposes.

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. 

Worker Responsibilities -  WAC 388-406-0005

FOR NON-COMPLIANCE SANCTION (NCS) APPLICATIONS:

See  WorkFirst Sanctions-Participation

Clarifying Information - WAC 388-406-0010

The following topics related to the above WAC are discussed below:

• Application Forms
• Name, Address, and Signature Requirements
• Informational Handouts and Supplemental Forms
• Review Alerts
• Interview
• Changes Made to Correct an Application
• Special Situations
  
  NOTE: For the purposes of the following section, the term "local office" refers to CSO, Social Security Administration, and HCS offices.

   

Application Forms

1. Opportunity to apply:
   
   1. Local offices must make application forms readily available and provide a form to anyone requesting one. Applying for benefits is separate from any other program requirements. We can't refuse to give an application form to a client because they aren't meeting other program requirements or for any other reason.
2. Application filing:

We can't require applicants to use a specific form to request benefits. Examples of typical requests for benefits include:

1. The ACES Request for Benefits (RFB);
2. ACES 3G Interactive Interview Declaration (IID) with telephonic signatures. Telephonic signatures are captured when an applicant contacts the customer service contact center and requests benefits but hasn't submitted a paper application. Staff complete an ACES 3G IID while on the phone with the applicant. Two telephonic attestation scripts are needed to complete the telephonic signature for an application or review.
   
   1. The first telephonic attestation script captures the date of the application, interactively screening an application into ACES 3G.
   2. A second telephonic attestation script completes the the telephonic signature after the IID is reviewed and the applicant confirms the information is correct.
3. The name, address, and signature on the DSHS 14-001(X) Application for Benefits form;
4. The name, address, and signature on the DSHS 14-078(X) Eligibility Review form; or
5. Part 1 of the online application.
6. Another form of written request that includes a name, address, and signature.

   3. Adding a request for assistance to a pending application or eligibility review for another  program:

1. Applicant or recipient can add a request for any cash or food benefits to a pending application or an unprocessed eligibility review verbally without submitting a new 14-001 or 14-078.
2. The applicant or recipient may make the request in writing by checking the appropriate boxes on the 14-001 or 14-078 form and, dating and initialing the form.
3. Use the date the applicant or recipient added the new request as the date of application for the new program. See WAC 388-406-0012.
4. If application or eligibility review for the other program has already been processed, the applicant or recipient must submit a new request for benefits.

   4. Handling multiple applications from the same household:

1. This applies to additional applications received before we determine eligibility on the first application:
   
   1. Don't deny the additional application(s).
   2. Review the application(s) for impact on eligibility or benefit level and whether the household is applying for any additional programs that weren't selected on the first application.
   3. If the household isn’t applying for additional programs, document the case that additional application(s) were received and that the department is still considering eligibility under the original application date.
   4. Treat the application as a new application for the additional programs only and continue to consider any requests for programs which are still pending under the original application date.
   5. Document in ACES and explain any additional information used to determine eligibility and/or benefit level.
   6. Don't extend the Standards of Promptness period for the original application.

       

      NOTE: If the additional application is received before we determine eligibility on the first application but isn’t acted on until after the first application has been denied, follow procedures under (b.) below.

5)  This applied to additional applications received after we determine eligibility on the first application:

1. If we denied the first application, treat this as an initial application according to WAC 388-406-0010 except, for Basic Food, if we denied the first application due to lack of information, treat this as a reapplication and follow procedures under WAC 388-406-0040 (6)
2. If we approved the first application, review the additional application(s) to determine if household circumstances have changed. Take appropriate actions on any changes reported.
3. Deny additional applications for the same program and same persons to avoid duplicate participation.

NOTE: When denying additional applications as described in (c.) above, avoid creating a new AU if an old AU is available.

Name, Address, and Signature Requirements

1. Name & address:

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.

1. Signatures:
   
   1. For cash or Basic Food, an authorized representative may sign an application if the applicant is unable to apply on their own behalf or is unable to sign the application. See Authorized Representative - Food, Cash and Medical Benefit Issuances | DSHS (wa.gov)
      
      1. For cash programs, a responsible adult member of the assistance unit (AU) must sign the application.  If both parents of the minor children are living in the home with the minor children, both parents must sign unless one is incapacitated and unable to sign the application.
      2. For Basic Food, the signature of one responsible AU member is required unless a current authorized representative (AREP) signs instead. Note: Unless an AREP is durable power of attorney (DPOA), the AREP designation is limited to one certification period.
      3. A minor child may sign the application if there is no adult in the AU.  
      4. A mark is an acceptable signature if another person witnesses it.
      5. Online applications for cash or Basic Food are electronically signed when transmitted. The password used to complete the online application is an electronic signature.
      6. Applications received without a signature must be signed either at the time of the interview or by mail. See matrix below for signature requirements and date of application for various programs.  

For Medical applications, please refer to the application section of the Apple Health Manual.

Informational Handouts and Supplemental Forms:

1. For all applicants:
   • Your Hearing Rights in a DSHS Case, DSHS 22-092
   • DSHS 14-113(X), Client Rights and Responsibilities
2. For cash:
   • How You Must Help with Child Support Collection, DSHS 18-334 - one per non-custodial parent; and
3. Assistance for applicants with children:
   • Women, Infants and Children (WIC) pamphlet to applicants who are pregnant, postpartum, or who have children under age five. Pamphlets are available to local WIC offices.
4. Additional Requirements for Emergent Needs or the Consolidated Emergency Assistance Program - CEAP:

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:

• Trial visit program
• Applications for MSP from Social Security Administration Interface (LIS file)

Worker Responsibilities

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:

1. Face to Face Interviews

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).

Clarifying Information - WAC 388-406-0012

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:

• Deny the application for the initial month (and second month if necessary) if they have already received or will receive SNAP or TANF benefits from the other state for that month(s).
• If Basic Food or Cash benefits can be approved for the ongoing months and the benefit start date isn’t more than sixty days from the initial application date, a new application isn’t needed..

Worker Responsibilities -  WAC 388-406-0012

1. Date stamping the application:
   
   1. Date stamp the application, the same day we receive the application; or
   2. The next business day if we received the application outside of normal business hours.
2. Adding a request for Basic Food to a pending 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.

1. Do not require the applicant to complete another application. If you need additional information to determine eligibility for Basic Food, request the necessary information;
2. Document the request for Basic Food and the date the applicant requested the benefits; and
3. Add a program for Basic Food.

Top of Page

Revised November 7, 2023

Purpose:

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.

WAC 388-406-0015 Can I get Basic Food right away?

• Clarifying Information and Worker Responsibilities

WAC 388-406-0021 How does being a migrant or seasonal farmworker affect my application for Basic Food?

• Clarifying Information and Worker Responsibilities

Clarifying Information - WAC 388-406-0015

1. Gross monthly income: 
   Food and Nutrition Services (FNS) defines “gross monthly income” as income before taxes less excluded income. We don't consider excluded income when determining expedited eligibility. See WAC 388-450-0015 for excludable income.
2. Resources 
   We must consider countable liquid resources under WAC 388-470-0055 when determining eligibility for expedited services, even if the client is categorically eligible under WAC 388-414-0001.
3. Request for Basic Food:
   Applicants request Basic Food by:
   • Checking “Food” on the application; or
   • Checking “Other” and indicating they want or need food on their application. See WAC 388-406-0010 for information on what constitutes an application.

4. Screening and Determining Eligibility for Expedited Service
   
   1. Households entitled to expedited services must be interviewed and receive benefits within seven calendar days of filing an application. If the seventh day falls on a day when the office is closed (holiday, temporary layoff), benefits must be issued the working day prior to the office closure.
   2. To identify households entitled to expedited service, we review the application to determine whether the circumstances meet one of the Expedited Service criteria under WAC 388-406-0015 (2). We must consider the household’s circumstances at the time of application, including work registration sanctions or disqualifications, when we are making the determination.
   3. We screen for expedited service eligibility on the day we receive each application. If we receive an application outside of normal business hours, we screen for expedited service on the next business day.
   4. All applicants, not interviewed on the date they apply, are sent an interview appointment letter (11-01) after screening to contact us for an eligibility interview within 7 days of the date of application. 
   5. We determine expedited service eligibility for all Basic Food applicants during the interview.
      
      1. Except for identification, verification that isn't available at the time of the interview is postponed (see Postponed Verification and Required Verification sections for more information).
      2. A person who wasn't screened as expedited or who waives the expedited interview can be determined expedited at the interview and receive benefits within seven days.
      3. A person who was screened as expedited but who is determined not expedite eligible at the interview must be processed under regular procedures.

5. Screening an institutionalized client for Expedited Service:
   Applications from persons living in an institution are denied unless the person will be released within 30 days of submitting the application. Use the date of release from the institution as the date of request and as the expedited service start date.
   1. If the applicant is eligible for expedited service, provide an interview within seven calendar days of the date of request; and 
   2. If the client is eligible for Basic Food, issue benefits within seven calendar days of the date of request.

6. Destitute migrant or seasonal farm workers:
   To determine if a client is a destitute migrant or seasonal farm worker use WAC 388-406-0021, then see WAC 388-450-0230 for information about budgeting income in the month of application.

7. Denying Expedited Service:
   
   1. If at the interview we determine a household isn't eligible for expedited issuance and more information is needed to determine eligibility:
      
      1. Inform the client that they don't meet the criteria for expedited issuance with postponed verification; and
      2. Explain how to get a department review of the decision (see WAC 388-406-0015(10)). 

8. Required Verification:
   
   1. Verification of identity of the applicant (and authorized representative if the head of household isn't at the interview) is the only required verification to issue benefits on an expedited case. All other verification can be postponed.
      
      1. Identity can be verified with available documents, through interfaces such as SOLQ, or through a collateral contact. Photo ID isn't required.
      2. Delay benefit issuance only when there is no means to establish identity.
   2. When all required verification to determine eligibility is available at the interview, issue benefits and establish an appropriate certification period (see WAC 388-416-0005 ).
9. Postponed Verification:
   
   1. When verification is postponed, issue benefits as described in WAC 388-406-0015(6) based on the information available.
   2. Send a letter of limited approval and request the client provide the missing information for continued eligibility to be determined. The letter also functions as a denial notice should the client fail to provide all of the verification listed in the letter timely.
   3. The denial of ongoing benefits can be reconsidered if all of the required information is provided within the timeframes listed in subsection (6) of the WAC. The letter will reflect the correct timeframes. Don't send another request letter with a new timeframe if the client provides only part of the required verification.
   4. If all postponed verification isn't received timely (within thirty days or the end of the second month), the client isn't eligible for ongoing benefits without a break in benefits. If the client turns in the postponed verification untimely, but before the 60th day after the date of application, refer to WAC 388-406-0055 (4) (c) to determine the reconsideration date of benefits.
   5. It is possible for a client to receive expedited benefits and not be eligible for on-going Basic Food when the postponed verification is provided. We must send clients a denial letter if we determine they are ineligible from the verification.

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).

Worker Responsibilities - WAC 388-406-0015

1. Record the date each application is received, or the next business day if received after business hours.
2. When the application is received, screen for expedited eligibility using the responses to the expedited screening questions on page one of the application (part one for the online application). Review other information on the application as needed to identify expedited households.
3. Whenever possible, interview clients who apply in person and meet expedited service criteria the same day the applications are received. The interview can be conducted by telephone.
4. Issue benefits the same day to households determined expedited.

Clarifying Information - WAC 388-406-0021

1. General information regarding seasonal farmworkers:
   
   1. A seasonal farmworker can work all year round and still be considered a seasonal farmworker.
   2. The unemployment compensation a seasonal farmworker may receive doesn't have to be from seasonal farmwork.
   3. We don't average a migrant or seasonal farmworker's income when determining if they are destitute.
   4. Seasonal farmworkers may be required to meet ABAWD participation.
2. Eligibility for expedited service:
   
   1. Destitute farm worker assistance units (AUs) with under $100 are eligible for expedited service.
   2. Migrant and seasonal farmworkers who aren't destitute may receive expedited service based on other criteria under WAC 388-406-0015.
3. Earnings from a previous season:
   ​Don't use a previous season's information unless it reflects what the client anticipates for the current season.
4. The source of a farmworker's income:
   Consider the grower, not the crew chief, as the source of income.
5. Farmworkers with income from a new source:
   We consider a farmworker who has income from a new source destitute unless it is reasonably certain that the farmworker will receive more than $25 in income within ten calendar days of the date of application.
6. Employer's statement of likely work:
   An employer’s statement that the client will likely have work shouldn't be considered a guarantee that the client will work and receive more than $25. Farm work is uncertain because harvests may be delayed or interrupted by weather problems. There also may be times when a grower discovers they need less labor than originally predicted.
7. Income from a terminated source:
   Consider income to be from a source no longer providing income when:
   1. The AU is usually paid at least once a month and income from that source isn't expected for the remainder of the month of application or the following month; or
   2. The AU is paid less often than monthly, such as quarterly, and the household won't receive the next payment in the month it would normally be received.
8. Income from a new source:
   Consider income to be from a new source when:
   1. The household is paid at least monthly and received $25 or less from that source in the 30 days prior to the date of application; or
   2. The household is paid less often than monthly, such as quarterly, and received $25 or less from that source since the last regular pay date.
9. Income from a terminated source and a new source in the same month:
   A farmworker AU may receive income from a source no longer providing income and a new source in the same month and still be considered destitute.
10. Travel advance:
    If a migrant/seasonal farmworker client gets an advance from an employer to cover travel costs, we don't consider the advance when deciding if the client is destitute.
    1. We exclude the travel funds if they are a reimbursement for travel expenses.
    2. If the funds are an advance on wages and not a reimbursement for travel, we budget the advance as earned income.
11. Budgeting income:
    
    1. For the standard rule on how to budget a client's income, see WAC 388-450-0215.
    2. For the rule about budgeting a destitute client's income, see WAC 388-450-0230.

Worker Responsibilities - WAC 388-406-0021

1. Document the decision on a client's destitute status:
   Document your decision on whether or not a migrant/seasonal farmworker client is destitute. If you exclude any income under WAC 388-450-0230 document that this income was excluded.
2. Document income:
   Always document the income you budgeted for the AU. 

ACES Procedures

See Process Application Month

See Finalize Application

See Basic Food Program - Expedited Services

Revised October 17, 2016

Purpose:

This section includes rules and procedures related to application processing time limits and processing delays.

WAC 388-406-0035 How long does the department have to process my application?

• Clarifying Information

WAC 388-406-0040 What happens if the processing of my application is delayed?

• Clarifying Information

WAC 388-406-0045 Is there a good reason my application for cash or medical assistance has not been processed?

• Clarifying Information 

Clarifying Information - WAC 388-406-0035

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:

1. Notify the client during interview  that we must have the required information/verification no later than the 30th day from their application date, otherwise they will not receive benefits for the application month. List the 10 day deadline to provide verification. 
2. Tell the client we can reconsider a denied application if we have the information/verification by day 60. We will prorate benefits for the second month starting the date we receive the required information/verification.

Clarifying Information - WAC 388-406-0040

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.

Clarifying Information - WAC 388-406-0045

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.

ACES Procedures

See:

• Standards of Promptness
• Standards of Promptness - When is there good cause for not processing an application by the SOP date?

Revised August 28, 2018

Purpose:

This section contains applications procedures for special situations, including when an applicant is temporarily out of state and the Trial Visit Program.

Worker Responsibilities

1. The Trial Visit Program is part of a treatment plan for clients in institutions. The institution determines if the client is able to participate in the program. If assistance is needed before the client can participate in the program, the CSO serving the client's institution will initiate the application.
   1. Administrative Disability Review Committee: Each institution will designate a liaison to coordinate with the CSO when an approved trial visit client is in need of public assistance. At least ten days prior to the scheduled release date, the liaison will provide the CSO with a completed Application for Benefits, DSHS 14-001(X) and related supplements. In addition, the liaison will provide:
2. Determine eligibility for a Medicare Savings Program (MSP) and, if requested, all other medical programs.
   1. Review ACES instructions for auto-screened MSP application.
   2. WA State SSI Related income and resource rules differ from SSA LIS income and resource rules so S03 cannot be auto-opened without an application.
   3. ACES sends a LTR 023-02 and a 14-001 application form.
   4. If client returns the application form, look to see if medical is requested. If so, determine eligibility for all medical programs.
   5. If medical is not checked, determine eligibility for only the Medicare Savings Programs (ie S03, S04, S05 and S06).
   6. The Standard of Promptness (SOP) count begins from the date DSHS received the SSA/LIS input file. ACES is programmed to apply the correct SOP date.
   7. Estate Recovery rules apply to all medical programs except MSP.
3. Denying automated MSP applications.
   1. ACES will auto-deny MSP applications with LTR 004-05 and reason code 230 after 30 days when an application is not returned.
   2. Do not deny for failure to provide information prior to the automated ACES denial.

Revised July 1, 2021

Purpose:

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.

WAC 388-406-0050 How do I know when my application is processed?

WAC 388-406-0055 When do my benefits start?

• Clarifying Information and Worker Responsibilities

WAC 388-406-0060 What happens when my application is denied?

• Clarifying Information and Worker Responsibilities

WAC 388-406-0065 Can I still get benefits even after my application is denied?

• Clarifying Information and Worker Responsibilities

Clarifying Information - WAC 388-406-0055

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.

• When an active member of a TFA AU moves away and applies for basic food in a different household, we must remove the applicant from the TFA AU before starting basic food or adding them to someone else’s basic food AU.
• The applicant is eligible for basic food effective the first of the month after they were removed from the TFA AU with advance notice.

Worker Responsibilities -WAC 388-406-0055

1. For approved applications processed outside the applicant’s catchment area, transfer the case record to the correct CSO and notify the applicant of the CSO address and phone number.Use ACES Letter 023-03 - Information/Action Request for Transfer. 
2. For applicants ineligible for benefits because they are institutionalized, open:
   1. Basic Food from the date:
      1. Of release from the institution, if released within 30 days from the date of application and we have the information needed to determine eligibility; or
      2. We have the information needed to determine eligibility, if released within 30 days from the date of application, and the information was received after the 30th day but before the 60th day, and the delay was caused by the applicant.
   2. Cash assistance from the date:
      1. Of release if released within 30 days from the date of application and we have the information needed to determine eligibility for TANF, SFA, PWA, or RCA; or
      2. Of release if the release date is past the forty-fifth day processing deadline; or
      3. We have the information needed to determine eligibility, but no later than the 30th day for TANF, SFA, PWA, or RCA.

Processing an NCS Application:

See WORKER RESPONSIBILITIES Non-Compliance Sanctions (NCS) Re-Applicants

Clarifying Information - WAC 388-406-0060

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.

Worker Responsibilities -WAC 388-406-0060

If a basic food applicant doesn't show for the required initial interview:

1. Send a letter immediately informing the applicant to contact their worker to schedule another appointment.

2. If a basic food applicant fails to show for the second interview:
   
   1. Continue the case as pending if the interview is scheduled before the 30th day.
   2. Deny the application on the appointment date if the interview is scheduled after the 30th day.

3. Deny the application on the 30th day if the household doesn't reschedule the interview. If the 30th day falls on a weekend or holiday, the applicant has until the close of the next business day to complete the interview. Send the denial letter on the next working day if the interview isn't completed.

Clarifying Information - WAC 388-406-0065

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:

•  Deny the application for the initial month (and second month if necessary) if they have already received or will receive SNAP benefits from the other state for that month(s).
•  If basic food benefits can be approved for the ongoing months and the benefit start date is not more than sixty days from the initial application date, a new application isn't needed.
  
  EXAMPLE: Theo moved to Washington from Nevada and applies for benefits on 3/15. We interview them on 4/2 and determine they are financially eligible at the time, except that they received 3/2021 and 4/2021 benefits from the other state. We have verified that they won't receive benefits in 5/2021. Correctly deny basic food for March and April for duplicate participation and approves benefits for May 2021 and ongoing. Use the initial application until May 14.

Worker Responsibilities -WAC 388-406-0065

1. Reconsidering a Denied Application
   If the applicant provides only part of the information we need per the timelines in WAC 388-406-0065 (1), take the following actions:
2. Review the case to see if we can determine eligibility for each program based on what we have received; and
3. Send the applicant a letter advising of our reconsideration decision for each program. This includes:
   1. An approval letter if we can determine they're eligible;
   2. A new denial letter if we are able to determine they're ineligible; or
   3. A second denial letter indicating the original denial reason and effective date stands and why.

4. NCS Re-applicants who failed to complete their 28 day participation:

Top of Page

Revised September 11, 2019

Purpose:

This section includes rules and procedures on what happens when a client applies for benefits and the department needs other information to determine eligibility.

WAC 388-406-0030 Do I need to submit other information after I apply for benefits?

• Clarifying Information and Worker Responsibilities

Clarifying Information - WAC 388-406-0030

Worker Responsibilities - WAC 388-406-0030

1. See verification. Whenever possible, obtain verification by phone. For cash, food, and long-term care programs, verify an applicant's circumstances if needed to determine eligibility.
2. Use cross-matches and alerts whenever possible to verify a client’s income or expenses.
3. Do not request a specific form to determine eligibility. For example, do not request a landlord statement. Instead, ask for what is needed to determine eligibility such as an address, household composition, and shelter costs. Give or send the client any departmental or approved local-office forms that would help give us the information we need to determine eligibility.
4. See WAC 388-406-0040 for what to do if the application process is delayed.
5. When requesting further verification or requesting missing verification, allow a ten-day extension on the due date as under WAC 388-406-0030, #4, as long as the client is not refusing to cooperate and/or the application processing time limits under WAC 388-406-0040 haven't passed.
6. If the application process has been delayed due to the household interviewing late in the 30 day processing period, we cannot give a ten day extension.
7. The application must be denied by the 30th day (first business day after the 30th day if it falls on a weekend or holiday) if we don't have all the information we need to determine eligibility and the delay has been caused by the household.

Revised July 24, 2023

Purpose:

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.

WAC 388-408-0034 - What is an assistance unit for Basic Food?

WAC 388-408-0035 - Who is in my assistance unit for Basic Food?

• Clarifying Information and Worker Responsibilities

WAC 388-408-0040 - How does living in an institution affect my eligibility for Basic Food?

• Clarifying Information

WAC 388-408-0045 - Am I eligible for Basic Food if I live in a shelter for battered women and children?

• Clarifying Information and Worker Responsibilities

WAC 388-408-0050 - Does the department consider me as homeless for Basic Food benefits?

• Clarifying Information and Worker Responsibilities

​Clarifying Information - WAC 388-408-0035

1. Buying and Preparing food:
   1. This rule (formerly known as the “purchase and prepare concept”) applies to the typical shopping and food preparation arrangements of the people who live in the home. Persons who normally buy and prepare their food separately can be in separate AUs if they do not have to be in the same AU for some other reason. This rule does not force people to be in the same AU if they occasionally share a meal or share insignificant items such as seasonings. It also doesn’t force people to be in the same AU if they buy food and make meals separately, but eat their meals together.
   2. Persons sharing a residence can be separate households when they regularly buy food and prepare meals separately.

Persons sharing a residence must be one Basic Food household when they:

• Buy food together;
• Prepare meals together; or
• Buy food and prepare meals together.

2. Transitional Food Assistance (TFA) AUs:

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.

3. Buying and Preparing food – Temporary arrangements based on no food money:

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.

4. Homeless Youth:

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:

• Receiving a TANF grant as the person's own payee; or
• Receiving, as the person's own payee, gross income equal to or exceeding the TANF grant payment standard; and
• Living in the home of a non-parental adult temporarily with no intention to remain permanently.

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:

• Homeless youths' living arrangements are often different than many other households, as they commonly share the housing of others in temporary, informal conditions.
• Unlike foster or kinship care, the non-parental adults have no legal responsibility or authority to control the youth. They provide temporary shelter, which may be inadequate and often unsafe for the youth. Youth may move on a weekly or even daily basis.
• There isn't a minimum age requirement to apply for Basic Food. If there isn't an adult exercising parental control of a minor, the minor can apply on their own behalf.
• Homeless youth may not have readily available photo ID. Just as with adults, we can accept a collateral contact to verify identity as needed and we must assist the youth in gathering needed verification.
• There is no requirement to provide information about persons outside of their household including the youth's parents. We would only request information on their parent's whereabouts if the individual circumstances of the case are questionable.
• Temporary living arrangement refers to an arrangement which will last less than 90 days.

5. When a minor child doesn't live with an adult:

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.

6. When a minor child lives with their 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.

7. When parents have shared custody of a child:

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.

1. If the child lives in one home 51% of the time, and the other home for the rest of the time, they can only get Basic Food in the home where they live 51% of the time. This is true even if the parent the child lives with the majority of the time doesn't apply for benefits.
2. If a child lives with two people for an equal amount of time, the child can get benefits in the AU that applies for benefits first.

8. Unmarried parents of a child in common:

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.

9. Adults living at the same address as their parents:

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.

10. Spouses who live at the same address:

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.

Worker Responsibilities - WAC 388-408-0035

Deciding if a Boarder Pays a Reasonable Amount for Meals

1. Use only the amount the boarder pays for meals to decide if they pay a reasonable amount.
2. If you can't decide how much the boarder pays for meals, use the amount they pay for both meals and lodging.
3. Decide if the boarder pays a reasonable amount for meals as follows:
   1. If the boarder gets two or more meals a day, the boarder must pay at least the maximum allotment under WAC 388-478-0060 for the boarder's AU size
   2. If the boarder gets one meal a day, the boarder must pay at least two-thirds of the maximum allotment for the boarder's AU size.
4. If the boarder pays a reasonable amount for food, the AU that provides the board can choose if they will include the boarder in their AU. Do not allow boarder to be a separate AU.
5. If the boarder doesn't pay a reasonable amount for food, they don't meet the definition of a boarder for Basic Food. In this situation the AU that provides the board must include the boarder in their AU.

Clarifying Information - WAC 388-408-0040

1. Federally subsidized housing for the elderly:

   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:

   1. The facility must be expressly for the elderly; and

   2. The facility must be federally subsidized.

2. Optional meal plans:

   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 .

3. When someone in an ineligible institution may get Basic Food:

   A person who lives in an institution that provides meals may be eligible for Basic Food benefits when:

   1. The person living in the institution can't eat the institution's meals because they need a special diet; and

   2. The institution is unable or unwilling to provide the special diet.

4. Release from a hospital or other institution:
   1. A person in a hospital or other ineligible institution is not eligible for Basic Food until they are released from the institution.
   2. If someone applies for Basic Food while in an ineligible institution and they are released within 30 days, we use the date of release as their date of application for Basic Food.
5. Group living arrangements that are not Qualified Group Homes:

   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.

6. Supported Living Providers / ITS Homes:

   A Supported Living Provider (formerly Intensive Tenant Support Services or ITS Home) provides services to DDA clients and is licensed by DDA.

   1. Most clients who receive services through one of these providers receive home care or live-in attendant services and are not a licensed group home. These persons are not living in an institution. We look at requirements under WAC 388-408-0035 to determine who must be in a client’s AU.
   2. Some Supported Living Providers also run qualified DDD group homes. Since these clients are living in a qualified DDA group home, they can receive Basic Food.

7. Nonprofit Drug & Alcohol Treatment Centers Authorized as FNS retailers:

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))

• The Center for Alcohol & Drug Treatment, Wenatchee, WA 98807
• Evergreen Recovery Centers, Everett, WA 98201
• Holman Recovery Center, Arlington, WA 98223
• Lifeline Connections, Vancouver, WA 98668
• New Horizon Care Center dba Isabella House, Spokane, WA 98220
• New Horizon Care Center dba Sun Ray Court, Spokane, WA 99220
• Seattle Drug and Narcotic Center (SEADRUNAR), dba Key Recovery and Life Skills Center, Seattle, WA 98168
• Triumph Treatment Services - Beth's Place, Yakima, WA 98902
• Triumph Treatment Services - Casita Del Rio, Yakima, WA 98902
• Triumph Treatment Services - Inspirations, Yakima, WA 98902
• Triumph Treatment Services James Oldham, Buena, WA 98921
• Triumph Treatment Services Riel House, Yakima, WA 98902

8. DOH licensing and certification of nonprofit drug and alcohol treatment facilities:

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))

• Adult & Teen Challenge Women's Center, Graham, WA 98338
• Adult & Teen Challenge International Pacific NW Center,  Renton, WA 98338
• Adult & Teen Challenge Men's Center Spokane, WA 99224
• Adult & Teen Challenge PNW, Pasco, WA 99302
• The Salvation Army ARP, Seattle, WA 98178

9. Nonprofit shelters for the homeless:

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.

Clarifying Information - WAC 388-408-0045

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".

Worker Responsibilities - WAC 388-408-0045

1. If clients are already receiving benefits in an AU, remove those who are in the shelter from their previous AU.
2. Tell the client they can:
   1. Use Basic Food benefits to buy meals prepared by the shelter if the shelter is authorized by Food and Nutrition Service (FNS) to accept them; or
   2. Designate an employee of the facility as an authorized representative when the shelter purchases food for shelter residents at retail stores.

Clarifying Information - WAC 388-408-0050

If the AU is homeless at the time of application or recertification, we consider the AU homeless for the entire certification period.

Worker Responsibilities - WAC 388-408-0050

The 90-Day Period for Temporary Living Arrangements

1. Start a new 90-day count when the client:
   1. Moves from the residence of one person to the residence of another person if the client is living there on a temporary basis; or
   2. Moves out of their current residence (for at least one day) and later moves back into that residence.
2. Count the 90-day period consecutively from the date the client moved into their current temporary residence.

ACES Procedures

• Assistance Units
• Basic Food

Revised December 18, 2023

Purpose:

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.

WAC 388-408-0005 What is a cash assistance unit?

• Clarifying Information

WAC 388-408-0015 Who must be in my assistance unit?

• Clarifying Information

WAC 388-408-0020 When am I not allowed to be in a TANF or SFA assistance unit?

• Clarifying Information

WAC 388-408-0025 When can I choose who is in my TANF or SFA assistance unit?

• Worker Responsibilities

WAC 388-408-0030 What children must be in the same TANF or SFA assistance unit?

• Worker Responsibilities

WAC 388-408-0060 Who is in my assistance unit for Aged, Blind, or Disabled (ABD) cash assistance?

• Clarifying Information

WAC 388-408-0070 Who is included in my assistance unit when the department determines eligibility for referral to the housing and essential needs (HEN) program?

For more complete details see these EA-Z Manual chapters: APPLICATION and INTERVIEW REQUIREMENTS OTHER HELPFUL INFORMATION

Clarifying Information - WAC 388-408-0005

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.

Clarifying Information - WAC 388-408-0015

1. Home-monitored clients for TANF/SFA:

   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.

2. How a child's adoption affects the relationship between a child and their siblings:

   Adoption ends the legal relationship between biological siblings.

3. How a child's adoption affects the relationship between a child and their biological parent(s):
   
   1. Adoption ends the legal relationship between a child and the biological parents.

4. When a child is placed in a permanent guardianship:
   
   1. WAC 388-450-0100  explains the financially responsible person is legally obligated to support the dependent and defines the financially responsible person as a parent, stepparent, adoptive parent, spouse or caretaker relative.  WAC 388-450-0105 says the income of a financially responsible person is countable to meet the needs of the assistance unit.  If a child is permanently placed with a guardian and the guardian now has legal and financial responsibility for the child, they must both be included in the AU. 

5. When a pregnant minor or minor parent lives with their parents:
   It doesn't change who we include in the AU if a pregnant or minor parent who lives with their parent gets married, starts military service, or gets emancipated by court order.
6. How we apply the AU rules in some common situations:
   
   1. A married woman applies for assistance for herself and her two children from a previous marriage. She lives with her husband. She has a child in common with her husband and he has a child by a previous marriage. She doesn't want assistance for her husband, his child, or the common child. We must include all of the children in the AU because the husband must be included as he is the natural father of two of the kids and the stepfather of the other two.
   2. A grandmother applies for cash assistance for her grandchild as a non-needy relative. The minor parent of the grandchild lives in the home as well. Since you can't separate a child from their parent that lives in the home, we must include the minor parent in the AU. In this case, we would include the minor parent and allocate the income of their parent to the AU.

Clarifying Information - WAC 388-408-0020

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.

Worker Responsibilities - WAC 388-408-0025

1. Parent or caretaker relative of a child that gets SSI:
   In order to decide if an AU member is eligible for TANF, count a child who gets SSI as an "eligible child" even though the child isn't eligible for TANF. Don't include the SSI child's income, resources, or needs when you determine the AU's eligibility and grant amount. If the parent of an SSI child asks for assistance as a needy caretaker relative, don't include the parent's spouse or other children in the AU unless the parent wants assistance for them.
2. Relatives who are not the child's parent:
   
   1. If a non-parent relative chooses to get TANF instead of foster care payments they can choose whether or not to be in the AU based on their needs.
   2. If a non-parent relative chooses to get foster care payments for a child in their care and the relative needs financial assistance, count the child a "dependent child" to make the relative eligible for TANF or SFA. Don't include the foster child's income, resources, or needs when you determine the AU's eligibility and grant amounts.
   3. If a couple is married and applying as a needy relative for a child who is not their child, only one of the relatives can be a recipient on the grant. The non-parental caregiver and their spouse cannot both be on the grant.
   4. If a non-parent relative chooses to get TANF for multiple siblings in their care, they can choose to exclude one or more siblings as a “recipient" if they have income or including that sibling would cause TANF ineligibility.

3. Child in common of unmarried parents:
   Unmarried parents that live together may choose to exclude their common child if one of the parents is a TANF or SFA recipient.

4. What happens when a TANF AU with an optional household member has a change in circumstances?