Eligibility A-Z Manual (EA-Z)

The Eligibility A-Z (EA-Z) Manual provides administrative rules and procedures for staff to determine initial and ongoing eligibility for people applying for and receiving cash and food assistance in Washington State and provides links to medical assistance eligibility information.

Eligibility A-Z (EA-Z) Manual Revisions

Created on: 
Jul 24 2017
Rev # Chapter / Section Issue Date
981 Budgeting September 13, 2017
980 Expedited Service for Basic Food August 28, 2017
979 Temporary Absence August 7, 2017
978 Mid Certification Reviews July 31, 2017
977 Child Abuse and Neglect Reporting  
976 Use of Benefits - Benefit Issuance July 17, 2017
975 Temporary Absence July 11, 2017
974 Child Support June 29, 2017
973 Self Employment Income June 21, 2017
972 Fraud June 12, 2017
971 Income - Effect of income on Eligibility and Benefit Level May 16, 2017
970 Transfer of Property for Cash and Basic Food May 11, 2017
969 TANF/SFA Temporary Absence May 11, 2017
968 TANF/SFA Minor Parents May 11, 2017
967 TANF/SFA Time Limit Overview and Indian Disregard May 11, 2017
966 TANF/SFA Time Limits Chapter May 11, 2017
965

Eligibility Review Requirements for Cash Assistance and Medical Programs / Eligibility Reviews/ Food Assistance Recertifications - Requirements for Cash Assistance and Medical Programs

April 17, 2017
964 Program Summary / Working Family Support April 17, 2017
963 Treatment of Income Chart March 2, 2017
962 Income Special Types March 2, 2017
961 Basic Food Overpayments March 1, 2017
960 Income - Effect of income on Eligibility and Benefit Level January 9, 2017
959 Interview Requirements January 4, 2017
958 Transfer of Property for Cash and Basic Food - State Median Income December 30, 2016
957 Income- Table of Contents- Self Employment Income- Mileage reimbursement January 3, 2017
956 State Median Income Chart December 30, 2016
955 Fraud December 19, 2016
954 Expedited Service for Basic Food December 7, 2016
953 Cash Assistance Programs November 28, 2016
952 Basic Food Work Requirements - Unsuitable Employment and Quitting a Job November 18, 2016
951

ABAWDs- Able-Bodied Adults Without Dependents

November 15, 2016
950 Self Employment Income November 15, 2016
949 Eligibility Review Requirements for Cash Assistance and Medical Programs: Eligibility Reviews/Food Assistance Recertifications – Requirements for Cash Assistance and Medical Programs November 1, 2016
948 Income Special Types October 20, 2016
947 Relative Placement Codes Excluded from Means Testing October 17, 2016
946 Time Limits for Processing October 17, 2016
945 TANF/SFA Time Limits: Indian Country Disregard October 11, 2016
944 Basic Food Work Requirements - Good Cause October 4, 2016
943 TANF/SFA Time Limits: Indian Country Disregard October 1, 2016
942 TANF - Program Summary - Tribal TANF September 8, 2016
941 TANF - Program Summary August 26, 2016
940 Interview Requirements August 25, 2016
939 Time Limit Overview August 5, 2016
938 Mid Certification Review August 5, 2016
937 Change of Circumstances - Effective Date August 5, 2016
936 Income - Effect of income on Eligibility and Benefit Level August 2, 2016
935 Diversion Cash Assistance Program Summary August, 1, 2016
934 Interview Requirements July 29, 2016
933 Citizenship and Alien Status - Definitions June 28, 2016
932 Fleeing Felons June 20, 2016
931 Income - Effect of income on Eligibility and Benefit Level May 17, 2016
930 Basic Food Work Requirements - Abled-Bodied Adults without Dependents (ABAWD) May 12, 2016
929 Program Summary- Working Family Support April 29, 2016
928 500 Series Reason Code Protocols April 29, 2016
927 400 Series Reason Code Protocols April 29, 2016
926 Basic Food Work Requirements - Unsuitable Employment and Quitting a Job April 26, 2016
925 Income - Effect of income on Eligibility and Benefit Level April 06, 2016
924 Diversion Cash Assistance March 31, 2016
923 Exception to Rule March 31, 2016
922 Verification Charts March 29, 2016
921 Refugee Cash Assistance March 16, 2016
920 Verification Chart March 10, 2016
919 Transitional Food Assistance March 7, 2016
918 Time Limits for Processing February 8, 2016
917 Effective Date - Change of Circumstance February 4, 2016
916 Replacements January 28, 2016
915 State Median Income Chart December 30, 2015
914 Change of Circumstance December 8, 2015
913 Pregnant Women Assistance December 8, 2015
912 Mid-Certification Reviews October 19, 2015
911 Applications for Assistance - Time Limits for Processing October 12, 2015
910 Applications for Assistance - Filing an Application October 5, 2015
909 Income - Treatment of Income Chart September 16, 2015
908 Self Employment Income September 4, 2015
907 Citizenship and Alien Status – Social Security Number Requirements August 21, 2015
906 Refugee Cash Assistance August 14, 2015
905 Letters July 31, 2015
904 Income - Special Types July 30, 2015
903 Consolidated Emergency Assistance Program (CEAP) July 30, 2015
902 Consolidated Emergency Assistance Program (CEAP) July 20, 2015
901 Standards - Cash Assistance July 20, 2015
900 Consolidated Emergency Assistance Program (CEAP) July 20, 2015
899 Income Special Types July 20, 2015
898 Income - Treatment July 20, 2015
897 Self-Employment Income July 20, 2015
896 Food Assistance Program for Legal Immigrants (FAP) July 2, 2015
895 Benefit Issuances and Use of Benefits - Replacements June 19, 2015
894 Change of Circumstances - Effective Date June 19, 2015
893 Change of Circumstances - Effective Date June 5, 2015
891 Categorical Eligibility for Basic Food March 19, 2015
890 Citizenship and Alien Status - For Food Benefits January 28, 2015
889 Interview Requirements January 14, 2015
888 Change of Circumstances - Reporting Requirements January 12, 2015
887 WorkFirst Sanctions - Participation December 10, 2014
886 Basic Food Work Requirements - Unsuitable Employment and Quitting a Job October 29, 2014
885 Basic Food Employment and Training (BFET) Program October 24, 2014
884 Verification August 5, 2014
883 Verification July 22, 2014
882 Transitional Food Assistance (TFA) July 14, 2014
881 Assistance Units - Basic Food July 2, 2014
880 Change of Circumstances - Reporting Requirements and Residency Requirements July 2, 2014
879 Fleeing Felons June 26, 2014
878 Income - Effect on Eligibility and Benefit Level June 20, 2014
877 Assistance Units - Basic Food June 20, 2014
876 Basic Food Work Requirements - BFET Payments for Related Expenses April 24, 2014
875 Benefit Errors - Basic Food Overpayments April 18, 2014
874 Applications for Assistance - Expedited Service for Basic Food March 28, 2014
873 Benefit Errors - Basic Food Overpayments March 20, 2014
872 Benefit Errors - Basic Food Overpayments March 20, 2014
871 Benefit Issuances - Use of Benefits and Fraud March 20, 2014
870 Mid-Certification Reviews January 27, 2014
869 Applications for Assistance - Completing the Process January 6, 2014
868 Basic Food Work Requirements - Unsuitable Employment and Quitting a Job November 22, 2013
867 Basic Food Work Requirements - ABAWD September 16, 2013
866 Assistance Units - Basic Food September 6, 2013
865 Interview Requirements July 13, 2013
864 Benefit Errors - Basic Food Overpayments July 11, 2013
863 Transitional Food Assistance (TFA) May 31, 2013
862 Citizenship and Alien Status April 15, 2013
861 Citizenship and Alien Status - Definitions April 15, 2013
860 Income Special Types April 11, 2013
859 Treatment of Income Chart April 9, 2013
858 Application for Assistance March 27, 2013
857 Application for Assistance - Filing an Application March 27, 2013
856 Income - Allocation and Deeming March 18, 2013
855 Refugee Cash Assistance Program(RCA), Immigration Status Requirements for Refugee Assistance, Income and Resources for Refugee Assistance Eligibility January 24, 2013
854 Applications for Assistance - Filing an Application January 17, 2013
853 Long-Term Care January 14, 2013
852 Long-Term Care January 11, 2013
851 Income - Treatment of Income Chart and Resources - Cash and Family Medical ( and Basic Food) January 11, 2013
850 Income - Treatment of Income Chart January 9, 2013
849 Long-Term Care November 22, 2012
848 Long-Term Care November 22, 2012
847 Long-Term Care November 22, 2012
846 Long-Term Care November 28, 2012
845 Long-Term Care November 27, 2012
844 Long-Term Care November 22, 2012
843 Mid-Certification Reviews October 31, 2012
842 Medical Assistance October 22, 2012
841 Refugee Cash Assistance Program(RCA), Immigration Status Requirements for Refugee Assistance, and Income and Resources for Refugee Assistance Eligibility October 13, 2012
840 Letters October 5, 2012
839 Applications for Assistance - Filing an Application September 21, 2012
838 Applications for Assistance September 14, 2012
837 Authorized Representative - Food Assistance September 14, 2012
836 Basic Food Work Requirements - ABAWD August 26, 2012
835 Authorized Representative - Food Assistance August 6, 2012
834 Authorized Representative - Food Assistance August 6, 2012
833 Authorized Representative - Food, Cash and Medical Benefit Issuances August 3, 2012
832 Authorized Representative - Food Assistance July 17, 2012
831 Basic Food Employment and Training (BFET) Program June 26, 2012
830 Citizenship and Alien Status - For Food Benefits June 29, 2012
829 Program Summary - Food Assistance Program for Legal Immigrants (FAP) June 29, 2012
828 Benefit Errors – Cash and Food Assistance Underpayments June 15, 2012
827 Standards – Cash Assistance July 1, 2012
826 Long-Term Care July 1, 2012
825 Student Status May 25, 2012
824 Long-Term Care May 21, 2012
823 Letters – 500 Series Reason Code Protocols May 21, 2012
822 Benefit Errors – Basic Food Overpayments May 21, 2012
821 Program Summary - Pregnant Women Assistance May 14, 2012
820 Long-Term Care May 14, 2012
819 Medical Assistance - Medical Redetermination (Repealed) May 1, 2012
818 Long-Term Care April 5, 2012
817 Long-Term Care April 5, 2012
816 Long-Term Care April 5, 2012
815 Long-Term Care April 1, 2012
814 Diversion Cash Assistance March 29, 2012
813 Income – Allocating and Deeming March 29, 2012
812 Long-Term Care March 26, 2012
811 Medical Assistance and Long-Term Care March 26, 2012
810 Long-Term Care March 23, 2012
809 Long-Term Care March 23, 2012
808 Long-Term Care March 22, 2012
807 Income - Budgeting March 14, 2012
806 Eligibility Reviews/Food Assistance Recertification – Process for Basic Food March 12, 2012
805 Applications for Assistance – Expedited Service for Basic Food February 22, 2012
804 Income – Special Types February 17, 2012
803 Income – Self Employment February 14, 2012
802 Emergency Assistance Programs - Consolidated Emergency Assistance Program (CEAP) February 1, 2012
801 WorkFirst - Sanctions December 1, 2011
800 WorkFirst - Sanctions December 1, 2011
799 Basic Food - Work Requirements January 4, 2012
798 Income – Self Employment December 12, 2011
797 Medical Assistance December 14, 2011
796 Various - Medical Care Services Changes (Repealed) November 1, 2011
795 Good Cause (Repealed) November 1, 2011
794 Certification Periods – Basic Food October 14, 2011
793 Student Status October 14, 2011
792 Transitional Food Assistance (TFA) October 7, 2011
791 Basic Food Work Requirements - ABAWD October 1, 2011
790 Benefit Errors – Basic Food Overpayments September 9, 2011
789 Citizenship and Alien Status September 7, 2011
788 Citizenship and Alien Status September 1, 2011
787 Quality Assurance August 29, 2011
786 Application for Assistance – Completing the Process August 27, 2011
785 Limited English Proficiency (LEP) August 11, 2011
784 Quality Assurance August 1, 2011
783 Filing an Application July 18, 2011
782 Mid Certification Reviews August 1, 2011
781 Requirement to Cooperate with Quality Assurance (Repealed) August 1, 2011
780 Diversion Cash Assistance July 1, 2011
779 Washington Combined Application Project (WASHCAP) July 1, 2011
778 Benefit Errors - Alien and Alien Sponsor Overpayments June 17, 2011
777 Income - Special Types April 29, 2011
776 Income - Treatment April 21, 2011
775 Benefit Issuances and Use of Benefits - Replacement April 20, 2011
774 Residency Requirements April 13, 2011
773 Rights and Responsibilities April 8, 2011
772 Applications for Assistance – Expedited Service for Basic Food April 8, 2011
771 Washington Combined Application Project (WASHCAP) April 8, 2011
770 Fleeing Felons March 31, 2011
769 Letters - Reason Codes March 16, 2011
768 Income - Treatment February 11, 2011
767 Applications for Assistance – Time Limits for Processing February 1, 2011
766 Standards - Cash Assistance February 1, 2011
765 Emergency Assistance Programs – Consolidated Emergency Assistance Program (CEAP) February 1, 2011
764 Emergency Assistance Programs – Additional Requirements for Emergent Needs (AREN) February 1, 2011
763 Emergency Assistance Programs – Consolidated Emergency Assistance Program (CEAP) February 1, 2011
762 Verification February 6, 2011
761 Income - Special Types - Community Jobs February 1, 2011
760 Reporting Requirements February 6, 2011
759 Citizenship and Alien Status - Definitions January 19, 2011
758 Citizenship and Alien Status - Sample SSN Request Letter January 12, 2011
757 Program Summary - Washington Basic Food Program, Citizenship and Alien Status, Basic Food - Work Requirements, and Income - Effect of income on Eligibility and Benefit Level January 21, 2011
756 Income (Repealed) January 11, 2011
755 Citizenship and Alien Status - Definitions December 22, 2010
754 Diversion Cash Assistance January 1, 2011
753 Basic Food Work Requirements - ABAWD January 1, 2011
752 Transfer of Property for Cash and Basic Food and State Median Income Chart January 1, 2011
751 Standards - Cash Assistance January 1, 2011
750 Transitional Food Assistance (TFA) December 21, 2010
749 Basic Food Work Requirements December 18, 2010
748 WASHCAP December 18, 2010
747 Citizenship and Alien Status – For Temporary Assistance for Needy Families (TANF) and Medicaid and Medical Assistance December 1, 2010
746 Citizenship and Alien Status - For State Cash Programs and Chemical Dependency Treatment December 1, 2010
745 Citizenship and Alien Status - Restrictions for State Medical Benefits - Medical Care Services and Pregnancy Medical December 1, 2010
744 Healthcare for Workers with Disabilities - HWD November 8, 2010
743 SSI-Related Medical General (Repealed) November 8, 2010
742 Letters October 12, 2010
741 Diversion Cash Assistance October 1, 2010
740 Emergency Assistance Programs - Additional Requirements for Emergent Needs (AREN) October 1, 2010
739 WorkFirst Sanctions - Participation October 1, 2010
738 Food Stamp Employment and Training (Repealed) and Basic Food Employment and Training (BFET) Program October 1, 2010
737 Change of Circumstances - Effective Date August 12, 2010
736 Benefit Issuances and Use of Benefits - When and How Benefits are Delivered August 3, 2010
735 Income - Budgeting August 3, 2010
734 Transitional Food Assistance August 1, 2010
733 Assistance Units - Basic Food August 1, 2010
732 ABAWDs - Able-Bodied Adults Without Dependents July 22, 2010
731 Emergency Assistance Programs - Consolidated Emergency Assistance Program - CEAP July 21, 2010
730 Change of Circumstances and Change of Circumstances - Effective Date August 1, 2010
729 Income - Allocation and Deeming August 1, 2010
728 Income August 1, 2010
727 Income - Allocation and Deeming August 1, 2010
726 Applications for Assistance - Filling an Application July 19, 2010
725 Medical Assistance Programs - Emergency Assistance - Psychiatric Indigent Inpatient (PII) (Repealed) July 16, 2010
724 Assistance Units - Cash Assistance Programs July 1, 2010
723 Assistance Units - Basic Food and Assistance Units - Cash Assistance Programs July 1, 2010
722 Assistance Units - Basic Food and Assistance Units - Cash Assistance Programs July 1, 2010
721 Benefit Errors - Basic Food Overpayments July 1, 2010
720 Applications for Assistance - Completing the Process July 1, 2010
719 Change of Circumstances July 1, 2010
718 Applications for Assistance - Filling an Application July 1, 2010
717 SSI-Related Clarifying (Repealed) June 2, 2010
716 Citizenship and Alien Status May 26, 2010
715 Benefit Issuances – Medical Services Card (Repealed) May 14, 2010
714 Verification April 21, 2010
713 Assistance Units - Basic Food April 12, 2010
712 Verification April 1, 2010
711 Citizenship and Alien Status - For Temporary Assistance for Needy Families (TANF) and Medicaid April 1, 2010
710 Medical April 6, 2010
709 Citizenship and Alien Status - Definitions April 2, 2010
708 Verification March 30, 2010
707 Verification Charts March 17, 2010
706 Medical March 1, 2010
705 Change of Circumstances - Effective Date March 1, 2010
704 Reporting Requirements April 1, 2010
703 Certification Periods - Basic Food March 24, 2010
702 Verification January 27, 2010
701 Interview Requirements January 22, 2010
700 Treatment of Income January 1, 2010
699 Program Summary - General Assistance - Unemployable (Repealed) November 17, 2009
698 Income - Effect of Income on Eligibility and Benefit Level November 15, 2009
697 Income - Treatment November 15, 2009
696 Benefit Issuances and Use of Benefits - Replacement November 15, 2009
695 Medical Assistance October 26, 2009
694 Treatment of Income October 8, 2009
693 Managed Health Care - GAU Managed Care Expansion (Repealed) October 15, 2009
692 Long-Term Care October 1, 2009
691 Applications for Assistance - Filling an Application September 28, 2009
690 Income - Budgeting September 25, 2009
689 Income October 1, 2009
688 Fleeing Felons September 4, 2009
687 Long-Term Care September 4, 2009
686 Long-Term Care July 28, 2009
685 Citizenship and Alien Status - For Food Benefits July 8, 2009
684 Citizenship and Alien Status - For Temporary Assistance for Needy Families (TANF) and Medicaid July 8, 2009
683 Long-Term Care July 6, 2009
682 Long-Term Care July 6, 2009
681 Long-Term Care July 6, 2009
680 Long-Term Care July 1, 2009
679 TANF/SFA Temporary Absence June 17, 2009
678 Chemical Dependency - Eligibility (Repealed) June 23, 2009
677 Payees on Benefit Issuances - Protective Payees May 19, 2009
676 Income - Allocation and Deeming May 8, 2009
675 Long-Term Care May 1, 2009
674 Refugee Assistance Program - Medical Assistance April 27, 2009
673 Refugee Assistance Program - Cash Assistance April 27, 2009
672 Refugee Assistance Program - Immigration Status Requirements April 27, 2009
671 Citizenship and Alien Status - For Temporary Assistance for Needy Families (TANF) and Medicaid April 27, 2009
670 Long-Term Care April 23, 2009
669 Long-Term Care April 23, 2009
668 Long-Term Care April 10, 2009
667 Emergency Assistance Programs - Consolidated Emergency Assistance Program (CEAP) April 14, 2009
666 Benefit Issuances and Use of Benefits - When and How Benefits are Delivered April 10, 2009
665 Long-Term Care April 1, 2009
664 Incapacity Determination - Process (Repealed) April 1, 2009
663 Limited English Proficiency (LEP) March 4, 2009
662 Long-Term Care March 4, 2009
661 Exception to Rule February 23, 2009
660 Exception to Rule February 19, 2009
659 Income - Allocation and Deeming February 9, 2009
658 Long-Term Care January 27, 2009
657 Long-Term Care January 14, 2009
656 Long-Term Care January 6, 2009
655 Long-Term Care January 6, 2009
654 Long-Term Care December 31, 2008
653 Long-Term Care December 31, 2008
652 Washington Telephone Assistance Program December 18, 2008
651 Standards January 1, 2009
650 Long-Term Care December 10, 2008
649 Transfer of Property for Cash and Basic Food November 18, 2008
648 Income - Treatment November 26, 2008
647 Long-Term Care December 1, 2008
646 Foster Care/Relative Placement/Adoption Support/Juvenile Rehabilitation/Unaccompanied Minor Program November 14, 2008
645 Long-Term Care October 31, 2008
644 Medical Assistance October 20, 2008
643 Medical RE-DETERMINATION (Repealed) October 1, 2008
642 Benefit Issuances - Basic Food October 1, 2008
641 Categorical Eligibility for Basic Food October 1, 2008
640 Standards - Basic Food October 1, 2008
639 Income - Effect of Income on Eligibility and Benefit Level October 1, 2008
638 WASHCAP October 1, 2008
637 Medical Assistance October 1, 2008
636 Emergency Assistance Programs - Disaster Cash Assistance Program October 1, 2008
635 Long-Term Care September 24, 2008
634 Long-Term Care September 23, 2008
633 Long-Term Care September 16, 2008
632 Long-Term Care August 20, 2008
631 Long-Term Care August 4, 2008
630 Ongoing Additional Requirements (OAR) July 23, 2008
629 Payees on Benefit Issuances - Protective Payees July 23, 2008
628 Long-Term Care July 1, 2008
627 Standards - Cash Assistance July 1, 2008
626 Long-Term Care June 23, 2008
625 Consolidated Emergency Assistance Program (CEAP) July 1, 2008
624 Long-Term Care June 18, 2008
623 Standards - Cash Assistance July 1, 2008
622 Standards - Cash Assistance June 11, 2008
621 Consolidated Emergency Assistance Program (CEAP) June 11, 2008
620 Long-Term Care May 2, 2008
619 Long-Term Care April 22, 2008
618 Long-Term Care April 22, 2008
617 Long-Term Care April 18, 2008
616 Student Status April 7, 2008
615 GA-U Program Summary (Repealed) January 30, 2008
614 Age Requirements January 30, 2008
613 Long-Term Care February 1, 2008
612 Income - Budgeting February 1, 2008
610 Long-Term Care January 1, 2008

 

ACES Upload Field: 

Eligibility A-Z (EA-Z) WAC (Rules) Index

Updated: December 10, 2014

Purpose: 

This page lists the Washington Administrative Codes (WACs) used throughout the Eligibility A-Z Manual. Use the "Find on this Page" (Ctrl+F) feature to quickly search for a WAC number or title. 

 
388-002-0495 What is equitable estoppel?
 
388-106-0045 When will the department authorize my long-term care services?
 
388-271-0010 What are limited English proficient (LEP) services?
388-271-0020 What are the department's responsibilities in providing me with an interpreter?
388-271-0030 What are the department's responsibilities in providing me with written communication in my primary language?
 
388-273-0010 Purpose of the Washington Telephone Assistance Program
388-273-0020 Who may receive Washington Telephone Assistance Program (WTAP)?
388-273-0025 Benefits you receive as a WTAP participant.
388-273-0030 How You Can Apply for WTAP.
388-273-0035 What We Reimburse the Local Telephone Company.
 
388-310-1600 WorkFirst-Sanctions.
388-310-1650 WorkFirst--Child SafetyNet Payments.
 
388-400-0005 Who is eligible for Temporary Assistance for Needy Families?
388-400-0010 Who is eligible for State Family Assistance?
388-400-0030 Who is eligible for refugee cash assistance?
388-400-0040 Am I eligible for benefits through the Washington Basic Food program?
388-400-0050 If I am not eligible for federal benefits through Washington Basic Food Program because of my alien status, can I receive state-funded Basic Food?
388-400-0047 Am I eligible for the heat and eat program?
388-400-0050 If I am not eligible for federal benefits through Washington Basic Food program because of my alien status, can I receive benefits through the state-funded food assistance program?
388-400-0055 Who is eligible for the Pregnant Women Assistance (PWA) program?
388-400-0060 Who is eligible for aged, blind, or disabled (ABD) cash assistance?
388-400-0065 Housing and Essential Needs (HEN)
388-400-0070 Who is eligible for referral to the Housing and Essential Needs (HEN) program?
 
388-404-0005 How does a child's age and attendance in school affect their eligibility for TANF and SFA?
388-404-0015 Definition of elderly person for food and cash assistance programs
 
388-406-0005 Can I apply for cash or Basic Food? 
388-406-0010 How do I apply for cash assistance or Basic Food benefits?
388-406-0012 What is the date of my application and how does it affect my benefits?
388-406-0015 Can I get Basic Food right away?
388-406-0021 How does being a migrant or seasonal farmworker affect my application for Basic Food?
388-406-0030 Do I need to submit other information after I apply for benefits?
388-406-0035 How long does the department have to process my application?
388-406-0040 What happens if the processing of my application is delayed?
388-406-0045 Is there a good reason my application for cash assistance has not been processed?
388-406-0050 How do I know when my application is processed?
388-406-0055 When do my benefits start?
388-406-0056 When does my eligibility for referral to the Housing and Essential Needs (HEN) program begin
388-406-0060 What happens when my application is denied?
388-406-0065 Can I still get benefits even after my application is denied?
 
388-408-0005 What is a cash assistance unit?
388-408-0015 Who must be in my assistance unit?
388-408-0020 When am I not allowed to be in a TANF or SFA assistance unit?
388-408-0025 When can I choose who is in my TANF or SFA assistance unit?
388-408-0030 What children must be in the same TANF or SFA assistance unit?
388-408-0034 What is an assistance unit for Basic Food?
388-408-0035 Who is in my assistance unit for Basic Food?
388-408-0040 How does living in an institution affect my eligibility for Basic Food?
388-408-0045 Am I eligible for Basic Food if I live in a shelter for battered women and children?
388-408-0050 Does the department consider me as homeless for Basic Food benefits?
388-408-0060 Who is in my assistance unit for Aged, Blind, or Disabled (ABD) cash assistance?
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?
 
388-410-0001 What is a cash assistance overpayment?
388-410-0005 Cash assistance overpayment amount and liability
388-410-0010 Repayment of grant overpayment occurring prior to April 3, 1982, and resulting from department error
388-410-0015 Recovery of cash assistance overpayments by mandatory grant deduction
388-410-0020 What happens if I receive more Basic Food or WASHCAP benefits than I am supposed to receive?
388-410-0025 Am I responsible for an overpayment in my assistance unit?
388-410-0030 How does the department calculate and set up my Basic Food or WASHCAP overpayment?
388-410-0033 How and when does the department collect a Basic Food or WASHCAP overpayment?
388-410-0035 Are alien and alien sponsors jointly responsible for cash and food assistance overpayments?
388-410-0040 Cash and food assistance underpayments.
 
388-412-0005 General information about your cash benefits.
388-412-0010 Endorsing the warrant.
388-412-0015 General information about your food assistance allotments.
388-412-0020 When do I get my benefits?
388-412-0025 How do I receive my benefits?
388-412-0030 Returning a warrant.
388-412-0035 Loss, theft, destruction or nonreceipt of a warrant issued to clients and vendors.
388-412-0040 Can I get my benefits replaced?
388-412-0046 What is the purpose of DSHS cash and food assistance benefits and how can I use my benefits?
 
388-414-0001 Do I have to meet all eligibility requirements for Basic Food?
 
388-416-0005 How long can I get Basic Food?
 
388-418-0005 How will I know what changes to report?
388-418-0007 When do I have to report changes in my circumstances?
388-418-0011 What is a mid-certification review, and do I have to complete one in order to keep receiving benefits?
388-418-0020 How does the department determine the date a change affects my cash and Basic Food benefits?
 
388-420-0010 Alcohol and drug treatment centers.
 
388-422-0005 What happens to my child and spousal support when I get public assistance?
388-422-0010 Do I have to cooperate with the division of child support (DCS)?
388-422-0020 What if you are afraid that cooperating with the division of child support (DCS) may be dangerous for you or the child in your care?
388-422-0030 What happens if my support is more than my TANF or SFA cash benefit?
 
388-424-0001 Citizenship and alien status - Definitions
388-424-0006 Citizenship and alien status - Date of Entry
388-424-0007 Citizenship and alien status - Armed Services or Veteran Status
388-424-0008 Citizenship and alien status - Work Quarters
388-424-0009 Citizenship and alien status - Social Security Number (SSN) Requirements
388-424-0010 Citizenship and alien status - Eligibility for TANF.
388-424-0015 Immigrant eligibility restrictions for the State Family Assistance, ABD cash and PWA programs. 
388-424-0020 How does my alien status impact my eligibility for federally-funded Basic Food benefits?
388-424-0025 How does my alien status impact my eligibility for state-funded benefits under the Washington Basic Food Program?
388-424-0030 How does my alien status impact my eligibility for state-funded benefits under the food assistance program?
 
388-426-0005 How do I make a complaint to the department?
 
388-428-0010 Request for address disclosure by a parent when a child is living with a nonparental caretaker
 
388-432-0005 Can I get help from DSHS for a family emergency without receiving monthly cash assistance?
 
388-434-0005 How often does the department review my eligibility for benefits?
388-434-0010 How do I get Basic Food benefits after my certification period has ended?
 
388-436-0002 If my family has an emergency, can I get help from DSHS to get or keep our housing or utilities?
388-436-0015 Consolidated emergency assistance program (CEAP).
388-436-0020 CEAP assistance unit composition.
388-436-0025 Eligibility conditions for CEAP--Job refusal.
388-436-0030 How does my eligibility for other possible cash benefits impact my eligibility for CEAP?
388-436-0035 Income and resources for CEAP.
388-436-0040 Excluded income and resources for CEAP.
388-436-0045 Income deductions for CEAP.
388-436-0050 Determining financial need and benefit amount for CEAP.
388-436-0055 What is the Disaster Cash Assistance Program (DCAP)?
388-436-0060 How much money can I receive from the Disaster Cash Assistance Program (DCAP)?
 
388-437-0001 Disaster food stamp program.
 
388-440-0001 Exception to rule.
388-440-0005 How am I informed of the decision my request to the department for an exception to rule?
 
388-442-0010 How does being a fleeing felon impact my eligibility for benefits?
 
388-444-0005 Am I required to work or look for work in order to be eligible for Basic Food?
388-444-0010 Who is exempt from work registration while receiving Basic Food?
388-444-0015 How can the Basic Food Employment and Training (BF E&T) program help me find work?
388-444-0020 REPEALED
388-444-0025 What expenses will the department pay to help me participate in BF E&T?
388-444-0030 Do I have to work to be eligible for Basic Food benefits if I am an able-bodied adult without dependents (ABAWD)?
388-444-0035 Who is exempt from ABAWD work requirements?
388-444-0040 Can I volunteer for an unpaid work program in order to meet the work requirements under WAC 388-444-0030?
388-444-0045 How does an ABAWD regain eligibility for Basic Food after being closed for the three-month limit?
388-444-0050 What is good cause for failing to meet Basic Food work requirements?
388-444-0055 What are the penalties if I refuse or fail to meet Basic Food work requirements?
388-444-0060 What is unsuitable employment for Basic Food work requirements?
388-444-0065 Am I eligible for Basic Food if I quit my job or reduce my work effort?
388-444-0070 What is good cause for quitting my job or reducing my work effort?
388-444-0075 What are the penalties if I quit a job or reduce my work effort without good cause?
 
388-446-0001 When does the department refer a cash or food assistance case for prosecution for fraud?
388-446-0005 Disqualification period for cash assistance
388-446-0010 TANF disqualification period for fraud convictions of misrepresenting interstate residence
388-446-0015 What is an Intentional program violation (IPV) and administrative disqualification hearings (ADH) for food assistance.
388-446-0020 What penalties will I receive if I break a food assistance rule on purpose?
 
388-447-0001 What are the incapacity requirements for referral to the Housing and Essential Needs (HEN) program?
388-447-0005 What evidence does the department consider to determine incapacity?
388-447-0010 What medical evidence do I need to provide?
388-447-0020 How does the department assign severity ratings to my impairments?
388-447-0030 Progressive Evaluation Process Step I - How does the department review the medical evidence required for an incapacity determination?
388-447-0040 Progressive Evaluation Process Step II - How does the department determine the severity of mental impairments?
388-447-0050 Progressive evaluation process step III — How does the department determine the severity of physical impairments?
388-447-0060 Progressive evaluation process step IV — How does the department determine the severity of multiple impairments?
388-447-0070 Progressive evaluation process step V — How does the department determine the impact of a mental impairment on my ability to function in a work environment?
388-447-0080 Progressive evaluation process step VI — How does the department determine the impact of a physical impairment on my ability to function in a work setting?
388-447-0090 Progressive evaluation process step VII — How does the department determine ability to perform past work?
388-447-0100 Progressive evaluation process Step VIII — How does the department determine ability to perform other work?
388-447-0110 When does my eligibility for referral to the housing and essential needs (HEN) program end?
388-447-0120 How does alcohol or drug dependence affect my eligibility for referral to the housing and essential needs (HEN) program?
 
388-449-0001 What are the disability requirements for the Aged, Blind or Disabled (ABD) program?
388-449-0005 Sequential Evaluation Process Step 1 -- How does the department determine if you are performing substantial gainful employment?
388-449-0010 What evidence do we consider to determine disability?
388-449-0015 What medical evidence do I need to provide?
388-449-0020 How does the department evaluate functional capacity for mental health impairments?
388-449-0030 How does the department evaluate functional capacity for physical impairments?
388-449-0035 How does the department assign severity ratings to my impairment? 
388-449-0040 How does the department determine the severity of mental impairments?
388-449-0045 How does the department determine the severity of physical impairments?
388-449-0050 How does the department determine the severity of multiple impairments?
388-449-0060

Sequential Evaluation Process step II - How does the department review medical evidence to determine if I am eligible for benefits?

388-449-0070 Sequential Evaluation Process step III — How does the department determine if you meet SSA listing of impairments criteria?
388-449-0080

Sequential Evaluation Process step IV — How does the department evaluate if I am able to perform relevant past work?

388-449-0100 Sequential Evaluation Process step V — How does the department evaluate if I can perform other work when determining disability?
388-449-0150 When does my eligibility for the Aged, Blind, or Disabled (ABD) cash benefits end?
388-449-0200 Am I eligible for cash assistance for Aged, Blind, or Disabled (ABD) while waiting for Supplemental Security Income (SSI)?
388-449-0210 What is interim assistance and how do I assign it to the department?
388-449-0220 How does alcohol or drug dependence affect my eligibility for the ABD cash and Pregnant Women Assistance programs?
388-449-0225 Am I required to participate in vocational rehabilitation services if I receive an ABD cash grant?
 
388-450-0005 How does the department decide if I own a type of income and if this income is available to meet my needs?
388-450-0010 The department takes some or all of your time-loss benefits if you get cash assistance while waiting for your claim to be processed
388-450-0015 What types of income are not used when figuring out my benefits?
388-450-0025 What is unearned income?
388-450-0030 What is earned income?
388-450-0035 Educational Benefits
388-450-0040 Native American benefits and payments.
388-450-0045 How do we count income from employment and training programs?
388-450-0050 How does your participation in the community jobs (CJ) program affect your cash assistance and Basic Food benefits?
388-450-0055 How does needs-based assistance from other agencies or organizations count against my benefits?
388-450-0065 Gifts - Cash and noncash.
388-450-0070 How do we count the earned income of a child?
388-450-0080 What is self-employment income?
388-450-0085 Does the department count all of my self-employment income to determine if I am eligible for benefits?
388-450-0095 Allocating income--General.
388-450-0100 Allocating income--Definitions.
388-450-0105 Allocating the income of a financially responsible person included in the assistance unit.
388-450-0106 How does the department count my income if someone in my family cannot get assistance because of their alien status?
388-450-0112 Does the department allocate the income of an ABD cash client to legal dependents?
388-450-0113 Does the department allocate income of a housing and essential needs (HEN) referral recipient to legal dependents?
388-450-0115 Does the department allocate the income of a financially responsible person who is excluded from the assistance unit?
388-450-0116 How does the department count my income if I cannot get assistance because I am an alien ?
388-450-0120 Does the department allocate the income of financially responsible parents to a pregnant or parenting minor?
388-450-0130 Does the department allocate the income of a nonapplying spouse to a caretaker relative?
388-450-0137 Does the department allocate income of an ineligible spouse to an ABD cash client?
388-450-0138 Does the department allocate income of an ineligible spouse to a housing and essential needs (HEN) referral recipient?
388-450-0140 How does the income of an ineligible assistance unit member affect my eligibility and benefits for Basic Food?
388-450-0145 Income of a person who is not a member of a food assistance unit.
388-450-0155 How does being a sponsored immigrant affect my eligibility for cash and food assistance programs?
388-450-0156 When am I exempt from deeming?
388-450-0160 How does the department decide how much of my sponsor's income to count against my benefits?
388-450-0162 How does the department count my income to determine if my assistance unit is eligible and how does the department calculate the amount of my cash and Basic Food benefits?
388-450-0165 Gross earned income limit for TANF / SFA.
388-450-0170 Does the department provide an earned income deduction as an incentive for persons who receive TANF/SFA to work?
388-450-0177 Does the department offer an income deduction for the ABD cash program as an incentive for clients to work?
388-450-0178 Does the department offer an income deduction for housing and essential needs (HEN) referral applicants and recipients as an incentive to work?
388-450-0185 What income deductions does the department allow when determining if I am eligible for food benefits and the amount of my monthly benefits?
388-450-0190 How does the department figure my shelter cost income deduction for Basic Food? 
388-450-0195 Does the department use my utility costs when calculating my Basic Food or WASHCAP benefits? 
388-450-0200 Will the medical expenses of elderly persons or individuals with disabilities in my assistance unit be used as an income deduction for Basic Food?
388-450-0215 How does the department estimate my assistance unit's income to determine my eligibility and benefits?
388-450-0225 How are my assistance unit's benefits calculated for the first month I am eligible for cash assistance?
388-450-0230 What income does the department count in the month I apply for Basic Food when my assistance unit is destitute?
388-450-0245 When are my benefits suspended?
 
388-452-0005 Do I have to be interviewed in order to get benefits?
388-452-0010 What does the family violence amendment mean for TANF recipients?
 
388-454-0005 Can I get TANF or SFA benefits for the child living with me?
388-454-0006 The department makes background checks on adults who are acting in place of a parent without court-ordered custody.
388-454-0010 Do I have to be related to a child in order to get TANF or SFA for the child?
388-454-0015 Temporary absence from the home
388-454-0020 Temporary absence to attend school or training
388-454-0025 The department notifies a child's parent when we approve assistance and the child is living with someone other than their parent
 
388-455-0005 How do lump sum payments affect benefits?
388-455-0010 When and how does the department treat lump sum payments as a resource for cash assistance programs?
388-455-0015 When and how does the department treat lump sum payments as income for cash assistance programs?
 
388-458-0002 The department of social and health services (DSHS) sends you letters to tell you about your case.
388-458-0006 DSHS sends you a letter when you withdraw your application.
388-458-0011 DSHS sends you a denial letter when you can't get benefits.
388-458-0016 DSHS sends you an approval letter when you can get benefits.
388-458-0020 You get a request letter when we need more information.
388-458-0025 We send you a change letter if the amount of benefits you are getting is changing.
388-458-0030 We send you a termination letter when your benefits stop.
388-458-0035 Why do you give me ten days notice before you reduce or stop my benefits?
388-458-0040 What happens if I ask for a fair hearing before the change happens?
388-458-0045 Will I get other kinds of letters?
 
388-460-0001 Who may be issued cash, child care, medical and Basic Food benefits?
388-460-0005 Can I choose someone to apply for Basic Food for my assistance unit?
388-460-0010 Do I have an authorized representative for Basic Food if I live in a treatment center or group home?
388-460-0015 Who will the department not allow as an authorized representative for Basic Food?
388-460-0020 Who is a protective payee?
388-460-0025 Who can be a protective payee?
388-460-0030 When is an emergency or temporary protective payee (TANF/SFA) used?
388-460-0035 When is a protective payee assigned for mismanagement of funds?
388-460-0040 When does the department assign a protective payee assigned to TANF/SFA or PWA pregnant or parenting minors?
388-460-0045 Are clients in WorkFirst sanction status assigned protective payees?
388-460-0050 When is a client transferred from a protective payee to guardianship?
388-460-0055 What are the protective payee's responsibilities?
388-460-0060 When are protective payee plans done?
388-460-0065 When is the protective payee status ended and how is a protective payee changed?
388-460-0070 What are your fair hearing rights regarding protective payment?
 
388-462-0010 Temporary Aid to Needy Families (TANF) or State Family Assistance (SFA) eligibility for pregnant women.
388-462-0020 Breast and cervical cancer treatment program (BCCTP) for women--Client eligibility
 
388-464-0001 Am I required to cooperate with quality assurance?
 
388-466-0005 Immigration status requirements for refugee cash assistance
388-466-0120 Refugee cash assistance (RCA)
388-466-0140 Income and resources for refugee cash assistance eligibility
388-466-0150 Refugee employment and training services
 
388-468-0005 Residency
 
388-470-0005 How do resources affect my eligibility for cash assistance and Basic Food?
388-470-0012 Does the department look at the resources of people who are not getting benefits?
388-470-0045 How do my resources count toward the resource limits for cash assistance?
388-470-0055 How do my resources count toward the resource limit for basic food?
388-470-0060 How does the department decide how much of my sponsor's resources affect my eligibility for cash and food assistance?
388-470-0070 How vehicles are counted toward the resource limit for cash assistance.
388-470-0075 How is my vehicle counted for food assistance?
 
388-472-0005 What are my rights and responsibilities?
388-472-0010 What are necessary supplemental accommodation services (NSA)?
388-472-0020 How does the department decide if I am eligible for NSA services?
388-472-0030 How can I get NSA services?
388-472-0040 What are the department's responsibilities in giving NSA services to me?
388-472-0050 What if I don't accept or follow through with program requirements because I'm not able to or I don't understand them?
 
388-473-0010 What are ongoing additional requirements and how do I qualify?
388-473-0020 When do we authorize meals as an ongoing additional requirement?
388-473-0040 Food for service animals as an ongoing additional requirement.
388-473-0050 Telephone services as an ongoing additional requirement.
388-473-0060 Laundry as an ongoing additional requirement.
 
388-474-0001 What is Supplemental Security Income (SSI) and who can get it?
388-474-0010 How does being a Supplemental Security Income (SSI) client affect your cash assistance eligibility?
388-474-0012 What is a state supplemental payment and who can get it?
388-474-0020 What can an Aged, Blind, or Disabled (ABD) cash assistance client expect when Supplemental Security Income (SSI) benefits begin?
 
388-476-0005 Social security number requirements.
 
388-478-0005 Cash assistance need and payment standards and grant maximum.
388-478-0010 Households with obligations to pay shelter costs.
388-478-0015 Need standards for cash assistance.
388-478-0020 Payment standards for TANF, SFA, and RCA.
388-478-0027 What are the payment standards for Pregnant Women Assistance (PWA)?
388-478-0033 What are the payment standards for Aged, Blind, or Disabled (ABD) cash assistance?
388-478-0035 What are the maximum earned income limits for TANF, SFA, PWA, and RCA?
388-478-0050 Payment standards for ongoing additional requirements.
388-478-0055 How much do I get from my state supplemental payments (SSP)?
388-478-0057 Year-end adjustments to the SSI state supplement.
388-478-0060 What are the income limits and maximum benefit amounts for Basic Food?  
388-478-0090 What are the monthly income limits for the Aged, Blind, or Disabled (ABD) cash assistance and Housing and Essential Needs (HEN) Referral program?
 
388-480-0001 Does being on strike impact my eligibility for the Washington Basic Food Program?
 
388-482-0005 How does being a student of higher education impact my eligibility for the Washington Basic Food Program?
 
388-484-0005 There is a five year (sixty-month) time limit for TANF, SFA and GA-S cash assistance
388-484-0006 TANF/ SFA time limit extensions
388-484-0010 How does the five year (sixty-month) time limit for TANF, SFA and GA-S apply to adults living in Indian country?
 
388-486-0005 Unmarried pregnant or parenting minors - Required living arrangement
388-486-0010 Unmarried pregnant or parenting minors - Required school attendance
 
388-488-0005 Transfer of property to qualify for cash assistance
388-488-0010 Transfer of property to qualify for food assistance
 
388-489-0005 Who is Eligible for Transitional Food Assistance?
388-489-0010 How is my Transitional Food Assistance Benefit Calculated?
388-489-0015 How Long Will My Household Receive Transitional Food Assistance?
388-489-0020 Am I Required to Report Changes in My Household's Circumstances while on Transitional Food Assistance?
388-489-0022 What happens if I reapply for Basic Food while receiving transitional food assistance?
388-489-0025 Can My Transitional Food Assistance Benefits End before the End of My Five-Month Transition Period?
 
388-490-0005 The department requires proof before authorizing benefits for cash and Basic Food.
 
388-492-0020 What are WASHCAP food benefits and what do I need to know about WASHCAP?
388-492-0030 Who can get WASHCAP?
388-492-0040 Can I choose whether I get WASHCAP food benefits or Basic Food benefits?
388-492-0050 How do I apply for WASHCAP?
388-492-0060 How do I get my WASHCAP food benefits?
388-492-0070 How are my WASHCAP food benefits calculated?
388-492-0080 Where do I report changes?
388-492-0090 How often do my WASHCAP food benefits need to be reviewed?
388-492-0100 How is my eligibility for WASHCAP food benefits reviewed?
388-492-0110 What happens if my WASHCAP food benefits end?
388-492-0120 What happens to my WASHCAP benefits if I am disqualified?
388-492-0130 REPEALED
 
388-865-0217 Psychiatric indigent inpatient program

 

Administrative Disqualification Hearings for Food Assistance

Revised November 13, 2015

Purpose:

WAC 388-446-0015  What is an Intentional program violation (IPV) and administrative disqualification hearings (ADH) for food assistance.

  • Clarifying Information, Administrative Hearing Coordinator Responsibilities, and Final Agency Decision


Clarifying Information:

WAC 388-446-0015 - Intentional Program Violation (IPV) and Administrative Disqualification Hearings (ADH) for Food Assistance

  1. An Intentional Program Violation (IPV) of the Food Assistance program can be determined by a decision in an Administrative Disqualification Hearing  or by a decision of the court in a criminal prosecution. 
  2. A person suspected of a IPV can choose to waive their right to an ADH by signing a Disqualification Consent Agreement (DCA) that waives their right to a ADH and accepts the IPV penalty under WAC 388-446-0020.
  3. The department must decide whether to refer an IPV instance for prosecution or for an ADH; both procedures shall not be pursued at the same time. Upon completion of an ADH, the department may choose to then refer the case for prosecution.
  4. Separate instances of suspected IPV could be combined into one complaint that totals $450 or more. See FRAUD
  5. The department must prove the IPV with "clear and convincing evidence". This means that the evidence must establish that it is highly probable the actions that resulted in the overpayment were intentional.

Administrative Hearing Coordinator Responsibilities:

  1. Review the Disqualified Recipient System (DRS) to determine if the person suspected of an IPV has a record of past disqualifications.
  2. Determine the appropriate penalty based on the record of past disqualifications, if any
  3. Review the department records to identify evidence that will establish:
    1. An overpayment or combination of overpayments exists which total over $450 (e.g. a copy of the overpayment letter with proof of service if already served, or a copy of the letter if the overpayment letter has not been served).
    2. The respondent was aware of the reporting responsibilities.
    3. There was a change in circumstances that affected eligibility (e.g. an employer report which establishes the date that work began)
    4. The respondent had an opportunity to report the change, and failed to do so (e.g. a change of circumstance completed during the period of the overpayment)
    5. The respondent provided false or misleading information (e.g. denied working at an eligibility review).
  4. Ensure that all of the evidence to be proposed at the hearing is included. The ALJ may not be able to admit new evidence at the hearing that was not included in the listing of evidence on the complaint.
  5. Complete the Disqualified Hearing Complaint, DSHS 12-119(x) or ACES letter 0055-02 (First or Second Occurrence), 0055-04 (Third Occurrence). Include a listing of the evidence that will be used at the hearing.
  6. Send the complaint to the Office of Administrative Hearings and include a blank envelope (not window), which shows the CSO return address. OAH will schedule the hearing and send the notice to the respondent in the CSO envelope.
  7. If the notice is unclaimed or otherwise undeliverable, it will be returned to the CSO. Determine whether delivery should be attempted again either by personal service or re-mailing of the certified mail.
  8. If no further attempts at delivery will be made, notify OAH immediately that delivery has not been accomplished and the case should be removed from the docket.
  9. Hold the case until it can be resubmitted to the OAH for scheduling.

Final Agency Decision:

Review the final decision and take the appropriate action to implement the final decision. 

Administrative Hearings

Purpose: 

This category will provide an explanation of the following elements regarding Administrative Hearings.

Overview

Revised October 29, 2015

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:

The Community Service Office (CSO) Administrative Hearing Coordinator (AHC) is usually a Financial Service Specialist (FSS) who has the responsibility for administrative fair hearings in the CSO. The Aging and Disability Services Administration (ADSA) AHC has the responsibility for the administrative hearings related to ADSA clients. The CSO Administrator (CSOA) has the authority to resolve issues with the client prior to an administrative hearing.

Remember that 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 are not appropriate for an administrative hearing.

Administrative hearings are conducted by Administrative Law Judges (ALJ), employed by the Office of Administrative Hearings (OAH) which is a separate agency from DSHS. The administrative hearing can be held in person or by teleconference call.  The Office of Administrative Hearings (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 cannot request reconsideration on Basic Food decisions. See 7 CFR 273.15 (q)(2).   

The client has the right to request judicial review of a final DSHS hearing decision.

 

Administrative Hearing Coordinator's Role

Revised October 28, 2015

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
360-338-5210
Email:  Danielle.LeMier@dshs.wa.gov


Clarifying Information: 

The Community Services Office (CSO) Administrative Hearing Coordinator (AHC) is usually a Financial Services Coordinator (FSS) who has responsibility for the Administrative Hearing operations in the CSO.

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 in BarCode Administrative Hearing Control System (AHCS) 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 local Assistant Attorney General (AAG) when necessary to determine whether an AAG should be present at an administrative hearing.
  7. Contact the division program manager for Administrative Hearings when a local AAG is not available;
  8. Notify the OAH of any accommodation needed due to client Equal Access (EA) status;
  9. Notify the OAH if interpreter services are requested for Limited English Proficient (LEP) clients;
  10. Prepare the DSHS 09-354(X), Administrative Hearing Report or similar document as an attachment to exhibits (Administrative Hearing Packet);
  11. Provide copies of the Administrative Hearing Packet to all parties;
  12. Coordinate and conduct pre-hearing meeting or pre-hearing conference activities;
  13. Arrange for subpoenas to be issued by the AAG, when necessary;
  14. Distribute copies of hearing decisions as necessary to:

          a) Supervisor/Social Service Supervisor.

          b) Coordinate implementation of hearing decisions;

          c) 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 (q)(2).

   17. Notify the Office of Fraud and Accountability (OFA) of any hearing requests on cases that have been referred for prosecution.

Continued Benefits

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 ACES letter D01C for cash or medical or D02C for Basic Food. 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.

Equitable Estoppel

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.

EXAMPLE:

 Client receives a letter informing him that his check will be $400. Client has reported income correctly and has no reason to suspect that the amount might be an error. 

The benefit is no longer available. Document the facts using the best verification obtainable, including the client's statements when necessary. 

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).

 

Hearing Requests

Revised November 13, 2015

DSHS Hearing Rules are found in chapter 388-02 WAC


Clarifying Information:

  1. Either the client or their representative may request an administrative hearing.  The request must be made within in 90 days of the date of the notice of the department decision.
  2. The Administrative Law Judge (ALJ) is responsible for determining whether hearing requests are filed timely.
  3. Hearing requests must be forwarded to the Office of Administrative Hearings (OAH) for scheduling regardless of the date of the hearing request. See RCW 74.08.080
  4. The hearing request does not need to be in any particular form and can be made verbally or in writing to the department or in writing to OAH.   Note: Provider hearing requests must be made in writing and submitted to the Office of Financial Recovery (OFR).
  5. The hearing request can be made to any department employee.
  6. The hearing request 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.
  7. Any communication with the department indicating dissatisfaction with a department decision should be treated as a hearing request.
  8. Hearing requests can be sent to the OAH by DSHS staff through interoffice mail to MS 42489. 
  9.  Hearing requests can be mailed directly by the client/representative to OAH at PO Box 42489, Olympia, WA 98504-2489.

Financial Service Specialist (FSS)/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. Give or mail the client the pamphlet, How to Request a Hearing, DSHS 22-092(X) and a Request for Hearing, DSHS 5-013(X).
  7. Offer to complete an electronic Fair Hearing Request form through BarCode 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. 
  8. Forward the paper hearing request via Hotmail to the Document Management System (DMS).

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.
  5. Follow up with the OAH if the hearing date is not received from OAH within 10 days.
 

Pre-Hearing Conference With An Administrative Law Judge

Created on: 
Sep 16 2015

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.

 

 

Pre-Hearing Meeting With the DSHS Representative

Created on: 
Sep 16 2015

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.

Preparation

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.

Presenting the Case

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.

Special Procedures on Non-Grant Medical Assistance and Health Care Authority hearings

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:

Pauline Douglas
Hearings Manager
(360) 664-7416

MS 45550

The Decision

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.

Age Requirements

Revised April 29, 2013

Purpose: 

This chapter explains age and school requirements for a child to be eligible for TANF or SFA and the definition of "elderly" for food assistance programs.

WAC 388-404-0005 How does a child's age and attendance in school affect their eligibility for TANF and SFA?

WAC 388-404-0015 Definition of elderly person for food and cash assistance programs.


Clarifying Information - WAC 388-404-0005

  1. When a child turns 18:

    1. They are considered an adult and can receive assistance for themselves and their children.

    2. They must participate full-time in a secondary education program or an equal level of vocational training to be eligible for assistance.

    3. The child's eligibility for TANF/SFA ends on the last day of the month in which the child turns 18 if the child:

      1. Is not participating in their education on a full-time basis.

      2. Has met the basic requirements to complete the education or training program even if they haven't gone though the official graduation ceremony.

  2. Needy caretaker relative of a child receiving SSI:

If the only child that meets the TANF/SFA age requirement gets SSI, the child parent or needy caretaker relative can get TANF or SFA for their own needs as long as the child meets the requirements of WAC 388-404-0005.

  1. Education:

    See VERIFICATION for information on how to verify a child's age or school attendance.

    See TEEN PARENTS for the school attendance requirements for TANF and SFA AUs that have an unmarried parent under the age of 18. 

    1. If a child is on summer vacation, we count the child as participating if they:
      1. Didn't finish the basic requirements to complete the program; and
      2. Are enrolled or intend to enroll as a full-time student for the next academic year.
    2. If a nineteen or 20 year old student attends only English as a Second Language classes or participated in non-state approved home schooling, as defined by RCW 28A.225.010(4), the student is not eligible for SFA.
    3. A child in special education meets the school's definition of disabled and the requirements of WAC 388-404-0005(3) and is eligible for SFA. 

Worker Responsibilities - WAC 388-404-0005

  1. ACES will generate an alert to notify the worker that a child is nearing their 18th birthday.  Review the case record when you get the alert.
  2. Verify the child's age, school attendance, and the date the child is expected to complete school as needed.

    1. If the child will have their 18th birthday during a summer vacation month, contact the school before the end of the school year to find out when the child will complete the program.  Update ACES based on the information provided by the school.

    2. Verify that the child:

      1. Is in a program that will lead to getting their diploma, GED, or equal level of vocational or technical training;

      2. Is making satisfactory progress toward completing the program; and

      3. Meets the institution's attendance requirement for a full-time student.

    3. Set an alert in ACES to follow up with the school as needed if:

      1. The school is not certain about the date they expect the child to complete their education; or

      2. Based on case history, you expect the child may not participate through the entire review period. 


Clarifying Information - WAC 388-404-0015

See WAC 388-408-0035  to decide if an elderly and disabled person can be in a separate food assistance unit.

See WAC 388-416-0005 to decide how long to certify an AU when all members are elderly.

See WAC 388-450-0190  for information on the food assistance shelter deduction for AUs with an elderly or disabled member.

See WAC 388-450-0200  to decide if an elderly food assistance client can have an income deduction for their out-of-pocket medical expenses over $35.

See WAC 388-470-0005  for the maximum resource limit for AUs with an elderly member. 

 

ACES Procedures 

Applications for Assistance

Purpose:

This chapter includes rules and procedures for processing applications for cash, medical and food assistance. It includes the following sections and rules:

Filing an Application

Created on: 
Oct 02 2014

Revised December 31, 2013

Purpose:

This section includes rules and procedures on 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?

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

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


Clarifying Information - WAC 388-406-0005

1.  Applications by others:

For cash, medical assistance, 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:

a.  Be familiar enough with the client's circumstances to complete the application accurately; and

b.  If we ask, tell us why they are applying on behalf of the applicant to help us identify if the applicant should get Equal Access (EA) services under chapter 388-472 WAC. Examples of when someone might apply for another person include when the applicant is:

  1. Mentally incompetent;
  2. Physically or mentally ill or otherwise incapacitated;
  3. A minor child;
  4. Deceased;
  5. Subjected to domestic violence;
  6. For Basic Food, living in a qualified DDD group home or qualified Drug & Alcohol treatment facility; or
  7. For ABD cash and medical programs, temporarily residing outside the state.
    NOTE: While many others can apply for benefits on behalf of clients, HIPAA restrictions prevent us from discussing the client's individual health information with the person making the application unless the representative has power of attorney for the client or the client has signed a DSHS 14-012(x), Consent form.

3.  Authorized representative:

An authorized representative can be any adult who is not a member of the AU and has sufficient knowledge of the client's circumstances to act on the client's behalf. In general, the client chooses who will be their authorized representative. For more information, see PAYEES ON BENEFIT ISSUANCES – Authorized Representatives.

4.  Applications while in a public institution:

Prior to release from a public institution, people may apply for public assistance. The CSO needs to accept these applications.

  1. Expedited medical assistance for people with mental disorders before release from public institutions.

    The enactment of House Bill 1290 in 2005 requires the department to perform expedited eligibility determinations and provide timely access to medical assistance by persons with mental disorders being released from confinement. The goal is to provide eligible people with a medical assistance identification card on the date they are released, whenever possible.

    • Work flow procedures will be developed as part of local agreements between the CSO and the institutions.
    • Direct questions to the State 1290 Coordinator.
    • Track 1290 and 1088 applications in aces.online. See ACES manual chapter Confinement and Release for detailed instructions.
  2. Dangerous Mentally Ill Offenders (DMIOs)

    The department (DSHS) has a state law-required agreement with the Department of Corrections (DOC) to accept Medicaid applications (in practice these are requests for DLX benefits), from an inmate who is classified as a dangerous mentally ill offender (DMIO). The CSO that serves the catchment area in which the correctional facility releasing the DMIO is located or an alternate CSO as designated by the Region Office must accept applications from inmates of that facility.

  3. Chemical Dependency Treatment

    People may apply for a determination of financial eligibility to allow the institution to arrange for chemical dependency assessment and treatment placement. Accept applications from a person whose situation is not described above, determine eligibility if possible or notify the person of necessary verification and schedule for follow-up after release.

  4. Program Options for Inmates

    The 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 is intended to clarify how placement in a correctional options program affects a person's eligibility for public assistance benefits. A person who has been suspended from SSI for 12 months or less solely due to incarceration in a public institution is eligible to receive SSI medical (S01) on the date of his/her release from the institution.

    In compliance with House Bill 1290 (2005), the CSO will open an S01 medical AU from an application for a person meeting the criteria in section 4a (above). A Medical ID card is sent to the facility so that the applicant can leave the institution with the ID card in hand.

Worker Responsibilities -  WAC 388-406-0005

FOR NON-COMPLIANCE SANCTION (NCS) APPLICATIONS:

See WORKER RESPONSIBILITIES Non-Compliance Sanctions (NCS) Re-Applicants in WAC 388-310-1600


Clarifying Information - WAC 388-406-0010

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

NOTE: For the purposes of the following section, the term "local office" refers to CSO, Social Security Administration, and HCS offices.
NOTE: We cannot require or ask that a TANF applicant participate in a WorkFirst activity before we give them an application form.

Application Forms

  1. Opportunity to apply:

    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 cannot refuse to give an application form to a client because they are not meeting other program requirements or for any other reason.

  2. Application filing:

    A client has filed an application when we receive a request for benefits. This means the client can get benefits from this date if all other eligibility requirements are met AND they complete an Application, Eligibility Review, or IID form. We can't require clients 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);
    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.
    EXAMPLE  Bob sends a letter requesting Basic Food benefits and we receive it on October 1st. We send Bob an interview letter and he calls for an interview on October 7th. We pend his Basic Food for a completed IID which he returns on October 15th. Bob meets all eligibility requirements. His Basic Food starts October 1st.
    NOTE  We can't require the use of a specific form to request benefits. But we do require that clients complete an Application for Benefits, Eligibility Review, or IID form to complete their application. These forms contain information we must provide to our clients according to federal and state law.
  3. Adding a request for assistance to a pending application or eligibility review for another program:
    1. Clients can add a request for any benefits to a pending application or an unprocessed eligibility review without submitting a new 14-001 or 14-078.
    2. A client 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. For cash and food, the request can also be made verbally.
    3. Use the date the client added the new request as the date of application for the new program. See WAC 388-406-0012.
    4. If the application or eligibility review for the other program has already been processed, the client must submit a new application.
      EXAMPLE Jenny has a pending application for Basic Food. At her intake interview she requests TANF. Add the TANF application to the Basic Food and note the date of request prominently in the ACES narrative.
      EXAMPLE Sam has a pending application for ABD cash. At his intake interview the worker makes him aware that he may be eligible for Basic Food. He decides to pursue Basic Food. Add the Basic Food application to the ABD cash and note the date of request prominently in the ACES narrative.
      EXAMPLE Maria has a pending application for Basic Food. At her telephone intake interview, the worker makes her aware that she may be eligible for medical benefits. She decides to add a medical request. The worker must print and mail the application to Maria so she can mark her request for medical and to initial, sign and date the application. She will also need to complete the resource sections since they are not required for Basic Food.
  4. Handling multiple applications from the same household:
    1. Additional applications received before we determine eligibility on the first application:
      1. Do not 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 were not selected on the first application;
      3. If the household is not 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. If the household is applying for additional programs, 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 to explain any additional information used to determine eligibility and/or benefit level; and
      6. Do not 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 is not acted on until after the first application has been denied, follow procedures under (b.) below.

b.  Additional applications received after we determine eligibility on the first application:

i.  If we denied the first application, treat this as an initial application according to WAC 388-406-0010 with the following exceptions:

  1. 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. For medical assistance, if we are still within the original 30 day reconsideration period under WAC 388-406-0065, send the client a pend letter for the information missing from the original denied application and any new information needed for the current application. Determine the appropriate medical coverage start date based on the date the client provides the missing information.

ii.  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; and

iii.  Deny additional applications for the same program and same persons to avoid duplicate participation:

  1. Use reason code 587;
  2. Send out the required denial letter (if not system generated); and
  3. Add text to explain that the application is being denied because the person(s) on the application is already receiving the requested benefits.
NOTE: Please Recycle! 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:

    If we receive an application without a name or address to contact the client we make any reasonable effort we can to contact the client to find out who the client is and where they can be reached. If the client is in the office, we ask the client for an address where they can be reached.

    Applications Marked “Homeless”:

    If we receive an application that includes a name and signature, but is marked "homeless" and/or does not 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 client. This can be done by searching the electronic case record, case narrative or remarks, online directories, etc. Even if contact information is not available, an appointment letter must be sent to the applicant. Address the letter in the client's name to General Delivery for the municipality indicated on the application. If no municipality is indicated, send the appointment letter to the client by General Delivery for the nearest municipality. The application must be processed in accordance with the Standards of Promptness guidelines in WAC 388-406-0035.

  2. Signatures:
    1. For cash, medical, or Basic Food, a representative may sign an application if the applicant is unable to apply on their own behalf or is unable to sign the application.
    2. For medical assistance, the applicant or representative must sign the application.
    3. For cash programs a responsible adult AU member must sign the application and if both parents of 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.
    4. For Basic Food, the signature of one responsible AU member is required.
    5. A minor child may sign the application if there is no adult in the AU.
    6. A mark is an acceptable signature if another person witnesses it.
    7. Online applications for cash, medical, or Basic Food are electronically signed when transmitted. The password used to complete the online application is an electronic signature.
    8. Applications we receive 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.

Application Received

Online - for cash or Basic Food

Online - for medical assistance only or long-term care

In-person, mailed, emailed, faxed, dropped off, or scanned

Application Signed?

Yes
Always electronically signed when transmitted. If applying for cash and a 2-parent household with minor children, need additional signature of other parent.

Yes. Always electronically signed when transmitted.

May or may not be signed.  Does not need to be signed in order to be accepted.

Date of Application

Date received or next business day if received after business hours

Date received or next business day if received after business hours

If signed, date received or next business day if received after business hours.

 

If not signed, see "Action to Take".

 

For cash and food assistance, the signature on the front page of the application after the applicant's name counts as a signature for the purpose of establishing a date of application.

 

If two-parent household applying for cash, at least one parent's signature is required to establish the date of application.

Action to Take

Interview if required or desk review.  If applying for cash and a 2-parent household with minor children, get other parent's signature at interview or mail back for signature.

Desk review only. Only applicant needs to sign in 2-parent households.

If not signed, have client sign at interview (if the client is in the office) or mail back for signature.  The date we receive the signature is the date of application for food assistance.  If applying for cash and a 2-parent household, get the other parent's signatures.

NOTE: If we receive an application without a name, address, or a signature to file, we accept the application and take whatever action we can to contact the client to get the information needed to officially file the application. We must take action on all applications, even if there is information missing that is needed to file the application such as a name, address, or a signature.

Informational Handouts and Supplemental Forms:

  1. For all applicants:
  2. For cash or family medical assistance:
  3. For pregnant women, family medical, and cash assistance for applicants with children:
    • EPSDT Information Brochure, DSHS 22-019(X);
    • 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. For persons applying for Aged, Blind or Disabled cash assistance:
    • Medical Coverage Information, DSHS 14-194(X) - if an applicant indicates existing health insurance coverage in the Medical Information section of the DSHS 14-001(X) / 14-078(X) or while completing the ACES TPL1 screen. See Third Party Liability (TPL) and Child Support for completion and distribution instructions.
  5. 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 client applies for benefits from these programs.

Review Alerts/ Ticklers

Check the AU's alerts for possible computer matches made after screening. Compare match information with information provided by the client. Discuss and clarify any discrepancies during the interview.

Interview

See INTERVIEW REQUIREMENTS and Documentation.

Changes Made to Correct an Application

  1. If possible, have the applicant or applicant's representative make the changes by:
    1. Drawing a line through the incorrect entry;
    2. Writing the correct entry; and
    3. Initialing and dating the change on the application.
  2. If the applicant or applicant's representative is not available to make the changes, follow the above procedures and document on the ACES remarks screen related to the change being made.

Special Situations

See APPLICATIONS FOR ASSISTANCE – Special Situations for the following situations:

  • Applicant temporarily out of state;
  • Medical applications by inmates of city or county jails;
  • Trial visit program; and
  • Persons paroled and released from state correctional institutions.
  • 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:

  1. 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 client 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 client, send them a copy of form DSHS 14-113, and request them to sign and return the document.

  2. 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 client 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 client, send them a copy of form DSHS 14-520, and request them to sign and return the document.

Informational Handouts and Supplemental Forms:

  1. For all applicants:
  2. For cash or family medical assistance:
  3. For pregnant women, family medical, and cash assistance for applicants with children:
    • EPSDT Information Brochure, DSHS 22-019(X);
    • 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. For persons applying for Aged. Blind or Disabled cash assistance:
    • Medical Coverage Information, DSHS 14-194(X) - if an applicant indicates existing health insurance coverage in the Medical Information section of the DSHS 14-001(X) / 14-078(X) or while completing the ACES TPL1 screen. See Third Party Liability (TPL) and Child Support for completion and distribution instructions.
  5. 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 client applies for benefits from these programs.

Review Alerts/ Ticklers

Check the AU's alerts for possible computer matches made after screening. Compare match information with information provided by the client. Discuss and clarify any discrepancies during the interview.

Interview

See INTERVIEW REQUIREMENTS and Documentation.

Changes Made to Correct an Application

  1. If possible, have the applicant or applicant's representative make the changes by:
    1. Drawing a line through the incorrect entry;
    2. Writing the correct entry; and
    3. Initialing and dating the change on the application.
  2. If the applicant or applicant's representative is not available to make the changes, follow the above procedures and document on the ACES remarks screen related to the change being made.

Special Situations

See APPLICATIONS FOR ASSISTANCE – Special Situations for the following situations:

  • Applicant temporarily out of state;
  • Medical applications by inmates of city or county jails;
  • Trial visit program; and
  • Persons paroled and released from state correctional institutions.
  • Applications for MSP from Social Security Administration Interface (LIS file).
NOTE: See APPLICATIONS FOR ASSISTANCE - Expedited Service for Basic Food to determine if the applicant can get Basic Food within seven calendar days.
  1. Applicant lives outside of the local office catchment area
    1. Determine if the application is in the correct local office. If the application received is in the wrong local office, date stamp the application and fax it to the correct office no later than the next business day (see WAC 388-406-0010). The correct local office must get the application the same day we fax it.
    2. Tell or notify the client that the application was forwarded and give the applicant the name, location, and contact information for the correct local office.
    3. If the applicant lives outside the local office catchment area, but cannot return to his or her home for a temporary period, accept the application for processing in the local office. Such temporary absences from the home include the applicant's temporary stay in a:
      1. Hospital or nursing home;
      2. Shelter for victims of domestic violence; or
      3. Emergency shelter or other living arrangement when the applicant is a victim of a natural disaster. (e.g., flood).
  2. See APPLICATIONS FOR ASSISTANCE – Completing the Application Process for instructions on processing these applications after eligibility has been determined.

Clarifying Information - WAC 388-406-0012

Processing Basic Food Applications for Individuals Receiving Benefits from Another State during Month of Application

When clients apply for Basic Food and they received benefits from another state during the application month this does not 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 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, the client does not need to submit a new application.

Worker Responsibilities -  WAC 388-406-0012

  1. Date stamping the application:
    1. Date stamp the application, the same day we get the application, even if the application is sent to the wrong office; or
    2. The next business day if we received the application outside of normal business hours.
      NOTE: If you received an application without a signature and the client has now signed the application, do not date stamp the form a second time.
  2. Adding a request for Basic Food to a pending application:

    If the client has a pending application for one of our programs and requests Basic Food, use the application the client provided for the other program. The date the client requested food benefits is the date of application for Basic Food.

    1. Do not require the client 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 client requested the benefits; and
    3. Add a program for Basic Food.
      NOTE: If you have already processed the application for the other program(s), the client will need to apply for Basic Food separately. See Clarifying Information #4 under WAC 388-406-0010 for details about handling multiple applications from the same household.

ACES Procedures

Information Needed to Determine Eligibility

Revised December 11, 2014

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 - WAC 388-406-0030

EXAMPLE Rayanna applies for food assistance on July 8th and has her interview on July 15th. The worker pends the food assistance for verification of income, due by July 25th. On July 25th, Rayanna requests extra time. If the worker determines the client is cooperating, the worker should extend the due date at least 10 days but may extend the due date more, to between August 4th (10 more days) and August 7th (30th day of application) without penalty. If Rayanna requests the due date to be extended past the 30th day of application, then we must deny the application by August 7th and would delay the start date of benefits as applicable in WAC 388-406-0040.

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 you can 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.

Expedited Service for Basic Food

Revised December 7, 2016

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?

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


Clarifying Information - WAC 388-406-0015

EXAMPLE:  Bob applies for Basic Food and meets expedited service criteria. He reports $100 income from his parents and $350 monthly income through AmeriCorps. Since we exclude AmeriCorps under WAC 388-450-0015(1)(g), his gross income is $100. Bob is eligible for expedited service.
  1. Applications received outside of service area: 
    See APPLICATIONS FOR ASSISTANCE - Filing an Application for information on filing an application and what to do when an office other than the CSO of residence receives an application.
  2. Gross monthly income: 
    Food and Nutrition Services (FNS) defines “gross monthly income” as income before taxes less income that can be excluded. We do not consider excluded income when determining expedited eligibility. See WAC 388-450-0015, for excludable income.
  3. Resources 
    Countable liquid resources under WAC 388-470-0055 must be considered when determining eligibility for expedited services, even if the client is categorically eligible under WAC 388-414-0001.
  4. 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.
EXAMPLE:  Joe checks “Food” on the application form. Consider this a request for Basic Food.
EXAMPLE:  Petra checks “Other” on the application form and indicates she needs food. Consider this a request for Basic Food.
EXAMPLE:  John does not check “Food” nor does he request food next to “Other” on his application form. Do not consider this a request for Basic Food.
  1. 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 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. We determine expedited service eligibility for all Basic Food applicants during the interview.
      1. Except for identification, verification that is not available at the time of the interview is postponed (see Postponed Verification and Required Verification sections for more information).
      2. A person who was not 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.
NOTE:  Applicants cannot waive being screened for expedited service and do not have to ask for expedited service screening. Clients can waive an appointment and interview for expedited service; this includes not appearing for the scheduled interview without notice.
NOTE:   Not all households are eligible for the Standard Utility Allowance (SUA). When comparing an AU's gross income and available cash resources to their total shelter cost, use the appropriate utility allowance as a part of their shelter cost.
EXAMPLE:  Bertha requests Basic Food on the application. The information provided in the expedited screening section of the application appears to make her eligible for Expedited Service. Provide Bertha an Expedited Service appointment.
EXAMPLE: A 3-person household applied on August 1st and reported anticipated income of $500 for the month, plus rent of $450 and the SUA. They receive an expedited interview based on this information. At the interview, you find out that the household has anticipated income of $1,000. Since the income is greater than rent plus the SUA the household is not eligible for expedited issuance. Process this application as a non-expedited application.
EXAMPLE: Don is unemployed and has no resources. He lives for free in a trailer in the back of his uncle's house. Don's parent's send Don $250 monthly to help out. With no utility expenses, Don is coded as ZUA.  He is not eligible for expedited service because his monthly income from his parents exceeds his countable expenses at time of application.
EXAMPLE: Jude files an application on Monday, May 23rd and meets expedited service criteria. The office is closed on Friday, May 27th for a temporary layoff day and Monday, May 30th for a holiday. The office is regularly closed for the weekend. Because the seventh day falls on a day the office is closed, expedited benefits must be issued by Thursday, May 26th (the working day prior to the office closure). To meet the seven day timeframe, Jude is interviewed on May 26th and is issued expedited benefits the same day.
EXAMPLE: Linda applies for Basic Food on March 25th and does not appear to meet the expedited criteria based on the information she provides on her application. At her regular interview on April 10th, she indicates that her circumstances have changed and her situation in April appears to meet the expedited criteria. Because expedited services are based on the circumstances at the time the person applies, we evaluate whether to provide expedited issuance based on the March information.
EXAMPLE: Teresa mails in her application and it is received on July 2nd. Based on the information available, Teresa does not appear to meet expedited criteria and is given a regular appointment on July 10th. At her interview, the worker finds that Teresa did actually meet one of the criteria. We provide expedited issuance and use July 10th as the date of discovery for expedited services.
  1. 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 or
    2. If the client is eligible for Basic Food, issue benefits within seven calendar days of the date of request.
EXAMPLE: Olivia files an application on May 6th. She is in the hospital and is not eligible for Basic Food until released from the hospital on May 16th. The date of request for Basic Food is May 16th; the date of her release from the hospital. Her answers to the screening questions suggest that she meets Expedited Service criteria. Further review of the information Olivia provided supports this finding. Because she must get an expedited interview within seven calendar days of the date of request, we must interview Olivia and issue benefits by May 23rd.
  1. 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.
EXAMPLE: Kate applies for Basic Food, and the answers to the screening questions suggest that her household may not meet Expedited Service criteria. A further review of income sources indicates that she has income in excess of the Expedited Service criteria that you cannot exclude.
  • Deny expedited service; and
  • Process the case using regular processing standards.
EXAMPLE: Mary applies for Basic Food, meets expedited service criteria and is interviewed the same day. At the interview, she states she does not have identification but previously received benefits in another state. We call the other state and ask them to fax a copy of her identification, which they say will take about a week. Mary's boyfriend is at the interview with her. Since the boyfriend is not a member of Mary's Basic Food household, we can take a statement from him as collateral contact verification of her identity and issue benefits the same day. All other verification is postponed including further verification of Mary's identity.
  1. Denying Expedited Service:
    1. If the household is not eligible for expedited services based on any of the criteria describe in WAC 388-406-0015:
      1. Inform them that they will get a regular appointment; and
      2. Explain how to get a department review of the decision (see WAC 388-406-0015(10)).
    2. If at the interview we determine a household is not eligible for expedited issuance and more information is needed to determine eligibility:
      1. Inform the client that they do not meet the criteria for expedited issuance with postponed verification; and
      2. process the case using regular application rules.
  2. Required Verification:
    1. Verification of identity of the applicant (and authorized representative if the head of household is not 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 is not 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 ).
  3. 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. Do not send another request letter with a new timeframe if the client provides only part of the required verification.
    4. If all postponed verification is not received timely (within thirty days or the end of the second month), the client is not 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 though they do not 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).

EXAMPLE: Edward applies for Basic Food May 6th (on or before the 15th of the month), and meets expedited service criteria. He is eligible for expedited Basic Food with postponed verification and benefits are issued for May only. Edward must provide postponed verification by June 5th (the 30th day from the date of request for Basic Food) to be eligible for ongoing benefits without a break in benefits.
EXAMPLE: Martina applies for Basic Food May 16th and meets expedited service criteria. She is eligible for expedited Basic Food with postponed verification and is issued Basic Food for May and June. Martina must provide postponed verification by the end of the second month after the date of request for Basic Food (June 30th) to be eligible for ongoing benefits without a break in benefits.

 

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

EXAMPLE: Seasonal farmworker client applied for Basic Food on April 22nd and has not received income in the month of April. The client has no available cash resources. The client states he has worked two 8-hour days for this period at $7 an hour. He expects to get this income on April 26th ($7/hr x 8hrs x 2 days = $112). The AU's shelter expenses for April are $200.00. - The farmworker client is not destitute because they will receive over $25.00 within ten days of their date of application. - Since they have income and available resource s under their shelter costs, the client is eligible for expedited service under WAC 388-406- 0015.
EXAMPLE: Seasonal farmworker client applies for Basic Food. The client is not currently working and has no other income. The client states that they will work as soon as the farms start hiring. The client has always worked this season over the past several years and averages $900.00 income each month. We would consider this client destitute because they do not have a source of income identified.
EXAMPLE: Migrant farmworker client arrived in the state on July 1st and was hired by a grower to pick cherries on July 2nd. On July 3rd, the client applied for Basic Food. The client was unsure of when he would be paid, and the worker was unable to contact the grower. The client was told that the farmer pays everyone when the harvest is complete. The client wasn't sure how much longer the harvest would take. In this example, the client is destitute. Based on the information available to us, we do not know when the worker will be paid or exactly how much. We cannot be reasonably certain that the client will receive more than $25 within ten days of July 3rd, the date of application.
EXAMPLE: Migrant farmworker client arrived in the state on July 1st and was hired by a grower to pick cherries on July 2nd. On July 3rd, the client applied for Basic Food. The client states he averages about twelve boxes a day but was unsure of when or how much he would be paid. The worker contacted the grower by phone and confirmed that the client was hired and worked on July 2nd. The grower stated that they expect to have work for the client through the rest of the month. According to the grower, the client will be paid weekly, beginning July 10th. The grower confirms that the client averages 12 boxes each day. He pays $3.50/box and the client will work 6 days/week. The first check will be for five days (12 boxes/day x $3.50/box x 5 days = $210). In this example, the client is not destitute. Because we have confirmed that the client will be paid on July 10th, we are reasonably certain that the client will receive more than $25 within ten days of July 3rd, the date of application.
EXAMPLE: Seasonal farmworker client applied for benefits on May 2nd. A grower hired the client, but the client isn't sure when work will start. The client must check with the grower each day to see if the harvest has started. The financial worker calls the grower and confirms that the client has been hired and says that work will start the next day, if the weather is good. The grower states that if all goes well, the client will be paid on May 9th and should receive over $25. In this example, work is uncertain. The client **is destitute. * * The uncertainty around the harvest and when the client will start work prevents us from being reasonably certain that the client will receive more than $25 within ten days of May 2nd, the date of application.
EXAMPLE: Client applied for benefits on May 2nd. The client works for the same grower every year. The financial worker calls the grower and confirms that the client has been hired and says that work will start on Monday May 5th. The grower states that first check will be paid on May 9th and client is expected to produce 10 boxes/day and will be paid for three days work at $3.50/box for the first week ($3.50x30=$1 05). The client agrees with the estimate.
EXAMPLE: Farmworker client arrived in Washington from California on June 16th. The client worked in California and was paid every Friday. They were last paid $ 90 on June 14, and will not be paid on June 21st. This income is from a terminated source, because the client does not expect to be paid by the California grower for the remainder of June or in July.
EXAMPLE: A seasonal farmworker applies on March 6th. They anticipate income on a weekly basis from their employer starting on March 22nd. The client last received wages from this employer on January 18th. We consider the income from this employer as income from a new source.
EXAMPLE:  Client arrived in Washington from California on June 16th and applied for Basic Food on June 17th. The client worked in California and was paid $200 on June 14 from a terminate d source. The client expects to be paid in Washington on June 28th from a new source. In this example, the client is destitute . They will not receive more than $25 from their new source of income within ten days of the date the client applied for benefits. In this scenario, don’t count the income the client expects to receive on June 28th. See WAC 388-450-0230.
  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 does not have to be from seasonal farmwork.
    3. We do not average a migrant or seasonal farmworker's income when determining if they are destitute.
  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:
    Do not 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 should not 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 is not 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 will not 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 do not 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

Time Limits for Processing

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?

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

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

(Emergency WAC currently in effect)


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.
EXAMPLE: Cliff applies for Basic Food on November 1st. He interviews on November 25th. The worker pends for verification. The worker enters December 10th as the due date on the RFI letter, but explains to Cliff that we will deny the application on November 30th unless we have all the verification required to determine his eligibility. The worker also explains that we can approve benefits from the date the verification is received if we receive all verification to determine eligibility by the 60th day from the application date
NOTE: For further information and canned text, see the Procedures Manual.

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.

EXAMPLE Client applies for TANF. We schedule an interview appointment timely. The client does not appear for the appointment. The client requests a second appointment on the 29th day following the date of application. Because the client caused the delay, good cause for not processing the application within 30 days exists.
EXAMPLE Mark applies for ABD cash on August 17th. He is scheduled to be released from Walla Walla Correctional facility on September 1st. His forty-five days ends on September 30th. We receive the medical evidence and establish disability on September 28th. He is released on October 5th. Mark is eligible for benefits beginning October 5th. The client caused the delay, so good cause for not processing the application within 45 days exists. (See: Applications for Assistance - Completing the Process)

ACES Procedures

See:

Filing Applications - Special Situations

Revised December 31, 2013

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.
    8. 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.
  4. Medicaid coverage for inmates of a public institution that are admitted inpatient to a hospital or chemical dependency treatment facility.
    1. Inmates of public institutions, such as prison or jail, may be Medicaid eligible if they are admitted to a medical institution (inpatient) and are categorically relatable to a Medicaid program. Being relatable to a program means the applicant is under age 19, pregnant, over age 65, or blind or disabled.
    2. Applicants age 19 to 65 who are not receiving SSI or Social Security Disability must be determined disabled using the SSA disability criteria (refer for NGMA determination through DDDS).
    3. A visit to the Emergency Room is not a qualifying event unless the individual is admitted to the hospital as an inpatient. If there are any questions about whether the stay is inpatient or not please contact the hospital or facility.
      NOTE: An overnight hospital stay is not a qualifying event by itself. Sometimes emergency services or outpatient services can be overnight. If you are unsure of whether the hospitalization was inpatient, please contact the facility before denying the application.
       NOTE: Many of the inmate applications that come to DSHS for inpatient stays are processed by financial staff dedicated to this function. NGMA requests are completed by jail or hospital staff, identified by an inmate application cover-sheet and directed to the attention of a dedicated staff person for completion. NGMA applications from the Dept. of Corrections are routed to Olympia CSO for processing. NGMA requests coming from the University of Washington Medical Center are processed by the Region 2 - 1290 staff.

Completing the Process

Revised December 11, 2014

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?

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

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


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 are not automatically removed from the TFA assistance unit.

Federal rules do not 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 someone is an active member of a TFA AU moves away and applies for Basic Food in a different household, we must remove them from the TFA before starting Basic Food or adding them to someone else’s Basic Food AU.
  • The person is eligible for Basic Food effective the first of the month after they were removed from the TFA AU with advance notice.
EXAMPLE: Mark, Heidi and Lance receive TFA with a certification period of March through July. On April 3rd, Lance moves out and is approved to receive Basic Food with his girlfriend Amber. Their worker removes Lance from Mark and Heidi’s TFA AU effective April 30th. Lance is added to Amber’s benefits effective May 1st.
EXAMPLE: Same scenario as above, but Amber applies to add Lance to her Basic Food on April 25th. We do not have time to provide Mark and Heidi 10 days adverse-action notice and remove Lance from their TFA benefits by April 30th.Their worker removes Lance from Mark and Heidi’s TFA AU effective May 31st. Lance is added to Amber’s benefits effective June 1st.

ABD cash: If the date of release from the facility or institution is beyond the forty-five day processing period then the beginning date of aid is the date the person is released or approved, whichever is later.

EXAMPLE: Mark applies for ABD cash on August 17th. He is scheduled to be released from Walla Walla Correctional facility on September 1st. His forty-five days ends on September 30th. We receive the medical evidence and establish disability on September 28th. He is released on October 5th. Mark is eligible for benefits beginning October 5th.

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 client of the CSO address and phone number.Use ACES Letter 023-03 - Information/Action Request for Transfer. 
  2. For clients ineligible for benefits because they are institutionalized, open:
    1. Basic Food from:
      1. The date 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. The date 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 client.
    2. Cash assistance from:
      1. The date 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. The date of release if the release date is past the forty-fifth day processing deadline; or
      3. The date we have the information needed to determine eligibility, but no later than the 30th day for TANF, SFA, PWA, or RCA.
NOTE: The system does not use a client's date of release from an institution, or the date delayed verification was received, as the start date for Basic Food. If the application has already been screened, you must deny the existing application and re-screen Basic Food using the client's release date, or the date delayed verification was received, as the date of application.
EXAMPLE: Client applies for Basic Food on May 1st. We schedule the appointment for May 20th and give the client until May 30th to provide information needed to determine eligibility. On June 3rd we deny the application. The client gives us the needed information on June 12th. Good cause does not exist. Since the client caused the delay, open Basic Food from June 12th. Do not request a new application to open benefits.
EXAMPLE: Same scenario as Example 1, except we schedule the appointment on June 1st. The client is given until June 11th to provide information and doesn’t provide it until June 13th. Since the delay is our fault because we didn’t schedule an appointment timely (see WAC 388-452-0005 (6)), we must open benefits from the date of application (May 1st).
EXAMPLE: Client applies for Basic Food on July 1st and is interviewed the same day. The application is denied on July 15th for failure to provide information. The customer submits the required information on August 10th and is determined to be eligible. Approve benefits effective August 10th. When rescreening the AU, use August 10th as the new application date.
EXAMPLE: Same as the previous scenario, except the customer submits the information on July 20th. Rescreen and start benefits from the date of application (July 1st) because the information was received within 30 days.
EXAMPLE: A client applied for Basic Food on May 15th. The customer was interviewed on May 20th and asked to provide additional information by May 30th. The client was determined eligible for Equal Access and contacted the department to get assistance in obtaining the required verification. The department was able to help obtain the verification on June 24th. The application was not processed within 30 days, but the client was eligible for EA and cooperated with the department to obtain the required verification. Open benefits for the client effective the date of application (May 15th).

Processing an NCS Application:

SeeWORKER RESPONSIBILITIESNon-Compliance Sanctions (NCS) Re-Applications inWAC 388-310-1600.


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 thefirst working dayafter the thirtieth day.

Worker Responsibilities -WAC 388-406-0060

  1. If a Basic Food applicant does not show for the required initial interview:

    1. Send a letter immediately informing the client to contact their worker to schedule another appointment.
    2. Pend the application until the 30th day after the date of application.If the 30th day falls on a weekend or holiday, pend until the next working day.
  2. If a Basic Food applicant fails to show for the second interview:
    1. Continue the case as pending until the 30th day after the date of application.If the 30th day falls on a weekend or holiday, pend until the next working 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 does not reschedule the interview.If the 30th day falls on a weekend or holiday send the denial letter on the next working day.
NOTE:If a client is applying for classic medical as well as other programs, the client is not required to have an interview for the classic medical. Most other programs require an interview. If you have accessed theINTERVIEW function in ACES to start processing the medical, ACES will not automatically deny the other AU based on the Standard of Promptness if the client failed to attend the interview. The worker must manually track the other assistance units and deny the application on the correct date.

Clarifying Information - WAC 388-406-0065

Processing Basic Food Applications for Individuals Ineligible Due to Duplicate Participation

When clients apply for Basic Food and they 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, the client does not need to submit a new application.
    EXAMPLE: The client has moved to Washington from Nevada and applies for benefits on 3/15. We interview the client on 4/2 and determine they are financially eligible at the time, except that they received 3/2012 and 4/2012 benefits from the other state. We have verified that they will not receive benefits in 5/2012. Worker correctly denies Basic Food for March and April for duplicate participation and approves benefits for May 2012 and ongoing. Initial application can still be used and considered up until May 14.
NOTE: SSI recipients in California (CA) are not eligible for SNAP food assistance benefits.Instead these individuals receive an extra cash benefit to help them buy food.This benefit is called the CA Cash-Out Program.

The CA Cash-Out benefit is not considered a duplicate benefit for SNAP (Basic Food) recipients so there is no requirement to provide proof that CA cash-out has stopped before approving Basic Food for an SSI recipient moving to WA from CA.Basic Food benefits can be approved from the date of application as long as the individual is otherwise eligible.

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 person a letter advising of our reconsideration decision for each program. This includes:
    1. An approval letter if we can determine that the person is eligible;
    2. A new denial letter if we are able to determine that the person is ineligible; or
    3. A second denial letter indicating that the original denial reason and effective date stands and why.
EXAMPLE: We request verification of income, residence, and utilities due by 5/15/04. This is not provided, and we send a denial letter on 5/20/04. Applicant then provides the residence and income verification on 5/30/04. This is within 30 days of the denial, and is sufficient to determine eligibility. We approve the benefits from the appropriate date and advise the person in the approval letter that utilities were not considered in the benefit decision, as that requested verification was not provided.
EXAMPLE: Same as above, but the applicant provides only the income verification. This information shows the person to be over the program’s gross standard. We send a new denial letter to the person advising of the change in denial reason.
EXAMPLE: Same as above, but the applicant provides only the residence verification. We cannot determine eligibility without the income information. We send a letter to the person advising that we received the partial information, but the denial from 5/20/04 stands as we still do not have the income and utility verification we require.
  1. NCS Re-applicants who failed to complete their 28 day participation:

SEE WORKER RESPONSIBILITIES NON-COMPLIANCE SANCTIONS (NCS) RE-APPLICANTS IN WAC 388-310-1600.


ACES Procedures

Top of Page

Assistance Units

Revised December 8, 2011

Purpose: 

To describe what an assistance unit is and how it is formed for cash, medical and food assistance programs. The following sections are contained in this chapter.

Assistance Units - Basic Food

Revised October 24, 2014

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?

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

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

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


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.
EXAMPLE: Kari and Steve are unmarried and share an apartment. They pool their resources for grocery shopping, but don’t normally prepare meals together because they work opposite shifts. Since they buy food together, Steve and Kari would be a single AU for Basic Food.
EXAMPLE: Art and Larry share an apartment. Larry prefers a vegan diet and Art typically eats a meat-based fare. Because of their different diets, they normally do not buy or prepare food together. They take turns buying salt, pepper, and spices that they both use. Since Art and Larry do not normally buy and prepare food together, they are separate AUs for Basic Food.
  1. 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.

EXAMPLE: Mandy, Pete, and Lucy receive Transitional Food Assistance benefits from March 1st through July 31st. In April, Mike moves into the home. Mike normally buys and prepares food with the family. Based on the food arrangements, Mike can’t be a separate AU from Mandy and the others. Since Mandy receives Transitional Food Assistance, the family would have to reapply for Basic Food to see if adding Mike to Basic Food would give them more benefits than they would get under TFA. If Mandy chooses not to reapply for Basic Food, Mike cannot get Basic Food on his own.
EXAMPLE: Ruth and her son Kenny receive Transitional Food Assistance from January 1st through May 31st. In March, Ruth’s younger son Bryce and his father Charlie move into the home. Charlie and Bryce are currently Basic Food recipients. Based on Bryce’s relationship to his parents, Charlie and Bryce cannot continue to receive Basic Food on their own. Ruth and Kenny could choose to remain on TFA, but Charlie and Bryce would no longer be eligible for Basic Food until the TFA expired. Otherwise, Ruth and Kenny would have to opt out of TFA and re-apply as one Assistance Unit for Basic Food with Charlie and Bryce.
  1. 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.

EXAMPLE: Bob applied for Basic Food on January 5th. He is homeless and staying at his friend’s house. Because he has no food or food money, he currently prepares the food his friend has purchased. The agreement between the two of them is that Bob will buy and prepare his own food as soon as he is able to do so. Because Bob and his friend are not required to be in the same AU based on relationship, and the two plan to buy and cook food separately as soon as the client has food money, they can be separate AUs for Basic Food. We use January 5th, the date Bob applied for Basic Food, as the date of application.
  1. 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.
NOTE: While homeless youth can apply on their own and are not considered to be under parental control of an adult in the household who isn’t supporting them, staff are still required to report if they receive information of potential abuse or neglect of a minor. To report abuse or neglect, contact 1-866-END HARM. (1-866-363-4636)
  1. 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.

  1. 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.

  1. 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.
  1. 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.

EXAMPLE: Jane applies for Basic Food for herself and her ten-year old child. The child’s father, who is not married to Jane, lives in the home, but wants to be excluded from the AU. The child’s father claims to buy and prepare food separately from Jane and his child. WAC 388-408-0035 requires Jane and her child to be in the same AU. The same rule requires the child and her father to be in the same AU. Because of this, all three must be in the same Basic Food AU.
  1. 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.

EXAMPLE: An 18-year-old woman lives in a basement apartment at her parent’s residence. The apartment has a small kitchen, living room, and bathroom that only the 18-year-old uses. If this person usually buys and cooks her food separately from her parents, she can be a separate AU.
EXAMPLE: Applicant, age 21, lives in a camper in the parent’s yard. The camper does not have a bathroom (only a porta-potty) so the applicant uses the bathroom in the parent’s residence for showers. This person is not a separate AU.

 Also see WASHCAP rules (WAC 388-492-0030, (1)(c)(ii)) for SSI recipients, ages 18 through 21 living with a parent.

  1. 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.

EXAMPLE: Husband and wife are separated. The wife lives in the house, but the husband lives in a trailer on the property. They both claim to buy and cook their food separately from each other. The trailer has separate heating, cooking, and sanitation facilities that the husband uses. The husband and wife can be separate AUs.
EXAMPLE: Husband and wife are separated. The husband lives in the house and the wife lives in a trailer on the property. The trailer has separate heating, cooking, and sanitation facilities, but the wife makes her meals in the house because the trailer only has a hot plate. The husband and wife cannot be separate AUs, because they use some of the same cooking 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.  Adopted 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.
NOTE: Knowing that a client gets services from a Supported Living Provider does not tell you if the client is in a qualified group home. To determine if the institution is eligible for Basic Food, review the group home files in ACES. 
  1. 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))

  • Drug Abuse Prevention Center Castle Rock, WA 98611
  • Evergreen Recoveries Everett, WA 98201
  • New Horizon Care Center Isabella House Spokane, WA 98220
  • New Horizon Care Center Sun Ray Court Spokane, WA 99204
  • Pioneer Center East - Spokane, WA 99209
  • Pioneer Center North - Sedro Woolley 98284
  • Lifeline Connections John Owens Vancouver, WA 98668
  • Seattle Drug and Narcotic Center (SEADRUNAR) Seattle, WA 98108
  • Spokane Addiction Recovery Centers (SPARC) Spokane, WA 99204
  • Northwest Indian Treatment Center Elma, WA 98541
  • The Center for Alcohol & Drug Treatment Wenatchee, WA 98807
  • The Salvation Army ARC Seattle, WA 98178
  • Triumph Treatment Services James Oldham Buena, WA 98921
  • Triumph Treatment Services Beth's Place Yakima, WA 98902
  • Triumph Treatment Services Riel House Yakima, WA 98902
  • Triumph Treatment Services Casita Del Rio Yakima, WA 98902
  • Triumph Treatment Services Inspirations Yakima, WA 98902
  1. DBHR licensing and certification of nonprofit drug and alcohol treatment facilities:

A facility's status as "DBHR 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 DBHR as eligible for Basic Food:

(Nonprofit facility authorized as a retailer under 7 CFR §278.1(e))

  • Tacoma Rescue Mission Tacoma, WA 98401
  • Adult & Teen Challenge Women's Center Graham, WA 98338
  • Adult & Teen Challenge Pacific Northwest Men's Center Renton, WA 98338
  • Adult & Teen Challenge Men's Center Spokane, WA 99224
  • Adult & Teen Challenge Tri-Cities Men’s Outreach Pasco, WA 99302
  1. 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.
NOTE: Clients who are in a shelter for battered women and children are often not able to access resources they legally own. Remember to exclude resources that aren't available to the client under WAC 388-470-0005

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

Cash Assistance Programs

Revised November 28, 2016

Purpose:

This section contains rules and procedures on how to decide who is in an assistance unit for TANF, SFA, PWA and ABD cash.

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

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

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

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

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

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

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.

EXAMPLE Doug and Wendy have legally adopted their 12-year-old grandchild Tom. They have taken in Tom's little sister Lisa, but haven't adopted her. Doug and Wendy want TANF for Lisa as non-needy caretaker relatives. Because his grandparents legally adopted Tom, we do not recognize Tom and Lisa as having a legal relationship as siblings.
NOTE: If Doug and Wendy wanted assistance for both Tom and Lisa, the four of them would all be in the same AU as required under WAC 388-408-0030.
  1. 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.
EXAMPLE Grandparents have legally adopted their grandchild. The biological mother has since moved into the household. The biological mother would like to apply for TANF for herself and the child excluding the adoptive parents in the AU. Because the child’s grandparents have legally adopted him or her, we do not recognize the biological mother and child as having a legal relationship.
  1. 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.
  2. How we apply the AU rules in some common situations:
    1. A non-needy grandmother applies for assistance for one grandchild. She cares for that child's half-sister, but doesn't want assistance for her because the child's father pays $250 child support each month. We can't exclude the half-sister from the AU because of her relationship to the other child.
    2. 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 common child is a half-sibling to her children and his child. The father must be included because he is the natural father of two of the kids and the stepfather of the other two.
    3. 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 and medical assistance, 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 countable, and is budgeted as 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 relative who isn't a parent 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 relative who isn't a parent 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 that 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.
  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. The excluded child in common may be eligible for medical.
EXAMPLE A mother and her two children get TANF and live with the mothers' boyfriend, who is not the father of the children. The mother gives birth to her boyfriend's child. The mother can choose whether or not to include the baby in the AU. If we include the baby, we must include the boyfriend. If the boyfriend has income or resources, it may be the best for the client to not include the common child.
EXAMPLE Two unrelated TANF AUs get assistance and live together. (AU#1 is a woman and her two children. AU#2 is a man and his two children.) The woman and man have a child in common and want to exclude the child in common from being on assistance. Because both parents are recipients of assistance, then neither parent is able to financially support the child in common. Therefore, they do not have the option to exclude the child from the AU. They will need to become one TANF household (one AU) as required under WAC 388-408-0030.
EXAMPLE AU contains a woman, her boyfriend, his child, and their common child. Nobody gets TANF or SFA. The boyfriend applies for TANF for himself and his child only. He doesn't want to include the common child because the mom gets UC and can provide for their child. As an applicant, the boyfriend doesn't have the choice to exclude the common child. All four people are in the AU since we can't exclude the common child for a reason other than need.
NOTE: In the example above, if the AU is eligible when we include the woman's income, the AU can then exclude the common child because it is now a recipient AU. If the family is eligible in the month of application, you can consider them as recipients and exclude the child before you issue benefits for the AU.
EXAMPLE Susan applies for assistance for herself and her two children from a previous marriage. She lives with her husband Doug and his child from a previous marriage - Timmy. The couple doesn't have a child in common. She doesn't want assistance for Doug or Timmy because he works and gets child support. Even though we can exclude Timmy from the AU because he is the other children's stepbrother, we must include Doug because he is the stepfather of Susan's two children. If we exclude Timmy, we would allocate some of Doug's earned income to Timmy. See INCOME - Allocation and Deeming.

Worker Responsibilities - WAC 388-408-0030

  1. If we don't have to include a child in the AU under WAC 388-408-0015, give the caretaker relative, guardian, or custodian the choice whether or not they include the child in the TANF/SFA AU.
  2. Explain to the client that the child cannot receive TANF/SFA in a separate AU.
EXAMPLE Aunt applies for TANF for her niece and nephew, who are cousins. Aunt doesn't want assistance. Set up a two-person AU for the niece and nephew.
EXAMPLE Married couple apply as needy relatives for their two grandsons. The grandsons are cousins to each other. Even though the grandfather claims to be the caretaker of one child and the grandmother claims to be the caretaker of the other, we must include the two children in the same AU.
EXAMPLE Woman applies for TANF for her daughter and nephew. Since the woman is the caretaker relative for both children and is the parent of one, include all three people in the same AU.
EXAMPLE Grandmother and two grandchildren receive a three-person grant. Her husband starts to get retirement benefits. We allocate $700 of the retirement benefits to the AU because the husband is financially responsible for his wife. Because the grandmother isn't financially responsible for her grandchildren, don't terminate assistance due to the excess income. Remove the grandmother from the grant and continue assistance for the grandchildren.
EXAMPLE A client gets a three-person grant of $546 for herself, her daughter and her nephew. She starts working and has monthly gross earnings of $1100. Terminate assistance for the woman and her daughter and authorize transitional medical. Continue cash assistance (one-person grant) for the nephew. When the income of an AU member reduces the grant payment to a level that is less than what the other AU members would get if the individual with income were not included, inform the client of the option to request termination from the AU member with income. By making this choice, the family would get more cash and, if the person with income is an adult, preserve their time-limited TANF eligibility. Add the following free form text to the ACES client notice: "Your family may be better off financially if you stop getting a cash grant for (Name of person receiving the income). To find out, call me at the number listed above."
EXAMPLE A client gets a three-person grant for herself, her daughter and her nephew. She starts working and has gross earnings of $800 per month. When we budget the income, the AU is eligible for a grant of $146. However, if the client chose to end TANF for herself and her child, she could get a one-person grant of $349 for her nephew and preserve he TANF eligibility under the 60-month lifetime limit.
NOTE: There are some valid values you can't enter in the Financial Responsibility field. ACES will enter these values after it determines eligibility and you finalize the action. Make sure that all the following conditions are true before you use the non-member valid value [NM]: - The person isn't part of the AU; - The person isn't financially responsible for anyone in the AU; and - We don't have to count the person's income or resources when we determine the AU's eligibility or benefits.

Clarifying Information - WAC 388-408-0060

  1.  Clients that are under "home monitoring" or "home detention" are not eligible for ABD because they are considered a "person in an institution". See WAC 388-400-0060.
  2. Persons who are participating in Department of Corrections Family & Offender Sentencing Alternative (FOSA) or Community Parenting Alternative (CPA) program may be eligible for ABD cash benefits. Refer to the Sentencing Alternatives – Offenders with Minor Children SSB 6639 desk aid, located in WorkFirst Handbook Chapter 1.2, under “Other Resources”  for additional information. Please contact Jennie Fitzpatrick at fitzpjr@dshs.wa.gov or 360-725-4648 or Tom Berry at berrytj@dshs.wa.gov or 360-725-4617 if you have any questions about FOSA or CPA.
  3. If a husband and wife that live together are both disabled and apply for ABD cash, they are in the same AU. We base the AU's benefits on the two-person payment standard for ABD, not two times the amount of the one-person standard. See WAC 388-478-0033 for ABD payment standards. Please see "How do I process Aged, Blind, or Disabled (ABD) Cash for a married couple when each is eligible for different programs?"
  4. If a client can get TANF or SFA, they can't get ABD cash under WAC 388-400-0060.
  5. If an AU with a disabled adult is over income for TANF because of a child’s income, the disabled adult may be eligible for ABD cash.
  6. An ABD cash AU contains the disabled adult and their spouse if the spouse is also disabled. We don’t allocate the child’s income to the parent because the child isn’t financially responsible for the parent. See WAC 388-450-0100
EXAMPLE A client takes care of their grandchild on an ongoing basis. Because the client can get TANF, they can't choose to get ABD cash for their own needs and not have assistance for the grandchild.
EXAMPLE A disabled woman applies for TANF for herself and her daughter. The daughter gets a monthly SSA death benefit of $475. This income makes the AU ineligible for TANF. Since the client is disabled and ineligible for TANF, she may be eligible for ABD cash. The daughter is not in the AU and the death benefit is not allocated to the AU.

ACES Procedures

See Assistance Unit (AU)

Authorized Representative - Food Assistance

Revised December 31, 2013

Purpose:

This section explains authorized representative rules specific for Basic Food and describes when an authorized representative is required for someone in a treatment center or group home.

WAC 388-460-0005 Can I choose someone to apply for Basic Food for my assistance unit?

WAC 388-460-0010 Do I have an authorized representative for Basic Food if I live in a treatment center or group home?

WAC 388-460-0015 Who will the department not allow as an authorized representative for Basic Food?


Clarifying Information - WAC 388-460-0005

  1. How clients designate an authorized representative:
    A client can designate an authorized representative by completing the appropriate section on the DSHS 14-001 Application for Benefits, DSHS 14-078 Eligibility Review, Washington Connection online application, or by completing a DSHS 14-532 Authorized Representative form.
  2. Drug and Alcohol Treatment Centers:
    If a client receives food assistance in a qualified drug and alcohol treatment center, the treatment center must be the authorized representative.
  3. DSHS FSS Staff as Authorized Representatives for Basic Food:
    DSHS Financial Services Specialist (FSS) staff may not act as an authorized representative or Alternate Card Holder for a household’s Basic Food benefits.
    1. Staff having access to change benefits due to their position and acting on behalf of the household is a direct conflict of interest.
  4. Verification:
    The identity of an authorized representative is a mandatory verification. See VERIFICATION.
  5. Alternative Card Holders:
    An authorized representative does not receive a Quest card or have the ability to access the AU's benefits. If a client needs someone outside of their AU to access the benefits, see information on Alternate Card Holders in BENEFIT ISSUANCES.
  6. Individuals who have Power of Attorney for a client:
    1. If an individual has Power of Attorney for a client, the person can be the client's authorized representative without the client having to specifically designate them as the authorized representative.
    2. If an individual has limited Power of Attorney, the Power of Attorney document must specifically give the person authority to act on the client's behalf for managing financial matters. If the document doesn't give the person this authority, the client must name the person as their authorized representative if they want them to act on their behalf.

Worker Responsibilities - WAC 388-460-0005

Authorized Representatives on Multiple Accounts:

ACES does not monitor or create reports on individuals who are authorized representatives for multiple cases. If you learn that a person is an authorized representative for multiple AUs and suspect the representative is misusing the client's benefits, refer the case to the Office of Fraud Accountability. See FRAUD.


Clarifying Information - WAC 388-460-0010

  1. When a facility acts as an authorized representative for persons in a group home or chemical dependency treatment facility, one person from the facility usually acts on behalf of all the clients in that facility or group home.
  2. The Department of Agriculture, Food and Nutrition Services (FNS) regulates the facilities in their use of client's Basic Food benefits. The following expectations are listed for information only. Upon leaving a group home or treatment facility, a Basic Food client is entitled to at least one-half of the Basic Food benefits if the client leaves before the 16th of the month and part of the benefits have already been spent on behalf of the client.

Clarifying Information - WAC 388-460-0015

Persons currently disqualified for an Intentional Program Violation (IPV) may not be an authorized representative for Basic Food.

  • In most cases, the disqualification of an authorized representative takes place as the result of a fraud investigation. 
  • IPVs from Washington and other states are also captured in USDA Food and Nutrition Service's Electronic Disqualified Recipient Subsystem (eDRS).

The head of household for the food assistance AU may request an administrative hearing when the person they have named as their authorized representative is disqualified from being an authorized representative. See ADMINISTRATIVE HEARINGS.

Worker Responsibilities - WAC 388-460-0015

  • When you learn than a current Authorized Representative or one newly selected by the household has an IPV, Use letter 050-01 General Correspondence to inform both the client and the authorized representative of the disqualification action.
  • Inform the client why the authorized representative is disqualified and of the client's right to an administrative hearing.

Additional Information

For additional information on Authorized Representatives, see AUTHORIZED REPRESENTATIVE - FOOD, CASH, AND MEDICAL BENEFIT ISSUANCES.

Authorized Representative - Food, Cash and Medical Benefit Issuances

Revised April 29, 2013

Purpose:

This chapter defines an authorized representative (AREP) and provides instruction on: What form to use in order to code someone in ACES or the ECR as an AREP. When to require the DSHS 14-012(x) consent form. When to require the DSHS 17-063 authorization form or HCA 80-020 authorization for the release of information form. When it's permissible to share information without consent. How to identify and code an AREP in our automated systems.


Definition

An AREP can be any adult who is not a member of the AU who is sufficiently aware of the household circumstances and is authorized by the household to act on behalf of the client for eligibility purposes. If an individual AREP is representing an organization, other individuals from that organization within the same department may also act as an AREP. An AREP assists the client with the application, recertification, and general eligibility processes.

NOTE: In everything we do, we need to maintain confidentiality. For example, King County Public Health is a large organization and while any employee from the Access and Outreach department may be authorized to act as an AREP on behalf of the organization, individuals from other departments within their organization are not authorized to represent the organization as an AREP.

An AREP is not authorized to receive health information about clients unless they have power of attorney or have been named on the completed and signed DSHS 14-012(x) consent form.

An AREP can share any information relevant to eligibility; however, the department can only share information with the AREP that is necessary for the purposes of determining financial eligibility.

An AREP can receive letters, including the income computation sheet, renewal forms, and ProviderOne services cards if the client has authorized the sharing of such correspondence.

What form is used for an AREP?

The client can identify an AREP on the application, eligibility review form, or DSHS 14-532 authorized representative form. The DSHS 14-532 authorized representative form shall be used when a client is authorizing an AREP at a time other than at application or eligibility review. The AREP information shall be reviewed at recertification. See WORKER RESPONSIBILITIES.

AREPs are not automatically eligible to be an EBT Alternate Card Holder for Basic Food or cash benefits. Both the client and Alternate Card Holder must complete and sign the EBT 002 form. Please refer to the EBT Handbook for more information.

Please refer to the Payees on Benefit Issuances - Authorized Representatives chapter, WAC 388-460-0005 through 460-0015 for AREP rules specific to the Basic Food (SNAP) program.

NOTE: The DSHS 14-532 AREP form is not required when the AREP has Power of Attorney or Legal Guardianship. Power of Attorney and Legal Guardianship must be verified.

Legal Guardianship is designated by coding the AREP screen Rep Type field in ACES with the following:

  • Cash and Medical : CG or GN
  • Basic Food: AD or NA

Power of Attorney for cash, medical, and basic food is designated by coding the AREP screen Rep Type field in ACES with AD or NA.

NOTE: When a child age 18 or younger is institutionalized and the facility is applying on their behalf, the DSHS 14-532 AREP form or the designation of the facility as an AREP on the application or eligibility review is not required when the individual is: a. In a court ordered, out-of-home placement under chapter 13.34 RCW; or b. Involuntarily committed to an in patient treatment program by a court order under chapter 71.34 RCW.

When is a DSHS 14-012(x) Consent form necessary?

The DSHS 14-012(x) consent form is a Health Insurance Portability and Accountability Act (HIPAA) compliant form designed for use by the client to authorize an exchange of information outside of basic eligibility information shared with an AREP. See AREP definition above. The 14-012(x) is the correct form for authorizing the sharing of specified confidential information between specified parties for a specified period of time.

HIPAA restrictions prevent us from discussing the client's individual health information with an AREP unless a current signed DSHS 14-012(x) consent form is in the record.

NOTE: Every signed consent form is unique so it is critical that the authorized information, designated parties, and effective dates be carefully reviewed before releasing information.

When is the DSHS 17-063 Authorization or HCA 80-020 Authorization for Release of Information form necessary?

The DSHS 17-063 authorization form and the HCA 80-020 authorization for release of information form are HIPAA compliant forms designed for use by the client to authorize the release of existing documents to a specified individual or agency. These forms allow the disclosure of a designated set of records from the individual's DSHS or HCA file. The Public Disclosure Unit is responsible for approving or denying requests for disclosure of confidential information.

For more information see Confidentiality and Public Disclosure.

When is it permissible to share information without consent?

There are times when we can share confidential client data without the client's permission:

  • When release is required by law (commonly by court order or subpoena); or
  • When the information is needed from DSHS to administer a DSHS program and get needed services to a client (example; verification for a child care provider; however, only share information that would be necessary for the provider to provide child care).

To learn more about when it is permissible to share client information please refer to DSHS Administrative Policy 5.02, Section D;4.

EXAMPLE:  The designation of an individual as AREP on the application: A mom with one child applies for family medical. She names her adult daughter as AREP on the application form. The adult daughter named as the AREP may only receive information necessary to determine financial eligibility and other information related to the benefits such as certification periods, benefit issuances, etc.
NOTE: In this example the AREP section of the application does not specify which letters the AREP is designated to receive. Further communication or clarification with the client may be necessary and should be documented in remarks behind the AREP screen in ACES.
EXAMPLE:  The designation of an AREP verses the authorization of sharing specified medical information: A client is receiving ABD cash benefits. The client's mom has been designated as the AREP on the most current application. There is also a signed DSHS 14-012 consent form on file authorizing the exchange of medical information between DSHS and the medical provider. The AREP (mom) is not included on the DSHS 14-012 consent form. The AREP calls DSHS requesting information on her daughter's medical treatment plan. The department cannot share that information with the AREP because DSHS is only authorized to share medical information with the medical provider. As the AREP, the mom is not entitled to this information because it is not related to the purpose of determining financial eligibility.
NOTE: Naming the medical provider on the signed DSHS 14-012 consent form does not make them an AREP. Only the client's mom should be coded as an AREP.
EXAMPLE:  The designation of an agency as AREP on the application: A hospitalized patient applies for medical benefits designating the hospital as an AREP on the application. Because there is no DSHS 14-012 consent form authorizing the exchange of medical information, the department can only share information necessary to determine financial eligibility.
EXAMPLE:  The designation of an AREP and the authorization of sharing specified medical information: A hospitalized patient applies for the ABD program. The hospital is named as an AREP on the application. The client has also signed a DSHS 14-012 consent form authorizing the sharing of medical information between the two agencies. The hospital and the department can exchange information necessary to determine financial eligibility and they can also exchange medical information specified on the DSHS 14-012 consent form.
NOTE: Naming the hospital on the signed DSHS 14-012 consent form does not make them an AREP; however, since the hospital is also name as an AREP on the application, they should be coded as an AREP in ACES.

Worker Responsibilities

For information regarding AREP for Long-Term Care cases see: Long-Term Care AREP or WAC - Long-Term Care for Families and Children.

  1. An AREP may receive letters/notices/forms/warrants/EFT/ProviderOne service cards or they may have permission to only discuss the case and not receive any written correspondence. Record the representative's name and address on the AREP screen in ACES. The REP Type code on the AREP screen determines what forms, letters, etc. they receive. See the Authorized Representative Payee Chart.

NOTE: There is no ACES code for being an AREP who doesn't receive written correspondence. The workaround for this situation is to record the AREP information in the Electronic Case Record (ECR). As soon as this functionality is programmed into ACES, the AREP form and this chapter will be updated.
  1. At each review, check that the AREP information coded in ACES is consistent with what the client indicated on the review form. AREP designation is not valid after the certification period and should not be extended without confirming with the client that the AREP information is still valid. Document extensions or changes to the designated AREP in remarks behind the AREP screen in ACES.
  2. If the client is completing their review over the phone without an eligibility review form and they are designating a new AREP, the client should complete a DSHS 14-532 AREP form. The worker should not add the new AREP until they receive the completed DSHS 14-532 AREP form or written confirmation from the client. Completing the DSHS 14-532 AREP form is not required if they are confirming or making changes to their current AREP.
  3. Initial designation of an AREP by a client should be made on the application, review or DSHS 14-532 AREP form. Changes to an AREP can be made verbally but must be well documented in the remarks behind the AREP screen in ACES.

ACES Procedures

Authorized Representative/Protective Payee

Automated Client Eligibility System (ACES)

Revised June 26, 2014

Purpose:

ACES is an acronym for the Automated Client Eligibility System. This system is used by the State of Washington's Department of Social and Health Services. ACES supports the operations of the department by integrating DSHS programs under a single, client-based, on-line system. The ACES system is a tool for determining eligibility, issuing benefits, management support, and sharing of data between agencies.

ACES Instruction in this Manual

The links to specific sections in the ACES User Manual are provided throughout the Eligibility A-Z Manual. See the ACES User Manual.

Basic Food Employment and Training (BFET) Program

Revised October 23, 2014

WAC 388-444-0015 How can the Basic Food Employment and Training (BF E&T) program help me find work?

 

Clarifying Information - WAC 388-444-0015

What is BFET?

Basic Food Employment & Training (BFET) provides training and education with a goal of assisting Basic Food clients to attaining a living wage career.  BFET services are available from all WA State community and technical colleges as well as many non-college community based organization (CBO) contractors. You can find more information such as the type of services and benefits on the public website.

Who can receive BFET services?

Most clients who receive federally funded Basic Food (SNAP) and are at least 16 years old can receive BFET services. Even clients with college education may benefit from retraining or job search services.

How can BFET help pay for college?

BFET students should utilize other forms of funding for tuition whenever possible. Typically all students who attempt to enroll into BFET will be asked by the college to apply for Federal Student Aid (FAFSA) as part of the enrollment process for BFET.

Who can't receive BFET services? 

Clients who receive receiving TANF or the State Food Assistance Program (FAP) are not eligible to receive BFET. Also, clients who want to complete a Transfer degree or a degree higher than an Associates degree should not be referred to BFET.

Do clients have to participate in BFET?

No.  To focus resources on the most motivated individuals, BFET is completely voluntary.  Services are available for exempt and non-exempt clients eligible for federal SNAP benefits living in Washington.

How does a student become eligible for Basic Food through BFET?

If a client appears to be an ineligible student, give the client basic information about BFET to help decide if they could become eligible for Basic Food. Refer to WAC 388-482-0005 for student eligibility. BFET recipients who are college students are typically eligible students (pending other Basic Food eligibility factors).

How do I find a list of current BFET providers?

See our public web site for a list of BFET Partner Colleges and the counties in which they offer services.

 

BFET Processes and Procedures

How does a Basic Food client receive BFET services?

DSHS staff may provide the client with basic information about BFET as well as contact information for Colleges and CBOs. You can find a list of current contractors on BFET Brochures in your local office (a statewide version is in development) or the public BFET website.

The contractor will complete an intake to determine appropriate BFET eligibility and services. The contractor will open components/activities for eligible clients in eJAS.

If the student is enrolling in college and appears eligible for BFET, but is not yet on Basic Food, then the college will fill out a Referral to DSHS for BFET form 10-501. This form tells DSHS that the client will be accepted into BFET upon approval of Basic Food benefits, so the client should be considered an eligible student. The college will still have to open the eJAS BFET components after Basic Food is approved.

How do I know that a client is a current BFET recipient?

BFET Staff use the following procedures to refer (or confirm) eligible clients for services:

  • Barcode - There should be a red BFET indicator in Barcode on the client ECR screen.
  • ACES - When the BFET is through a college, the student should be coded with PS (on ALAS in ACES and Student/Education in 3G) to show they are in an acceptable post-secondary education program. When BFET is through a CBO, there is no student coding since the client is not considered a student of higher education.
  • eJAS - The client will have components open in eJAS. In order to distinguish BFET from WorkFirst in eJAS, an FI component is opened. Then an actual activity component is opened, for example, JS (job search), VE (vocational education) or BR (job retention). You can find the scheduled hours per week for each component, as well as the dates of eligibility. This information can help in determining child care (CCSP) eligibility.
  • BFET Staff - You can ask BFET staff. Email policy at SWBFETPolicy@dshs.wa.gov

 

eJAS Procedures

  1. Search to see if the client information is in the system.
    1. If the client information is not found in the system, add the client information by pressing the Client Add Screen.
    2.  The Case Number for client receiving only Basic Food shows a $ in the third character of the number. The $ distinguishes a Basic Food client from a TANF client. (I.e., 68$94568987)
    3. Food Stamp Type (F1 HELP) provides the codes for ABAWDs and non-ABAWDs.
    4. The BFET staff or contractor are also usually able to use the new BFET eligibility function ("eJAS automation") to open BFET eligible clients in eJAS.
  2. On the component screen enter:
    1. The "RF" (referral) (Note: workfare and work experience are not currently used);
    2. The date you see the client to determine eligibility (State Date);
    3. The DSHS worker ID of the person who will be responsible for the follow-up activities;
    4.  For all codes input the end date for when the component is scheduled to end. For example:
      1. For Job Search the end date is up to 84 days from the start of the component.
    5. Authorize support services as described in Basic Food Work Requirements Section D - BF E&T Payments for Related Expenses.
  3.  The eJAS Basic Food Status field is updated automatically based on coding in ACES. eJAS updates the Basic Food Status based on the following coding in ACES:
  • If the Food Stamp Participation status is AB (Able Bodied Adults without Dependents), and the Financial Responsibility is not RN and the client's age is 18-49, then the Basic Food Status will be ABD (ABAWD)
  • If the Food Stamp Participation Status is AB (Able Bodied Adults without Dependents), and Financial Responsibility is not RN, and age is not 18-49, then the Basic Food Status will be blank.
  • If the Food Stamp Participation status is MP (Mandatory Participant) , and there is a member on the STAT screen with HOH Relationship Code = CH (child) and age is 16-59, then the Basic Food Status will be NON (Exempt)
  • If the Food Stamp Participation status is MP(Mandatory Participant), and first two conditions are not met, and age is 50-59, the Basic Food Status will be NAB (Non ABAWD)
  • If the Food Stamp Participation status is MP (Mandatory Participant), and none of the above are met, the Basic Food Status will be blank.
  • If the Food Stamp Participation status is VP (Voluntary Participant), the Basic Food Status will be VOL (Volunteer).

 

ACES Procedures

Work Registration

BFET - Reimbursement of Participant Expenses

Purpose:

WAC 388-444-0025 What expenses will the department pay to help me participate in BF E&T?


Clarifying Information - WAC 388-444-0025

  1. BFET Participant Reimbursements:

    People participating in BFET can receive reimbursements to help them participate in the program:

Transportation allowance for participants:

BFET participants may receive a maximum $150 allowance per month for transportation costs related to BFET participation. Bus passes and gas vouchers are permitted under this allowance, and may be authorized by the BFET Provider (contractor) upon availability of funds.

Clothing allowance for participants:

BFET participants may receive a maximum $300 clothing allowance once in the 12 month period from October 1 to September 30. This allowance may be authorized by the BFET Provider upon availability of funds.

NOTE:  Earlier receipt of Work First support services or current receipt of post-TANF support services does not impact eligibility for the participant reimbursement

       2.  Dependent care allowance - Non-ABAWD participants only:

  • Allowed to BFET participants ages 16 through 59 with dependents.
  • Allowed for children up to age 12.
  • Subject to funds availability by the Child Care Subsidy Programs (CCSP) and/or BFET.
  • Must follow all other rules as established by CCSP unless the funding is directly from BFET.

Basic Food - Work Requirements

Purpose:

This section provides rules and instructions for Basic Food work requirements and the Basic Food Employment and Training Program (BFE&T). BFE&T services are voluntary and apply to non-TANF clients receiving federal SNAP Benefits. Work Requirements for nonexempt ABAWDs are not voluntary.

A. BASIC FOOD WORK REQUIREMENTS - Work Registration

WAC 388-444-0005 Am I required to work or look for work in order to be eligible for Basic Food?

B. BASIC FOOD WORK REGISTRATION EXEMPTIONS

WAC 388-444-0010 Who is exempt from work registration while receiving Basic Food?

C. BASIC FOOD EMPLOYMENT AND TRAINING (BFET)

WAC 388-444-0015 How can the Basic Food Employment and Training (BFET) program help me find work?

D. BFET PAYMENTS FOR RELATED EXPENSES

WAC 388-444-0025 What expenses will the department pay to help me participate in BFET?

E.   ABAWDs - Able-Bodied Adults Without Dependents

WAC 388-444-0030 Do I have to work to be eligible for Basic Food benefits if I am an able-bodied adult without dependents (ABAWD)?
WAC 388-444-0035

Who is exempt from ABAWD work requirements?

WAC 388-444-0040

Can I volunteer for an unpaid work program in order to meet the work requirements under WAC 388-444-0030?

WAC 388-444-0045

How does an ABAWD regain eligibility for Basic Food after being closed for the three-month limit?

F.   BASIC FOOD WORK REQUIREMENTS - GOOD CAUSE

WAC 388-444-0050 What is good cause for failing to meet Basic Food work requirements?

G.  BASIC FOOD WORK REQUIREMENTS - DISQUALIFICATION

WAC 388-444-0055 What are the penalties if I refuse or fail to meet Basic Food work requirements?

H.   BASIC FOOD WORK REQUIREMENTS - UNSUITABLE EMPLOYMENT AND QUITTING A JOB

WAC 388-444-0060 What is unsuitable employment for Basic Food work requirements?
WAC 388-444-0065

Am I eligible for Basic Food if I quit my job or reduce my work effort?

WAC 388-444-0070

What is good cause for quitting my job or reducing my work effort?

WAC 388-444-0075

What are the penalties if I quit my job or reduce my work effort without good cause?

I.  APPENDIX I -  ABAWD participation requirements by location     

J. Current Partners - BFET Partner Colleges and Agencies 

Basic Food Work Requirements - Work Registration

Purpose:

WAC 388-444-0005 Am I required to work or look for work in order to be eligible for Basic Food?

 

Clarifying Information - WAC 388-444-0005

Exempt clients (per WAC 388-444-0010) are not required to register for work, so they are not work registrants.

Non-exempt clients are people who receive Basic Food and must be registered for work. They are considered work registrants, and further divided into two groups:

ABAWD Work Registrant 

  • Effective January 1, 2016, Able-bodied adults ages 18 through 49 without dependents who live in King County, Snohomish County, or Pierce County (Outside of the cities of Lakewood and Tacoma) are required to participate in specific activities outlined in the ABAWD WACs to stay eligible for Basic Food and avoid the three month time limit.   
  • Time limit exemptions and participation for ABAWDs are different than non-ABAWD work registrants, and only apply to those not exempt per WAC 388-444-0010.

 

Non-ABAWD Work Registrant

  • All other non-exempt clients age 16 through 59 must meet work registration requirements or they could be disqualified from Basic Food.
  • All non-ABAWDs who receive Basic Food benefits and are not exempt per WAC 388-444-0010 must register for work.
  • There is no time limit for non-ABAWD clients.
  • There are no mandatory participation in BFET. All clients are voluntary participants and may participate in BFET if otherwise eligible.
DSHS registers the clients for work by completing the WORK Registration screen in ACES/3G.

Worker Responsibilities - WAC 388-444-0005

  1. During application, add a person or eligibility review, determine if members of the Basic Food AU are non-exempt work registrants or exempt.
  2. For any exempt work registrants, code the most appropriate exemption per current procedure, on the Exempt Reason field on the WORK Registration screen in ACES/3G.
  3. For any non-exempt work registrant, determine if the client(s) is considered ABAWD.
  4. Register the client for work by coding the WORK Registration screen in ACES/3G with the appropriate E&T status code. For ABAWDs, see ABAWD WACs to determine if you should code participation or exemptions in the Work Status field.
  5. If a WorkFirst household is sanctioned, determine whether or not the sanctioned persons are exempt from Basic Food work requirements.  Disqualify non-participating members of the TANF household from receiving Basic Food unless they are exempt under WAC 388-444-0010.

Basic food may also be terminated for TANF applicants/receipients who do not cooperate with other TANF eligibility (such as financial) criteria.

 

Basic Food Work Registration Exemptions

Revised June 12, 2015 (WAC revisions also proposed to be released in late 2015)

Purpose:

WAC 388-444-0010 Who is exempt from work registration while receiving Basic Food?

  • Clarifying Information

Clarifying Information - WAC 388-444-0010

  1. We apply and code personal exemptions (such as child under six, etc.) in all areas of the state.  There is no geographic or regional exemption for Basic Food work registration.
  2. If someone participates in methadone treatment, we do not consider this to be regularly participating in drug treatment and rehabilitation. Methadone treatment is meant to help the patient carry on with everyday activities such as working without relying on illegal drugs and without withdrawal symptoms that could prevent them from working.
  3. We must register non-exempt persons who receive state-funded FAP benefits even though they cannot receive federally- funded E&T services.
  4. ABAWD is a small subset population of Work Registrants that have extra requirements; therefore, specific ABAWD exemptions (such as pregnancy or waived counties) under WAC 388-444-0035 that apply to those extra requirements do NOT apply to work registration in general.

Worker Responsibilities - WAC 388-444-0010

  1. Screen for work registration status:
    1. Determine the client's exempt or non-exempt status for work registration. See WAC 388-444-0010; and
    2. Code work exemption information on the WORK screen for every person age 16 and over.
    3. Register non-exempt clients for work at the initial application and at recertification as described in the ACES Procedures - Work Registration.
  2. Volunteering for BF E&T Services:
    All clients who receive federally-funded Basic Food (SNAP) benefits may volunteer for E&T services. As a volunteer they may:
    1. Receive supportive services (see Basic Food Work Requirements Section D - BF E&T Payments for Related Expenses); and
    2. Not be disqualified for not cooperating with the program.
  3. Verifying a Personal Exemption
    1. Accept a client's statement of employment status or job availability unless the information is questionable.
    2. To verify questionable information have the client provide:
      1. Evidence of the claimed exemption; or
      2. The name and contact information of an acceptable collateral source who can be contacted for further verification.
    3. The exemption for physical or mental inability to work (including when client claims to care for an incapacitated person) follows WorkFirst guidelines, which require a minimum of a 12 month duration. If a client claims to be physically or mentally unable to work and the client's statement is questionable, verify the claim by:
      1. Proof of permanent disability benefits issued by a public or private source; or
      2. A statement from a qualified professional or their staff; or
      3. A medical verification through DSHS form 10-353.
      4. Do not refer to an SSI facilitator for purposes of Basic Food disability verification.
    4. For self-employment the client must provide records to show the hours worked.
    5. An adult may claim a child under 6, as their exemption, if they have a majority (50% or more) parental responsibility to care for that child. In households with multiple adults, any adult that has a valid claim to majority parental responsibility for the child can claim the exemption. Allow the client to change their election of who is claiming the child under 6 as an exemption up to once per month if necessary; however, the change of election may not be utilized as a means to remove an individual's work registration food disqualification (by becoming exempt).

ABAWDs- Able-Bodied Adults Without Dependents

Revised November 15, 2016

Purpose:

WAC 388-444-0030 Do I have to work to be eligible for Basic Food benefits if I am an able-bodied adult without dependents (ABAWD)?

WAC 388-444-0035 Who is exempt from ABAWD work requirements?

WAC 388-444-0040 Can I volunteer for an unpaid work program in order to meet the work requirements under WAC 388-444-0030?

WAC 388-444-0045 How does an ABAWD regain eligibility for Basic Food after being closed for the three-month limit?  

Administrative Hearing Procedures


Clarifying Information - WAC 388-444-0030

Countable Months

A countable month or non-qualifying month refers to any month in which an ABAWD receives Basic Food benefits for the full benefit month while not:

  • Being exempt from the 3-month time limit
  • Fulfilling ABAWD work requirements
  • Being covered by a waiver of the ABAWD time limit
  • Being exempted for the month using one of the State’s 15 percent exemption

 If a client enrolls into a qualifying program to participate, but does not reach the full participation for that month, then they will accrue a countable month against the three month time limit. 

36-Month Period

The current 36-month time limit period began January 1, 2015 and ends December 31, 2017. Another 36-month period will begin January 1, 2018.
Even though the current 36-month period is in effect, we do not count any month before January 2016 against an ABAWD's three-month time limit. 

NOTE: 
ABAWDs and households that contain ABAWDs receive a certification period as described under WAC 388-416-0005, but they cannot receive more than three full months of benefits without meeting the ABAWD work requirements. 

Children in the home  

When an Assistance Unit (AU) includes a member that is under age 18, all adults in the AU are exempt from ABAWD participation and are not considered ABAWDs, regardless of their responsibility to care for the child. Sometimes the child may not be eligible, such as due to alien status or failure to provide their Social Security number; this does not affect the ABAWD status of the adults in the home.  If the child is not on the AU, such as in a roommate situation where the adults purchase and prepare separately, the client will still be considered an ABAWD.

NOTE: If there is a child in the AU there are not any ABAWDs. However, this does not automatically exempt the adult(s) in the AU from work registration. The work screen should still be correctly coded to reflect the adult(s) work registration status.

 State Funded Food Assistance Program (FAP) Clients

Note WAC update November 19th, 2016. 

FAP follows the same rules as federally funded food assistance except for citizenship requirements (WAC 388-400-0050 #2). To maintain eligibility, FAP recipients that meet the definition of ABAWD in non-exempt areas are required to:

  • Work,
  • Participate in an approved employment and training program,
  • Volunteer in Workfare, or
  • Qualify for a personal exemption.

NOTE: FAP clients are not eligible for BFET or RISE. See the ABAWD section for a list of other state approved employment and training activities.

 

Temporary Assistance for Needy Families (TANF) Clients

TANF clients aren’t subject to ABAWD time limits because they have children or meet the pregnancy exemption for ABAWD participation.  Do not code them as an ABAWD. 

A pregnant TANF recipient, with no other children, who is sanctioned for non-participation in WorkFirst activity can be disqualified from Basic Food under the Work Registration rules.  Do not exempt them from Work Registration because pregnancy is not an exemption.

 

Moving Between Non-Waived and Waived Areas

 A waived area:

 A non-waived area:

  • Exempt from ABAWD work requirements while they live in an exempt area.
  • Must meet ABAWD requirements to stay eligible for Basic Food.

 

  1. If an ABAWD moves to a waived area, the person becomes exempt from ABAWD work requirements.
  2. If an ABAWD moves from a waived to a non-waived area during the 36-month period, they must meet ABAWD work requirements or have a personal exemption from ABAWD requirements. The three-month period starts with the first full month of benefits received in the non-waived area.
  3. If a client has previously used countable months during the same 36-month period, those months of non-participation, still count toward the three-month limit.
    • Moving between waived and non-waived areas does not restart the 3-out-of-36 month clock.
    • The months stop or start based on the exemption for the area where the person now lives.
  4. If an ABAWD loses eligibility for Basic Food due to the three-month limit and later moves to an exempt area, they are eligible to receive Basic Food while living in any exempt area.

 

Employment or Work: 

Work means providing a paid service to an employer.

  • This also includes in-kind work and rental income, based on the actual number of hours the client works.
  • The wage offered should not be less than the state minimum wage or in-kind goods or service of equal value.
  • ABAWDs can work an average of 80 hours per month to avoid gaining countable months.  For example, the work could be 20 hours per week, or even 39 hours if the client is paid every other week (39 x 2.15).
  • Self-employed persons must work 20 hours or more per week (averaged monthly or 80 hours per month) to meet the ABAWD work requirement. Annual hours cannot be averaged for ABAWD participation. 

Worker Responsibilities - WAC 388-444-0030

Out of State Countable Months

If there is evidence the ABAWD received food benefits in another state, verify any non-qualifying months received from that state. If the months accrued during Washington's current 36 month period update the clients Worker Registration Details screen. 

A written or verbal statement from the other state agency of countable months is acceptable proof. This should be checked at application despite the client moving to a waived area in Washington. 

  • Verify with that state the number of months the ABAWD has received benefits without participating in work requirements; and
  • Input the non-qualifying months that were reported after 1/1/2016. Document the information.
  • Expedited cases can be approved with postponed verification.

NOTE: 
If the client was not exempt and had a countable month in another state, we count that month, even if the client would have been exempt had they been receiving the benefits in Washington State. 

 

EXAMPLE:
Joe is an ABAWD who is chronically homeless and unable to work that was receiving benefits in Idaho. He is now applying for benefits in Washington.  The worker verifies that Joe accrued two countable months in Idaho, as he lived in a non-exempt area and did not participate. Idaho does not explicitly exempt chronically homeless as Washington does. 
The worker records Joe's two countable months in Idaho despite the difference in exemption policy.
Now that Joe lives in Washington State, he is coded exempt for the current and ongoing months as he is unable to work due to his living situation.  

Clarifying Information - WAC 388-444-0035

Consideration of Exemptions

ABAWD participation exemptions are reasons that an ABAWD client is not able to participate in work or work activities for 80 hours a month.  

Personal Exemptions

Personal exemptions apply in both exempt and non-exempt areas.

The priority for exemptions is:

  1. Use any personal exemption the ABAWD may have. The personal exemptions include:
  • Caretaker of an incapacitated person;
  • Physically or Mentally  unable to work;
  • Pregnancy;
  • If the ABAWD does not have a personal exemption, they may qualify for the limited “15% additional exemption” if they are participating in less than 80 hours a month in Resources for Initiating Successful Employment (RISE).  A specialized unit will be responsible for identifying and documenting when a client receives this exemption.   Use exempt area if the client can’t meet other exemptions  and the client lives in an area waived by the USDA.    
NOTE: 
See the ABAWD website for more information about exempt and nonexempt areas.   

Caretaker for a disabled adult

Only the individual(s), not the entire household, responsible for the care of an incapacitated person is exempt from the ABAWD.  The incapacitated person doesn’t have to reside in the same household as the responsible individual. 

Physically or Mentally Unfit for Employment

A client is physically or mentally unfit for employment if unable to work for at least twenty (20) hours per week or 80 hours a month. Examples of reasons they are unfit for employment can include:

  • Going through Drug/Alcohol Treatments
  • Receiving L&I, Veterans, or private disability insurance
  • Chronically Homeless (see link for more information before apply this exemption).

See more in the Unable to Worksection.

 

Worker Responsibilities - WAC 388-444-0035

Verifying a Personal Exemption

  1. Accept a client's statement for personal exemptions, such as pregnancy or inability to work, unless it is questionable.
  2. To verify questionable information have the client provide:
    1. Proof of the claimed exemption; or
    2. An acceptable collateral source who we can contact for further verification.
  3. If a client claims to be physically or mentally unable to work please refer to the Unable to Work section.
  4. If the client is not able to verify their claim for an exemption, make a decision using the available information that is in the client's case file. Document your decision on the exemption.
  5. The client is exempt from ABAWD requirements pending a HEN/ABD determination.
    1.  If the client is denied HEN/ABD:
      • Review the reason for denial.  Even though the client is not eligible for HEN/ABD, they may be “unable to work” based on the Unable to Work exemption. Follow the steps in the Unable to Work section. 
      • The client is required to participate in work requirements if they are not eligible for an exemption. 
        1. If non-qualifying months remain:
          1. Send a notice to the client giving 10 days advanced noticed that they must participate
          2. Participation is required the first of the month following the end of the 10 day advanced notice
        2. If no non-qualifying months remain:
          1. Send a notice to the client to terminate Basic Food for reason, “Failed ABAWD Requirement” effective the end of the month after 10 day Advanced Notice.
    2. If the client is approved HEN/ABD:
      • For HEN the client is exempt from work registration for reason "unable to work".
      • For ABD the client is exempt from work registration for reason "federally/state determined disabled"
  6. Clients that are ineligible due to having reached the three month time limit are not eligible based on an unverified questionable exemption claim, even if the client is expedited.  
EXAMPLE: 
On March 14th, a worker reviews John’s denial for ABD and determines that he is an ABAWD who doesn’t qualify for the "federally/state determined disabled" exemption. The worker sends John a letter on March 15th to inform him that he must meet ABAWD work requirements to remain eligible for Basic Food. Since the letter provides at least 10 days’ notice before the beginning of the next full month, the letter should include text that he must start meeting the work requirements on April 1st.

 

Unable to Work

ABAWD personal exemption from participation due to being unable to work:

NOTE: 
For the purposes of documenting ABAWD personal exemptions in the system “Temporarily Incapacitated” or the “TI” coding is equal to “unable to work.”  This is not the same as ABD or HEN definitions of incapacity determined by social workers.

Unable to work means that the client is physically or mentally not able to work at least 80 hours a month as required by ABAWD rules

If a client states they are unable to work and there isn’t a reason to question the claim, document that the client is “exempt from ABAWD participation due to not being able to work” and use the appropriate coding on the work screen for this.

If the client’s statement is questionable, attempt to get a collateral contact from someone aware of the person’s circumstances / condition. If you cannot make this contact by telephone, you can advise the client to get collateral contact from a reliable source and provide DSHS 14-541 (www.dshs.wa.gov/forms).  

NOTE:
We cannot require a particular type or form of verification. See WAC 388-490-0005.

We automatically consider someone as unable to work if they receive any of these disability benefits:

  • Veterans Disability Benefits (any level)
  • L&I or other Worker’s Compensation
  • Private disability insurance benefits

Collateral contact can come from:

  • A medical professional: nurse, doctor, psychologist, psychiatrist, etc.
  • Drug or alcohol treatment professional
  • Any reliable medical source that is familiar with the circumstances that make the client unable to work twenty hours a week.

When further verification is needed:

  1. If the client has non-qualifying months left (WORK Registration/ Participation Screen) and is otherwise eligible for benefits, approve Basic Food with the client coded as a non-exempt ABAWD. Set a communication to the ABAWD specialized team for review of verification. Send a request for verification notice to the client.   The client is not exempt from the ABAWD time limits if they fail to provide verification. When the deadline for the third month approaches, the client will receive notification that their benefits will terminate if they do not participate or meet a personal exemption.
  2. If the client doesn’t have countable months available, pend the case to the ABAWD Specialized Team for further determination. Send a request for verification notice to the client. The specialized team will deny benefits if the client does not provide this verification benefits will be denied.
NOTE:
If the client's statement changes, to able to work, they can meet participation with any qualified work activity to remain qualified for basic food.  

Chronic Homelessness:

A chronically homeless client may have a personal exemption for ABAWD work participation because they are unable to work at least 80 hours a month.  Homelessness on its own is not an exemption.   A “chronically homeless” determination should be made after completing the interactive interview involving the entirety of the person’s situation or through a thorough case review when a client is determined ABAWD. Staff will use all aspects of the client’s situation and prudent person to decide if the client is homeless and unable to work.

Examples of chronic homelessness:

  • The client states they are homeless and do not have a regular nighttime place to sleep, “living on the streets”
  • The client’s residence or mailing address is a shelter location
  • The client has a history of homelessness
  • The client is homeless with housing or “couch surfing”

AND one or more of the following:

  • The client requires an Equal Access Plan
  • The client has a diagnosed or undiagnosed mental or physical barrier
  • The client is obviously not work ready in appearance or behavior

Clearly document your decision and exempt the client using the “unable to work” exemption. 

 

NOTE:
A person’s inability to work does not have to be for a specific duration of time to meet the exemption. Staff will ask about the client’s ability to work during their next certification or re-certification. If it is questionable at that time, then updated verification is required. 

 


Clarifying Information - WAC 388-444-0040

Volunteer and unpaid work programs.

ABAWDs can combine work and work programs to fulfill the 80 hour per month requirement.

Workfare

Workfare is unpaid work performed by an ABAWD for a public or private non-profit organization. Workfare is available to non-exempt ABAWDs only. Workfare is not available to non-ABAWDs.,  

  1. Unpaid work in the community - ABAWDS can meet their work requirement by completing volunteer hours at a non-profit or public agency.
    1. ABAWD clients must participate based on the household's food benefit allotment divided by the state minimum wage (rounded down):

      The state minimum wage of $11.00 an hour effective January 1, 2017.

      EXAMPLE:
      Bill is an ABAWD who receives $115 in Basic Food benefits each month.  115 ÷ 11= 10.45 hours Bill must volunteer for 10 hours (rounded down) of workfare per month.
    2. An ABAWD may volunteer at any non-profit agency that agrees to provide Workfare opportunities for ABAWDS to meet their work requirements. The non-profit must have a current Workfare Site agreement 09-866 and communicate with the ABAWD Specialized Unit.
    3. Clients must receive a referral from DSHS to that site before their hours will begin to “count”.

If you are a non-profit agency interested in becoming a Workfare Site please inquire with jobhelp@dshs.wa.gov.

Non-profit agencies agree to verify that the ABAWD has met their hourly requirement. Upon verification we will not count a month against the three-month limit. The Workfare nonprofit agencies also agree to notify us when a participant is no longer meeting the required hours.

 

State approved Employment and Training programs for ABAWD Participation

There are a number of programs that ABAWDs can participate in to meet participation.

  • Basic Food Employment and Training (BFET) – This is a statewide program managed by DSHS, community based organizations and colleges that provide training, retraining, job search and other supplemental support services to Basic Food recipients. This is not available to FAP clients.
  • Resources for Initiating Successful Employment (RISE)- This  is a pilot study implemented by DSHS and DSHS, community based organizations and colleges that provide barrier reduction, training, retraining, job search and other supplemental support services to Basic Food work registrants in King, Pierce, Spokane and Yakima counties. This is not available to FAP clients.
  • Limited English Proficiency (LEP) Pathway- This program is for refugees and other special immigrants (under the five year bar) to gain English skills and other trainings and support to join in the workforce. Available to some FAP clients; please check with the Office of Refugee and Immigrant Assistance (ORIA) for more information.
  • Programs included with the Workforce Investment and Opportunity Act (WIOA)
  • Program included under Section 236 of the Trade Act of 1974
  • Washington Service Corps/AMERICORPS;
  • Corrections Clearinghouse;
  • NAFTA Transitional Adjustment Assistance Programs;
  • Seattle Jobs Initiatives (SJI);
  • And others as they apply

ABAWD Participation in BFET or RISE

Participating in Basic Food Employment and Training (BFET) in King or Pierce County can be used to meet work requirements for ABAWDs as an approved Employment and Training Program.  The Resources to Initiate Successful Employment (RISE) pilot in King County can also be used to meet ABAWD requirements.  To be eligible for Basic Food, an ABAWD must participate in BFET or RISE before losing eligibility for Basic Food.

Enrolling in BFET or RISE before Basic Food Closes due to the three-month limit:

If an ABAWD client enrolls in BFET or RISE before the end of their 3rd month of non-participation in work requirements, the participant will qualify for an exemption until they are ready to participate enough hours that their participation meets the 20-hour work requirement. 

Enrolling in BFET or RISE AFTER Basic Food Closes due to the three-month limit:

If an ABAWD client enrolls in BFET or RISE after Basic Food closes due to non-participation in work requirements, they must engage in work activities for a minimum of 80 hours in a month period or 16 hours of workfare, before they would be eligible to receive basic food assistance.  Once the client has been approved for Basic Food, they may engage in pilot services through a contracted provider. 

Individuals who apply for the pilot (RISE (treatment group) or BFET (control group)) are eligible for an exemption in their ABAWD status if they do not have enough participation hours. 

Job Search Services for ABAWDs:

Job search hours are only countable for less than half of the total time a client is participating in BFET or RISE. For example, if a client is participating in BFET twenty hours a week, then only up to nine hours of Job Search can be counted as “participation” for ABAWD requirements.  The other eleven must be in another activity such as training, or a separate program such as Workfare.

Employment Pipeline:

Employment Pipelines are pathways to employment for Department of Social and Health Services clients. DSHS works with employers in different fields to provide clients with a choice of career opportunities. This is not an allowable program activity for ABAWD clients as hours and participation are not tracked, however this could be a great transition to employment for ABAWD clients. ABAWD clients interested in Employment Pipeline should be sent the brochure, or directed to our Publications Library to download it.

Worker Responsibilities - WAC 388-444-0040

Monitoring ABABWD Participation

If a client fails to participate in the month the ABAWD Specialized Team will:

  1. Record on the Work Registration/Participation screen the month and year of non-participation under the appropriate 1st, 2nd or 3rd month. ACES will automatically terminate the case when the third date is entered.
  2. Terminate benefits to clients who have regained eligibility but failed to participate, unless they are receiving the subsequent additional three months.
  3. Send a termination letter with an explanation as to how to regain eligibility.

 


Clarifying Information - WAC 388-444-0045

Ineligibility Due to ABAWD Requirements

  1. If a client exhausts the 3-out-of-36 months eligibility limit, we must terminate the person's Basic Food benefits as soon as we become aware of this information. We must also deny this person Basic Food at application or recertification if they do not have a personal exemption and they do not live in a waived area, unless they requalify under Regaining Eligibility
  2. If a client is not eligible because the client does not participate, the person is an ineligible household member. We count this person's income to any remaining persons in the Basic Food Assistance unit as described under WAC 388-450-0140. How does the income of an ineligible assistance unit member affect my eligibility and benefits for food assistance?

Regaining Eligibility

There are no  limits to the number of times a client can regain eligibility.  To regain eligibility a client must perform one of the following:

1.    Complete 80 hours of training within a 30-day period;

2.    Work 80 hours in a 30-day period; or

3.    Participate in Workfare for the required number of hours per month or, at a minimum, the number of required Workfare hours based on the benefit amount on the reconciliation chart.

Eligibility for a Second 3-month period for ABAWDs

This section only refers to those ABAWDs who are eligible for a second three-month period as described in WAC 388-444-0045(1) & (3).  If an ABAWD becomes eligible for a second 3-month period the 3 months are consecutive months.  A partial month of benefits does not count toward this second 3-month period.  The client receives this second 3-month period whether or not the client is participating in work requirements.

If the ABAWD cannot use the additional 3-month eligibility period due to a disqualification, the ABAWD may work another 80 hours in a 30-day period again to become eligible for the second 3-month period.

 

Worker Responsibilities - WAC 388-444-0045

  1. If the client has completed the necessary participation and regained eligibility at the time of application and is otherwise eligible for Basic Food:
    1. Remind them of the ongoing participation requirements; and
    2. Certify the case for Basic Food.
  2. If the client has not regained eligibility at the time of application:
    1. Deny the application until we receive verification that they have met participation;
    2. Inform them how they can regain eligibility through participation activities;
    3. They must regain eligibility within thirty days of the application or they will need to reapply once they have met participation.
  3. If the applicant completes the required number of hours for Workfare within the 30-day application period, follow the procedures in (1) of this section.
  4. Once the requirements for regaining eligibility are met by work or an employment and training activity:
    1. The client with a closed Basic Food case may, if otherwise eligible, receive benefits from the date they completed the necessary hours of participation (either 80th hour for work like activities or required amount of Workfare hours as determined by the Specialized ABAWD Team).
    2. The client in an open Basic Food case, if otherwise eligible, is added back to the household following WAC 388-418-0020.  How the department determines the date of change affects the benefit level.

 

Good Cause:

Please see Chapter Basic Food Work Requirements – Good Cause.


Administrative Hearings

If an ABAWD requests an administrative hearing:

  1. The client's three-month clock is paused by removing the 3rd non-qualifying month and benefits will continue until there is a hearing decision. 
  2. If the Department is upheld, the original 3rd non-qualifying month is counted and the case will close establishing an overpayment; or
  3. If the client is upheld, benefits received are retained and we will review ABAWD participation status for the on-going month.

 


ACES Procedures

Basic Food Work Requirements - Good Cause

Revised October 14, 2013

Purpose: 

WAC 388-444-0050 What is good cause for failing to meet Basic Food work requirements?

  • Worker Responsibilities


Worker Responsibilities - WAC 388-444-0050

When you are informed that a non-exempt Basic Food client has not complied with work requirements:

For Mandatory Work Registrants

  1. Begin the good cause process no later than 10 calendar days from the date you are notified on noncompliance, by sending a letter to the client. The letter must include:
    1. A description of the non-compliance; and
    2. The date by which the client must contact the worker to provide good cause for non-compliance. (This date should not exceed 10 calendar days from the date the notice is sent.)
NOTE:
If the client does not respond within 10 calendar days, determine that good cause does not exist. Refer to step 3. below.
  1. Determine good cause for clients not meeting the work registration requirements described in WAC 388-444-0005, #3.
  2. When good cause does not exist the client must be disqualified. See Disqualification.
  3. Inform disqualified clients how they may regain eligibility for Basic Food.
  4. Volunteers for Basic Food E&T components (services) who fail to participate are not disqualified.

 

For ABAWDs

  1. Begin the good cause process no later than 10 calendar days from the date you are notified on noncompliance, by sending a letter to the client. The letter must include:

    Consider an ABAWD to have met the work requirement if they havea  temporary absence from work and they have not lost their job.

    1. Good cause includes circumstances beyond the individual’s control, such as:
      • Illness;
      • Care for another household member;
      • a household emergency;
      • or the unavailability of transportation.
    2. Document the reason for good cause in the case notes. Good cause should not exceed two months in a row. If the frequency of good cause requests become questionable, a worker can ask the the client to provide collateral contact for the exemption. Assess the client for a personal exemption if it appears that the good cause reason will last for longer than two months.
    3. If you determine there is no good cause, record non-qualifying work months as described in Section E, ABAWDS.

Basic Food Work Requirements - Disqualification

Revised October 14, 2013

Purpose: 

WAC 388-444-0055 What are the penalties if I refuse or fail to meet Basic Food work requirements.

  • Clarifying Information and Worker Responsibilities

Clarifying Information - WAC 388-444-0055

The disqualification rules and procedures are for Basic Food non-exempt work registrants only. Please see Section E, ABAWDS for disqualification rules and procedures for able-bodied adults without dependents.

 

Worker Responsibilities - WAC 388-444-0055

  1. At the time the worker determines that a comparable sanction will be applied, or benefits denied because of lack of cooperation with a comparable program (Work First, unemployment compensation, or Refugee Assistance) work requirements, the worker must:
    1. Review the client's circumstances to determine if any Basic Food work registration exemptions apply.  See WAC 388-444-0010 
    2. If the client meets an exemption then the client continues to receive Basic Food benefits;
    3. If the client does not have a work registration exemption, the worker must notify the client that a Basic Food work requirements disqualification will be applied unless the client complies with the comparable program requirements
    4. When disqualifying a client for non-compliance with a comparable program, notify the non-exempt client that:
      1. Basic Food work requirements must be met within 10 days of the notice;
      2.  Basic Food work requirements can only be met by cooperating with the comparable program requirements;
      3. The disqualification period is determined under WAC 388-444-0055.
  2. If the client complies with the comparable program requirements within the 10 day notice, then the client is once again exempt from Basic Food work registration or ABAWD requirements.
  3. If the client does not comply with the comparable program requirements within the 10 day notice, the client is disqualified from receiving Basic Food benefits.
  4. Apply the disqualification in the month following the 10-day advance notice.  Enter the following information in free form text:
    1. The reason for the disqualification;
    2. The period of disqualification;
    3. The disqualification only ends if the client complies with [name of comparable program] requirements or serve the appropriate disqualification period. See WAC 388-444-0055 for when to end the disqualification period.
  5. Apply the disqualification the first month following the 10-day notice of adverse action

 

Procedures for Disqualifying a Client

  1. Enter non-cooperation in ACES as described in the ACES Procedures at the end of this section.
  2. If the disqualified client leaves the Basic Food program before the disqualification starts, impose the disqualification when:
    1. The person reapplies; and
    2. Start the disqualification period with the first full month of certification.
  3. If a disqualified person leaves the program before completing the disqualification period:
    1. The person serves any remaining time of disqualification when the person applies for benefits; and
    2. Start the remaining disqualification period with the first full month of certification.

 

Regaining Eligibility

  1. If otherwise eligible, a client regains Basic Food benefits when they complete their penalty period.
  2. A disqualified client is treated as an ineligible household member. See INCOME
  3. For a one person household, the client must reapply for benefits. A household of two or more will have the client's portion of benefits restored.

 

Ending a Disqualification When a Client Becomes Exempt During the Penalty Period

A disqualification ends when the client becomes exempt during the penalty phase.

NOTE:
A disqualification for failing to comply with Basic Food work requirements is not canceled because of a disqualification for noncompliance with some other Basic Food program requirement. Multiple disqualifications may run at the same time.

 Fair Hearing Procedures

When a person requests a fair hearing within 10 days of the issuance of the Notice of Adverse Action, and the certification period has not expired, benefits will continue.

  1. If the hearing goes against the client, and the client received continued benefits, DSHS will establish an overpayment;
  2. Give the client 10-day advance notice;
  3. The disqualification period begins the first of the month following the 10-day notice.

ACES Procedures

 

See Interview (WORK) screen

See Disqualified or Sanctioned Assistance Unit or Client - Quitting a Job

 

Basic Food Work Requirements - Unsuitable Employment and Quitting a Job

Revised November 18, 2016

Purpose: 

WAC 388-444-0060 What is unsuitable employment for Basic Food work requirements?

WAC 388-444-0065 Am I eligible for Basic Food if I quit my job or reduce my work effort?

WAC 388-444-0070 What is good cause for quitting my job or reducing my work effort?

WAC 388-444-0075 What are the penalties if I quit a job or reduce my work effort without good cause? 

  • Clarifying Information and Worker Responsibilities

Clarifying Information - WAC 388-444-0075

The rules for quitting a job or reducing work effort below thirty hours per week apply to both Basic Food applicants and recipients.

General Requirements

  1. The following requirements apply to all Basic Food clients 16 through 59 years old who:
    1. Quit a job or reduce  their work effort within 30 days of application.
    2. Quit a job or reduce  their work effort after an application for benefits was submitted but before  benefits are certified.
    3. Quit a job or reduce their work effort during certification.
    4. Would have been required to register for work at the time of quit or reduction of work effort.
  2. The following situations are not considered a voluntary job quit:
    1. Terminating a self-employment enterprise; and
    2. Resigning at the request of the employer.

       3.   We cannot disqualify  a recipient or applicant for less than the penalty time period unless they become exempt from work registration as described in WAC 388-444-0075 (5).

The penalties for quitting a job or reducing hours are:

  1. First time - one benefit month;
  2. Second time – three benefit months;
  3. Three or more times - six benefit months.
EXAMPLE:
Sherry applies for benefits on December 20th, she quit her last job on November 30th without good cause. This is her first offense. December is Sherry’s  one-month penalty even though the benefits are prorated. ACES will approve ongoing benefits as long as Sherry is otherwise eligible.
Same as above but it’s Sherry’s second offense. ACES will deny all three months: current, ongoing, and the third month (December – February). Sherry can reapply at any time but will not be eligible for benefits again until March.

Worker Responsibilities -WAC 388-444-0075

 Verifying and Documenting a Voluntary Job Quit or Reduction in Work Effort 

  1. Verify the client's claim of good cause if questionable.
  2. Whenever possible, verification should be accepted from but not limited to:
    1. The previous employer;
    2. An employee organization or union; or
    3. A grievance committee or organization.
  3. Disqualify a client that doesn’t have good cause from the date of application following ACES procedures below.
  4. For a recipient without good cause, send the notice of adverse action and apply the disqualification the first of the month following the 10-day advance notice.

NOTE:
Do not delay benefits to an otherwise eligible person beyond the normal processing time while awaiting a good cause determination.

 


ACES PROCEDURES

See Disqualified / Sanctioned Assistance Unit / Individual - Quitting a Job Without Good Cause

Benefit Errors

Revised August 4, 2011

Purpose: 

This category is about how to identify incorrect benefit payments and how to establish and refer for collection cash, medical and food assistance overpayments. The rules and procedures for identifying and correcting underpayments are also in this category.

WAC 388-410-0001  What is a cash / medical assistance overpayment?

WAC 388-410-0005  Cash and medical assistance overpayment amount and liability

WAC 388-410-0010  Repayment of grant overpayment occurring prior to April 3, 1982, and resulting from department error

WAC 388-410-0015  Recovery of cash assistance overpayments by mandatory grant deduction

WAC 388-410-0020  What happens if I receive more Basic Food or WASHCAP benefits than I am supposed to receive?

WAC 388-410-0025  Am I responsible for an overpayment in my assistance unit?

WAC 388-410-0030  How does the department calculate and set up my Basic Food or WASHCAP overpayment?

WAC 388-410-0033  How and when does the department collect a Basic Food or WASHCAP overpayment?

WAC 388-410-0035  Are alien and alien sponsors jointly responsible for cash and food assistance overpayments?

WAC 388-410-0040  Cash and food assistance underpayments.

Alien and Alien Sponsor Overpayments

Revised June 3, 2011

Purpose:

WAC 388-410-0035  Are alien and alien sponsors jointly responsible for cash and food assistance overpayments?


Worker Responsibilities - WAC 388-410-0035

If the department determines that an assistance unit’s overpayment amount needs to be modified because of an error, the worker should refer to the ACES manual Benefit Error Group, Modify a BEG – Underpayment or Overpayment.


ACES Procedures

See Benefit Error Group (BEG) – Modify a BEG – Underpayment or Overpayment

Basic Food Overpayments

Revised March 1, 2017

WAC 388-410-0020 What happens if I receive more Basic Food or WASHCAP benefits than I am supposed to receive?

WAC 388-410-0025 Am I responsible for an overpayment in my assistance unit?

WAC 388-410-0030 How does the department calculate and set up my Basic Food or WASHCAP overpayment?

WAC 388-410-0033 How and when does the department collect a Basic Food or WASHCAP overpayment?


Clarifying Information - WAC 388-410-0020

  1. Examples of an Administrative Error (AE) overpayment include when we:
    1. Did not act timely on a reported or known change in circumstances;
    2. Made a mistake in determining the AU’s eligibility or benefits;
    3. Incorrectly issued duplicate benefits;
    4. Issued allotments after the end of the AU's certification period without redetermining the AU's eligibility;
    5. Did not disqualify a client for an IPV on time as required under chapter 388-446 WAC;
    6. Made an incorrect change to the case or failed to make a needed change that caused the department to make an incorrect decision on the AU's eligibility or benefit amount.
  2. Examples of an Inadvertent Household Error (IHE) include when the AU:
    1. Understand what they were required to report; or
    2. Report a change or provide accurate and complete information, but they did not do this to get more food assistance benefits than they were eligible for.
  3. Examples of an Intentional Program Violation (IPV) include when a client does any of the following on purpose:
    1. Makes an oral or written false or misleading statement that affects their benefits;
    2. Misrepresents, conceals, or withholds facts; or
    3. Violates the Food Stamp Act, Basic Food regulations, or any state laws that cover:
      1. How someone can get, have, and use Basic Food benefits or EBT cards; or
      2. The transfer of Basic Food benefits or EBT cards.

NOTE: See chapter 388-446 WAC for information and rules on IPV disqualification hearings and penalties. WAC 388-446-0015 explains that an administrative disqualification hearing (ADH) is a formal hearing to determine if a person committed an IPV. FSS workers cannot code an overpayment as IPV until an ADH is held and the outcome determines an IPV was committed and caused the overpayment. See Clarifying Information #6 under WAC 388-446-0001.

  1. Date of discovery:

The Date of Discovery is the date we have adequate information to validate that the AU has an overpayment, and determine the amount overpaid. It is not the date of a system-generated BEG, because these only give enough information to identify a potential overpayment.

The date we "open" the BEG in ACES is the official date of discovery.  The exception to this rule is Basic Food errors discovered through the federal Quality Assurance review process.  The official date of discovery for a QA error is the date the Basic Food Process Preview Panel (PRP) is held where the error would be reported out as final to Food and Nutrition Services (FNS).

  1. Date of establishment:

The Date of Establishment is the date staff establishes an overpayment, send the household notification of the claim, and refer the case to the Office of Financial Recovery (OFR) for collections. The date of the overpayment letter is the official date of establishment.

  1. Timeframes to set up overpayments :

We must process at least 90% of all overpayments by the end of the calendar quarter after the quarter we discover an overpayment. A claim is not timely if we sent the AU an overpayment letter later than the last day of the quarter after the quarter in which we "opened" the overpayment BEG.  Even though we can set up a valid overpayment after the timely processing period, federal rules require the department to meet this timeframe.  For information on processing a BEG, see the ACES User Manual

NOTE: Potential overpayments discovered by the Basic Food quality assurance (QA) process must be considered "priority"and every attempt must be made to establish these overpayments within federal time limits, but only after the payment errors associated with these overpayments have been reviewed and finalized by the Basic Food Process Review Panel (PRP).

To ensure that staff review potential overpayments and promptly act on this information, the department monitors Benefit Error Group (BEG) lists.

To measure if we are meeting federal timeliness standards for establishing overpayments, staff compares the dates an overpayment BEG was "opened" to the date we sent the overpayment letter.

EXAMPLE

  1. If we discover an overpayment on February 6th (1st quarter) we must set up the overpayment by June 30th (2nd quarter).

  2. If we discover an overpayment on June 28th (2nd quarter) we must set up the overpayment by September 30th (3rd quarter).

 7.   Other program reporting requirements and Basic Food overpayments:

If someone does not report a change in circumstances required under WAC 388-418-0005, we determine if a client has an overpayment for each program based on that program’s reporting requirements.

  • For Basic Food, the household must report changes as required under WAC 388-418-0005(2).
  • If a Basic Food assistance unit would not have to report the change based on the AU's circumstances, we do not set up an overpayment even if the household had to report a change for another department program.

EXAMPLE: Julie, Spencer, and their two children receive TANF and Basic Food. They fail to report that Spencer got a job Earning $900 monthly. Spencer received his first paycheck on August 25th. We discover this information in November.
TANF: The family was required to report getting a job for TANF. We determine amount of TANF benefits the family was eligible for if they reported the change timely on September 10th and set up an overpayment for October and November.
Basic Food: The new job did not cause the family to go over the income limit for a family of four. Since they did not have to report this change for Basic Food, we do not set up an overpayment.

EXAMPLE: Diane receives TANF and Basic Food for herself and her daughter. Diane doesn't report she has switched to full-time status at work and now earns $2,500 monthly. Her paycheck on April 30th puts her over the income limit for Basic Food. We discover this information in July.
TANF: Diane was required to report the change in employment status and going over the earned income limit for TANF. We treat this change as if Diane had reported it timely on May 10th. We would set up an overpayment for the TANF benefits the AU received in June and July.
Basic Food: Diane’s $2,500 monthly income is over the income limit for a two-person AU. Since she was required to report this change for Basic Food, we set up a Basic Food overpayment for benefits the AU received in June and July.

Worker Responsibilities - WAC 388-410-0020

  1. Timely processing of overpayments:

When you learn of a potential overpayment through an interface, alert, client contact, or other source, take all needed actions as appropriate to validate that an overpayment occurred and determine the amount of the overpayment. This may include requesting additional information or proof of someone's circumstances.

  1. When you have adequate information to determine that the AU was overpaid and determine the amount they were overpaid, this is the date of discovery for the overpayment. The date of discovery is recorded as the date you "open" the overpayment BEG in ACES.
  2. After you have established the date of discovery, finish processing the overpayment by sending the client an overpayment letter including the calculation and refer the case to the Office of Financial Recovery for collections. This is the date of establishment for the overpayment. The date of establishment is recorded as the date you generate the overpayment letter to refer the case to OFR.

 

Claims Establishment Timeline

 

1st Quarter

2nd Quarter

3rd Quarter

4th Quarter

If your date of discovery is in:

January;
February; or
March

April;
May; or
June

July;
August;
September

October;
November; or
December

You must establish the claim by:

June 30th

September 30th

December 31st

March 31st

 

NOTE: There is a federal requirement to establish a minimum of 90% of valid overpayments by the end of the calendar quarter after the quarter we discovered the overpayment.  This is especially important for overpayments validated by the federal SNAP (Basic Food) QC process.

By working the potential overpayment immediately to validate and process the overpayment, we ensure that we meet the federal requirement.

  1. Review client-caused errors for potential IPVs:
    • Consider what appears to be the AU's intent or lack of intent to decide if an overpayment is an IHE or a suspected IPV.
    • Set up a suspected IPV overpayment as an IHE overpayment until an administrative disqualification hearing or a court determines the client's intent.
  2. Modifying an overpayment:

If the department determines that an assistance unit’s overpayment amount needs to be modified because of an error, the worker should refer to the ACES manual, Benefit Error Group (BEG) - Modify a BEG – Overpayment or Underpayment.


ACES Procedures

See Benefit Error Group (BEG) – Modify a BEG – Overpayment or Underpayment


Clarifying Information - WAC 388-410-0025

Even though all adult members of an AU with an overpayment are liable for the full overpayment, the Office of Financial Recovery (OFR) tracks payments to ensure that we do not collect more than the amount of the overpayment.

Worker Responsibilities - WAC 388-410-0025

Overpayment Liability

  1. Set up the overpayment in the name of every adult who was a member of the AU at the time the AU was overpaid.
  2. Create a Basic Food overpayment letter naming each responsible member for the entire amount of the overpayment.
  3. Send separate letters only if certain responsible adults now live at a different address. 
  4. Make sure each overpayment letter states the name of the primary payee and the total overpayment amount.

 

ACES Procedures


See Benefit Error Group (BEG) - Confirm a BEG - Overpayment


Clarifying Information - WAC 388-410-0030


NOTE: When the overpayment involves food assistance, current policy states that only a court of law or an Administrative Disqualification Hearing can determine an Intentional Program Violation (IPV).
The FSS establishes an unintentional overpayment, called Inadvertent Household Error, and refers the food and any related cash overpayment to OFA for investigation and potential prosecution.
  1. Calculating the Overpayment
    1. The overpayment amount is the difference between what the client received and what they were eligible to receive.
    2. When determining an overpayment amount, you may subtract an under payment, if not already issued, from an overpayment to get the net overpayment amount.
       
  2. Overpayments discovered by QC Reviews:  If the department discovered an overpayment through the federal QC process or the QC process reports the case as ineligible for benefits, we must set up an overpayment regardless of the amount. 
     
  3. Overpayments discovered outside the QC Review process: If we didn't discover the overpayment through the federal QC process, we set up an overpayment if:
    1.  The responsible household members still receive Basic Food or WASHCAP benefits and the overpayment is over $85; or
    2.  The overpayments total more than $125.
       
    3. NOTE: Overpayments discovered through internal audits, Management Evaluation reviews, or any payment accuracy initiatives are not considered as discovered through the federal QC process.

       
  4. OFR collects on established debts regardless of the amount.  The $85 and $125 rules apply to whether or not we establish an overpayment for Basic Food or WASHCAP. OFR will collect on established overpayments regardless of the amount. This includes when we:
  • Set up an overpayment for an AU who no longer receives Basic Food; or
  • Modify an existing overpayment to $125 or less.

OFR is the point of contact for compromising (reducing) overpayment balances or making decisions on waiving overpayment collections. Clients must be referred to OFR for these requests.

 


Clarifying Information - WAC 388-410-0033

  1. Who has to repay an overpayment:
    1. The Department collects from the client by reducing Basic Food benefits. Clients can also repay an overpayment by paying the Office of Financial Recovery directly.
    2. The adults in the overpayment assistance unit share the responsibility for repaying an overpayment even if they later belong to different assistance units.
    3. We consider a person who receives Basic Food or WASHCAP benefits as having the ability to repay an overpayment.
  2. When we can reduce an overpayment for a client who receives benefits:
    1. The CSO can reduce an overpayment debt only if the overpayment was incorrectly calculated for an amount larger than is actually owed.
    2. An Administrative Law Judge can order an overpayment debt waived or reduced to correct an overpayment that was calculated in error.  An ALJ does not have the authority to reduce or waive an overpayment based on hardship. 
  3. When the Office of Financial Recovery can reduce an established overpayment:

A person responsible for an overpayment may be able to negotiate a reduction of the debt with the Office of Financial Recovery. OFR is the secretary's designee for the department under RCW 43.20A.110 and uses criteria under RCW 43.20B.030 to determine if an overpayment should be reduced or dismissed  as allowed under Title 7 CFR §273.18(c)(7)  

  • OFR determines if a reduction of the debt would be cost effective for the department instead of continuing collections through other means.
  • Normally, reducing the debt is cost effective only if the person is willing to pay the remaining debt off in full.
  • People can contact OFR to negotiate a reduction in the overpayment by calling OFR at 800-562-6114.
  • The first month's allotment of a newly approved application:

We do not recover an existing overpayment from the first month's benefits of a newly-approved application for WASHCAP or Basic Food. We do recover an overpayment from the first month of an AU's certification period if we recertified the AU with no break in eligibility.

5. Collecting overpayments:

OFR takes the necessary steps to collect the overpayment. This includes allotment reduction, installment payments, and lump sums, as well as other means of collection.

 

NOTE: If we have removed Basic Food benefits from a client's EBT account through the expungement process, OFR will reduce the client's overpayment by the amount we expunged from the client's EBT account.

Worker Responsibilities - WAC 388-410-0033

ACES is programmed to calculate the overpayment and generate the correct letter and computation sheet.  However, you must review the letters and make sure they are complete and correct.

  1. Work potential overpayments when you are alerted to a discrepancy.
    1. Set up all overpayments as soon as possible.  Make sure that you set up the overpayment by the end of the calendar quarter after the quarter you discover the overpayment.
    2. Send a separate overpayment letter for every responsible person for the full amount of the overpayment only if they live at separate addresses or are now in separate AUs.  Otherwise, address the letter to the AU head of household and list all responsible adult AU members on the letter.  Use either:
      1. 0045-05, Food Assistance Overpayment - Inadvertent Error; or
      2. 0045-06, Food Assistance Overpayment - Administrative Error.
    3. ACES sends the overpayment letter and claim determination report from state office by certified mail, return receipt requested.
    4. The overpayment letter will contain information about the conditions for compromising or waiving overpayment claims and contact information for OFR to make these requests.
  2. When an overpayment appears to be an Intentional Program Violation:
    1. Set up suspected IPV overpayments as an inadvertent household error (IHE) overpayment and follow the Administrative Disqualification Hearing (ADH) process described under WAC 388-446-0015.
    2. If the client is found by a court or ADH to have an IPV, change the IHE overpayment to an IPV.
      1. Do not create a new BEG.
      2. Modify the existing overpayment by creating 0045-09, Overpayment Modification letter in aces.online.
      3. In the letter, select the box for "The type of overpayment has changed."
      4. Add text notifying the client that the overpayment changed from an IHE to an IPV due to an ADH or court decision.
      5. Send the client a Disqualification Notice; 0056-01, 0056-02, or 0056-03.
  3. Let OFR know when the overpayment had been determined to be an IPV, even if the overpayment was paid in full.  OFR will need IPV documentation and will change the overpayment coding for federal funding purposes.  Send OFR:
    1. The Overpayment Modification letter;
    2. The Disqualification Notice; and
    3. Copy of the final hearing decision, court order, or diversion agreement and disqualification consent agreement.
  4. Potential Fraud:  If you suspect a client has committed fraud, see FRAUD for instructions.

Cash and Food Assistance Underpayments

Revised July 27, 2012

WAC 388-410-0040 Cash and food assistance underpayments.


Clarifying Information - WAC 388-410-0040

Effect of Underpayments on Resources: The unspent amount of a cash assistance underpayment is not included in computing the value of a household's nonexempt resources in the month the underpayment is reimbursed or in the following month.

Date of Discovery for Department Errors: When the underpayment is discovered by the department, the date of discovery is the date we have adequate information to validate the household has an underpayment and determine the amount the household was underpaid.  It is not the date the department received information or verification.

EXAMPLE While processing an eligibility review on 1/01/12, the worker discovers that the household provided verification on 6/01/10 of a decrease in their direct support payments.  The date of discovery is 1/01/12.  The department can establish an underpayment for the 12 month period prior to 1/01/12.  The household can request an administrative hearing if they think the underpayment should be for more than the allowable 12 month period.

Worker Responsibilities - WAC 388-410-0040

  1. Repay all underpayments that are not applied toward reducing an overpayment.
  2. Document in the ACES narrative, any request received, oral or written, from an assistance unit indicating a belief they were entitled to more benefits than were received.
  3. To restore unpaid food assistance benefits, determine the amount the household was eligible to receive during each month in which there was an error. Disregard any months in which the household was not certified except those months where benefits were lost due to an incorrect denial or termination.
  4. Restore food assistance benefits back to the date of application when a delay past the first 30 days is the fault of the department.
  5. Upon discovering an underpayment, check the history file to determine if an outstanding balance on an overpayment remains. If so, complete a notice to Office of Financial Recovery indicating the adjustment to the overpayment balance from a restoration of unpaid benefits.
  6. If a cash or food assistance underpayment is in excess of any overpayment or remaining overpayment balance, create a beg for the excess amount to the appropriate assistance unit.

Cash and Medical Assistance Overpayment Descriptions

Revised December 31, 2013

Purpose:

WAC 388-410-0001 What is a cash assistance overpayment?

WAC 388-410-0005 Cash assistance overpayment amount and liability


Clarifying Information - WAC 388-410-0001

1.      An intentional overpayment is the result of the client's willful knowing concealment of information or failure to reveal information resulting in an overpayment.

2.     Unintentional overpayment: 

a.   An unintentional client error overpayment is based on the condition that although caused by the client, there was no intent to obtain or retain assistance for which the client knew they were not eligible.

b.   An unintentional department error overpayment is the direct result of omission, neglect or error by the department in taking action on information affecting the amount of benefits for which a client is eligible.

c.   An unintentional technical error is an overpayment not directly caused by department error or client error. These types of overpayments are due to effective dates and procedural requirements. Following are examples of technical errors:

  1. Administrative Hearings:  Continued assistance pending a fair hearing results in an overpayment when the decision of the Department is upheld.  Continued assistance overpayments cannot be established for more than 60 days' worth of benefits from the date the administrative hearing was requested.
  2. Ten-Day  Advance Notice:  When advance notice requirements for termination or reduction result in a payment of benefits for which the client is not eligible, the resulting One-Time Payment is an overpayment.

3.   Strikers:

Prior to July 1, 1999, an overpayment exists for any month in which a member of a TANF/SFA household is on strike on the last day of that month.  Starting with July 1999 benefits, there are no overpayments based solely on a member of the TANF/SFA assistance unit being on strike.

4.    Prospective budgeting:

An overpayment exists when a client intentionally understates his or her estimated income for the first 2 months of eligibility.  See WAC 388-450-0215.

5.    When someone fails to report a change in circumstances required for cash only:

When someone does not report a change in circumstances required under WAC 388-418-0005, we determine if a client has an overpayment for each program based on that program’s reporting requirements.

If the person was not required to report a change for Basic Food or medical benefits, we do not set up an overpayment for these programs based on the unreported change. This is true even if we would have reduced benefits if the household reported the change.

EXAMPLE Julie, Spencer, and their two children receive TANF and Basic Food. They fail to report that Spencer got a job Earning $900 monthly. Spencer received his first paycheck on August 25th. We discover this information in November. 
TANF: The family was required to report getting a job for TANF. We determine amount of TANF benefits the family was eligible for if they reported the change timely on September 10th and set up an overpayment for October and November.
Basic Food:The new job did not cause the family to go over the gross income limit for a family of four. Since they did not have to report this change for Basic Food, we do not set up an overpayment. ABD cash grants that are subsequently duplicated by receipt of SSI benefits for the same period are considered an unintentional overpayment and are subject to recovery. See WAC 388-474-0020.

Worker Responsibilities - WAC 388-410-0001

  1. Do not establish an intentional overpayment when the overpayment is directly due to any omission, neglect or error by the department, unless:
    1. The client kept the assistance; and
    2. Knew or had reason to believe he/she was not eligible for the assistance.
  2. Establish an intentional overpayment for funds that were authorized to replace lost, unendorsed warrants when it is later determined the claimed loss was false. See WAC 388-412-0035.

 Clarifying Information - WAC 388-410-0005

  1. All members of an assistance unit, including children, are responsible for overpayments incurred after January 1, 1982 provided they were actually members of the assistance unit at the time of the overpayment.
  2. The amount of an overpayment can be reduced by the amount of any unpaid underpayments in any period prior to the month in which the overpayment is computed.

Worker Responsibilities - WAC 388-410-0005

Verification of Overpayment

  1. The department will attempt to verify all pertinent information when an overpayment has occurred.
  2. If the verification obtained is incomplete, the department will contact the recipient to obtain an explanation of the circumstances to clarify the overpayment.
  3. If the recipient fails to cooperate, the department will make an independent determination based on all available information and initiate recovery of the overpayment.
    1. If an employer does not respond to a request for a statement of earnings in a timely manner the department may file a Subpoena Request without a FRED or DFI referral.

Invalid Overpayment

  1. When the department determines that it has mistakenly charged an assistance unit with an overpayment, the department will cancel the overpayment account and credit any amount paid to any other outstanding debt obligation.
  2. The client will be notified of the error and of the amount credited to any existing debt obligation. If any balance remains from the amount paid by the client the department will refund the balance to the assistance unit.
  3. If the department determines that an assistance unit’s overpayment amount needs to be modified because of an error, the worker should refer to the ACES manual, Benefit Error Group (BEG) - Modify a BEG - Overpayment or Underpayment.

Establishing Overpayments

  1. Once an overpayment is verified, determine the assistance program involved in the cash, medical or food assistance overpayment. Determine the amount of the overpayment using the following criteria:
    1. Reconstruct eligibility in cases where the client failed to report information or where reported information was not acted upon.
    2. Consider the change as it would have been considered if reported and acted upon timely.
  2. If all criteria specified in WAC 388-410-0005 (3) (a)&(b) are met do not refer cases to Office of Financial Recovery.

Eligibility for Other Programs

  1. Financial assistance:  Reduce the amount of an overpayment by the amount of cash assistance a client would have received if eligible for another cash program during the period of the overpayment.
  2. Medical assistance:
    1. Redetermine eligibility for medical assistance beginning the first of the month in which ineligibility occurs.
    2. If the assistance unit was ineligible for any medical assistance, all medical expenses paid by the Health Care Authority (HCA) for the period of ineligibility are an overpayment.
    3. If the assistance unit was eligible for the Medically Needy Program the overpayment is:
      1. The amount the assistance unit would have been required to spend-down before medical expenses would have been paid for the overpayment period.
      2. The difference between those medical payments covered by the CN program and those covered by the MN program.
      3. Scope of care determinations are referred to HCA.
    4. If the assistance unit was eligible for the Psychiatric Indigent Inpatient Program (PII), the overpayment is:
      1. The amount paid by HCA up to the deductible; plus
      2. Any additional amount the assistance unit would have been required to spend down; plus
      3. The difference between medical payments covered by the CN program and those covered under the PII program.

ACES Procedures

Recovery Through Mandatory Grant Reductions

Revised March 25, 2011

WAC 388-410-0015 Recovery of cash assistance overpayments by mandatory grant deduction


Clarifying Information - WAC 388-410-0015

Grant Deductions

  1. A grant deduction is a specified dollar amount used to recover grant overpayments. If the amount is more than the mandatory deduction standard (10 per cent) for intentional grant overpayments, it must be agreed to by the client.
  2. Five percent mandatory deductions are used for unintentional grant overpayments
  3. A grant deduction to temporarily reduce the standard 5 or 10 per cent deduction can be used if an exception to policy due to hardship is approved.
  4. A grant deduction can be taken in addition to, or instead of, a 5 or 10 per cent deduction.

Worker Responsibilities - WAC 388-410-0015

  1. If the recipient requests a fair hearing regarding the assessment of the overpayment or the monthly deduction of overpayment during the advance notice period, notify OFR to discontinue collection.
  2. Reimburse the client as soon as possible for any underpayment resulting from erroneous monthly deductions.

Repayments for Overpayments Prior to April 3, 1982

Revised March 25, 2011

Purpose:

WAC 388-410-0010 Repayment of grant overpayment occurring prior to April 3, 1982, and resulting from department error


 Worker Responsibilities - WAC 388-410-0010

  1. If recovery of the overpayment is determined to be inequitable;
    1. Determine the months that the overpayment occurred, but do not compute the amount of the overpayment.
    2. Complete a DSHS 06-094(X), Overpayment Letter (Liability Waived), and notify the client.
    3. Document the reason for the decision in the narrative in ACES.
  2. If recovery of the overpayment is not determined to be inequitable:
    1. Follow normal overpayment recovery procedures; and
    2. Notify the client the reason the overpayment was not waived.
  3. Revoke the waiver and establish an overpayment if it is later determined the requirements specified in WAC 388-410-0010 (1) (a-e) were not met.

Benefit Issuances and Use of Benefits

Purpose:

This section describes how the department issues benefits, requirements to endorse warrants, how and when the department provides benefits, the allowable use of cash and food assistance benefits, and the replacement of benefits and Electronic Benefits Transfer (EBT) cards.

Use of Benefits - Benefit Issuances

Created on: 
Jun 09 2017

Revised June 9, 2017

Purpose:  

This section describes how the department issues benefits, requirements to endorse warrants, how and when the department provides benefits, the allowable use of cash and food assistance benefits, and the replacement of benefits. 

WAC 388-412-0046  What is the purpose of DSHS cash and food assistance benefits and how can I use my benefits?

WAC 388-460-0035  When is a protective payee assigned for mismanagement of funds?


Worker Responsibilities - WAC 388-412-0046

1.    Use of Cash and Food Assistance Checklist

a.      Review form  DSHS 14-520, Your DSHS Cash or Food Benefits with clients during the interview process at application and eligibility review to ensure that the household understands:

i.  The allowable use of DSHS benefits;

ii.  The illegal uses, including the purchase of marijuana and/or marijuana-based products with EBT cards or cash from the EBT cards; and

iii.  The penalties for illegal use of benefits.

b.    Request that the head of household or authorized representative sign the 14-520 and send the document as file only for the client's electronic case record (ECR).

If the client refuses to sign the form or fails to return the signed form, do not deny the application or terminate assistance.  Signing the form is not a condition of eligibility.

2.    Referrals to the Office of Fraud and Accountability (OFA)

Refer allegations of reported misuse of cash or food assistance benefits to OFA utilizing the Barcode referral for FRED.

Worker Responsibilities - WAC 388-460-0035

  1. A protective payee will be assigned when the Office of Fraud Accountability (OFA) determines that a customer has used their EBT cash assistance two or more times in a prohibited location.

When a worker receives the DSHS-FRED form from OFA identifying use in a prohibited location, review the ECR for prior offenses (document type FR)

  1. If there is a prior offense, a protective payee must be assigned. 

  2. The worker will:

    1. Notify Social Services Specialists through Barcode tickle to @SOC

  3. The Social Services Specialist will:

    1. Assign a protective payee (see Payees on Benefit Issuances - Protective Payees)

    2. Input a -COMM tickle to 900@FIN for input of protective payee information into ACES

  4. The worker who receives the tickle will:

    1. Input the Authorized Representative information under Contact Information in ACES 3G

 

 

 

Basic Food - Benefit Issuances

Revised March 25, 2011

Purpose:

WAC 388-412-0015 General information about your Basic Food allotments.


 Worker Responsibilities - WAC 388-412-0015

Prorating Benefits

Subtract the date of application from 31 and divide the result by 30. Multiply the result by a full month benefit amount.Round down to the nearest dollar.

EXAMPLE The date of application is the 20th of the month. The assistance unit is eligible for $200 for a full month. 
31 - 20 = 11
11 ÷ 30 = .367
0.367 x $200 = $73.40
$73.40 = $73.00 (the prorated amount)

Cash Assistance - Benefit Issuances

Revised March 25, 2011

Purpose:

WAC 388-412-0005 General information about your cash benefits


ACES Procedures

When and How Benefits are Delivered

Revised December 6, 2013

WAC 388-412-0020 When do I get my benefits?

WAC 388-412-0025 How do I receive my benefits?


Clarifying Information - WAC 388-412-0025

NOTE: If benefits are deposited into an EBT account just before the benefits are expunged, the new deposit will also be expunged along with the stale (inactive) benefits. If the household asks us to replace the benefits, the worker should notify State Office EBT staff to replace the cash benefits and food benefits that were issued less than a year from the date they requested the replacement.
NOTE: State and federal regulations do not allow cash or food benefits to be transferred to individuals who were not a part of the AU. These benefits are not part of the deceased client’s estate. 

The Office of Accounting Services (OAS) holds the funds from cash benefits issued to someone in the form of a state warrant (check). Warrants are stale-dated at the 180 days from issuance based on the statute of limitations.   

The department uses expunged Basic Food benefits to reduce any outstanding Basic Food overpayments. The DSHS Office of Financial Recovery automatically uses any expunged Basic Food benefits to reduce person's outstanding overpayment balance.

NOTE: See the EBT Training Manual for additional information on expunged benefits.

Normally we require that mail we send must be returned if the post office knows that the client does not live at the residence.  However, if a client requests the post office to hold their mail due to a temporary absence (i.e., vacation or hospital stay), the post office may hold mail that we send.

  1. Washington’s Quest Card:
    1. Most initial EBT cards and all Alternate Cardholder cards are issued over the counter by the local office.  Replacement cards can be issued over the counter if a client meets one of the following criteria:
      1. An administrative error was made while issuing the previous card;
      2. The client lives in a domestic violence (DV) shelter;
      3. The client has a General Delivery address;
      4. The previous card was destroyed in a natural disaster;
      5. The previous card was mailed to the wrong address or was returned to the EBT card vendor; or
      6. The client's case is closed and their address is incorrect in the EBT card vendor system.
    2. Clients requesting a replacement card or who are unable to come to the office for an initial card, receive their cards by mail through the EBT card vendor.
    • Mailed cards could take seven to ten business days to arrive.
    1. The Washington State Quest Card is accepted in most ATMs and food retailers across the country.
  2. When EBT benefits can be cancelled (Pending Voids): A "pending void" applies to a window of time between ACES deadline and when the funds become available to the client. You cannot void a partial amount. The full issuance amount must be voided.
    To process a "pending void", the following conditions must occur:
    1. Issuance has occurred for the benefit month;
    2. The cash case is closed for one of the following ACES reason codes:
    • (226) Institutionalization
    • (244) Head of household not eligible
    • (557) AU request
    • (551) Whereabouts unknown
    • (249) Receiving benefits in another State
    • (569) Member removed from home to go into foster care
    • (210) (248) Failed residency requirements (Every individual has to be closed with reason code 210, causing the AU to be closed for reason code 248 before the pending void action applies).
    1.  The Basic Food case is closed for one of the following ACES reason codes:
    • (244) Death of all AU members
    • (557) Household request
    • (251) Recipient of assistance in another State
  3. EBT benefits can be recovered from EBT account prior to be expunged:
    Benefits may be removed from an account when we discover that a client is deceased and there are no other eligible members.  If the client died prior to the issuance month for cash benefits, we attempt a pending void to get the benefits back.  If we cannot complete a pending void, we contact EBT headquarters staff to remove the issuance month’s benefits.  The case is then closed in ACES (See ACES User Manual,  Close an Assistance Unit/Client, Manually Close an AU/Client).
  4. Cancelled (expunged) benefits:
    Benefits in an EBT cash or food account that are cancelled (expunged) if there is no withdrawal/debit from the account for 365 days.  Cash and Basic Food accounts age separately depending on the last withdrawal date from the specific account. A debit in one account does not update the inactive status of the other account.
    1. Replacing expunged benefits.
      1. Expunged cash benefits may be replaced to the head of household or any other remaining household member at any time.
      2. Expunged food benefits may only be replaced if the benefits were deposited and available to the client less than 365-days from the date of the client request.
      3. Replace food and/or cash benefits according to instructions in the EBT manual under 4.10 Replacement of EBT Benefits to Clients.
    1. Replacement of warrants (checks):    
    • Clients can have a stale-dated warrant replaced by contacting the local office or calling OAS at (360) 664-5753.   
    • OAS holds funds from stale-dated warrants for two years. After two years, they send the funds to the Department of Revenue to hold until the payee claims these benefits.
    • OAS does not replace any other type of benefit.
    1. Expunged Basic Food & outstanding overpayments:
  5. Client can ask Post Office to hold mail:
  6. Types of allotments:
    1. An initial allotment is the first allotment issued to an assistance unit during a month.
    2. A supplemental allotment is any allotment after the initial allotment in a month including an issuance of benefits for a past period that a client was eligible to get (restoration of lost benefits).  This does not include replacement of lost benefits.
  7. Drug and alcohol treatment center as alternate card holder:

If a client receives Basic Food benefits while they are a resident of a qualified drug and alcohol treatment center under WAC 388-408-0040, the facility will be an alternate card holder even if the client does not sign to authorize them as an alternate card holder.

 

Worker Responsibilities - WAC 388-412-0025

Clients may have their cash assistance deposited directly into a checking or savings account by completing Part 1 of the Direct Deposit Enrollment - DSHS 14-432 and taking Part 2 to their bank to complete.

A client who wants another person to have access to their benefits must authorize the person to be an alternate card holder.

NOTE: A Quest card for an alternate card holder cannot be mailed.  The person must come into the CSO to pick up the card.  There isn't a mechanism in EBT card vendor's system to mail it.

If a responsible member of the AU cannot access the benefits for the AU because the head of household cannot complete and sign the Alternate Card Holder Authorization due to incapacity or other circumstances, document the circumstances in the case record and authorize the issuance of a Quest card for the responsible member as an alternate card holder.

If client contacts you about wanting to stop receiving their benefits through EFT, you have two options to assist the client.  You may delete the banking information on the EFTR screen or you may inform the client that a written request can be sent to EFT HQ via fax 360-725-4577 or mailed to:

Checks for cash benefits can be mailed to a Post Office box or the CSO when a payee meets WAC 388-412-0025(1)(c) and makes this request in writing.  If a client requests that checks be mailed to an address other than their residence address:

  1. Inactive accounts:
    If you receive an ACES alert that a client's EBT account has been inactive for 60 days contact the client to determine why they have not used their benefits.
    1. If they don't know how to use their EBT card, explain how to access their benefits;
    2. If they don't need the benefits, ask the client if there is other income or resources available to them.
    3. Explain that if they do not use their account for a period of 365 days the benefits in their EBT account are expunged. Expunged food benefits issued a year or more ago cannot be replaced.
    4. Inactive benefits are automatically expunged from the clients' accounts after 365 days of nonuse.
  2. Direct deposit or Electronic Fund Transfers (EFT):
    1. When the financial institution returns the completed form to you, send the form to the EBT Project Office by:
      • Forwarding the form to MS 45445; or
      • Faxing this form to EBT/Direct Deposit at (360) 725-4577.
    2. Provide the client with the toll free number to call if they have questions about EFT:  1-888-235-2954.
  3. Client chooses an alternate card holder:
    1. Explain to the client that an alternate card holder has access to all of the benefits in the client's EBT account (cash or food access only, if the client requests it);
    2. If the client wants to authorize another person to be an Alternate Card Holder, have the client complete and sign the EBT 002, Alternate Card Holder Authorization; and
    3. When the form is returned, authorize the issuance of a Quest card for the alternate cardholder.
  4. Assigning an alternate card holder in special circumstances:
  5. Client wants to end or change EFT:
  6. DSHS Direct Deposit/EBT
    PO Box 9254
    Olympia WA 98507-9737

    If a client wants to make a change to their EFT, provide them with the following phone number so they can have the change made: 1-888-235-2954.
    For details on Financial Workers procedures stopping/deleting EFT for active cash AUs, please refer to Chapter 10.8, section C (1) of the EBT Manual. For details on written request procedures to HQ, please go to section C (2).
  7. Post Office box:
    1. Verify the client’s current living situation;
    2. Evaluate the client’s reasons for wanting the check mailed;
    3. Notify the client of the decision;
    4. Make the necessary changes in ACES, if approved;
    5. Notify the appropriate staff of the address change;
    6. Document the action taken; and
    7. Create an alert to review the situation at least once every six months.
  8. Combined issuance:
    Authorize benefits at the same time for the month of application and the following month when a client applies on or after the 16th of the month.

ACES Procedures

See Issuances

Loss, Theft, Destruction or Non-Receipt of a Warrant to Clients or Vendors

Revised March 25, 2011

WAC 388-412-0035 Loss, theft, destruction or nonreceipt of a warrant issued to clients and vendors.


Clarifying Information - WAC 388-412-0035

  1. The department does not replace lost or stolen cash. Do not replace a warrant which was endorsed by the payee as this is considered to be the same as cash.
  2. The Office of the State Treasurer (OST) Inquiry System is used to determine whether a warrant was endorsed and redeemed. If a warrant was redeemed but the client claims they have not received or endorsed the warrant, the worker must determine if the warrant should be replaced.
  3. If a client makes numerous requests for replacement warrants the department is to investigate the need for a protective payee and establish one, if it is in the best interest of the client to do so.
  4. If the original warrant is redeemed by the state treasurer, the department takes the necessary action to collect repayment.

Worker Responsibilities - WAC 388-412-0035

  1. Reported loss:
    1. The worker:
      1. Gets all facts surrounding the report of loss;
      2. Explains to the client that when the Division of Fraud determines that both the original and replacement warrants are endorsed by the client:
        1. An intentional overpayment is established;
        2. The grant is reduced by ten percent; and
        3. May be referred to the county prosecutor for criminal prosecution.
      3. Assesses the reported facts and make a judgment of the validity of the report using the following sources:
        1. The Registration and Control of Negotiable (RCN) program to determine if the warrant returned to the CSO; If not:
        2. OST to determine if the warrant was redeemed.
      4. Requires the payee to report the non-receipt or theft to the post office or police, as appropriate;
      5. Determines an appropriate course of action; and
      6. Informs the client in writing of the action taken.
    2. If the worker decides to replace the warrant:, the worker:
      1. Asks the payee to sign a DSHS 07-008(X) Affidavit of Lost, Stolen, or Destroyed Warrant. Follow the forms instruction for distribution of the form.
      2. Authorizes a replacement warrant; and
      3. Documents all actions taken.
  2. Redeemed warrants and affidavits of forged endorsement:  If the original warrant that was replaced is redeemed, Disbursements sends the CSO a copy of the signed warrant for the client to examine.
    1. When the CSO receives this copy, the worker sends a letter to the payee within 10 days asking the payee to come to the CSO to examine the signature.
    2. When the payee examines the signature and declares it is a forgery, the worker:
      1. Has the payee sign a DSHS 09-052(X), Affidavit of Forged Endorsement in the presence of a notary; and
      2. Sends the DSHS 09-052(X) with a copy of the DSHS 07-008(X) to Disbursements.
    3. If the payee declares the signature is theirs, the worker:
      1. Sends a memorandum to Disbursements immediately;
      2. Determines if there was intent to commit fraud;
      3. Establishes an overpayment if the payee benefitted from both the original and replacement warrants; and
      4. Sends a DSHS 02-182(X), DFI Referral if there was intent to commit fraud.
    NOTE: The payee may have signed both warrants but the payee may not have realized that they did due to confusion or mental deficiency. If unsure of intent, establish the overpayment based on DFI's findings.

    Office of Accounting Services

    Central Operations, SOL Desk
    PO Box 45845
    MS:  45845
    Olympia, WA  98405-5845

    Requests for a warrant are processed weekly and returned via campus

    1. If the payee is not sure if the signature is theirs, the worker:
      1. Sends a DSHS 02-182(X) attaching a copy of the endorsed warrant;
      2. Takes the appropriate action based on DFI's findings;
      3. Has the client sign the DSHS 09-052(X) when DFI determines that the payee did not redeem both warrants; and
      4. Sends the DSHS 09-052(X) to Disbursements.
    2. If the payee does not come into the CSO to examine the signature, the worker:
      1. Sends a DSHS 09-182(X) to DFI to determine if there was intent to commit fraud; and
      2. Take appropriate action based on DFI's findings
  3. Replacing Lost or Out-of-Date SSP Warrants
    1. When a payee reports a lost SSP warrant, ask the payee to sign a DSHS 07-008(X) Affidavit of Lost, Stolen, or Destroyed Warrant.
    2. Send the notarized affidavit along with the worker's name and phone number to the address at the top of the form.
    3. If the warrant is out-of-date, send the warrant along with a note requesting replacement. Include the worker's name and phone number.  Send to:
  4. Requesting Copies of Warrants:
    1. To receive a copy of a warrant, contact your regional fiscal office.
    2. Include the following information in the request 
      1. Warrant number;
      2. Date on the warrant;
      3. Amount of warrant; and
      4. Payee name.

Endorsing the Warrant

Revised March 25, 2011

Purpose:

WAC 388-412-0010  Endorsing the warrant.

Replacement

Revised June 19, 2015

Purpose:

WAC 388-412-0040 Can I get my benefits replaced?


Worker Responsibilities - WAC 388-412-0040

  1. When a client reports the loss of benefits from their EBT account (see below #4 for replacing benefits that paid for food destroyed in a disaster or household misfortune):
    1. Review the client's EBT account to verify that benefits were issued;
    2. Determine if we can replace this type of loss;
    3. Access the EBT functions through the drop-down menus in “BarCode AU/Cl Search” or from the clients Electronic Case Record “ECR”.
      • Complete the new “Authorize EBT Replacement” screen as described in the EBT Manual at:  Replace EBT Benefits to a Client. Once you complete the screen the EBT staff will work their end of the system and generate the new E002 tickler to inform you of the outcome.
      • Complete the “Authorize EBT Recovery” screen as described in the EBT Manual at: Recover Benefits from an EBT Account. Once you complete the screen the EBT staff will work their end of the system and generate the new E003 tickler to inform you of the outcome. 
  2. Loss due to administrative error:
    • If the department makes an error that causes a loss of benefits to the client such as linking a Quest card to another client's account, we replace those lost benefits.
    • Follow the procedures in Replacing EBT Benefits (1. above).
    • EBT staff will take the steps necessary to replace the benefits and can help identify who incorrectly used the benefits
  3. Replacement of Electronic Funds Transfer (EFT) for cash benefits:
    • When a client reports that he or she did not get a deposit of cash benefits in an account, tell the client to call the Direct Deposit Input Unit at 1-888-235-2954.
    • Do not take any further actions or replace the cash benefits unless the EFT Manager notifies you.
  4. Food destroyed in a household disaster or misfortune when the food was purchased with Basic Food benefits: 
    • A household disaster or misfortune includes events such as a house fire, long-term power outage, other weather-related mishaps, or refrigerator/freezer breakdown, that was caused by reasons beyond the client's control. 
EXAMPLE 1: A wind storm caused the client to lose power for several days. Basic Food benefits can be replaced in this situation. 
EXAMPLE 2: The client lost power for several days because he/she failed to pay the electricity bill. Basic Food benefits are not replaced in this situation.
  • Food replaced due to a household disaster or misfortune does not require the federal government to declare a portion of the state as a disaster area.
  • When a client requests replacement of food that was destroyed in a household disaster or misfortune:
    1. Determine if the client reported the loss timely;
    2. Verify the disaster or misfortune through a collateral contact such as the fire or police departments, utility companies, local media, the Red Cross, an insurance agent, or home visit;
    3. Replace the amount of food that was destroyed up to the amount of the household's monthly allotment. Use the client's statement when considering the amount of benefits to replace. If the client's statement is questionable, consider when the client received benefits, when the food was destroyed, and the day of the month of the disaster;
    4. Document the replacement in the case record.
    5. See link to ACES Procedures below.

NOTE: We can only replace the value of the amount of food lost in a household disaster, up to the household's monthly allotment. We do not replace food benefits more than the amount: 

  • Lost in the household disaster; or 
  • Issued to the household. 
  1. Food destroyed in a federally declared disaster when the food was purchased with Basic Food benefits:
  2. Replacing out-of state food benefits:
    1. Verify that benefits were issued but not returned to the public assistance office in the other state.
    2. Ask the client to sign a statement that they did not receive the benefits. 
    3. Document the loss on the (Remarks) screen.
    4. Determine eligibility for Basic Food by using the regular procedures; and
    5. Inform the other state that benefits were issued in Washington and to cancel the benefits if they are returned

ACES Procedures

Returning a Warrant

Revised March 25, 2011

Purpose:

WAC 388-412-0030  Returning a warrant.

Categorical Eligibility for Basic Food

Revised March 9, 2016

Purpose:

This section explains which Basic Food assistance units do not have to meet all of the eligibility requirements for Basic Food.

WAC 388-414-0001 Do I have to meet all eligibility requirements for Basic Food?


Clarifying Information - WAC 388-414-0001

200 percent of Federal Poverty (FPL) based on Federal Poverty Guidelines published January 25, 2016.

April 1, 2016 – March 31, 2017

Persons in AU

200 percent FPL

Persons in AU

200 percent FPL

1

$1,980

6

$5,430

2

$2,670

7

$6,122

3

$3,360

8

$6,815

4

$4,050

9

$7,509

5

$4,740

10

$8,202

Add $693 for each person over 10 AU members. 

NOTE: Categorical Eligibility eliminates resource requirements, the gross income test, and net income test for AUs with countable income up to 200% of the federal poverty guidelines. If an AU has income up to this limit, we do not need to look at income limits or resources for Basic Food unless the AU can’t be CE because:
  • A member of the AU is disqualified from Basic Food for an Intentional Program Violation (IPV); or
  • The Head of Household is disqualified for not meeting Basic Food work requirements.​
NOTE: As stated in WAC 388-412-0015, if the monthly benefits of a one or two-person assistance unit are less than the minimum benefit because we are prorating the benefits for the month of application, the AU will not receive the minimum benefit for this initial month. 

An AU that is CE doesn’t automatically receive Basic Food benefits. If the AU is ineligible for a reason other than income or resources, CE status does not make them eligible for benefits. Examples of eligibility requirements not met by CE include:

  1. CE does not meet all eligibility requirements for Basic Food if: 
    1. AUs ineligible based on Striker requirements under WAC 388-480-0001
    2. AUs disqualified for transferring countable resources based on Transfer of Property requirements under WAC 388-488-0010;
    3. A member of the AU is disqualified from Basic Food for an Intentional Program Violation (IPV); or
    4. The Head of Household is disqualified for not meeting Basic Food work requirements.
  2. CE based on gross countable income:
    1. AUs with countable income up to 200% of the federal poverty guidelines are eligible to use the department’s Online CSO website. This website provides information about our programs as well as referrals to resources in the community.
    2. This web-based information and referral service partly funded with TANF and TANF Maintenance Of Effort funds. Because of this funding, we use this service to make AUs categorically eligible for Basic Food if they have countable income at or under 200%.
    3. Clients are notified and authorized to receive this service through a text block on their approval letter for Basic Food.
  3. Reporting requirements for CE Households:
    Households must report if their gross monthly income is more than 130% of federal poverty based on the number of people in the household when the household was last certified / recertified.
  4. CE based on receiving other benefits from other department programs:
    Households are still CE if everyone in the assistance unit receives TANF/SFA, Tribal TANF, or if all Basic Food AU members receive GA, ADATSA, SSI or a combination of the three.  Additionally, receiving Diversion Cash Assistance (DCA) makes a household CE for the month the AU receives the payment and the following three months.
  5. CE and minimum monthly benefit for one and two person households:
    All eligible one and two-person assistance units will receive at least the minimum monthly benefit as described under WAC 388-412-0015.  This includes one and two person AUs with income up to 200% of the poverty guidelines whose monthly benefits would calculate to zero.
  6. Residency:
    Households that are CE have the residency requirements deemed if residency verification is available from another program (TANF, SSI, ABD cash, etc.). This does not mean that if a household moves out of the state that it will continue to be eligible for Washington Basic Food benefits.
  7. Social Security Numbers and Sponsored Alien Information:
    1. CE households are not generally required to provide Social Security Numbers (SSN) or sponsored alien information. However, we must verify information necessary for the benefit determination if it is not captured in another program.
    2. If the household is CE based on gross income only, and:
    • The information is not otherwise available; we will need to obtain the SSN.
    • We have not previously verified the information; we must obtain the sponsored alien information if required under WAC 388-450-0155.
  8. SSI recipient in cash-out state: 

    California is a state where the SSI payments are specially increased to include the value of the food assistance allotment (cash-out state).  No one who receives SSI benefits and/or State supplementary payments as a resident of California is eligible to receive Supplemental Nutrition Assistance Program (SNAP) benefits.

    If a client stops receiving SSI benefits from a cash-out state and they move to Washington to establish residency here, they may receive Basic Food benefits and be categorically eligible.  

  9. How to treat the Resources of an ineligible member of a CE Assistance Unit: 

If an AU is CE for Basic Food, but a member is ineligible for benefits, the resources of the ineligible member do not impact the AU’s eligibility for Basic Food.

  1. How to treat the income of an ineligible member of a CE Assistance Unit: 

To determine if the AU is CE based on having income at or under 200% of the federal poverty guidelines, we count a portion of the ineligible member’s income to the AU as required under WAC 388-450-0140. We then compare the AU’s gross income to the 200% standard based on the number of eligible AU members to determine if the AU is categorically eligible.

EXAMPLE Basic Food AU consists of three eligible members and one member who is ineligible based on their undocumented status.  The AU is not CE based on receipt of TANF/SFA, DCA, SSI, or ABD benefits.  The three eligible members of the AU have $600 monthly earnings.  The ineligible member has $400 countable monthly income.  Determine if the AU is CE as follows: 
$300 Prorated share of countable income from ineligible member under WAC 388-450-0140 (¾ of $400) 
+$600 Gross countable income of eligible AU members
$900 Income used to determine if AU meets 200% test. Because the gross countable income of $900 isn’t over 200% of the federal poverty guidelines for the three eligible  AU members, the AU is CE for Basic Food.

Certification Periods

Revised September 26, 2013

Purpose: 

This category contains two sections which address the length of certification periods.

 

Certification Periods - Basic Food

Revised September 26, 2013

Purpose: 

This section explains: What a certification period is for Basic Food; The longest certification period we can give people based on their Assistance Unit's situation; and When ACES will set a certification period to match the review end date of other programs.

WAC 388-416-0005 How long can I get Basic Food?


Clarifying Information - WAC 388-416-0005 

  1. Start date of a certification period:

We start the certification period on the date people's benefits start under WAC 388-406-0055, even if they do not receive benefits for the first month they are eligible.

EXAMPLE David applies for Basic Food on October 31, 2005, and is eligible for $4. David does not receive benefits for October because his benefits in the first month are less than $10. His 12-month certification period starts October 31, 2005, and ends on September 30, 2006.

ACES sets certification periods based on the circumstances of the AU and what other benefits they receive from us. The table below shows the certification period the system will set if not matching a review period to another program.

  1. Certification period defaults:

ACES sets certification periods based on the circumstances of the AU and what other benefits they receive from us. The table below shows the certification period the system will set if not matching a review period to another program.

AU Circumstances / Other Programs

Default Certification

All non-WASHCAP Basic Food AUs

12

WASHCAP

36 

Transitional Food Assistance 

5

  • Matching cash review periods and Basic Food certification periods:
  • When possible, ACES will automatically match the cash review periods and Basic Food / TANF related family medical certification periods to minimize the number of reviews as described below:
  • Basic Food approved first:
    • If there are at least six months left in the Basic Food certification period, ACES sets the mid-certification review and eligibility review end dates for the new cash / medical benefit to match dates for Basic Food.
    • If there are less than six months left in the Basic Food certification period, the systemwill not change the certification period end date for Basic Food. ACES sets a 12-month review period with the mid-certification review due at six months for the new cash / medical benefit.
NOTE: When the system does not automatically match the mid-certification review and review end dates because there are less than six months in the certification period, staff can match these dates by initiating a review for Basic Food.
  • If we do not initiate a review to manually match the certification / review periods, these mid-certification reviews and eligibility review periods will not match and will result in the household receiving more than one mid-certification review.
  • The system initiates a review for associated cases at the next ER or recertification. When we complete the review, the end dates and mid-certification review due date will match.
  1. Cash / Family medical approved first:
    1. ACES extends the current cash / medical review periods to match the certification period end date for Basic Food.
    2. ACES sends the mid-certification review for all programs that require a report in month five of the certification/review period. This mid-certification review is due in month six.
EXAMPLE: The Adams family receives TANF benefits only. TANF review period expires in February. In January, they apply for Basic Food benefits. The Basic Food case will be assigned a certification period of January through December. ACES will adjust both the TANF review period and mid-certification review due date to match the newly opened Basic Food benefits.

Worker Responsibilities - WAC 388-416-0005 

  1. Close Basic Food benefits when:
    1. When you have proof of a change that make an AU ineligible; or
    2. You receive information that suggests that the household may be ineligible; and
    3. The household doesn’t clarify their circumstances.
EXAMPLE You receive a call from an anonymous source that Stan is working and has income over the gross income standard. You send Stan a written request for him to give us proof of his income or deny the claim that he is employed. If Stan does not respond within ten days, close his case with advance and adequate notice.
EXAMPLE Dee calls to report that she is working. The income she reports is over the net income limit for TANF but is just short of the income limit for Basic Food. Dee's TANF terminated while she was in sanction for failing to cooperate with DCS. The household is not eligible for TFA. Because Dee's worker is unsure of her eligibility for Basic Food, he adjusts the income in ACES to close TANF and asks for proof of her income to decide if she is still eligible for Basic Food. If the proof shows that Dee is over income for Basic Food, her worker closes the case with advance and adequate notice.

ACES Procedures

Change of Circumstances - TOC

Purpose:

This chapter describes what changes a client needs to report, how changes affect the monthly benefit level and what actions are needed. This chapter contains the following sections:

Reporting Requirements

Created on: 
Jan 05 2015

Revised January 12, 2015

Purpose:

WAC 388-418-0005 How will I know what changes to report?

WAC 388-418-0007 When do I have to report changes in my circumstances?


Clarifying Information - WAC 388-418-0005

1.  SSI / SSI-related medical benefits:

  • Reporting requirements for SSI-related medical benefits do not apply to a person who receives SSI medical (S01).  Changes for SSI recipients are reported to the Social Security Administration.
  • If someone receives S01 medical and benefits from another program, they must report based on the requirements for the other program.

EXAMPLE:  A family receives S01 medical, TANF, and Basic Food benefits.  S01 medical does not follow the same reporting requirements as SSI-related medical (i.e., S02).  The family must report changes based on the cash reporting requirements.

2.  Reporting Requirements for Basic Food Simplified Reporting:

Basic Food households must report if their income goes over 130 percent of poverty based on the number of eligible household members in their assistance unit.  Once a household reports a change in income and is certified eligible above the 130 percent poverty level, the reporting requirements under simplified reporting have been met and the household doesn't have to report any other income changes until:

a.  The mid-certification review (MCR);

b.  The eligibility review (ER); or

c.  Until the household income increases to an amount greater than 200 percent of poverty, whichever comes first.

3.  Reporting Requirements for State Supplemental Payment Program (SSP):

We decide if someone is eligible for SSP based on information Social Security Administration (SSA) gives us through the State Data Exchange (SDX). A person does not have to report changes for SSP.

4.  Taking action on changes:

When we receive information about someone's circumstances, we must determine the impact on the person's benefits. This may include contacting them, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.

a.  Client Reports:

  • Take action based on changes the person reports. This includes when someone volunteers information after we contacted them.
  • Get proof of a person's circumstances if they report:
    • A decrease in income that increases their benefits; or
    • Expenses that increase benefits and the expenses are questionable given their income and other circumstances.

b.  Third-Party Reports:

  • If we receive information from a third party about someone, follow-up on the information to decide how it impacts the person’s eligibility and benefits.
  • This may include contacting the person, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.

c.  Alerts Verified Upon Receipt:

  • An interface that automatically updates the ACES case record is "verified upon receipt".
  • We do not need to take action on alerts the interface automatically updates in ACES.

d.  Other Alerts:

  • We do need to take action on alerts that are not verified upon receipt.
  • Work alerts that are not verified upon receipt to decide how the information impacts the person's eligibility and benefits.
  • This may include contacting the person, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.
NOTE: EXCEPTION TO THIRD-PARTY REPORTS PROCESS: If a financial worker receives potential change information from a WCCC child care worker, the financial worker should: a. Not contact the AU about the change; b. Act on the change only if they have proof of the change from the WCCC eligibility system or child care worker, even if it reduces benefits; and c. Set an alert to get verification of the change at the next recertification if no proof was previously received.

5.  ABAWD reporting requirement:

With the statewide ABAWD waiver ending December 31, 2015, people must report when a non-exempt ABAWD receive benefits in the AU and the ABAWD's hours of employment drop below 20 hours per week. This includes when the non-exempt ABAWD is the head of household for Basic Food. 

People in most counties of the state are still exempt from ABAWD work requirements.  People must report if an ABAWD's hours drop below 20 hours per week in the following areas:

  • King County
  • Snohomish County
  • Pierce County (Except those living in Lakewood and Tacoma)

Worker Responsibilities - WAC 388-418-0005

The DMS E001 tickler uses EBT transaction data to identify EBT cash or food clients who may no longer be living in Washington because they are consistently using their benefits out of state.  Out of state EBT transactions are defined as any EBT purchase, ATM withdrawal or manual voucher transaction at a non-Washington site that requires the use of an EBT card as part of the transaction.  W hen this occurs, the residency may be questionable. 

Follow the E001 tickler handling process described in the CSD Procedures Handbook.


Clarifying Information - WAC 388-418-0007

  1. When a change happens:

    Non-Income Changes

    The date of a change is normally the date a change happens. Examples of this include the date:

    • Someone gets married;
    • A newborn comes home from the hospital; and
    • Someone moves to a new home.

    Income Changes The date of an income related change is the date someone receives income based on the change. Examples of this include the date:

    • On the first paycheck that reflects a wage increase; and
    • On the person's first paycheck for a new job.
EXAMPLE:  Sandy is hired for a new job on May 31st. She starts work on June 10th. Her first paycheck is July 5th. Because this is a change in income, we count the date of Sandy's first paycheck on July 5th as the date of the change.   If Sandy must tell us about the change based on her reporting requirement under WAC 388-418-0005, she must tell us about this change by August 10th. · If Sandy reported this change earlier, we would act on the change based on when we expect her to receive the income.
EXAMPLE: Nick is hired for a new job on May 1st. He receives his first paycheck on June 1st. Nick must report this change of employment status and income by July 10th.
EXAMPLE: Stacey receives TANF and Basic Food. She had her employee evaluation on October 1st. Based on this evaluation, Stacey gets a promotion and a $1.25 hourly wage increase. The wage increase takes effect October 15th. She will receive the first check showing this increase on November 10th. Because this is a change in income, we count the date of Stacey's first paycheck on November 10th as the date of the change. - Stacey must report this change to us by December 10th. - If Stacey reported this change earlier, we would act on the change based on when we expect her to receive the income.
  1. Changes a client voluntarily reports:
    • If people report a change, we must act on the change they report even if they didn't have to tell us about the change under WAC 388-418-0005. This includes asking for more information or proof of a change when we can't tell the impact on their benefits.
    • For Basic Food, under simplified reporting rules, clients do not have to report when they move until recertification or until the mid-certification review, whichever comes first. If they voluntarily report a move between mandatory reports or for another program, they must provide their new shelter costs. The new shelter costs do not need to be verified unless questionable. See "Worker Responsibilities" (4.) and (5.) below.
    EXAMPLE Larry receives Basic Food only. He calls and reports that his monthly rent expense went from $300 to $500 monthly. Larry's worker Bob chooses to verify this change as "questionable" because the $500 plus utilities are so close to Bob's monthly income. After he receives proof of the expense, Bob updates the shelter cost for Basic Food.
    EXAMPLE Ian receives TANF and Basic Food. He leaves a message with his worker reporting that he started a job and would like to close his TANF benefits today. Ian's worker closes TANF benefits based on the request. Since Ian reported that he is now employed, his worker must follow up to see how this impacts his medical and Basic Food benefits.
  2. Unverified changes that increase benefits:

    If a client reports a change that would increase their benefits because of a decrease in income, we ask for proof of the change. We only ask for proof of an increase in expenses if the expenses are questionable. We increase the AU's benefits based on the effective date rules under WAC 388-418-0020.

    • If we have asked for verification, and they fail to give us proof of a reduction in income or an increase in expenses, we do not update their case to increase benefits.
    • We also do not close the case based on their failure to give proof of a change that would increase their benefits.

  3. Changes someone reports on an application or eligibility review:

    People may report a change in their circumstances on an eligibility review form or an application for benefits. If you receive an application or eligibility review form:

    1. Before the fifteenth day of the second to last month of their certification period, treat this form as a change of circumstances.
    2. On or after the fifteenth day of the second to last month of their certification period, treat this form as a request for review or recertification. See ELIGIBILITY REVIEWS AND RECERTIFICATIONS for procedures.
    3. In the month before the mid-certification review is due, use the information on the application / review form to complete the MCR for any related programs.
    4. For medical, you may use an application or review at any time to update the medical certification period.
    5. For handling additional applications received before initial application is processed see "Clarifying Information" #4 under WAC 388-406-0010 .
      EXAMPLE Susan's Basic Food certification period ends on July 31st. She turns in an Eligibility Review form for Basic Food only on May 31st. Because Susan turned in the ER before the 15th of the month before the month her certification period ends, we treat the form as a change of circumstance report.
  4. Temporary absence of an AU member: If an AU member is temporarily out of the home:
    • For cash and medical assistance, follow the rules in WAC 388-454-0015 to determine if the person is still eligible for benefits.
    • For Basic Food, follow the rules in WAC 388-408-0035 to determine if the person is still eligible for benefits.

  5. AU member moves out of Washington:

    People must be state residents to be eligible for most programs. If an AU member or the entire AU leaves the state, follow the rules in WAC 388-468-0005 to determine if the person is still eligible for benefits.

WORKER RESPONSIBILITIES - WAC 388-418-0007

  1. During the application, recertification or eligibility interview:
  1. Inform clients what changes they must report and how much time they have to report the changes;
  2. Explain how to report changes either in writing, by phone, or in person. (See RIGHTS AND RESPONSIBILITIES); and
  3. Give them a DSHS 14-076(X), Change of Circumstance form, and a return envelope to report changes. ACES automatically mails the DSHS 22-297, How to Report Changes with the award letter.
  1. When people report a change or when you learn of a change:
    1. Ask for more information or proof if needed. See LETTERS for the rules and the process on asking someone to take an action or give us information.
    2. Take action on the information using the effective date rules in WAC 388-418-0020.
    3. If we averaged their income under WAC 388-450-0215, recalculate this source of income if you expect this change to last at least a month beyond when you learn of the change.
    4. Document:
      • The details of the change;
      • The date we learned about the change or the date the change was reported;
      • The impact on benefits; and
      • The effective date for any change in benefits.
    5. Send written notice about the change based on requirements in LETTERS even if the benefits do not change.
  1. For Basic Food, if the client does not report a change in medical expenses, but you learn about a change:
    1. Do not contact the AU about the change;
    2. Act on the change only if you can get proof of the change from someone other than the AU; and
    3. Set an alert to get proof of the change at the next recertification. Update the MEDX screen in ACES once you get proof of the medical expenses.
    4. Document in the ACES narrative whether or not we should use the medical expense at the next recertification.
NOTE: If you later approve medical assistance that covers a person's medical expenses, delete the medical expenses on the MEDX screen and recalculate the person's Basic Food benefits.
  1. For Basic Food, when the client voluntarily reports a move in person or on the phone:
    1. Ask for the new out-of-pocket share of shelter costs associated with the new residence.
    2. Do not require verification of the new shelter expenses unless questionable.
    3. Make it clear that they do not need to wait for the first regular rental or utility payment to tell us the amount(s).
    4. Update and document the new shelter costs in ACES.
    5. Send notice to the client if there is a change in the benefit amount. Give advance notice if there is a decrease.
  2. If the client reports a move in writing or we receive returned mail with a new forwarding address on the envelope:
    1. First, attempt to contact the client by phone. If successful, follow instructions in (4.) above.
    2. If unable to contact by phone, send the client a general correspondence letter asking for the new shelter costs associated with the move.
      • Include a statement in the letter warning the client that the old shelter deduction will be removed from the budget and benefit will be recalculated using no shelter costs if new expenses are not reported within 10 days;
      • Make it clear in the letter that they do not need to wait for the first regular rental or utility payment to tell us the amount(s); and
      • Do not require verification of the new shelter expenses unless questionable.
    3. If client responds to the letter:
      • Update and document the new shelter costs in ACES; and
      • Send notice to the client if there is a change in the benefit amount. Give advance notice if there is a decrease in benefits.
    4. If client does not respond to the letter:
      • Do not close the BF AU;
      • Remove the old shelter costs; and
      • Send advance notice to the client if there is a change in the benefit amount.
NOTE: Do not use a "Request for Information" letter as this letter requires a BF AU closure if the client does not respond.

Mid-Certification Reviews

For information on mid-certification reviews, please see the Mid-Certification Reviews section.


 

Top of Page

Effective Date - Change of Circumstances

Created on: 
Nov 09 2015

 

Revised February 4, 2016

WAC 388-418-0020 How does the department determine the date a change affects my cash and Basic Food benefits?


Clarifying Information - WAC 388-418-0020

1. Advance notice:

  •  LETTERS to determine advance notice time limits.

2. Overpayments due to not reporting or reporting late

See BENEFIT ERRORS and BENEFIT ERRORS – BASIC FOOD OVERPAYMENTS for information on how to set up an overpayment when someone did not report a change timely or when we did not make the change timely.

If someone does not report a change in circumstances required under WAC 388-418-0005, we determine if a client has an overpayment for each program based on that program’s reporting requirements.

·  For Basic Food, the household must report changes as required under WAC 388-418-0005(2)(a).

·  If a Basic Food assistance unit would not have to report the change based on the AU's circumstances, we do not set up an overpayment even if the household had to report a change for another department program.

3. Mass changes

Examples of mass changes include:

Changes to allotments or payment standards

Changes to income standards

Changes to the Basic Food maximum shelter deduction

Cost of Living Adjustment (COLA) to SSI, Social Security, or VA benefits

Changes to the standard deduction for Basic Food

Changes to utility allowances for Basic Food

 

Worker Responsibilities - WAC 388-418-0020

1. Temporary changes in income:

When a client reports a change in income that we do not expect to last at least a month beyond the month they reported the change, do not change their benefits. This includes having income over the gross income limit for Basic Food. Instead, take the following steps:

a. Document the reported change, that the change is not expected to last at least a month beyond the date the client reported the change; and

b. Leave the person's benefits unchanged.

NOTE: If you expect the change to last at least a month after the month the change was reported, adjust the person's income for the change. If we averaged this income, you must re-calculate the averaged income based on this new information.
EXAMPLE: On September 19th, Sue reports that her hours have increased because her co-worker is on medical leave through October 15th. We would not re-calculate Sue's income based on this report because the change won't last through the end of October.
EXAMPLE: On November 14th, Dan reports that he will be working full time for the holiday season through January 1st. We re-calculate Dan's income based on this report because we expect the change to last at least through the end of December.

2. Changes that cause an increase in benefits:

  • We require proof of a decrease in income before we update benefits based on the reported change if the change will increase the household's benefits. We decide when to change benefits based on whether or not they provide the proof we asked for within ten days.  If they take more than ten days to provide this proof, we increase benefits starting the month after the month we received the proof even if they request more time to give us the proof.
  • If a change is reported through the online system on a weekend or holiday, the change is considered reported to the department on the first business day following the date the client entered the change online.  We increase the benefits starting the following month.  So if the client enters a change into their CBA on Saturday, March 30, the change would not take effect until May benefits.  We consider the change received Monday, April 1.
     
  • We require proof of expenses that will increase Basic Food benefits only if the expense is questionable.
     
  • When cash assistance benefits increase because someone starts paying shelter costs, we adjust the cash benefits in the same month that the change was reported if proof was provided timely. We do this instead of waiting until the following month. If the proof was not provided timely, then we follow the regular rules for the effective date of the change.
     
  • If a person leaves a community residential facility or a medical institution after the first of the month and they have been receiving CPI monies per WAC 388-478-0045 or 388-478-0040, the effective day for the change in benefits is the day they leave the facility.  

    Benefits are determined by dividing the grant amount by the number of days in the month. The remainder is multiplied by the number of days left in the month counting the date of discharge. The CPI is divided by the number of days in the month and the remainder is multiplied by the number of days the person was in the facility. The two sums are added together and the CPI amount is subtracted from the total.

EXAMPLE: Sam and his family receive TANF assistance. Up until October 1, Sam had no rent obligation, so the family was receiving a supplied shelter grant. Beginning October 1, he started paying $200 a month in rent. He reported and verified this change to the CSO on October 10th. Instead of waiting to increase his cash benefits in November, the change in the TANF grant standard takes effect in October, which is the beginning of the month that the change was reported and verified.
EXAMPLE: Tommy is receiving Aged, Blind or Disabled (ABD) cash. He was receiving a supplied shelter grant because he was living rent free at his brother’s house. On December 1st, his brother starts charging him $100 a month for rent. Tommy is not required to tell us about this change due to simplified reporting. He tells the CSO about the change on February 10th. He verifies the new shelter obligation on February 15th. The office makes the changes and supplements Tommy’s February cash grant, instead of waiting until March. This is because he was not required to report the change, but when he did, he verified timely.
EXAMPLE: Sheri and her child receive TANF assistance. They were receiving a supplied shelter grant. In September they moved and started to pay rent. Sheri reported this on September 5th, but she did not provide proof of the change as requested until October 15th. Her payment standard for TANF will change from the supplied shelter standard to the full shelter standard beginning in November (the month after the month we received the verification).

EXAMPLE: Bill is in an ARC (Adult Residential Care facility) and is receiving CPI, $38.84. He is released from the facility on April 10th and will be responsible for paying shelter costs. He is eligible for a supplemental payment of $210.11 calculated as follows:

$339 divided by 30 = $11.30

$11.30 x 21 = $237.30

$38.84 divided by 30 = 1.29

$1.29 x 9 = $11.65

$237.30 + 11.65 = $248.95 which rounds up to $249.00

$249.00 – 38.84 = $210.16 (ACES issues the exact amount for the BEG)

If Bill were going into supplied shelter, the same equation applies with the supplied shelter amount being used.

NOTE: If someone reports a change that would increase their benefits, but fails to provide the needed proof, we do not update the case to increase the AU's benefits. We also do not terminate the AU's benefits based on the missing proof. We continue to use the previous income and expenses until the next review / recertification.
NOTE: A reported one-time medical expense may have a different effective date as a deduction depending upon how the person chooses to have it budgeted.

3. Changes that reduce benefits:

When people report a change that will reduce their benefits, make the change to reduce their benefits (with advance notice). Do not require proof of the change. We will verify this information at the next eligibility review / recertification.

4. When someone reports multiple changes at one time:

When clients report multiple income-related changes at the same time, review each change separately to decide how the change impacts their eligibility and benefits.

EXAMPLE: Rebecca did not receive her March TANF or Basic Food benefits because she moved in February and did not report this change. Her mail was returned, "Moved, left no forwarding address". Her benefits closed without advanced notice on the last day of February.  On March 3rd, she reports her new address. In addition, Rebecca reports a new job. Reinstate her TANF and Basic Food back to March 1st. Give Rebecca 10 day's advanced and adequate notice regarding any benefit changes from the new job. Any reductions to her TANF and Basic Food would be effective in April.
EXAMPLE: Charles lost his job. He applied for TANF benefits and was approved. The first change is that Charles lost his job. The second is that he now receives TANF.  Charles losing the income from his job is a change that increases benefits. If Charles gives us proof of the change timely, we increase his benefits effective the first of the next month.  The second change was that he started to receive income from a new source. This is a change that decreases benefits. We reduce benefits effective the month after the change when this meets advance notice requirements.

5.  For Basic Food: When a newborn's date of birth is between the application date and interview date:

The newborn is eligible for benefits in the month of application effective the date of birth.  However, ACES does not correctly prorate benefits in the month of application when the newborn's application date is different than the rest of the household members.  When finalizing the case, you will need to exclude the baby in the first month and manually create a BEG to supplement the newborn's portion.  The supplement amount the difference between what the household is eligible to receive with and without the newborn, prorated from the date of birth.

To determine the BEG amount, take the following steps:

  1.  Determine how much the household is eligible to receive if the newborn was in the household at the time of application.
    •  Screen the newborn onto the Basic Food AU.  Use the date of birth as the application date.
    •  Go through "O" and "P" as usual.
    •  Go into "Q" and start the finalize process.  Even though you screen the newborn in as of the date of birth, ACES will open everyone (including the newborn) from the original application date.
    •  Make note of the benefit amount on the FSFI screen for the month of application and F3 out(don't finalize!).
  2.  Determine how much the household is eligible to receive without the newborn in the month of application.
    •  Go into "P" in the month of application only and code the newborn as a non-member on the Basic Food STAT screen.
    •  Go into "Q" and finalize the case.
    •  The amount for the month of application should exclude the newborn.  The amount for the on-going months should include the newborn.
  3.  Take the difference between the amounts in Step 1 and Step 2 and divide by the number of days from the application date through the 30th.
    •  We always assume a 30-day month.
    •  Count the application date as day "one".
  4.  Multiply the result from Step 3 by the number of days from the newborn's date of birth through the 30th, and round down.  This is your BEG amount.
    •  We always assume a 30-day month.
    •  Count the newborn's date of birth as day "one".

EXAMPLE: A husband and wife apply for Basic Food on 07/10/10.  The wife gives birth on 07/20/10 and reported this information during their interview on 07/25/10.  The worker screens the newborn onto the AU.  After going through Steps 1 and 2, the worker determines that in the month of application, the household is eligible for $250 as household of three (including the newborn) and  $180 as a household of two (excluding the newborn).  The worker finalizes the case and approve benefits as a household of two for the month of application, and a household of three for the rest of the certification period.

To figure out the BEG amount, the worker follows Step 3 and 4:

  • $250 - $180 = $70
  • $70 ÷ 21 days (from 07/10 through 07/30) = $3.33 per day
  • $3.33 x 11 days (from 07/20 through 07/30) = $36.66
  • The worker creates a BEG for $36.

NOTE: For information on how to create a BEG, see Benefit Error Group (BEG) in the ACES User Manual.

6.  For Basic Food: When someone (other than a newborn) moves into the household between the application date and interview date:

If someone moves into the household between the application date and interview date, that person is eligible for benefits effective the application date, along with the rest of the household members.

7.  Requests to add a person to an open case:  When cash assistance benefits increase because a person is added to an assistance unit, use the effective date rules for applications in WAC 388-406-0055. See below to decide if you need an application or Eligibility Review (ER) form to add the new person to the current benefits:

  Cash Assistance

If someone asks to add an adult to their cash benefits, have the person complete an application or ER.

  • For cash, the responsible adult members of the AU must sign the application or ER.
  • We do not need a new application / ER form to add a child to TANF/SFA AU.
  Basic Food

 

We do not need a new application / ER form to add someone to the AU.

 

 

8. Changes that cause a cash program change:

When clients report changes that makes them ineligible for the active cash program but eligible for another cash program, verify the change and process the cash program change without a new application or ER form unless it is required for other reasons.  See CSD Procedure Handbook – Change of Circumstances Processing (For staff only) for procedures. 

Examples:  Mary is receiving ABD and reports that her 9 year old child has moved back into her home.  Mary meets all eligibility requirements for TANF.  Verify that the child has returned to Mary’s home and terminate ABD with advance and adequate notice.  Screen in a TANF AU using procedures found in CSD Procedure Handbook – Change of Circumstances Processing (For staff only).    
Using the same scenario as above but Mary reports that the child’s father, Robert, also moved back into her home.  Since we are also adding an adult to the assistance unit, an application or ER form will be needed with the signatures of all responsible adult members of the AU.  Please see the table in #7 above for more details about when an application or ER form is needed.    

9.  Return Mail:
If you receive returned mail for someone and there is a new or forwarding address, take the following steps:

a. If the client's new address is in the State of Washington; refer to Worker Responsibility #5 for WAC 388-418-0007 in the Reporting Requirements section of the EAZ Manual.

b. If the client's new address is out of state, terminate benefits without advance notice as described in WAC 388-458-0030 (3)(b).

Note: When mail is returned by the post office, and there is no new or forwarding address, HIU will dispose of the envelope.

c. No other action is necessary until the household makes contact at the next eligibility,  or mid-certification review.

ACES Procedures

 

  See Interview
Add a Person: See Add a Person
Add a Program: See Add a Program
Update AU / Client Data: See Update Assistance Unit / Client Data
Terminating an AUs / Client's Benefits: See Close Assistance Unit / Client
Adverse Action: See Update Assistance Unit / Client Data
See Deny an Assistance Unit / Client
Trickling and Sprouting: See Trickle and Sprout

 

 

Chemical Dependency Treatment

Purpose:

To describe the services available to assist clients who are chemically dependent or abusing alcohol or drugs. This topic also describes the process for access to chemical dependency treatment for people who are on other public assistance programs and for those who are not eligible for any public assistance program.

Chemical Dependency Treatment - TOC

TABLE OF CONTENTS - Chemical Dependency Treatment

Access to Chemical Dependency Treatment

Purpose:

To provide information to CSD staff when contacted by people who want chemical dependency treatment services.

Clarifying Information

  1. The Division of Behavioral Health and Recovery (DBHR) contracts with the counties to provide outpatient chemical dependency treatment services to low-income clients who are not eligible for any public assistance program or only eligible for  food assistance.
  2. Information about agencies contracted to provide chemical dependency treatment services can be obtained by calling the Alcohol/Drug Helpline at 1-800-562-1240.
  3. Every county has a designated Alcohol and Drug Coordinator who works with DBHR and coordinates all services related to chemical dependency treatment and prevention activities.

Chemical Dependency Treatment and SSI

Purpose:

This section describes the chemical dependency treatment services available to Social Security Supplemental Security Income (SSI) beneficiaries.

Clarifying Information

  1. The Social Security Administration (SSA) suspends benefits when an SSI beneficiary is placed in a "public institution" for more than 30 days.  SSA terminates benefits when a beneficiary resides in an institution for more than 12 months.
  2. DBHR contracted residential treatment facilities are not considered “public institutions.”

Worker Responsibilities

When an SSI beneficiary is placed in a DBHR contracted residential chemical dependency treatment facility, see Chemical Dependency Treatment and Food Assistance to determine effect on eligibility.  The client's SSI income is considered in determining eligibility for Food Assistance.

Chemical Dependency Treatment via ALTSA and Food Assistance

Purpose:

This section explains the availability of food assistance for an individual eligible for ALTSA Treatment Services.

WAC 388-420-010 Alcohol and drug treatment centers.


Clarifying Information - WAC 388-420-010

  1. The facility chooses the designated employee to act as the authorized representative. 
  2. See WAC 388-460-0010  for an explanation of what the facility must give residents (related to food assistance) when they leave the facility.
  3. The CSO has a list of state-certified non-profit treatment centers. Residents in these facilities may be eligible for food assistance.

Worker Responsibilities - WAC 388-420-010

    ALTSA Treatment

  1. Maintain the case record in the originating office when placement is made outside of the catchment area.
  2. Consider the client's income as income.
  3. Consider the payment to the treatment facility as a vendor payment. Do not consider it as income to the client.
  4. Certify persons in outpatient treatment based on their living arrangements.

NON-ALTSA Clients

Clients placed in a chemical dependency treatment facility but not in an ALTSA contracted treatment bed may be eligible to receive food assistance. For example, a person receiving involuntary treatment or a pregnant woman receiving treatment.


ACES Procedures

See  Authorized Representative

Child Abuse and Neglect Reporting

Revised July 25, 2017

Purpose: 

This section lists the procedures on how to report suspected child abuse, neglect, or the rape of a child. For purposes of this section, “Abuse and neglect” of children means the injury, sexual abuse, sexual exploitation, negligent treatment, or maltreatment of a child by any person under circumstances which indicate that the child’s health, welfare, and safety is harmed. The laws addressing child abuse and neglect are codified in RCW RCW 26.44.020(12) and RCW 26.44.030(1(d). The laws addressing child rape are codified in RCW 9A.44.073-079.

A. DO I HAVE TO REPORT SUSPECTED CHILD ABUSE OR NEGLECT TO CPS?

State law requires all DSHS employees to report to Child Protective Services (CPS) the suspected abuse or neglect of a child under the age of 18 whenever there is reasonable cause to believe abuse or neglect exists.

Clarifying Information

The term “reasonable cause” means that if we observe or learn that a child has been abused or neglected, then we must report the incident to CPS.  We must report suspected abuse or neglect even if there is no proof that an incident occurred.  The gender or sexual orientation of the parties involved does not matter. We are not required to tell the minor or adult about the report.

Examples of abuse or neglect include:

  1. Physical abuse (e.g. unexplained bruises or cuts or repeated untreated injuries)
  2. Sexual abuse or exploitation (e.g. online pedophiles or child prostitution)
  3. Negligent treatment (e.g. appears malnourished, unclean, or refuses to get needed medical care)
  4. Emotional or mental health issues (e.g. appears depressed, agitated, or nonresponsive)
  5. Suspected Prenatal Substance Abuse (e.g. drug or alcohol abuse)
  6. Child tells us they have been abused or neglected.
NOTE:  All DSHS employees are Mandatory Reporters, meaning that by law we are required to report suspected child abuse, neglect, and child rape. Mandatory Reporters may provide information to CPS and law enforcement when reporting abuse or neglect that would otherwise be confidential.  Persons who report in good faith have immunity from liability, while those who fail to report or make a bad faith report may be charged with a gross misdemeanor under RCW 26.44.080.

Worker Responsibilities

Always report suspected abuse at the first opportunity, but no later than 48 hours after you decide reasonable cause exists that an incident occurred.  Report the abuse to CPS at 1-800-562-5624. Document in the case file that a report to CPS was made.

NOTE:  For all cases involving child abuse, neglect, or rape, do not delay authorizing medical or financial assistance to an eligible household or completing a teen living assessment for a pregnant or parenting minor applying for TANF.  Refer all pregnant clients to First Steps (Social Services Manual)

 

B. DO I HAVE TO REPORT SUSPECTED CHILD RAPE TO LAW ENFORCEMENT?

  1. State law requires all DSHS employees to report suspected child rape to law enforcement.  We often become aware of child rape when working with a pregnant or parenting female under the age of 16.  For this reason, the definitions below refer to the age of “the father” of the minor’s child.  However, the requirement to report is not limited to female pregnant or parenting minors under age 16, or only to child rape that results in pregnancy.
  2. There are three degrees of child rape (as defined in RCW 9A.44.073-079). The age of the minor refers to the age at the time of conception, and “father” refers to the father of the minor’s child.  Report child rape to law enforcement when the child is a pregnant or parenting minor and at the time of conception the child was:
    1. Less than 12 years of age when the father of the minor’s child was at least 24 months older;
    2. At least 12 years of age but less than 14 when the father of the minor’s child is 36 months older; or
    3. At least 14 years of age but less than 16 when the father of the minor’s child is at least 48 months older and is not married to the minor.
  3. When we report suspected child rape to law enforcement, the report must include the following, if known:
    1. The child’s name, address, and age;
    2. The name and address of the child’s parent, stepparents, guardians, or other persons having custody of the child;
    3.  Information about injuries, neglect, or sexual abuse; and
    4. The identity of the alleged perpetrator.

Clarifying Information

A report of child rape to law enforcement can be made only when the department knows the age of the alleged perpetrator.  We do not have to ask the age of the alleged father.  However, if the age of the father is known and it meets one of the child rape conditions above, a report of suspected child rape must be made to the law enforcement agency that has jurisdiction where the minor lives (either city police or county sheriff).

The gender or sexual orientation of the parties involved does not matter.   If the incident meets the child rape criteria above, we must report it to the appropriate law enforcement agency (e.g. city policy or county sheriff). 

Worker Responsibilities

An oral report can be made, but a written report must be sent upon request by the law enforcement agency. To find a law enforcement agency, click on: http://www.westernwashington.com/stateinfo/enforcement/

To report the incident, use DSHS 10-294 - Mandatory Report to Law Enforcement.  Document in the case record that a report to law enforcement was made.

Also, report to CPS at 1-800-562-5624 if abuse or neglect is a factor. There may be situations in which reports to both law enforcement for child rape and CPS for abuse or neglect are made.

Child Support

Revised June 29, 2017

Purpose:

This chapter provides information and instructions on the assignment of support rights to the State. It includes the requirement to cooperate with the Division of Child Support (DCS) as a condition of eligibility for TANF and SFA.

WAC 388-422-0005 What happens to my child and spousal support when I get public assistance?

WAC 388-422-0010 Do I have to cooperate with the division of child support (DCS)?

WAC 388-422-0020 What if you are afraid that cooperating with the division of child support (DCS) may be dangerous for you or the child in your care?

WAC 388-422-0030 What happens if my support is more than my TANF or SFA cash benefit?


Clarifying Information - WAC 388-422-0005

Child Support Requirements

  1. A parent/caregiver assigns all rights to support, including child support, child care, and spousal maintenance for each person applying for or getting TANF/SFA.
  2. A parent/caregiver incurs a debt with DCS if they retain support payments received after the assignment to DCS.
  3. DCS establishes and enforces child support and medical support on a case when a child receives TANF or SFA, unless the department grants good cause not to cooperate. A parent/caregiver whose child receives TANF or SFA doesn’t have the option to request DCS taking only partial action on their case. 

Note: In some cases child support arrears “past due support” is not assigned to the state and is forwarded to the custodial parent while on TANF.  Budget child support arrears income received by the custodial parent as unearned income “DP”.  

 

Worker Responsibilities - WAC 388-422-0005

How do I complete child support referrals? 

  1. Enter Non-Custodial parent (NCP) information for TANF and SFA applications in ACES on the Non-Custodial Parent Screen (NCP). The ACES Manual provides information about completing the NCP page and processing the case in ACES.
  2. Collect and enter as much information as possible on the NCP page so the system can generate the Division of Child Support (DCS) referral (SEMS Quick Referral) for DCS to establish paternity or collect support. 
  3. Choose the Quick Cash (QC) option from the drop down menu in SEMS to check for child support income send comments to DCS when screening parent/caregivers for child support income or payments.  SEMS QC can be found at the SEMS website (only authorized DSHS staff can enter this website).
  4. Notify DCS if a parent/caregiver receives a support payment from any party other than DCS after assignment is complete.
  5. Treat support payments received by the parent/caregiver prior to assignment as unearned income. 
Note: See Treatment of Income Chart and Child Support Matrix for details on how to treat and code child support income.

Clarifying Information - WAC 388-422-0010

Cooperation

  1. Explain to the parent/caregiver that they have assigned the support rights for each child applying for or getting TANF / SFA by signing the application, and  unless a Social Service Specialist (SSS) determines that good cause for noncooperation exists, they must cooperate with DCS. DCS will provide full support enforcement services which may include enforcement of the noncustodial parent's (NCP) obligation to provide health insurance and contribute his/her share of uninsured medical expenses for the child(ren). DCS also enforces existing orders for spousal maintenance owed to the parent/caregiver.
  2. At the interview, have the parent or caregiver relative completes a DSHS 18-334Your Options for Child Support Collection while receiving Temporary Assistance for Needy Families (TANF) on each Non-Custodial parent (NCP) of each child in the TANF/SFA assistance unit, indicating whether or not cooperating with DCS may be dangerous for the applicant or the child. During the interview, code each NCP page and document for each NCP whether the custodial parent (CP) or caregiver states that it is safe for DCS to collect or asks that we determine good cause for noncooperation. For phone interviews, mail a General Correspondence Letter (0050-01) with the 18-334(s) and request the parent/caregiver complete, sign and return the 18-334(s). Don’t pend the TANF application for the 18-334(s).
  3. Both parents in a two-parent household must help DCS establish paternity for each child in the assistance unit.
  4. For unmarried, two-parent TANF applicants where the father isn't named on the child's birth certificate, give the mother and alleged father the pamphlet titled, "Establishing Parentage for Your Child's Sake...  What Every Parent Should Know", DSHS 22-586(X). Encourage them to sign a notarized Paternity Acknowledgment, DOH/CHS 021 in the CSO. If the parents choose not to sign the Paternity Acknowledgement, explain to them that the father will be referred to DCS for paternity establishment and both will be required to cooperate with DCS unless good cause exists.
  5. There is no requirement for the parent/caregiver to cooperate with DCS when they claimed good cause verbally or in writing and the department's decision is pending.  For more information on how to process a case when a custodial parent requests good cause after a noncompliant sanction has been entered, see worker responsibilities 9.
  6. Whenever possible, the SSS will interview the parent/caregiver on the same day the Good Cause claim is received.
  7. If a parent/caretaker claims good cause at a phone interview immediately refer the good cause claim to the SSS without waiting for the returned 18-334(s). The SSS will schedule an interview as soon as possible no later than 20 days from the good cause claim.  For more information, see the good cause section below and the Social Services Manual - Good Cause.
  8. DCS determines when a parent/caregiver isn’t cooperating with DCS as required and notifies the CSO what the parent/caregiver must do to be considered “cooperating with DCS”.
  9. DCS also determines when a parent/care giver resumes cooperation and notifies the CSO. Lift imposed non-cooperation sanctions effective the date that DCS declares is the date the parent/caregiver began cooperating.

Worker Responsibilities - WAC 388-422-0020

Good Cause

See instructions for explaining assignment of child support rights and completing the 18-334(s) in the Clarifying Information, Cooperation section above.

  1. When the CP applying for or receiving TANF/SFA states it isn’t safe for DCS to provide full collection services (which may include collection of medical support), this is a request for a good cause determination.

  2. Send a General Correspondence letter with instructions to complete and return the DSHS 18-334.  If a parent already receiving TANF/SFA requests good cause over the telephone or in writing, do a referral to the SSS for the good cause determination while you wait for receipt of the form.

  3. When a parent/caregiver requests good cause, enter an "N" in the IV-D cooperation field, a “Y” in the good cause indicator field, the appropriate code in the reason field, and a “CP” (claim pending) in the status field on the NCP page of the NCP that the CP (custodial parent) states may cause harm.

  4. After entering the NCP page information, refer the parent/caregiver to the SSS who will make the good cause determination. Refer the good cause claim to the SSS immediately following the phone interview if the parent/caregiver claims good cause without waiting for the returned 18-334(s).

  5. The SSS must complete the good cause determination even if the parent/caregiver terminates TANF/SFA during the good cause determination process.

  6. The supervisor approves the DSHS 18-444(X) - Good Cause Decision by checking the 'reviewed by Supervisor' box in the Barcode Good Cause system.This is a requirement before generating the decision letter.

  7. Replace the “CP” (claim pending) coding with the appropriate code when the SSS approves or denies good cause.

  8. Begin the good cause process as detailed above if a parent/caregiver begins to cooperate with DCS and then requests good cause. Change the reason and status fields to the appropriate code when the determination is pending and again after approval or denial.

  9. When a custodial parent requests good cause after a noncompliant sanction has been entered, begin the good cause process as detailed above.Instead of coding “CP” (claim pending) enter a “NS” (Pending Non-Cooperation) in the status field. DCS will be notified that the client has claimed good cause and they will put a hold on the collection process for 30 days. DCS will send a Cooperation Notice, and staff will follow the Lifting DCS noncooperation sanction process.

  10. The system notifies DCS in the overnight batch process (e-Referral) when the NCP page changes.

For more information see the Social Services Manual - Good Cause

Note: Don’t require the parent/caregiver to cooperate with DCS when they claim good cause and the department's decision is pending.

Worker Responsibilities - WAC 388-422-0030

A TANF grant will automatically close after the second consecutive month that child support collections exceed the grant payment amount unless there are optional members in a Consolidated Assistance Unit.  For instruction about how to close these cases, go to ACES Procedures.  See link below.


ACES Procedures

See Close an Assistance Unit - Close TANF as the Recipient Has Received Direct Support Above the Grant Standard Two Months in a Row

Citizenship and Alien Status

Citizenship and Alien Status Requirements for all Programs

Definitions

Revised June 27, 2016

Purpose:

This section provides basic definitions of various citizen and immigrant statuses relevant for determining eligibility for federal and state programs.

WAC 388-424-0001 Citizenship and alien status - Definitions

  • Clarifying Information


Clarifying Information - WAC 388-424-0001

Eligibility for all programs must determine an individual's citizenship or alien status. An individual will fall into one of the following four groups for purposes of benefits eligibility:

  • Citizen or U.S. National;
  • Lawfully Present Qualified Aliens;
  • Lawfully Present Non-Qualified Aliens; or
  • Undocumented Aliens.
NOTE:
 
Deferred Action Childhood Arrivals (DACA) are not eligible for Medicaid or CHIP. DACA individuals are non-qualified aliens who have been granted deferred action, but unlike other deferred action individuals, they are not eligible for Medicaid or CHIP. DACA individuals may be eligible for state-funded assistance, including MCS, SFA, and FAP. DACA individuals must be coded CL in the INS Stat field on the ALAS screen in ACES.

Consult the "Decision Trees" in Appendix I for an overview of citizenship and alien status eligibility rules. For a list of typical citizenship/immigration documents and some sample documents, see the National Immigration Law Center NILC Guide in Appendix II.

For guidance on how to read a Visa, I-94 or Permanent Resident Card select the appropriate link.

NOTE: 
If uncertain as to the individuals eligibility for benefits do not deny or approve without review of the NILC guide or if needed clarification please contact appropriate program staff below.

For cash or food eligibility:

For medical eligibility:

Contact your HCA Area Representative at https://www.hca.wa.gov/assets/free-or-low-cost/area_representatives.pdf

 

  1. Child Citizenship Act of 2000. To acquire citizenship under the Act, persons must have met all the conditions in WAC 388-424-0001 on or after February 27, 2001. The Act applies to children related to the citizen parent by birth or adoption only - stepchildren are not included unless also adopted. Once the terms of the Act have been met, subsequent changes in the parents' marital status, such a separation or divorce, have no bearing on the child's citizenship. Nor does it matter whether the parent in question was a U.S. citizen at the time the child entered the U.S.
    If the child is 18 years or older when the parent becomes a citizen, child citizenship laws do not apply and he/she must independently apply for naturalization. For information on the Department's naturalization assistance program, see the Social Services Manual, SSI Facilitation Chapter, Section E, subsection on SSI facilitation.
    For persons who automatically become citizens under terms of the Child Citizenship Act of 2000 or previous legislation, USCIS issues no documentation unless requested. Clients themselves may not be aware that they or their children are already citizens. If there is uncertainty about whether a particular client has met the conditions for automatic citizenship, you might want to refer them to an immigration attorney or the Northwest Immigrant Rights Project in Western Washington at 206-587-4009 or in Eastern Washington at 509-854-2100.
  2. Born Abroad/Acquisition of Citizenship. It is possible that a child or grandchild of a U.S. citizen who was born abroad may have acquired citizenship at birth. In such cases, citizenship may depend on which parent is a U.S. citizen, how long the citizen parent resided in the U.S., and whether the parents were married at the time. A person that might belong to this category should be referred to an immigration attorney for advice.
  3. American Indians. The term "American Indian" refers to tribes throughout North America, including Canadian tribes. American Indians born outside the United States are eligible for federal benefits to the same extent as U.S. Citizens if they are:
  • Canadian-born American Indians who are at least 50 percent American Indian blood. This category does not include the spouse or child of such a person unless he or she also possesses 50 percent American Indian blood (request tribal verification that verifies 50% American Indian blood).
  • Canadian-born American Indians who are less then 50 percent American Indian blood who have been continuously residing in the U.S. since prior to December 24, 1952.
  • A member of a federally-recognized Indian tribe (see Governor's Office of Indian Affairs website) or Alaska Native villages and corporations (see Federal Register Notice).

Non-citizen cross-border Indians who do not meet the criteria above are considered undocumented unless they have another immigration status with USCIS.

NOTE:
 Non-citizen American Indians have the same eligibility for benefits as U.S. Citizens, but citizen documentation requirements do not apply.  they will need to supply tribal verification they meet the requirements above.

4. Lawfully present alien" - Refers to any non-citizen presently permitted to remain in the United States. "Lawfully present" means that USCIS has actively granted these immigrants permission to remain in the U.S. and has issued documentation that is currently valid as to their status. A lawfully present alien must still meet state residency requirements in WAC 388-468-0005 to qualify for benefits.

5. "Qualified alien" and "Non-qualified alien" are terms used in federal immigration law and do not by themselves indicate whether an immigrant is eligible for benefits. "Qualified", "non-qualified" and undocumented aliens may be eligible for some benefits.

6. Hmong or Highland Laotian tribe members:

  • They may be eligible for federal benefits based on the individual's qualified alien status. For example, after tribe members are admitted as refugees.
  • If not eligible under a qualified alien status, they must be lawfully present in the U.S. and must sign the following statement under penalty of perjury to be eligible for federal benefits: I was a Hmong (or Highland Laotian) tribe member when the tribe assisted the U.S. military during Vietnam era (August 5,1964 to May 7, 1975). See Appendix III for a printable version of this statement.
  • The tribe member must be born prior to May 8, 1975. The tribe member's spouse and unmarried dependent children do not have to be tribal members in order to qualify for federal benefits.

7. The following lawfully present non-qualified aliens may be eligible for State funded assistance:

  • Abused aliens who are a relative of a U.S. citizen with an approved I-130 petition but not meeting the other requirements of battered immigrants, as described in WAC 388-424-0001. Abused aliens who have self-petitioned under VAWA but not yet received "Notice of "Prima Facie" eligibility, as described in   .
  • Applicants for adjustment of status, asylum, cancellation of removal, suspension of deportation or withholding of deportation or removal.
  • Cancellation of removal, deferred action or suspension of deportation granted. (Note: if a person is granted cancellation of removal or suspension of deportation based on having been abused or granted deferred action based on an approved self-petition as an abused alien, they are a "qualified alien").
  • Deferred enforced departure granted.
  • Family Unity granted.
  • "K", "S", "U" or "V" statuses, designated on a person's visa, allow holders to work and eventually to adjust to Lawful Permanent Resident (LPR) status.
  • Lawful temporary residents under the amnesty program of the Immigration Reform and control Act (IRCA), including those admitted under Sections 210 ("special agricultural workers") and 245A of the INA.
  • Citizens of the Marshall Islands, Micronesia or Palau. These individuals have special rights under Compacts of Free Association and are lawfully allowed to enter, reside and work in the U.S. but are not U.S. Nationals.
  • Order of Supervision granted.
  • Paroled into the U.S. for a period of one year or less.
  • Residing in the U.S since prior to January 1, 1972.
  • Eligible to petition as special immigrant juveniles. these are juveniles who have been declared a "dependent of the state" and eligible for long-term foster care due to abuse, neglect or abandonment.
  • Stay of deportation or removal granted.
  • Temporary protected status granted.
  • Voluntary departure granted - definite or indefinite time.

8. Expired Documents versus Expired Status.

  • Many immigrant documents have expiration dates. Some immigrants lose their immigrant status when their immigrant document expires; however, many do not.
  • Qualified Aliens: Qualified alien status does not expire even if the document is expired, with the following exceptions:
  1. Parolees - Their status expires after the expiration date. Parolees usually have an I-94 arrival/departure record stamped with an entry and expiration date. Some may have their expiration date stamped "waived" or "indefinite".
  2. Lawful Permanent Resident with Conditions (2 year Conditional Residents) - Conditional residents receive a 2 year LPR card based on a recent marriage to a U.S. citizen. At the end of the 2 years, they must either file a joint petition to remove the condition or a request for a waiver of the joint filing requirement (for grounds that include divorce and /or domestic violence). Clients with this expired status need to be asked for proof of a pending petition to remove the condition or copy of application to waive the joint filing requirement.
NOTE:
 Battered immigrants may face difficulties in filing to remove the condition on residence.  You may want to refer such clients to an immigration attorney or Northwest Immigrant Rights Project in Western Washington at 206-587-4009 or Eastern Washington at 509-854-2100.

 

  • Non-Qualified Aliens: Some lawfully present non-qualified aliens have temporary status or pending applications and consequently their status may expire when their document is expired or when a final denial of their application is issued, with the following exceptions:
    1. Citizens of Marshall Islands, Micronesia or Palau - They may have a birth certificate, current or expired I-94 Arrival/Departure Record, current/expired passport, or other document verifying they are citizens of one of these countries.
    2. Persons granted cancellation of removal or suspension of deportation.
  • Additional Information Regarding Specific Document Types and Status: 1. I-797
    1. Notice of Action may or may not have an expiration date. It is used to notify the client that a fee was paid, an application was accepted, the case is pending, a step in the process is completed, or status is approved. Immigrants with I-797s are undocumented unless it verifies that status has been approved.
      • An example that a step in the process has been completed but status has not been approved is the Notice of Approval for "Immigrant Petition for Relative". This is the initial step in the family -related immigrant application process. It solely establishes relationship. It does not establish status. If this is the only document provided, the immigrant is considered undocumented for purposes of benefits eligibility.
      • An example that status is approved is the "Approval Notice" of an I-360 Self-Petition under the Violence Against Women Act (VAWA). In most cases a VAWA self-petitioner will first receive a "Prima Facie" notice, indicating that the petitioner has submitted evidence sufficient to establish a case. Both notices verify that the client is a "Qualified Alien" and their status does not expire.
    2. Order from Immigration Judge - An order is issued because the immigrant is or has been in removal proceedings. The Judge provides a decision notifying the immigrant whether the immigrant can remain in the country. The order does not have an expiration date.
      • An example of a status granted by an "Order from Immigration Judge" are "Granted withholding of deportation" which is a "Qualified Alien" category and "Order of Supervision" which is a non-qualified alien category.
    3. Form I-589 - Applicant for Asylum (non-qualified alien) does not have an expiration date, however, USCIS is required to provide a decision within 180 days. Despite this requirement, some asylum applicants may not receive a decision within the 180 day deadline. If the document is more than 180 days old staff will need to check USCIS website (see below) to determine if it is still pending a decision. If still pending a decision, the asylum applicant retains their non-qualified status.
NOTE: 
If an applicant for Asylum is a national of Cuba or Haiti they are Cuban/Haitian Entrants eligible for benefits to the same extent as refugees while their application is pending.

 

  • In cases with expired immigration documents, direct clients to apply with USCIS for renewal with instructions to submit the new USCIS form I-912 "Request for Fee Waiver", at the same time they apply for the new documents. As public benefit's recipients, DSHS clients are eligible for Fee Waiver with their application.
    • Form I-912, "Request for Fee Waiver", and instructions on how to complete this form, are now available on he USCIS website at USCIS - FORMS. Fee Waiver Guidance can be found at USCIS - Fee Waiver Guidance.
  • If USCIS denies the fee waiver request, they will notify the client with a notice of rejection and an explanation why the fee waiver request was denied. In these cases, copy the notice of rejection into the client's file and offer help paying for the documents. If USCIS approves the fee waiver request, the client will also be notified.
  • Staff can check the current case status of pending USCIS documents by entering the receipt number on the document at https://www.uscis.gov/.
NOTE: 
If unable to verify claim is still pending using the USCIS website the client will need to provide updated documentation from USCIS as to their current status.  You may want to refer the client to an immigration attorney or Northwest Immigration Rights Project in Western Washington at 206-587-4009 or Eastern Washington at 509-854-2100.
  • All non-qualified aliens with expired documents or no current claim or document pending with USCIS, would be considered undocumented for purposes of benefits eligibility.

9. Reporting or release of information regarding immigrants.

  • Release of information about immigrant clients is subject to he same confidentiality rules that govern release of all client information to outside parties, including law enforcement agencies such as USCIS.
  • The department is only obligated to report legal immigrants in the case of the "indigence exemption" from sponsor deeming. See WAC 388-450-0156 for a description of this reporting requirement.
  • The department's obligation to report the presence of undocumented immigrants to USCIS has been very narrowly defined by the federal government. Such a report is only to be made in the following circumstances:
    1. An administrative law judge (ALJ) has determined that an individual is unlawfully present in the U.S., in the course of the individual's pursuing eligibility for federally funded benefit (including TANF, non-emergency Medicaid, CHIP, SSI and federal Basic Food); and
    2. The ALJ's finding is supported by a determination by USCIS, such as a Final Order or Deportation.
  • The department is only expected to make a determination about an individual's legal or illegal immigration status if such determination is necessary to decide whether the individual is eligible for benefits. Undocumented immigrants should never be required to contact USCIS themselves.
  • If you believe a report to USCIS is required, based on all the above circumstances, contact the appropriate immigrant eligibility program manager. Do not contact USCIS directly.

10. When requesting information necessary to determine citizenship or alien status, be sensitive to the right of clients not to be discriminated against on the basis of race, color or national origin. All similarly situated clients should be treated in the same manner. For example, while it is necessary to clarify questionable information to establish eligibility, clients should not be singled out for closer scrutiny simply because they look or sound "foreign."


ACES Procedures

Recording Citizenship / Alien Status

Completion of the (ALAS) Screen for Non-Citizens

Decision Trees

Revised April 18, 2013

Purpose:

Appendix I - Citizenship and Alien Status Decision Tree: Basic Food

Cash/Medical Programs Based on Citizenship/Alien Status

Date of Entry

Revised March 25, 2011

Purpose: 

This section explains how to determine an alien’s “date of entry” into the United States. It describes which groups of aliens are subject to the five-year bar on receipt of federal means-tested benefits and which groups are not. Finally, it describes how to determine the date on which the five-year bar begins.

WAC 388-424-0006 Citizenship and alien status - Date of Entry


Clarifying Information - WAC 388-424-0006 

  1. Determining whether a person has entered the U.S. before August 22, 1996.
    A person is not subject to the five-year bar for TANF or medical assistance if he entered the U.S. before August 22, 1996 even if he did not obtain a “qualified” immigration status until some time after he entered. As long as a person “continuously resided” in the U.S. from the earlier date, that date will be considered the “date of entry”. Continuously resided means the person may only have left the U.S. for short periods of time.
    However, an applicant for federal BF who became “qualified” on or after August 22, 1996 and who requires 5 years of residency for eligibility, cannot count years of residence before he became a “qualified alien” toward his 5 year residency requirement.
EXAMPLE: A person came to the U.S. in 1992 as an undocumented alien and resided in the U.S. since that time, making annual trips to her country of origin to visit parents. In July 1999 she self-petitioned under the Violence Against Women Act (VAWA) and received a notice that she and her children have a “prima facie case” (see WAC 388-424-0001).  She is a "qualified alien" and not subject to the five- year bar because her entry date is 1992. She and her children are eligible for TANF and medical.  Since she is not currently eligible for federal Basic Food under any other provision of the law (not an armed services member or veteran or married to one) she will become eligible in July 2004, after 5 years residency as a “qualified alien”. Her children are eligible now. (See WAC 388-424-0020 for a complete description of federal Basic Food eligibility.)
EXAMPLE: A person came to the U.S. in 1992 as a visitor for three months. The person came again in 1994 as a student and returned to his country of origin in 1995. He came to the U.S. again after he obtained lawful permanent resident status on October 10, 2001. He did not continuously reside in the U.S. prior to August 22, 1996. His date of entry is October 10, 2001. He is not a veteran or on active duty in the U.S. military (or the spouse or dependent child of such a person). He is barred from TANF, non-emergency Medicaid, and SCHIP for five years until September 30, 2006.
  1. How to determine the date a battered immigrant becomes a “qualified alien."
    For immigrants such as parolees, refugees, and asylees, the date that they become a “qualified alien” is on their I-94 card and later on their lawful permanent resident (“green”) card. However, the date that a battered alien becomes “qualified” is the date of the approval (or notice of prima facie case) of a Violence Against Women Act (VAWA) petition or the date that the U.S. citizen or lawful permanent resident spouse petitioned for the family visa application. These dates will not be the same as the date the alien was granted lawful permanent residence and will not be the date on the green card.
EXAMPLE: A person came to the U.S. in 1997 as an undocumented alien. She married a lawful permanent resident who received notice of his family visa petition on March 1, 1998. She is a victim of domestic violence and no longer living with him. She has not yet adjusted to lawful permanent residence and does not have her green card. The date she became "qualified" is March 1, 1998 because that is the date of the family visa petition. Her five-year bar will be over on February 28, 2003. (When she has her adjustment interview on June 1, 2003 that will be the date on her green card.)
  1. Aliens who are exempt from the five-year bar. Those who are exempt from the five-year bar due to immigration status (refugee, asylee, withholding of deportation/removal, Cuban/Haitian entrant, Special Immigrants from Iraq and Afghanistan, and Amerasian lawful permanent resident) remain exempt after they have adjusted to lawful permanent residence and have a "green card". The code on their green card will tell under what provision of law they came to the U.S.  For more information on documentation, Immigration Status codes, benefit eligibility and step-by-step process, please see desk aid Iraqi and Afghan Special Immigrants Benefits.
EXAMPLE: A refugee came to the U.S. on September 1, 1999. One year after coming to the U.S. he adjusted to lawful permanent residence. His green card is dated to his date of entry and has the code “RE-6”, for refugee (see page 70 in the NILC Guide in Appendix II). He is not subject to the five-year bar, even though he is currently a lawful permanent resident.

Worker Responsibilities - WAC 388-424-0006 

  1. You may use whatever document the client provides if you decide it adequately confirms residence in the U.S. A person claiming to have continuously resided in the U.S. may use many types of proof such as, but not limited to:
    1. Medical records;
    2. Pay Stubs;
    3. School records;
    4. Tax records; or
    5. Utility bills.
  2. You may accept a written and signed statement from the client when the client is unable to provide any proof and has experienced special circumstances. See the VERIFICATION chapter for further guidance.
    For more information about verifying an asylee’s entry date, see “Asylum Documentation” under WAC 388-466-0005, Clarifying Information.

Social Security Number Requirements

Revised August 21, 2015

Purpose: 

The purpose of this section is to explain the special situations that affect immigrants when there are requirements for a Social Security number (SSN) in federal and state benefit programs.

WAC 388-424-0009 Citizenship and alien status - Social Security Number (SSN) Requirements

The rules and information below supplement information provided in the SSN Chapter (WAC 388-476-0005 ).


Clarifying Information -  WAC 388-424-0009

  1. Some immigrants who are "qualified" and some who are "non-qualified" (see WAC 388-424-0001 ) are not immediately eligible for employment authorization and therefore may not be issued an SSN:
    1. For example, most political asylum applicants who have a notice that their political asylum application has been received and is being processed must wait six months or longer before they can apply to work in the U.S.
    2. Abused immigrants whose spouse has filled out an I-130 or who have a Notice of Prima Facie eligibility may sometimes have to wait for months or years before they are authorized to work legally.
  2. Some immigrants who do not have work authorization can sometimes get a non-work SSN (see Worker Responsibilities #1 below), but staff in most Social Security Administration (SSA) offices will deny these applications.
  3. Abused immigrants who are filing a petition under the Violence Against Women Act (VAWA) will often receive a Notice of Prima Facie eligibility that does not specifically list their children, even though the children are listed in the original application. Children of abused immigrants are considered eligible for benefits to the same extent as the primary applicant, even though they will often be unable to get a non-work SSN.
  4. SSA staff are not familiar with many immigration documents that are used to show “qualified alien” status (such as the Notice of Prima Facie eligibility under VAWA) and will often not accept these documents as proof of lawful status (see Table 5, page 62 in the NILC Guide in Appendix II for a list of documents). In addition, new SSA requirements that immigrants have evidence of date of birth and identity may prevent many immigrants who have lost their documents (often as a result of fleeing persecution or escaping domestic violence) from getting a non-work number.
  5. Sometimes a client may choose not to provide an SSN (and consequently be excluded from the AU) but the Department inadvertently learns of their SSN (for example, through a pay stub the client provides to verify income). In such cases we continue to honor the individual client’s wish to be excluded from the assistance unit.
    Alternatively, a client may choose not to provide an SSN midway through the process of applying for benefits, or at a recertification, even if they have already provided it. The guiding principle is that we will honor client choice. A client may choose to be excluded from the assistance unit by not providing an SSN at any point.
    However, we may still use a valid SSN in our possession for verifying income and resources. Staff should explain to the immigrant that the SSN will only be used to verify income and resource information and will not be released to federal immigration authorities. Sometimes, a client may not have a valid SSN but is attempting to provide evidence of income or resources to comply with Department requirements – he or she should be allowed to remove the SSN from these documents and should not be discouraged from providing proof of income.

Worker Responsibilities - WAC 388-424-0009

  1. If the client is applying for a federal program which requires an SSN and a current and valid SSN is not available, the Department is responsible for providing the client with assistance in applying for an SSN. (If the client needs financial assistance to complete this process, the Department will assist as well - follow procedures in the Verification Chapter, Worker Responsibilities #9)
  2. If the client has already tried to apply at the local Social Security Administration (SSA) office and has been denied, the Department should issue benefits (if the client is otherwise eligible) and, if the customer requests our assistance, take the following steps:
    1. Draft a letter on Department letterhead which specifies the names of all family members applying for benefits and requests that the SSA issue a non-work SSN for each. The letter must explain that the SSNs are being requested so that the clients can participate in the federal programs for which they are eligible. List all programs which apply. See Appendix VI for link to a sample SSN request letter.  Please see the Non-work SSN Request Process Instructions for more information (for staff use only). 
    2. If a client is unable to get either a regular or non-work SSN, request an Exception to Rule (ETR) and continue benefits until client is work-authorized. Also ask the client to re-apply for an SSN once she is eligible for and has received an Employment Authorization Document (EAD) from USCIS.
    3. If the client is able to get a non-work SSN, document the number in ACES and remind the client that this SSN cannot be used to work.
  3. Some persons in a household may not be a part of the assistance unit (AU) which is applying for assistance (for example, undocumented parents of citizen children). In such a case, SSNs for those non-AU members are not a requirement for processing the application of the applying AU.

Veteran Status

Revised March 25, 2011

Purpose:

WAC 388-424-0007 Citizenship and alien status - Armed Services or Veteran Status

  • Clarifying Information and Worker Responsibilities


Clarifying Information - WAC 388-424-0007

A veteran is a person who served in the active military, naval, or air service of the U.S., who fulfilled the minimum active duty service requirements or 24 months of continuous active service, whichever is less, and was honorably discharged or released. Veterans also include men and women who died while on active duty in the U.S. armed forces or forces under U.S. command. For purposes of determining a surviving spouse or dependent child's eligibility for benefits, a person who died after being released from active duty in the U.S. armed forces is also a veteran.

Worker Responsibilities - WAC 388-424-0007

Obtain evidence of armed services or veteran status. For those veterans who are Hmong or Highland Lao who fought with the U.S. in Southeast Asia, have the veteran or family member sign the statement in Appendix III

Citizenship and Alien Status - Work Quarters

Revised March 25, 2011

Purpose:

WAC 388-424-0008 Citizenship and alien status - Work Quarters


APPENDIX IV

Earnings Required for Work Quarters for Recent Years

This chart shows the amount of earnings needed to qualify for each SSA work quarter of coverage for 1978 through 2011.

 

Calendar Year

Amount Needed for a Quarter of Coverage

Amount Needed to Qualify for Four Quarters

1978

$250

$1000

1979

$260

$1040

1980

$290

$1160

1981

$310

$1240

1982

$340

$1360

1983

$370

$1480

1984

$390

$1560

1985

$410

$1640

1986

$440

$1760

1987

$460

$1840

1988

$470

$1880

1989

$500

$2000

1990

$520

$2080

1991

$540

$2160

1992

$570

$2280

1993

$590

$2360

1994

$620

$2480

1995

$630

$2520

1996

$640

$2560

1997

$670

$2680

1998

$700

$2800

1999

$740

$2960

2000

$780

$3120

2001

$830

$3320

2002

$870

$3480

2003

$890

$3560

2004

$900

$3600

2005

$920

$3680

2006

$970

$3880

2007

$1000

$4000

2008

$1050

$4200

2009

$1090

$4360

2010

$1120

$4480

2011

$1120

$4480

Citizenship and Alien Status Requirements Specific to Program

Citizenship and Alien Status - For Food Benefits

Revised July 10, 2015

Purpose: 

This section describes which immigrants are eligible for benefits through federally-funded Basic Food and state-funded Food Assistance Program.

WAC 388-424-0020 How does my alien status impact my eligibility for federally-funded Basic Food benefits?

WAC 388-424-0030 How does my alien status impact my eligibility for state-funded benefits under the food assistance program?


Clarifying Information - WAC 388-424-0030

If a client does not provide proof of the alien status of someone in the assistance unit (AU), the client can withdraw the application or apply for Basic Food without that person. That person is an ineligible AU member under WAC 388-408-0035. Please refer to the VERIFICATION chapter for general rules regarding documentation.

We must deem income to a sponsored immigrant who is not exempt from deeming requirements under WAC 388-450-0156. This includes a sponsored immigrant who is eligible for federal benefits based on being a qualified alien who has lived in the U. S. for five years, if they do not have 40 qualifying quarters of work or qualify for a different exemption.

  1. Proof of alien status:
  2. Income of immigrants and their sponsors:
    • See WAC 388-450-0140  for treatment of income of AU members who are ineligible to receive federally funded Basic Food due to alien status.
    • See WAC 388-450-0160  for treatment of income of a sponsored alien's sponsor.
  3. Deeming requirements for sponsored immigrants: 
    NOTE: An immigrant who is an ineligible member of a federally-funded Basic Food AU should not have his sponsor's income and resources deemed to eligible AU members.
​NOTE: We must deem resources in addition to income when the AU is not Categorically Eligible (CE) as defined inWAC 388-414-0001. See WAC 388-470-0070  for deeming sponsor resources.

4. ​​When a “qualified alien” child turns 18 before being in the U.S. for five years: 

  • If the immigrant turns age 18 before they have been in the U.S. for five years, they must meet one of the other requirements under WAC 388-424-0020  to keep getting Basic Food benefits.
  • The immigrant regains eligibility for benefits after they have been in the U.S. for five years or meet one of the other criteria under WAC 388-424-0020.

5. ​"Lawfully residing"

  • A qualified alien;
  • An alien who has been inspected and admitted and who has not violated the terms of that admission;
  • A parolee (for less than 1 year), except those paroled pending a determination of excludability or for prosecution;
  • A Lawful Temporary Resident;
  • A person under Temporary Protected Status;
  • A Cuban-Haitian entrant;
  • A Family Unity beneficiary:
  • A person granted Deferred Enforced Departure;
  • A person in Deferred Action;
  • An alien who is the spouse or child of a U. S. citizen, whose visa petition has been approved and who has a pending application for adjustment of status;
  • An applicant for asylum or for withholding of removal under the Convention Against Torture, who has been granted employment authorization or who is under the age of 14 and has had an application pending for at least 180 days.

6.  Iraqi and Afghan Special Immigrants (SIVs): For more information on documentation, Immigration Status codes, benefit eligibility and step-by-step process, please see desk aid Iraqi and Afghan Special Immigrants Benefits

7.  Haitian Entrants vs. Haitian Nationals Granted Temporary Protected Status:

  • Haitian Entrants granted status under section 501(e) of the Refugee Education Assistance Act of 1980 are qualified aliens and eligible for Basic Food benefits if they meet all other eligibility requirements.
  • Haitian Family Reunification Parole (HFRP) Program Entrants granted status under section 501(e) of the Refugee Education Assistance Act of 1980 are qualified aliens and eligible for Basic Food benefits if they meet all other eligibility requirements.
  • Haitian Nationals Granted Temporary Protected Status (TPS) are not eligible for federal SNAP benefits.  These persons are PRUCOL as described under WAC 388-424-0001 and cannot receive Basic Food.

 

Citizenship and Alien Status - For Temporary Assistance for Needy Families (TANF) and Medicaid

Revised April 18, 2013

Purpose: 

This section provides information on how an alien's immigration status affects their eligibility for Temporary Assistance for Needy Families (TANF) and medical benefits, including non-emergency Medicaid and the state children’s health insurance program (CHIP).

WAC 388-424-0010 Citizenship and alien status - Eligibility for TANF, Medicaid, and CHIP


Clarifying Information - WAC 388-424-0010

  1. For Title XIX Medicaid programs, all U.S. citizens as defined in WAC 388-424-0001, must verify citizenship and identity to receive or continue benefits.  If a U.S. citizen does not have verification of citizenship but has a valid SSN see worker responsibilities #2 below.
  2. For other programs, when a client states he or she is a U.S. citizen, take this declaration at face value.  Do not routinely request proof of citizenship unless there is a specific and substantive reason to do so, such as an inconsistency in a client's statements or in the information presented on their application for benefits.
  3. Immigrant children and pregnant women who are lawfully present non-qualified aliens as defined in WAC 388-424-0001 and meet residency requirements in WAC 388-468-0005 are eligible for federally funded medical benefits, unless they are approved under Deferred Action Childhood Arrivals (DACA). The following non-qualified aliens are considered lawfully present and eligible for federally funded Apple Health for Kids or pregnancy medical if they meet all other eligibility criteria:
    • Pending applicants for Asylum, Withholding of Deportation/Removal under the Convention Against Torture (CAT) if over age 14 with an approved work authorization or if under 14 and their application has been pending for 180 days or more;
    • Aliens who have been granted withholding of removal under the Convention Against Torture (CAT);
    • Aliens who have been paroled into the U.S. for less than 1 year;
    • Aliens in current lawful temporary resident status (LTR), current Temporary Protected Status (TPS) or pending applicants for TPS granted employment authorization;
    • Aliens granted deferred action status, with the exception of Deferred Action Childhood Arrivals (DACA) or Deferred Enforced Departure (DED);
    • Family Unity beneficiaries;
    • A child who has a pending application for Special Immigrant Juvenile status;
    • Citizens of the Marshall Islands, Micronesia and Palau.  These persons have special rights under compacts of Free Association and are lawfully allowed to enter, reside and work in the U.S., but are not U.S. Nationals.  They are considered lawfully present non-qualified aliens unless they have some other immigration status;
    • Individuals with approved relative visa petitions who have applied and are pending adjustment to LPR status;
NOTE:
  1. For Title XIX Medicaid programs, all U.S. citizens as defined in WAC 388-424-0001, must verify citizenship and identity to receive or continue benefits.  If a U.S. citizen does not have verification of citizenship but has a valid SSN see worker responsibilities #2 below.

  2. For other programs, when a client states he or she is a U.S. citizen, take this declaration at face value.  Do not routinely request proof of citizenship unless there is a specific and substantive reason to do so, such as an inconsistency in a client's statements or in the information presented on their application for benefits.

  3. Immigrant children and pregnant women who are lawfully present non-qualified aliens as defined in WAC 388-424-0001 and meet residency requirements in WAC 388-468-0005 are eligible for federally funded medical benefits, unless they are approved under Deferred Action Childhood Arrivals (DACA). The following non-qualified aliens are considered lawfully present and eligible for federally funded Apple Health for Kids or pregnancy medical if they meet all other eligibility criteria:

    • Pending applicants for Asylum, Withholding of Deportation/Removal under the Convention Against Torture (CAT) if over age 14 with an approved work authorization or if under 14 and their application has been pending for 180 days or more;

    • Aliens who have been granted withholding of removal under the Convention Against Torture (CAT);

    • Aliens who have been paroled into the U.S. for less than 1 year;

    • Aliens in current lawful temporary resident status (LTR), current Temporary Protected Status (TPS) or pending applicants for TPS granted employment authorization;

    • Aliens granted deferred action status, with the exception of Deferred Action Childhood Arrivals (DACA) or Deferred Enforced Departure (DED);

    • Family Unity beneficiaries;

    • A child who has a pending application for Special Immigrant Juvenile status;

    • Citizens of the Marshall Islands, Micronesia and Palau.  These persons have special rights under compacts of Free Association and are lawfully allowed to enter, reside and work in the U.S., but are not U.S. Nationals.  They are considered lawfully present non-qualified aliens unless they have some other immigration status;

    • Individuals with approved relative visa petitions who have applied and are pending adjustment to LPR status;

  • Aliens who have been granted employment authorization under one of the following categories:
    1. C9 - pending adjustment of status under section 245;
    2. C10 - Applicant for Suspension of Deportation or Cancellation of Removal;
    3. C16 - Applicant for creation of record of lawful admission for permanent residence;
    4. C18 - Order of Supervision;
    5. C20 - Applicant for Special Agricultural Worker Legalization under Section 210;
    6. C22 - Applicant for legalization under Section 245A; or
    7. C24 - Applicant for adjustment under the LIFE Act Legalization Program.
NOTE: An Employment Authorization Document (EAD) does not in itself confer immigration status.  EADs contain coded information that indicates a client's immigration status.  Immigrants with a variety of statuses may be issued an EAD.  An expired EAD does not mean that a person's immigration status has expired and should not in itself be a reason to deny benefits.
  • Aliens with a current nonimmigrant status who have not violated the terms of their status.  Examples include:
    1. "U" visa holders;
    2. Religious workers under section 101(a)(15)(R) of the INA;
    3. An individual with a petition pending for 3 years or more, as permitted under section 101(a)(15)(V) of the INA;
    4. A fiancé of a citizen, as permitted under section 101(a)(15)(K) of the INA;
    5. Tourist/Visitor visa holders; and 
    6. Visitors on business. 
NOTE: Examples of violation of status are persons who overstay their visa or work without permission from USCIS.  If in violation of status and still in the U.S. without proof of pending status change or extension of status, these nonimmigrants are considered undocumented.
EXAMPLE A client applying for benefits has an I-94 (Arrival/Departure Record) with a "B2" code that is not expired.  According to the NILC Guide, "B2" signifies tourist status.  A person with a tourist status is considered a lawfully present nonimmigrant and if otherwise eligible (including residency requirements) may qualify for Apple Health for Kids or pregnancy medical benefits.
EXAMPLE A five-person family applies for benefits.  The father has a Lawful Permanent Resident card (I-551) but the mother and three children only have Employment Authorization Documents (EADs).  All four EADs are coded "A15".  According to the NILC Guide, the "A-15" code indicates "V" status.  These are spouses and children of lawful permanent residents whose visa petitions have been pending for at least three years.  Immigrants with "V" status are lawfully present non-qualified aliens.  These aliens may qualify for state benefits or federal Apple Health for Kids or pregnancy medical.  The father may be eligible for federal benefits depending on other factors such as date of entry into the U.S.
EXAMPLE A mother and child apply for benefits. The mother has an I-94 Arrival/Departure form stamped with a "U" visa stamp that is currently valid.  The child would likely have been included as a dependent on the mother's U visa application.  Both mother and child are considered "lawfully residing" and may be eligible for state benefits or federal Apple Health for kids or pregnancy medical.
  1. Immigrants who are not eligible for the federal TANF and medical programs should be considered for the state programs.  They should also be provided information about naturalization assistance offered by naturalization agencies.  For information on the Department's naturalization assistance program, see the Social Services Manual, SSI Facilitation – Facilitation Process – SSI Facilitation Process.
  2. Immigrants from Iraq or Afghanistan who were granted Special Immigrant Status under section 101(a)(27) of the INA are qualified aliens and are eligible for federally funded benefits, such as TANF, Basic Food and Medicaid, to the same extent and for the same time period as refugees.  Their eligibility period starts from their date of entry into the United States or, if occurred after the U.S. entry, the date Special Immigrant Status was granted.  For more information on documentation, immigration status codes, benefit eligibility and a step-by-step process for these immigrants, please see desk aid Iraqi and Afghan Special Immigrants Benefits.

If you have questions regarding eligibility or how to process a case, please contact Tome Berry or Olga Walker, in the CSD Office of Programs and Policy -

Tom (360) 725-4617 or by e-mail at berry@dshs.wa.gov
Olga (360) 725-4641 or by e-mail at walkeop@dshs.wa.gov

If you have questions regarding eligibility or how to process a medical only case, please contact Dody McAlpine or Kathy Johansen, in HCA Office of Medicaid, Medicare Eligibility & Policy.

Dody (360) 725-9964 or by e-mail at dody.mcalpine@hca.wa.gov
Kathy (360) 725-1321 or by e-mail at Kathy.Johansen@hca.wa.gov

 

Worker Responsibilities - WAC 388-424-0010

  1. Gather all the information necessary to determine eligibility as described in WAC 388-424-0001WAC 388-424-0006WAC 388-424-0007WAC 388-424-0008, and WAC 388-424-0009. Document immigration status, date of entry, armed service/veteran status, work quarters, and SSN information in ACES. Inform any client who is subject to the five-year bar of the expiration date of their five-year bar and of the need to inform the Department if family members become citizens (including parents who have children under 18).
  2. For U.S citizens, with a valid SSN applying for Medicaid, who cannot verify citizenship:
    1. Accept declaration; and
    2. Code ACES valid value with "CS".
NOTE: Once the SSN is federally verified, ACES will send back to SSA to verify citizenship status.  If SSA cannot verify citizenship, MPA will receive an alert to work with the client to verify citizenship.
  1. For aliens who have an Affidavit of Support form (I-864) filled out on their behalf, be sure to determine work quarters and citizenship status. If the affidavit is still in effect:
  2. See WAC 388-450-0155 and WAC 388-450-0156  to determine if sponsor deeming applies;
  3. See WAC 388-450-0160  for treatment of the sponsor's income; and
  4. See WAC 388-470-0060  for treatment of the sponsor's resources.

ACES Procedures

Alien Emergency Medical

Citizenship and Alien Status for State Cash Programs

Revised June 15, 2012

Purpose: 

This section provides information on how an alien’s immigration status affects their eligibility for the State Family Assistance (SFA), Aged, Blind, or Disabled (ABD) cash, and Pregnant Women Assistance (PWA) programs. The purpose of SFA is to provide assistance to immigrants and others who are ineligible to receive TANF benefits because of the restrictions imposed under federal welfare reform. ABD provides assistance to disabled or aged individuals, including those who are ineligible for Supplemental Security Income (SSI) due to immigrant or other restrictions. Chemical dependency services are broadly available to legal immigrants.

WAC 388-424-0015 Immigrant eligibility restrictions for the State Family Assistance, ABD cash, PWA, and ADATSA programs.


Clarifying Information - WAC 388-424-0015

  1.  ABD and PWA are broadly accessible to immigrants as long as they meet all other program requirements. Non-immigrants and undocumented aliens, as defined in WAC 388-424-0001, are not eligible for ABD or PWA.
  2. Becoming a citizen (naturalizing) is not a program requirement for any state or federal benefit. Generally, a client is not eligible to naturalize until 5 years after they have attained legal status, but there are some exceptions. Refugee resettlement agencies and Community Based Organizations (CBO) provide naturalization assistance to those immigrants receiving state or federal benefits so that they can become citizens. For more information, see the Social Services Manual SSI Facilitation Chapter,  for non-U.S. citizens. Immigrants who don’t become citizens and lose SSI due to expiration of seven years of refugee status (which also affects asylees, victims of trafficking, Cuban Haitian entrants, Amerasians, and those granted withholding of removal) will be provided ABD or TANF, Basic Food, and medical assistance, assuming they are otherwise eligible.

Worker Responsibilities - WAC 388-424-0015

  1. Related WACs:
    1. See WAC 388-450-0116  for treatment of the income of household members who are ineligible to receive SFA due to their alien status.
    2. See WAC 388-450-0160 and WAC 388-470-0060  for treatment of income and resources of a sponsored alien’s sponsor.
  2. When a client reports a change in their status, update their alien status on the ALAS screen in ACES. It is particularly important to record changes in status for recipients of state-funded cash or medical programs, as these aliens may become eligible for federal programs as a result of this change in status.

Restrictions for State Medical Benefits– Medical Care Services and Pregnancy Medical

Revised January 25, 2012

Purpose: 

This section provides information on how an alien's immigration status affects their eligibility for state medical programs.

Worker Responsibilities

  1. Provide information about naturalization assistance offered by the Refugee resettlement agencies and Community Based Organizations (CBO) for immigrants who are not eligible for federal benefits. For information on the Department’s naturalization assistance program, see the Social Services Manual, SSI Facilitation.

Resources, Desk Aids and Links

Citizenship and Identity Documents for Medicaid

Citizenship and Identity Verification Documents – T1 – T4

T1 Documents (Only Tier 1 documents are considered by the federal government to document both citizenship and identity).

  • US Passport.
  • Enhanced Drivers license or state ID (only if issuing state verifies citizenship to issue enhanced document)
  • Certificate of Naturalization.
  • Certificate of Citizenship.
  • Tribal Membership Card with picture.

T2 Documents

  • Official state/county US birth certificate. ***
  • Other certification of birth issued by the Department of State.
  • Department of Health (DOH) printout for Washington State Birth
  • US Citizen ID card.
  • Final adoption decree in the US.
  • Evidence of civil service employment by the US government before June 1976.
  • Official military record of service that shows a US place of birth.

***NOTE: A "hospital" birth certificate is considered by the federal government to be a souvenir and DOES NOT meet the federal requirement for any "T" level of verification.

T3 - Examples

The T3 tier of verification must be created 5 years before the date of initial application or eligibility review.

  • Religious records within 3 months of birth showing US place of birth.
  • Early school record showing a US place of birth.
  • Insurance company records (life or health), that indicate a US place of birth.
  • US hospital record created at the time of birth, indicating a US place of birth such as:
    • Chart notes of the birth.
    • Hospital records of the baby's stay in the hospital.
  • Other document that shows a U.S. place of birth that was created at least 5 years prior to the client’s initial application for Medicaid.

T4 - Examples

  • Federal or State census record indicating US citizenship or US place of birth.
  • Institutional admission papers indicating a US place of birth and created 5 years before the date of initial application or review.
  • Other medical records (clinic, doctor, or hospital), created five years before the date of initial application or review that indicate a US place of birth.
  • Citizenship Affidavit (DSHSH 27-033)
  • The Citizenship Documentation and Identity Declaration form (DSHS 13-789) does not fulfill this requirement.
  • Clients exempt from citizenship requirements due to SSI, Medicare or receiving SSA disability if no level T1 or T2 exists.

Identity - Examples

  • A current state driver's license with individual's picture.
  • A state identity card with individual's picture.
  • A US American Indian/Alaska Native tribal document.
  • Military identification card with individual's picture.
  • For disabled individuals in residential care facilities the facility administrator or director may submit affidavits attesting to the client's identity.

A child under the age of 16 (or 16-17 if they have no ID verification above) may present the following documents as evidence of identity:

  • Citizenship Documentation and Identity Declaration form (DSHS 13-789) signed by the parent or guardian attesting to the child's identity.
  • School record (including daycare and nursery school records)
  • Clinic, doctor or hospital record.

Immigration Law Center (NILC) Guide

Revised March 21, 2012

APPENDIX II

National Immigration Law Center (NILC) Guide

The National Immigration Law Center (NILC) publishes the "Guide to Immigrant Eligibility for Federal Programs, Fourth Edition". This appendix gives you access to sections of the NILC Guide, which contain descriptions and pictures of key citizenship and immigration documents, and information on how to decipher the coding on these documents.

  • While this information was current as of the 2002 NILC Guide publication date, it is not a complete list of immigrant statuses and documents. If you encounter a client with a status or document that is not on these lists, or a client claims legal status but has no supporting documentation, please contact  Tom Berry regarding cash or food assistance:
  • Tom Berry can be reached at 360-725-4617 or berrytj@dshs.wa.gov
  • Other types of immigrant eligibility questions should be submitted to the Policy Clarification Database through your Regional Financial Coordinator.

Sample SSN Request Letter

Revised September 20, 2011

APPENDIX VI

Click the following link to complete the SSN Request  used to request a non-work SSN from the Social Security Administration on behalf of clients applying for benefits.

Citizenship and Alien Status - Statement of Hmong/Highland Lao Tribal Membership

Revised March 25, 2011

APPENDIX III

Statement of Hmong/Highland Lao Tribal Membership

I declare, under penalty of perjury, that I was a Hmong or Highland Laotian tribe member when the tribe assisted the U.S. military during the Vietnam era (8/5/64 to 5/7/75).

 

Signature

 

Date

Work Quarters Barcode Procedures

Revised March 25, 2011

APPENDIX V

BARCODE PROCEDURES FOR REQUESTING WORK QUARTERS THROUGH THE SSA QUERY SYSTEM

Civil Rights and Complaints

Created on: 
Nov 18 2015

Revised June 30, 2015

Purpose:

This section describes civil rights rules and how to file a complaint.

WAC 388-426-0005How do I make a complaint to the department?


Your civil rights when you do business with us; 
This includes:

  • Who to contact with a civil rights complaint;
  • How to tell us if you do not agree with an action we took or a decision we made;
  • How we respond to civil rights complaints; and
  • Annual staff training requirements for civil rights.

USDA Non-discrimination Statement

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, religious creed, disability, age, political beliefs, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.
 
Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
 
To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:
 
(1) mail: U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410;
 
(2) fax: (202) 690-7442; or
 
 
This institution is an equal opportunity provider.

Clarifying Information - WAC 388-426-0005

  1. Department policy on equal opportunity and access:

    Department of Social and Health Services (DSHS) is committed to equal employment opportunity and access to its programs and services for all persons without regard to race, color, sex, religion, creed, age, marital status, national origin, sexual orientation, disabled and Vietnam era veteran's status or the presence of any physical, sensory or mental disability.

  2. Discrimination complaints filed with the department:

    The Investigations and Reasonable Accommodation Unit (IRAU) investigates complaints we receive on discrimination. Someone may file a complaint with the IRAU using one of the toll free numbers below or by completing one of the two complaint forms listed below and sending the complaint to IRAU.

    • DSHS 22-552(X), Nondiscrimination in the Food Stamp Program

    Investigations and Reasonable Accommodation Unit (IRAU)
    1115 S. Washington, OB2 2nd Floor NE Wing
    PO Box 45839
    Olympia, WA 98504-5839

    Toll Free 1-800-521-8060 (inside Washington)
    Toll Free TDD 1-800-521-8061 (inside Washington)

  3. Hearings / Judicial review:

    If we receive a complaint that a future hearing or judicial review covers, we can tell the person that the hearing or review will resolve the issue.

  4. Necessary Supplemental Accommodation (NSA):

    See NSA if we get a complaint from someone:

    1. Who gets NSA services; or

    2. Does not agree with our decision about their NSA status or accommodation plan.

Worker Responsibilities - WAC 388-426-0005

  1. Explain why we made the decision: If someone doesn't like a decision we made or action we took, explain why we took the action and the rules we used to make the decision.
  2. Tell people about their options: If someone disagrees with a decision, tell them the options they have to review our decision, including:
    1. How to make a complaint;
    2. Their right to talk to a supervisor;
    3. Their option to call customer relations at 1-800-865-7801; and
    4. Their right to ask for a fair hearing.
  3. Verbal complaints of discrimination: If someone verbally complains that they were discriminated, ask them to write down the complaint. If they cannot or will not write down the complaint, write down the details of the complaint for them.
  4. When someone wants to make a complaint:
    1. Help them write down their complaint as needed;
    2. Give them the number for customer relations if they ask for it; and
    3. Get the complaint to the person who supervises the client's worker right away.
  5. Civil rights complaints:
    1. Tell the person that they can file a discrimination complaint about the Food Stamp Program directly with the US Department of Agriculture - Food and Nutrition Service. Help the person with the complaint as needed and give them the address to mail the complaint.
    2. If the person is applying for or gets food assistance, give them DSHS 22-252 - Nondiscrimination in the Food Stamp Program.
    3. If the client is applying for or gets benefits from other programs, give them DSHS 22-171(X) - Discrimination brochure / complaint form.
    4. Help the person write down their complaint as needed;
    5. Get the complaint to the person who supervises the client's worker right away.
    6. Give them the number for customer relations if they ask for it.
  6. Discrimination complaints log: Every local office must keep a discrimination complaints log. The log must record the following information: The log must contain the
    1. Date of complaint;
    2. Name, address, telephone number, and client ID of the person making the complaint;
    3. The specific location and name of the agency that authorizes the benefits;
    4. Type of complaint (race, color, sex, political beliefs, etc.);
    5. The names, titles, and business addresses of people who may know about the action or decision in the complaint;
    6. How we addressed the complaint and the date we did this; and
    7. A copy of the written response to the complaint.
  7. Mandatory Civil Rights Training: Every year, all local office staff must complete the online civil rights training using the DSHS Learning Center. This must be completed by local office staff and supervisors by the end of February.  Completion of this training is monitored, and staff will receive a reminder if the training has not been completed timely.
  8. Client Demographics on Race / Ethnicity at interview:
    1. ​​At interview, inform clients that we must collect racial & ethnic information for statistical reporting requirements and that the information has no impact on eligibility. 
    2. Ask clients to self-identify their racial and ethnic group.
    3. If the client chooses not to identify a race / ethnic group,  make a visual determination where possible and record this information in the demographics.  This is required under federal regulations. 
    4. Allow the household to update this information by self-identifying if they choose to do so.

 

Confidentiality

A.  CONFIDENTIAL INFORMATION

WAC 388-428-0010 Request for address disclosure by a parent when a child is living with a non-parental caretaker.

 

B.  ADDRESS CONFIDENTIALITY PROGRAM (ACP)

Rules for the Address Confidentiality program are found in chapter  434-840 WAC.  This program is governed by the Office of the Secretary of State.

Confidentiality - Address Confidentiality Program (ACP) for Domestic Violence Victims

Revised March 25, 2011

Purpose: 

The ACP protects the address of persons attempting to escape from domestic violence, sexual assault, trafficking, or stalking situations. Participants use a substitute address in place of their actual physical or mailing address.

Rules for the Address Confidentiality program are found in WAC 434-840-001 through WAC 434-840-310 and are governed by the Office of the Secretary of State.


Clarifying Information

The ACP provides the following services to victims of domestic violence, sexual assault, trafficking or stalking:

  1. Helps the participant maintain the secrecy of home, work, or school address.
  2. Gives the participant a substitute mailing address.
  3. Forwards first class mail from the substitute address.
  4. Helps the participant obtain many state and local agency services without revealing the physical or mailing address.
  5. Helps the participant to register to vote or obtain a marriage license without having those records available to the public.

Participants are given a laminated authorization card the size of a driver's license.   The card has the client's signature, substitute address, expiration date, and a toll-free number to the ACP office for information.  The toll-free number is 1-800-822-1065.  The TTY number is 1-800-664-9677.

When a public assistance client uses the substitute address, the ACP authorization card must be presented to the worker.  The worker may make a copy of the ACP authorization card.

Worker Responsibilities

When a client presents an ACP authorization card:

  1. Call the ACP at 360-753-2972 to verify that the client is currently certified in the program.
  2. If the client is currently certified in the ACP:
    1. Use the ACP mailing address and participant code number as shown on the card in place of the client's physical address on the ACES ADDR screen.
      Example:
      Jane Doe
      1453
      PO Box 257
      Olympia, WA  98507-0257
    2. Mail all benefits and information for the client to the substitute address:
    3. Do not ask the client to provide their actual address.  Do not record the client's physical address in ACES or retain copies of any documents that list the client's physical address.
    4. When verifying residency, household composition, or shelter costs, do not ask the client to provide documents that state their physical address.  Accept any document that lists the ACP address and reasonably verifies the eligibility factor.  See VERIFICATION for instructions on determining reasonableness.
    5. If the client provides a document that lists the physical address:
      1. Do not keep the document.
      2. Explain to the client that if we have anything in the case record that lists their physical address, we may have to reveal that information if we are issued a subpoena.
      3. Document in the narrative:
        1. What documents were used as verification;
        2. What eligibility factor the documents verify; and
        3. Why copies of the document are not in the record.
    6. Allow the client to provide any document that has the physical address concealed.
    7. Re-verify the client's participation in the ACP at eligibility review / recertification, if questionable.
  3. If the client is not currently certified in the ACP:
    1. Do not enter the ACP mailing address and participant code into ACES;
    2. Require the client to provide their actual address;
    3. Record the address in ACES; and
    4. Follow the normal verification procedures as described in VERIFICATION.

Confidentiality - Information

Revised March 25, 2011

Purpose: 

The department is responsible for ensuring that confidential information is not released to clients or third parties inappropriately or illegally. Confidential information can be disclosed only under the specific criteria in chapter 388-01 WAC.

WAC 388-428-0010 Request for address disclosure by a parent when a child is living with a nonparental caretaker


Clarifying Information  

Policies related to disclosure of confidential information are contained in chapter 388-01 WAC and in departmental administrative policies. The CSO Public Disclosure Coordinator is responsible for approving or denying requests for disclosure of confidential information.

  1. The following information is considered confidential:
    1. Information contained in case records:
      1. Names, birth dates, marital status, employment status, personal history;
      2. Location, current address and telephone number;
      3. Types of services being received, amounts of benefits and fair hearing activity;
      4. Social Security numbers; and
      5. Medical or psychiatric information.
    2. Information about third parties:
      1. Information about the identity of individuals who have filed complaints; and
      2. The identity of individuals who have provided information under condition of remaining anonymous.
    3. Information available from other agencies:
      1. Employment or benefit information from the Employment Security Department;
      2. Information from the Social Security Administration; and
      3. Birth information from Vital Statistics.
  2. Confidential information except chemical dependency treatment information may be provided to a person who works directly with:
    1. Federal- or state-funded public assistance programs including the federal food stamp program when used for the administration of the programs;
    2. The child support program under Title IV-D of the Social Security Act when used for the administration of the child support program; or
    3. Local, state or federal law enforcement agencies. Information will be released to a local, state, or federal law enforcement agency only when the request:
      1. Identifies the person making the request including their authority to do so;
      2. Identifies the client;
      3. Provides the Social Security Number of the client;
      4. States the request is an official duty or that finding and apprehending the client is an official duty;
      5. Describes the violation being investigated; and
      6. Limits the requested information to the address of the client.
  3. Release information to the U.S. Consulate (U.S. Department of State) only when the client has provided a written release for the information requested.
  4. At the client's request information provided by the client or previously given to a client may be disclosed to the client or their representative.
  5. Information provided by third parties may be disclosed to the client or the client's representative when:
    1. A fair hearing has been requested on an issue related to the information; or
    2. The Public Disclosure Coordinator determines that:
      1. The release is necessary; and
      2. The information was provided with the understanding that it might be released.
  6. Information relating to the identity of third parties who have filed complaints regarding clients (or other) and/or who have provided information on condition of anonymity must not be released unless required by a court order.
  7. Information may be released to individuals or agencies with valid releases of information signed and dated by the client. A release of information is valid if it is:
    1. Signed by the client, presented within any time frames mentioned on the release;
    2. Presented by the individual to whom the release is made out; and
    3. A request for information that can be legitimately released.
  8. Information except chemical dependency treatment information may be disclosed to any administrative division of DSHS when the purpose of the request for information is to administer the programs of the department.
  9. Routine transfers of information are subject to the same criteria.
  10. Information may be disclosed to outside agencies only for purposes directly connected with the administration of department programs. Outside agencies who receive confidential information are bound by the same rules as DSHS.
  11. The following information may be disclosed to medical providers:
    1. Proof that the client is eligible for medical assistance;
    2. Dates of eligibility;
    3. The PIC code with the tie breaker;
    4. The program for which the client is eligible; and
    5. Medicare eligibility status.
  12. The following information may not be disclosed to medical providers:
    1. Client names and addresses;
    2. Medical services provided;
    3. Social and economic conditions or circumstances;
    4. Agency evaluation of personal information; and
    5. Medical data.
  13. Confidential information cannot be provided for:
    1. Commercial or political purposes
    2. Personal purposes by any employees of the department.

Worker Responsibilities 

  1. Disclosure to third parties:  The department must disclose to anyone making inquiry whether or not a named individual is currently receiving assistance. The department's response is limited to a "yes" or "no" answer. Further information is prohibited without a release from the client.
  2. Disclosure to courts of law: Information can only be disclosed with a court order.
  3. Disclosure to government officials:Treat requests from government officials like any other third-party request. Refer the request to the CSO Public Disclosure Coordinator.
  4. Special situations:
    1. Translators and contractors must be informed of the rules regarding confidentiality and are bound by those rules to the same degree as a department employee.
    2. See INTERVIEW REQUIREMENTS for rules and procedures related to TANF/SFA Family Violence Screening and Referral.
    3. See RIGHTS AND RESPONSIBILITIES for rules and procedures related to the rights and responsibilities of a client receiving public assistance.
    4. See the NSA (Needs Supplemental Accommodation) Handbook for rules and procedures for NSA.

Clarifying Information - WAC 388-428-0010

Disclosing Information to Parents with Visitation Rights or Legal Custody

  1. Disclosure of the address of a child on assistance to a parent who is not in the child's household is governed by RCW 74.04.060, 26.23.120 and 74.12.
  2. Disclosure of information to any other parent of a child on assistance is handled by the Division of Child Support.

Consolidated Emergency Assistance Program (CEAP)

Data Sharing

Revised March 25, 2011

Purpose:

To describe how the department receives information from other sources regarding a clients eligibility for program benefits.

Clarifying Information

ACES provides workers with information on a variety of interfaces including:

  • Medicaid Management Information System (MMIS)
  • Office of Financial Recovery (OFR)
  • DSHS Central Accounting
  • Disqualified Recipient System (eDRS)
  • Federal Bureau of Indian Affairs (BIA)
  • Income and Eligibility Verification System (IEVS)
  • Beneficiary Earnings Exchange Records (BEER)
  • Beneficiary Data Exchange (BENDEX)
  • Employment Security Department
  • Internal Revenue Service (IRS)
  • State Data Exchange (SDX)
  • XRPIEN/Numident/SSA
  • Division of Child Support
  • Labor and Industries
  • Medicare Buy-In
  • Treasurer's Office
  • Washington Telephone Assistance Program (WTAP)
  • JAS (WorkFirst automated system)
  • Case and Management Information System (CAMIS)

ACES Procedures

Diversion Cash Assistance

Revised March 31, 2016

Purpose:

This category describes an emergency cash benefit available to families that meet the eligibility criteria for TANF or SFA but do not need ongoing monthly cash assistance. Assistance under this program is limited to one 30-day period every 12 months.

WAC 388-432-0005 Can I get help from DSHS for a family emergency without receiving monthly cash assistance?


Clarifying Information - WAC 388-432-0005

  1. TANF / SFA eligibility:
    In order to be eligible for DCA, the assistance unit must meet all of the eligibility requirements for TANF / SFA except WorkFirst requirements and assignment of child support rights. See PROGRAM SUMMARY for the eligibility requirements of each program. The eligibility requirements include the limits for earned income, unearned income and resources.
  2. Ineligible for cash assistance:
    1. Reasons why an adult member of a family may not be eligible for DCA include but are not limited to:
      1. Immigration status;
      2. Conviction in a state or federal court for unlawful practices in getting TANF/SFA;
      3. Conviction in a state or federal court of misrepresenting residence in order to get public assistance in two or more states;
      4. Disqualification because of being a fleeing felon;
      5. TANF/SFA was closed because of an NCS (non-compliance sanction);
      6. TANF/SFA was closed while in WorkFirst sanction on or after July 1, 2010; or
      7. A member of the household is in non-compliance with the division of child support; or
      8. An adult in the AU is over the TANF time limit, and no adults in the household qualify for a time limit extension.
    2. Child only cases (with non-needy relative caretaker) are not eligible for DCA.
  3. Effect of DCA on food assistance:
    1. If DCA payment is made directly to the client:
      1. It is considered a non-recurring lump sum payment and not counted as income.
      2. It is counted as a resource in the month received.
    2. If DCA payment is made directly to the vendor:
      1. It is considered a vendor payment for emergency and special assistance and not counted as income.
      2. It is not counted as a resource.
  4. In determining the need for DCA, utilities are considered part of the housing costs.

Worker Responsibilities - WAC 388-432-0005

  1. An application is always required (WAC 388-406-0010).
  2. When a family requests TANF/SFA:
    1. Screen the application ACES for TANF,
    2. Review the application for DCA to see if the family has income that would meet the family needs for at least 12 months.
    3. If the family decides to apply for DCA, add the DCA program in ACES before you withdraw the TANF ACES using closing code 550. (This can be done at screening if the family is there or during the interview)
  3. Determine if the family meets all eligibility criteria for TANF/SFA other than WorkFirst requirements and assignment of child support.
    1. Decide if the family has a bona fide need such as the ones listed in WAC 388-432-0005 (2).The family must provide proof of this need. Issue a denial letter when the family does not have a need or does not provide proof of the need.
    1. Decide if the family has enough or is expected to have enough income or resources to keep them off of TANF / SFA for 12 months.
      1. Use these guidelines to help determine a family’s ability to remain off TANF / SFA. Other factors may also be considered but must be documented in the case file:
        1. Is there a current or potential income source? (e.g. Earned Income, Unemployment, Child Support, or other regular source)
        2. Is this enough income to enable the family to stay self-sufficient? (Will it cover the rent, utilities, and other bills?)
        3. Does the applicant’s history indicate an ability to remain self-sufficient? (Review the case record to see if the family cycles on and off TANF.)
        4. Is the applicant highly motivated to stay off TANF / SFA?
      2. If there is little chance that the family could be self-sufficient, issue a denial letter for DCA benefits. Help the family consider applying for ongoing assistance or referrals to community resources.
    2. Review whether the family has received DCA payment in the past 12-month period or if the family is currently receiving TANF / SFA. If the family received DCA in the last 12 months or if the family is currently receiving TANF / SFA, issue a denial letter.
    1. Decide how much the family needs to meet their bona fide needs (up to $1250). Do not pay more than the need. Make the payment directly to the vendor whenever possible.
    1. Refer the family for any other benefits and resources that can help them to be self-sufficient. Encourage clients to use Working Connections Child Care (WCCC) to help pay for childcare expenses.
    2. TANF / SFA eligibility within the DCA 12-month period: If you approve TANF / SFA within 12 months of the family’s DCA begin date, establish the DCA loan.
      1. The amount of the loan depends on how many months the client remained off TANF / SFA before they start receiving TANF / SFA. Calculate the loan amount by using these steps:
        1. Starting with the month DCA benefits were authorized count the number of months before the month TANF / SFA benefits started.
        2. Subtract those months from 12 to determine the number of remaining months.
        3. The number of remaining months is multiplied by one-twelfth of the total DCA payment to calculate the amount that must be repaid.
      2. DCA assistance units remain open in ACES for 12 months but do not receive monthly payments.
      3. You must close the DCA assistance unit with the ACES closing code 585 (DA Adult Eligible for TANF) in order to open TANF / SFA for months in the 12-month period.
      4. ACES will create the necessary Benefit Error Group (BEG) for any closed months in the 12-month period.
      5. Send the client a 0045-04 DCA Loan letter and update the BEG to finalize the loan and initiate a repayment process.
EXAMPLE A two-person AU (mom and child) applies for TANF. Mom has earned income that appears to meet the ongoing needs of the family. DCA is screened into ACES and then the TANF is denied as a withdrawal. At the interview, Mom's gross income is confirmed to be $1000 a month and this is entered in ACES. The AU is not eligible for DCA since they do not meet the maximum gross earned income standard of $906 a month. ACES will deny the AU for over the gross earned income standard. Have ACES send out the denial letter. Follow up to see if the family would like to apply for food and medical assistance and determine eligibility if family is interested.
NOTE: All DCA denials need to be in writing. Make sure you have ACES letter 04-01 Cash Denial for AU sent out.
EXAMPLE A four-person AU (mom and three children) applies forTANF and opts for DCA.Mom’s gross earned income for the AU is $1200. No other source of income is available for the AU. Family is requesting $800 to fix their car. Mom needs the car for transportation to and from her job. However, mom does not have proof of the amount needed to fix the car. The AU will need to provide proof that $800 is needed to repair car (i.e. telephone number and name of repair garage, invoice from garage showing estimated costs for car repairs). If mom does not provide proof, enter the ACES 586 code (Ineligible for DA) for the AU and have ACES send out denial notice. Follow up to see if the family would like to apply for food and TANF/SFA cash assistance and determine eligibility if the family is interested.
EXAMPLE Three-person AU (mom, dad and child)requests DCA in September. Currently, they receive no assistance. They last received DCA in May of the same year. Since 12 months have not passed since the last time the AU has received DCA, enter in ACES 586 closing code (Ineligible for DA) and have ACES send out the denial notice.
EXAMPLE A two-person household (dad and child)requests DCA. The only source of income for the AU isL&I benefits of $400 a month. Since the AU has Section 8 housing, their rent is $57 a month. Dad’s L&I benefits will end but he expects to go back to work in four weeks based on doctor’s statement. The AU requests DCA to pay for car repair bills. Dad needs the car to return back to work. He provided an invoice from the garage to verify the estimated cost to repair his car at $900. Send a 02-07 DCA approval letter. Make the payment to the car repair garage. Open F04 medical for the family. Two weeks later, AU applies for additional DCA and requests $50 for overdue utility bill. He provides proof of this need. The AU is eligible to receive this second payment since it is within the 30-day period. Send additional DCA request status ACES 75-01 letter and make the payment to the utility company.
NOTE:  If the request for help is greater than the $1250, but does not exceed $1500 as allowed under RCW 74.08A.210, an ETR is required.

ACES Procedures

Eligibility Review Requirements for Cash Assistance and Medical Programs

Revised March 25, 2011

Purpose:

This category contains the following sections:

A. ELIGIBILITY REVIEW REQUIREMENTS FOR CASH ASSISTANCE AND MEDICAL PROGRAMS

  • WAC 388-434-0005 The department reviews each client's eligibility for benefits on a regular basis.

B. RECERTIFICATION PROCESS FOR FOOD ASSISTANCE

  • WAC 388-434-0010 How do I get Basic Food benefits after my certification period has ended?

Eligibility Reviews/ Food Assistance Recertifications - Process for Basic Food

Revised December 27, 2012

Purpose:

WAC 388-434-0010 How do I get Basic Food benefits after my certification period has ended?

To keep getting Basic Food benefits after your certification period in WAC 388-416-0005 has ended, we must determine if you are still eligible for benefits. This is called recertification.


Clarifying Information - WAC 388-434-0010

  1. Equal Access:
    Someone who needs Equal Access accommodations has more time to meet certification requirements. If a person receives these services and meets the requirements to be certified within 20 days after the end of their previous certification period, their benefits start on the first of the month of the new certification period. See Equal Access.
  2. Forms / processes a person can use to recertify Basic Food:
    Someone can recertify Basic Food benefits by:
    • Completing DSHS 14-001 (X) Application for Benefits;
    • Completing DSHS 14-078(X) Eligibility Review;
    • Participating in the interactive ACES Application for Benefits (AFB); or
    • Completing the online application.
  3. Adding a request for assistance to an eligibility review:
    See CLARIFYING INFORMATION #3 under WAC 388-406-0010.
  4. Notice of expiration:
    If we certified an AU for three or more months, we send them a letter to tell them that their food benefits are ending by the first day of the last month of their certification period.
  5. When the system automatically initiates reviews for associated cash and food AUs:
    Associated AUs are ones that have the same head of household in ACES. The system matches the certification/review periods for associated cash and food AUs at review as described below:
    • If we initiate a review for cash benefits and there is an active associated Basic Food AU, ACES also initiates a review for Basic Food.
    • If we initiate a review for Basic Food benefits and there is an active associated cash AU, ACES also initiates a review for cash.
  6. Verification at recertification:
    • If someone does not give us proof we ask for by the end of their certification period or within 10 days of the date we asked for it, we count the proof as late.
    • A person has until the end of the month after the month their certification ended to give us any late or missing proof without losing benefits.
    • If someone gives us an application or proof to finish a recertification after the 10-day timeframe and after the end of the month following the certification end month, the person must reapply for benefits.
EXAMPLE John's certification period ends on May 31st. On May 15th, he turns in an eligibility review. On May 23rd, John's worker asks for proof of income and gives him until June 2nd to give us the information. On June 12th, John turns in his proof of income. If John is still eligible for benefits, his worker reinstates the benefits back to June 1st.
EXAMPLE: Same as above, except John does not submit the outstanding verification until July 5th. Because John missed the one-month window to recertify, he must reapply for benefits.
 EXAMPLE:  Vicky's certification ends on April 30th. On April 1st, she turns in a review. On April 5th, her worker asks for proof of her circumstances by April 15th. Vicky does not give us the required proof timely, and her worker denies the application to recertify her food benefits. On May 4th, Vicky turns in the required proof. If Vicky is still eligible for benefits, her worker reinstates the benefits back to May 1st.

EXAMPLE:  Bill's certification period ends 7/31.  He turns in the ER form 7/28, but doesn’t contact the CSO for an interview.  His benefits terminate 7/31. 

On 8/25 Bill contacts the CSO and completes his recertification interview that same day.  The worker must pend completion of the ER because Bill hasn't provided proof of income.  Bill has until the end of August to provide the income verification in order to have benefits reinstated back to 8/1. 

The worker should send an information request letter on 8/25 to Bill giving the him until 8/31 to provide the information.  If Bill doesn't provide the income proof by 8/31the case remains closed and Bill must reapply.

NOTE: People have 10 days to provide information or proof we need to determine if they are eligible. The denial letter we send if they do not give us the proof we ask for informs them what they must do to have us reconsider the denied recertification. 

 

7.  See Letters for information on what to include in approval and denial letters.

8.  See Limited English Proficiency (LEP) for information on what we must translate in letters.

Worker Responsibilities - WAC 388-434-0010

  1. Electronic or Paper Application / Eligibility Review Form
    1. Ensure the household has completed and signed one of the following as part of the recertification process:
      1. Online application or eligibility review;

      2. Application for Benefits (DSHS 14-001);

      3. Eligibility Review (DSHS 14-078); or
      4. ACES AFB after reviewing the information for accuracy.

  2. Rights and Responsibilities (14-113) and Your DSHS Cash or Food Assistance Benefits (14-520)
    1. Face to Face Interviews
      1. When conducting a face-to-face interview, review DSHS 14-113 and 14-520 with the client and ask them to sign the forms to acknowledge their understanding. Send the forms as file only to be scanned into the client's Electronic Case Record (ECR).
    2. Phone Interviews
      1. When conducting a phone interview, review DSHS 14-113 and 14-520 with the client. Send the client a copy of the forms and request them to sign and return both forms.
  3. Recertification Interview
    1. If the client calls before the end of the certification period to do an interview but we have not received the review form:
      1. Complete the interview.
      2. Send a letter requesting for a completed and signed review form.
      3. If the review form is received after the certification period ends but before the end of the following month, issue prorated benefits from the date the form is received. Another interview is not required.
      4. If the review form is received later than the end of the month following the month the certification period ends, an intake is required before benefits can be issued.

Mid-Certification Reviews

For information on mid-certification reviews, please see the Mid-Certification Reviews section.


ACES Procedures

Eligibility Reviews/ Food Assistance Recertifications - Requirements for Cash Assistance and Medical Programs

Revised April 17, 2017

Purpose:

This section explains how often we review someone's eligibility based on the benefits they receive and their circumstances and when ACES will set a review period to match the review end date or certification end date of other programs.

WAC 388-434-0005 How often does the department review my eligibility for benefits?

WAC 388-493-0010 Working Family Support

Clarifying Information - WAC 388-434-0005 and WAC 388-493-0010

ACES sets a review period for cash and medical benefits based on the AU's circumstances and other benefits the AU receives from the department. The table below shows the length of certification period the system will set if not matching a review period to another program. 

AU Circumstances

Default Review Period

ABD cash

12

Refugee Cash Assistance

Up to 8

TANF/ SFA

12

TANF/SFA  – AU is Homeless

6

TANF/SFA – AU has Migrant / Seasonal Farm workers

6

L99, and MN with Spend-down

6

AEM

3

All other medical not associated with a cash grant

12

Working Family Support

6

When possible, ACES will automatically match the cash review periods and Basic Food / TANF related family medical certification periods to minimize the number of reviews as described below:

  1. Eligibility Review period defaults:
  2. Matching cash review periods and Basic Food certification periods:
  3. Basic Food approved first:
    1. If there are at least six months left in the Basic Food certification period, ACES sets the mid-certification review (MCR) and eligibility review end dates for the new cash / medical benefit to match dates for Basic Food.
    2. If there are less than six months left in the Basic Food certification period, ACES sets a 12-month review period and with the MCR due at six months for the new cash / medical benefit. The system will not change the review end date for Basic Food.
    NOTE: When the system does not automatically match the mid-certification review and eligibility review end dates because there are less than six months in the certification period, staff can match these dates by initiating a review for Basic Food. Staff can initiate reviews within 45 days of the certification end date.
    • If we do not initiate a review to manually match the certification / review periods, the MCR due dates and review periods will not match. The household will receive more than one MCR.
    • The system initiates a review for associated cases at the next ER or recertification. When we complete the review, the end dates and MCR due dates will match.
  4. Primary source of information for medical:
    1. The case record is the primary source of information used to redetermine medical eligibility. Ask the person for more information if the case record is not enough.  (See Worker Responsibilities, below.)
    2. We don't need the actual review form DSHS 14-078(X) to determine eligibility for medical if during the past six months, the assistance unit completed:
      1. An application;
      2. An eligibility review;
      3. A Basic Food application or recertification;
      4. An in-person or telephone interview.
  5. Citizenship verification at time of review: 
    1. When processing an eligibility review for any Medicaid-related AU (this includes Medical Assistance for AF/F01 and ABD/G02), update the citizenship/identity verification following ACES procedures. If the record does not contain citizenship / identity verification then the CCU will follow up with the client to help obtain the missing documentation.
    2. If the CCU terminates the ABD/G02, the G02 will auto change to G01. If the case cannot automatically change, then a tickler will be sent to the worker to re-determine eligibility for ABD/G01. Please note that verification of citizenship and picture identification are not requirements for ABD/G01.

See ACES User Manual - Separate Medical Eligibility for processing.

WORKER RESPONSIBILITIES - WAC 388-434-0005

Rights and Responsibilities

Review form DSHS 14-113(X), Client Rights and Responsibilities with the household:

  1. Review at interview for cash and food assistance:
    1. Face to Face Interviews 
      When conducting a face-to-face interview, explain the rights and responsibilities to the client and ask them to sign 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 client, send them a copy of form, and request them to sign and return the document. 

      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: 

    3. Face to Face Interviews: 
      When conducting a face-to-face interview, explain the allowable use of benefits to the client and ask them to sign form 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). 
    4. Phone Interviews:
      When conducting phone interviews, explain the allowable use of benefits to the client, send them a copy of form DSHS 14-520, and request them to sign and return the document. 
  2. Review of current circumstances:
    1. As part of the review ensure that:
      1. The person answered all questions clearly and completely; and
      2. For cash assistance the person(s) has signed and dated the application or ER. Both husband and wife, or both parents of a child in common must sign when the parents live together.
    2. Review the record for the Equal Access (EA) plan (see EA).
    3. Review the record to see if earlier actions or changes may have an impact on eligibility.
    4. Review for eligibility factors, especially:
      1. Income:
        1. Review income to see if net income meets expenses for rent, utilities, and other expenses the assistance unit pays.
        2. For medical programs, we must get proof of income at each review.
      2. Resources: (Except for: Children's medical, recipients of Family Medical, or Basic Food AUs that are Categorically Eligible)
        1. Review resources the household claims to see if there are any changes to resources we earlier excluded or decided were not available.
        2. Review funds in joint checking accounts that we excluded earlier.
        3. Review the plan to exclude business property of a self-employed person to decide if the property leads to full or partial self support.
        4. Review the value of liquid and nonliquid resources. Look for an increase in the value of real estate, cash value of life insurance, and securities that can be sold such as stocks, bonds, and certificates of deposit.
        5. Review and get proof of eligibility factors that have changed.
        6. Review and document previous proof to ensure that:
      3. Previously verified factors are clear and complete in the case file; and
      4. We are not asking the person to give us duplicate or unneeded proof.
        1. Document proof you received.
        2. Take action on incorrect payments you discover. Send the person a letter about the actions you took.
  3. Referrals: Review all mandatory and voluntary referrals and complete referrals as needed.
  4. Incomplete and late reviews: A household is ineligible for benefits if they do not complete a required interview, complete a review form (if asked to do so), or give us proof we ask for.
    1. See Equal Access for additional actions required when the household has an Equal Access plan.
    2. If the person does not take the needed actions or give you the proof you need to decide if they are eligible for benefits by the end of the review month, cash assistance will auto close.
    3. If the person fails to complete a review, has an incomplete review, or misses the required interview, continue medical assistance for twelve months from the last completed:
      1. Application;
      2. Eligibility review; or
      3. Basic Food application or recertification.
    4. If you receive a review for TANF cash and medical, but the person does not complete the required interview for cash assistance, cash assistance will auto close. Continue medical while you review continued medical eligibility.
    5. If you initiate a review for CN medical, ACES continues to issue medical benefits even if the person does not return the required proof. When pending a review, set an alert to check the case and determine if the person returned the required proof.
    6. If someone does not provide the proof you asked for, and you asked for proof for:
      1. Both cash and medical assistance, cash will auto close. Medical assistance will need to be closed with advance and adequate notice.
      2. Cash assistance but you also need the information for medical, cash will auto close. Send a letter asking for the proof needed to determine medical eligibility. Give the person 10 days to return the proof. If they do not respond, close medical assistance with advance and adequate notice.
      3. Cash assistance but not for medical, continue medical for 6 months from the last complete application, eligibility review or recertification.
    7. If you receive information to establish eligibility the month after the month the review was due, reopen the benefits effective the date you determined they were eligible. See APPLICATIONS.
  5. Redetermination of Medical:  When our review results in someone losing eligibility for cash:
    1. Continue the same medical coverage that the person received when eligible for cash assistance while you redetermine if they are eligible for other medical programs; and
    2. Notify the assistance unit of the action you took.
EXAMPLE Mary had a TANF and Basic Food certification period from 9/2010 - 2/2011. When Mary failed to turn in her eligibility review for March 2011, her cash and Basic Food benefits closed effective 2/28/2011. The family is eligible for F04 medical for 12 months from their last review. Mary's completed her last review for TANF and Basic Food in September 2010. The family is still eligible for F04 medical through September 2011.
EXAMPLE Teresa has a TANF case with a review period of January 2006 through June 2006 based on her circumstances and homeless status. In March 2006, we opened Basic Food from March 2006 through June 2006. At her eligibility review in June, Teresa reports that she now receives $3,000 in monthly unearned income. Her worker closes cash and Basic Food benefits with advance notice. Teresa's family is not eligible for F04 medical because their income is more than the F04 standard. Teresa's children are eligible for F07 as the family's income is below the SCHIP standard.
EXAMPLE Cheryl's household has a TANF review period and Basic Food Certification of August 2005 through January 2006. On January 2nd, we received the review and set up an interview for January 15th. Cheryl did not make her required interview. We terminate TANF and Basic Food effective January 31st. Since we received the ER form by the end of the review period, we continue medical while we determine eligibility for family medical.

WORKER RESPONSIBILITIES – WAC 388-493-0010

Working Family Support recertifications occur every six months and align with the Basic Food Mid-Certification (MCR) and Eligibility Review (ER) periods. See the CSD Procedures Manual section Working Family Support for WFS recertification procedures at Basic Food MCR and ER.

 

Emergency Assistance Programs

Revised June 20, 2012

Consolidated Emergency Assistance Program - CEAP

Revised July 29, 2015

Purpose:

This section describes a cash program available to families or pregnant women who face an emergency and do not have the money to meet their basic needs, including families whose TANF cash assistance has been terminated for Non-Compliance Sanction - NCS and those who have already received 60 months of TANF and do not qualify for a Time Limit Extension. Most cases closed for NCS must participate for four consecutive weeks before they qualify for TANF/SFA. These families may qualify for CEAP until their participation requirement is met. Assistance under this program is limited to not more than thirty consecutive days within a period of twelve consecutive months.

WAC 388-436-0015 Consolidated emergency assistance program - CEAP.

WAC 388-436-0020 CEAP assistance unit composition.

WAC 388-436-0025 Eligibility conditions for CEAP--Job refusal.

WAC 388-436-0030 How does my eligibility for other possible cash benefits impact my eligibility for CEAP?

WAC 388-436-0035 Income and resources for CEAP.

WAC 388-436-0040 Excluded income and resources for CEAP.

WAC 388-436-0045 Income deductions for CEAP.

WAC 388-436-0050 Determining financial need and benefit amount for CEAP.


Clarifying Information - WAC 388-436-0015

  1. Being a citizen or legal resident alien is not an eligibility requirement for CEAP.
EXAMPLE: A migrant farmworker household consisting of a mother, father, and one child applies for cash assistance. They are not eligible for ongoing cash assistance since they are undocumented. The TANF is denied and CEAP is now considered for meeting the family's current needs as CEAP is available to undocumented households.
  1. Proof of social security numbers is not required. Do not require the client to provide SSN for the family as an eligibility requirement.
  2. Applicants for CEAP must complete the Client Declaration of need on the Emergency Assistance Request/Grant Computation form DSHS 14-337(X).
NOTE: The on-line application or the DSHS 14-001 Application form can be used to request CEAP. If these forms are used, a DSHS 14-337 must still be completed.
  1. For Residency requirements, see RESIDENCY.
  2. Families whose TANF grant has been terminated for during Non-Compliance Sanction can apply for CEAP under the same rules as other applicants. WorkFirst participation is not an eligibility requirement for CEAP.

Worker Responsibilities- WAC 388-436-0015

  1. Review the request form with the applicant. It is the applicant's responsibility to verify unpaid medical bills, utilities, and shelter costs. The applicant may request food, clothing, and household maintenance items without providing proof of the need.
NOTE: For Disaster Cash Assistance, the client does not have to produce proof of expenses unless it is questionable.
  1. Explain to the CEAP applicant the limited availability (thirty consecutive days within twelve consecutive months) of this program.
EXAMPLE: The client applies on February 5th with an eviction notice. CEAP is approved on February 6th and a payment is made to the landlord. The client returns on February 10th with an electricity shut off notice. Since it is within the 30 day limit it can be approved. The client returns again on March 15th with a shut off notice for the natural gas, This is denied as it is after the 30 day period.

Worker Responsibilities - WAC 388-436-0020

  1. When determining which members of the household will make up the CEAP assistance unit, first look at who must be members through relationship. A child within the family who is step-sibling to one child but half-sibling to another child becomes a mandatory member because of the half-sibling relationship.
EXAMPLE:
A household consists of a married couple, two children belonging to the wife, two children belonging to the husband, and one child belonging to both parents. The couple wants to exclude the two children of the wife from the CEAP application because they receive child support income. They are step-siblings to the husband's two children. The children are mandatory members because they are half siblings to the one child belonging to both parents. All the children must be included.
  1. When adding a caretaker relative other than a parent, or adding step-siblings, determine if it is to the advantage of the assistance unit to add that person. Inform the client that when choosing to add a member who doesn't have to be included, that person's income and resources are considered in determining need and benefit amount.
  2. A minor parent living in the home of his/her parents is a mandatory member of the parent's CEAP assistance unit. When the parent's CEAP request is denied because resources and income exceed the need, the minor parent's child only can become a separate CEAP assistance unit if that child has an emergent need.
NOTE:
A minor child cannot apply for CEAP by themselves. There must be a parent or relative of specified degree in the household.

Clarifying Information - WAC 388-436-0030

  1. Eligibility and payment amounts for all other DSHS financial, medical and food assistance programs must be determined before CEAP benefits may be approved, except for families who do not qualify for cash assistance because their case was terminated while in NCS.
  2. If the household contains a member who is eligible to receive or is receiving TANF, SFA or RCA, the family's emergency needs may be covered under the AREN benefit provisions in WAC 388-436-0002.
  3. Families receiving TANF/SFA or RCA at a reduced level, due to sanction or penalty, are not eligible for CEAP.

Clarifying Information - WAC 388-436-0035 

An income estimate is based on income already received plus a reasonable expectation of anticipated income for the month of application.

  1. Resources include items such as cash, checking & savings accounts, marketable securities, personal property and real property. Real property is land and buildings. See RESOURCES for more complete information.

  2. If an optional member as described in WAC 388-436-0015 (3) is included in the CEAP assistance unit, the resources and income of that person and that person's spouse are considered available to the CEAP assistance unit. If those income and resources would reduce or deny the CEAP benefit, the optional member can be excluded.

EXAMPLE:
An aunt applies for emergency cash assistance for her niece and wants to be included in the assistance unit as a needy caretaker relative. The income and resources belonging to the aunt and her husband show that no emergency need exists. The aunt can be excluded. She and her husband don't have a legal obligation to support the minor child.

Clarifying Information - WAC 388-436-0040

The equity value of a vehicle is determined by subtracting the amount still owed from the fair market value of the car. The fair market value is the average loan value as listed in the NADA Official Used Car Guide, or the wholesale value as listed in the Kelly Bluebook.

Worker Responsibilities - WAC 388-436-0040

  1. See RESOURCES for:

    1. A complete list of resources exempt under Federal Law;

    2. Determining real property as a home;

    3. The method of establishing values on non-exempt resources.

  2. Document in Remarks (REMA) behind the Resource screens how income and resource values were established.


Clarifying Information - WAC 388-436-0050

The amounts requested in each category can't exceed the maximum limit allowed. Excess amounts from one category can't be carried over to another category that is below the maximum.

EXAMPLE:
 A CEAP assistance unit of 3 persons verifies a need of $500 for rent, and $60 in utilities. Net income and resources equal $100.
  Need Maximum (3 persons) Allowed
Rent $500

$386

$386

Utilities $ 60

$130

$ 130

 
  $516 Total needed or allowed
  $521 Payment standard for 3
  $516 The lesser of the two above
  -100 minus available income and resources
  $416 CEAP payment

Worker Responsibilities - WAC 388-436-0050

  1. Explain that they may choose to receive the CEAP funds directly or have them sent to a vendor on their behalf.
  2. I f the client does not have an EBT account, then an account must be opened.

ACES Procedures

See Consolidated Emergency Assistance Program - CEAP

Top of Page

Disaster Cash Assistance Program

Revised November 1, 2011

Purpose:

This section describes a cash program available because of a disaster declared by the Governor. It is available to families or individuals including families or individuals with no children who face an emergency and do not have the money to meet their basic needs. This program is available only once within a twelve-month period.

WAC 388-436-0055 What is the Disaster Cash Assistance Program (DCAP)?

WAC 388-436-0060 How much money can I receive from the Disaster Cash Assistance Program (DCAP)?


Clarifying Information - ​WAC 388-436-0055

The disaster for individuals must be declared by the Governor. When the disaster is declared, Consolidated Emergency Assistance Program (CEAP) will authorize the Disaster Cash Assistance Program (DCAP) to provide funds for families and individuals with or without children who have suffered losses as a result of the disaster.

  1. The following applies to DCAP:
    1. The applicant had to have been living in the declared disaster area before the disaster happened. Having a vacation home does not count for residency.
    2. The applicant must have suffered a loss of income or property as a result of the disaster.
    3. The CEAP income rules apply to DCAP. See WAC 388-436-0045.
    4. The applicant must apply for any other assistance available, such as:
      1. TANF/SFA/RCA
      2. ABD cash
      3. Basic Food Assistance
      4. Medical
      5. Unemployment compensation
  2. Under DCAP, applicants are not required to:
    1. Meet citizenship or alien requirements; or
    2. Provide a Social Security number.

 

Worker Responsibilities - WAC 388-436-0055

  1. Review the application (DSHS 12-207) with the DCAP applicant. The applicant may request help with any of the basic requirements listed in WAC 388-436-0055 (2) without verifying the need with a bill or receipt unless questionable.
  2. Explain to the DCAP applicant the limited availability of this program.

Clarifying Information - WAC 388-436-0060

You use CEAP rules when calculating the income and resources for DCAP.
The differences between DCAP and CEAP are how the program looks at household composition and deductions:

  1. Household composition:
    1. Does not require a dependent minor child to be in the home.
  2. Deductions:
    1. The disaster losses can be used as a deduction from the income/resources calculation.
    2. The losses are only used if the applicant does not expect to be reimbursed (such as insurance settlement) during the month of application.

 

Worker Responsibilities - WAC 388-436-0060

  1. Determine who must be included in the household. This is anyone the applicant declares as being financially responsible for or who shares the financial responsibility.
  2. Proof of the income, resources, or expenses is not required unless questionable.
  3. Complete the calculations using the DSHS 12-208 form.

Disaster Supplemental Nutrition Assistance Program (D-SNAP)

Revised December 13, 2011

Purpose:

This section explains the general eligibility criteria for the Disaster Supplemental Nutrition Assistance Program (D-SNAP) and when the State may use it.

WAC 388-437-0001 Disaster food stamp program.


Clarifying Information - WAC 388-437-0001

The disaster must be declared by the President or FNS. When the disaster is declared, FNS negotiates with the department to determine:

  • What eligibility rules we will use;
  • The length of time we will accept D-SNAP applications in each area;
  • If the allotment will be for a half or full month; and
  • How we will calculate D-SNAP benefits.

General Guidelines

  1. Disaster related loss: The assistance unit must have a loss from a federally declared disaster:
  2. Residency: At the time of the disaster, the assistance unit lives within the geographical area designated as part of the disaster area. After the disaster, the assistance unit may be eligible for D-SNAP even if they are temporarily living outside the designated disaster area.
  3. Purchase and prepare: The assistance unit must purchase food and prepare meals together during the disaster certification period. Assistance units residing in temporary shelters that provide 50%of their meals during this period are ineligible for D-SNAP.
  4. Resources: Non-liquid resources are excluded. Liquid resources such as cash on hand or cash balances in accessible checking or savings accounts are considered as "income".
  5. Current food assistance recipients: Food assistance recipients may also be eligible for D-SNAP benefits. When an assistance unit receives a replacement issuance before the D-SNAP is implemented, the replacement amount is deducted from the D-SNAP allotment.
  6. Other eligibility criteria:
    1. The following eligibility factors are not applicable to D-SNAP:
      1. Alien status;
      2. Social Security number;
      3. Student status; and
      4. Work requirements.
    2. A prior disqualification in the regular food assistance programs does not disqualify an applicant for D-SNAP.

D-SNAP Procedures

After the disaster is declared and FNS approves use of a D-SNAP, CSOs will receive instructions, procedures, and forms. These will be sent from the Community Services Division headquarters or the state office disaster alternate (Region 1).

Emergency Assistance Programs - Additional Requirements for Emergent Needs (AREN)

Revised May 9, 2014

Purpose:

This section describes an additional cash benefit available only to persons eligible for Temporary Assistance to Needy Families (TANF), State Family Assistance (SFA), or Refugee Cash Assistance (RCA) programs.

WAC 388-436-0002 If my family has an emergency, can I get help from DSHS to get or keep our housing or utilities?


Clarifying Information - WAC 388-436-0002

NOTE: If the client does not get assistance, does not want on-going TANF, SFA or RCA, and has an on-going means of support, the client must complete an application as required in WAC 388-406-0010. We would then look at the client's eligibility for Diversion Cash Assistance.
EXAMPLE Susan, her minor daughter Cindy, and Cindy's child get TANF. They received AREN for an emergency housing need on August 5, 2006. Cindy later moved out of the TANF AU with the child. Cindy requested AREN on October 5, 2006. The worker decided Cindy had a good reason for not having money to meet their needs. Cindy is a minor child and lived with an adult when her AU received AREN. Cindy could get AREN.
EXAMPLE A TANF AU of Mom, Dad, and two children received AREN in August. Mom and one of the children moved out of the AU at the end of August. Mom was an adult member of an AU that received AREN. If Mom requested AREN, the amount she received in August would be deducted from the $750 twelve-month limit.
EXAMPLE Doug, Sally and their child receive AREN of $750 in March of 2010 to prevent eviction from their apartment. Doug and Sally get divorced, and he marries Tiffany in 2012. He and Tiffany apply for AREN to prevent utility shut off. Tiffany has never applied for, or received AREN. The assistance unit is eligible for AREN, because neither Doug nor Tiffany has received any AREN funds within the past twelve months.

Decide if the client has an emergency housing or utility need and the amount of the need. The client must have an emergency need under WAC 388-436-0002 (3).

NOTE: See VERIFICATION for information on how to get verification. If you need to request verification of the amount of the client's emergency need in writing, use ACES letter 0075-02 AREN Status.
NOTE: A statement from the client or their landlord that they are simply behind on their rent does not necessarily meet the emergency requirement. At that point, the landlord may be willing to make arrangements for a payment plan with the client.

 

Emergency Need AREN payment? Comments

Back Rent

Yes

 

Car Repair

No

 

Clothing

No

 

Credit Card Bills

No

 

Deposits for rent or utilities

Yes

 

Food

No

  • If client does not get food assistance, ask if they want to apply.
  • We may replace food bought with food assistance benefits and lost in household disaster. See WAC 388-412-0040.

Furniture

No

 

Home repairs

Yes

  • When the damage puts the client's health or safety at risk; and
  • The client owns the home; 
  • Or, the landlord will not fix the damage and it is less expensive to fix the damage than to move.

Licensing, auto fees, automobile insurance

No

 

Relocation

Yes

  • To flee domestic violence.
  • To leave unsafe housing.
  • As a lower cost option to paying back rent to prevent eviction.

Short-term lodging such as motels

Yes

  • Only when there is no other option.
  • Decide how long of a stay to approve based on when you expect the client to get more permanent housing.
  • Not allowed on an ongoing basis.

Utility Bills

Yes

  • The least amount to prevent a utility shut off.
  • For phone service, only the amount to keep local phone service when the client needs the service for their health and safety.
NOTE:If you can meet the client's emergency needs using AREN, continue to the next step. If not, the AU is not eligible for AREN. If the client gets TANF or SFA, look to see if you can meet the need with WorkFirst support services.
EXAMPLE A four-person AU applied for TANF and requested AREN to pay for new housing and furniture. The AU currently lives in a domestic violence shelter. The AU has no income, but will get $562 in TANF monthly. The rent for the new apartment is $450 a month. We can use AREN to get the new apartment, but not for furniture. Refer the client to resources in the community to see if someone can help with the client's furniture needs.
EXAMPLE A two-person AU asked for AREN to help pay for their overdue utility bill and current long-distance telephone bill. The family provided proof that their usual monthly income covers these expenses but due to an injury, the client missed 6 weeks of work. The client had a claim for L&I, but after a delay the client ended up receiving benefits for 2 weeks instead of the six weeks of benefits the client expected. We can use AREN for the utility costs. We do not pay the long distance bill, because the service is not a health or safety factor. If the client does not already get local phone service at a reduced rate, refer them to the local phone company to apply for the Washington Telephone Assistance Program (WTAP).
NOTE: These guidelines do not cover every acceptable reason for a client to not have money to cover their expenses. If you are not sure if a client has good reason for how they spent their funds, you may want to talk to your lead worker or supervisor about the situation.
EXAMPLE A three-person AU requests AREN to pay for rent that is two months behind. The AU’s only income is their TANF grant of $478. The AU lives in subsidized housing and has a rent cost of $300 a month. To decide if the AU is eligible for AREN, we must look at how the AU spent their grant for the last two months. The AU must show that their TANF grant was used to pay other necessary expenses as listed in WAC 388-436-0002. Make your decision based on information that is readily available to the AU.
EXAMPLE A family of four applied for assistance and asked for AREN to pay for a utility bill and rent that is three months past due. The mom left her job a week ago when she was diagnosed with cancer. Her overdue utility bill is $400 and her overdue rent is $1800. Her monthly rent is $600. Although the family has an emergency housing need, we must look at how the AU has spent their money for the last three months. - Were the AU's earnings used to pay for necessary expenses , such as medical care? - Will the AU be able to pay for the ongoing rent of $600 in addition to their other bills? - Will the AU's only source of income be the TANF grant of $562 or will they have other forms of income, such as SSI or child support in addition to TANF, that will be available to meet their future needs? - If not, it would be more appropriate to look at AREN to help the family get housing they could afford based on the AU's change in income.
EXAMPLE A three-person AU requested AREN to pay $1600 for rent that is two months overdue. The ongoing rent is still $800 a month, and the AU’s only income is the TANF grant of $478 a month. Even if the AU has good reason for their lack of funds to meet the emergency need, you may not want to issue AREN to prevent the eviction. The AU is living beyond their means and can not show how they will be able to afford this expense in the near future. Instead, consider looking at using AREN to help the family avoid homelessness by getting housing that they can afford based on their income.
EXAMPLE If a client comes in with an eviction notice on the 1st of October and a utility shut off notice on the 25th of November, we can use AREN to pay the landlord and the utility company as long as they meet the AREN requirements and the total amount does not exceed $750.
EXAMPLE Mom and Dad get TANF for their two children. The AU received $400 in AREN for their emergency housing needs on August 10. Mom and dad split up at the end of August. Dad moved out with one child and is now in a new AU. Mom stayed in the home with the other child and is in the original AU. On October 1st, Dad requested AREN for a utility shut-off. Dad was an adult member of an AU that received AREN. He is eligible for up to $350 in AREN.
  1. Application process: Clients that need AREN can request assistance as follows:
    1. If a client currently gets TANF, SFA, or RCA, the client can request AREN by:
      1. Completing the Emergency Assistance Request, DSHS 14-337(X), or
      2. Requesting the assistance over the phone and we will complete form DSHS 14-337(X).
    2. If a client does not get TANF, SFA, or RCA, they must complete both an:
      1. Application as required in WAC 388-406-0010, and
      2. Emergency Assistance Request, DSHS 14-337(X).
    3. If a client is requesting assistance with utility bills, the Department must receive confirmation from the local community resources providers that utility assistance is unavailable.
    4. All AREN requests for assistance beyond five hundred dollars and up to the seven hundred fifty dollar program limit require referral to a supervisor or designee for approval of payment.
    EXAMPLE Shelley receives a monthly TANF grant of $305 because she is acting in the place of a parent for John, an unrelated child. Despite her best efforts to keep up on the bills, John was hospitalized and the unplanned medical expense prevented Shelley from being able to pay the utility bills. She has now received a notice to pay the $380 balance or the heat will be cut off in February. Because Shelley receives a TANF grant for John's needs, we can consider paying the emergency utility cost under AREN. When evaluating the request, we do consider Shelly's income and available cash resources even though we did not use this to determine eligibility for the child-only TANF grant.

    A client who has applied for TANF in Washington, but is not eligible until the month after the application because they received TANF in another state, is considered to be receiving TANF for the purposes of this rule. The client can get AREN if they meet all other eligibility factors.

    EXAMPLE In March, a TANF eligible family moves from California to Washington. The family applies for assistance in Washington on 3/15/07, and is determined TANF eligible. Because the family received March TANF benefits from California, their Washington TANF grant cannot be opened until 4/1/07. They can get AREN in March if they meet all other program requirements.

    The intent of the AREN program is to get clients into housing that they can afford on an ongoing basis. Paying for a hotel or motel stay should be a last resort and for a short term solution.

    We only allow AREN to get phone service or prevent a shut off of basic service when the client can show a need for the service to meet the client's health and safety needs. Refer clients who need help with their basic phone service to the local phone company to apply for the Washington Telephone Assistance Program (WTAP). See chapter 388-273 WAC. Examples of clients that may need a phone for health and safety reasons include:

    1. AREN for "child only" households:

      Households that receive a "child only" grant (e.g., non-needy relative, SSI parent, or someone acting in loco parentis) may receive AREN for emergent needs because the emergent need has an impact on children receiving TANF, SFA, or RCA. When we determine the household's needs, we must consider the income of the entire household, including income that we exclude when determining the household's ongoing assistance.

      1. When a client receives TANF from another state:
      2. Use of AREN for temporary housing:
      3. AREN to get or prevent a shut off of basic telephone service:
      4. The $750 twelve-month limit follows all adults in the same assistance unit and minor parents that were not living with an adult when the AU received AREN. The limit also applies to non-needy caretakers who receive AREN on behalf of a child.

Worker Responsibilities - WAC 388-436-0002

When a client requests AREN, they must complete the Emergency Assistance Request DSHS 14-337(X). If a client makes the request by phone, complete the form for the client. Do not require a signature on the form. Complete the steps below to decide if the client is eligible for AREN and how much to issue:

  1. Exception to rule (ETR):

    Payments that exceed the $750 twelve-month limit may be requested using the Exception to Rule (ETR) process. ETRs for AREN are authorized through headquarters. Only those relating to health and safety will be approved.

    EXAMPLE A three-person AU applies for AREN. Mom's gross earned income is $1500 a month. The AU is not eligible for AREN because the AU exceeds the gross earned income limit of $955 for the AU size. Ask the client if they want to apply for medical and food assistance.
    EXAMPLE A two-person AU applies for TANF and AREN. Mom earns $800.00 monthly. The AU has no other income. Both the mother and the 17-year old child are fleeing felons. The AU is not eligible for AREN. The AU is not eligible for food assistance.
    EXAMPLE A four-person AU applies for AREN. The father is the only person with income. He gets $800 a month in unemployment compensation. The AU is not eligible for AREN because the AU's unearned income is greater than the TANF/SFA and RCA payment standard of $613 for the AU size. Ask the client if they want to apply for food assistance.
    EXAMPLE A three-person AU applies for AREN. Mom earns $900.00 monthly. The AU has no other income. They meet all the requirements for TANF eligibility. Continue to the next step below to decide if the client has an emergency housing or utility need. /p>
    1. Elderly or disabled clients.
    2. Clients who need access to emergency services. (e.g., a parent of a child who is on a ventilator would need a phone to contact an ambulance in an emergency).
    3. Domestic violence victims or others who are likely to need police protection.
    4. When a client leaves an AU that received AREN:
      NOTE: Complete all AREN denials in writing. Use ACES letter 0075-02 AREN Status.
      • Document the client's request for AREN in the ACES Narrative.
      • Decide if the client is eligible for TANF/SFA or RCA:
        • If the client is not eligible for TANF/SFA or RCA, the AU is not eligible for AREN. If the client does not get food assistance or medical benefits, ask the client if they want to apply for them.
        • Deny AREN If the client receives TANF/SFA and has a WorkFirst Sanction or is in Non-Cooperation with the Division of Child Support.
        • Review the case to determine if an adult or minor parent not residing with an adult has received AREN assistance that should be applied towards the $750 twelve-month limit.
      1. If the client is eligible for TANF/SFA or RCA, continue to the next step.
      2. Decide if the client has an emergency housing or utility need and the amount of the need. The client must have an emergency need under WAC 388-436-0002(3).
        1. If the client does not have an emergency housing or utility need, the AU is not eligible for AREN.
        2. If the client has an emergency housing or utility need, obtain proof of the client's need and the cost it would take to end the emergency.
  1. If the client does not have an emergency housing or utility need, the AU is not eligible for AREN.
  2. If the client has an emergency housing or utility need, obtain proof of the client's need and the cost it would take to end the emergency.
  3. Determine if the assistance unit still has AREN funds available to resolve the emergent need.
  4. Decide if you can use AREN to meet the client's emergency housing or utility need. We can only use AREN to help a client get or keep housing and utility services. Use the table below to find out which needs we can pay through AREN.
  1. Decide if the client has good reason for why the AU does not have enough money to pay for the expense. If the client has good reason, continue to the next step. If not, the AU is not eligible for AREN. Some questions to look at when you decide if a client has good reason include:
    1. Did the client misuse their money?
    2. Did the client spend their money in a reasonable manner under the circumstances
    3. Was the client’s choice to spend their funds reasonable at that time?
    4. Did the client spend their money on necessary expenses?
    5. Do the client's circumstances, such as mental or physical disability, explain why they used their money in a way that would not typically be looked at as a reasonable? If so, you should discuss Necessary Supplemental Accommodation (NSA) services available to the client. See [NSA](NSA.shtml).
    6. Will paying the request meet the client's short-term emergency need, or will the client continue to need additional assistance? Will the action just delay what will happen anyway? If the request will just delay the emergency need, you may want to discuss other options with the client.
  2. Find out if an adult in the AU has received AREN within the past twelve-months,the amount they are eligible for is $750 minus what they have already received.
  3. Determine the lowest amount that will end the client's emergency housing or utility need up to the twelve-month maximum of $750, and issue the lowest amount needed to resolve the emergency completely, not just for a few months. Use the following steps to decide on the lowest amount:
    NOTE: If the utility company provides services not related to the client's health or safety (e.g., one company provides electric, phone, cable, and garbage), find out if the provider will separate the expenses. Do not pay for services that are not related to health and safety if the company will separate the expenses.
    EXAMPLE In December, a TANF-eligible family of three requests AREN for $500 to repair the heater in their home. The family does not have any other safe and reliable way to keep their home heated. The family is not on assistance and does not want ongoing assistance. The family's gross income is normally $900 a month, but the father had to take a leave of absence for two months due to a medical emergency. Even though AREN would cover this expense, we would not authorize AREN for the repairs. Since the client is eligible for TANF but is not requesting ongoing benefits, we must look at their eligibility for Diversion Cash Assistance for the emergency housing need under WAC 388-432-0005.
    EXAMPLE A TANF AU requested AREN to help pay for a leak in the roof. The AU lives in an apartment and the lease agreement states that the landlord is responsible for maintenance and repairs of the apartment. The AU would have to contact the landlord and have them fix the roof. The client can reference the Residential Landlord-Tenant Act to persuade the landlord to make the needed repairs. If the family’s health or safety is endangered and the landlord refuses to make the needed repairs, use AREN for the least expensive option of making the repair or relocating the client.
    EXAMPLE A three-person TANF AU requested AREN to help prevent eviction. The AU provided court papers showing the amount they owed. In order to avoid eviction, the AU needed to pay $600.00 in back rent and $80.00 in court and legal fees. We can use AREN to pay for the legal and court fees only if it will prevent the AU from being evicted or foreclosed.
  1. Contact the person the client owes the payment to (e.g., landlord, utility company, etc.). Find out what it will take to prevent the client from being evicted or having their utilities shut off. Ask if the vendor if they will set up a payment plan for the debt or if they will accept a partial payment and have the client set up a realistic repayment plan for the rest of the bill. Do not provide legal advice or attempt to settle a client's legal claims.
  2. Look at what resources the client has available to meet the need (e.g. cash, checking, savings). Reach an agreement with the client on how much of the need they can cover. Clients do not have to use all of their resources to meet the emergency need. Look at what other expenses the client may need to pay. The following are examples of possible resources:
    1. Money on hand in the form of cash, checking or savings.
    2. Income the AU has that is not excluded for cash assistance. (income of an SSI child, earnings of an ineligible AU member, etc.)
    3. Money from other individuals such as family or friends voluntarily provide.
    4. Money from a non-needy relative caretaker living in the home.
  3. Check other resources that may be able to meet the client's needs:
  4. If the client does not get and is not applying for ongoing TANF/SFA benefits, use Diversion Cash Assistance (DCA) instead of AREN. See WAC 388-432-0005 for information on DCA.
  5. Look at what community resources are available to the client to meet the emergency need. (e.g. Catholic Charities, LIHEAP, Millionaire's Club, Multi-Service Center, Salvation Army, St. Luke's, St. Vincent DePaul, etc.)
    1. After you determine the least amount necessary to meet a client's emergency housing or utility need, issue the AREN for the approved needs by vendor payment. You must issue AREN payments directly to a registered vendor.
    2. Use ACES letter 0075-02 AREN Status and call the client.
    3. Review the circumstances that led to the client requesting AREN and decide if the client should have a protective payee under WAC 388-460-0020 and WAC 388-460-0035. Refer the client to social services to get a payee if necessary.
    4. Document the following in the remarks of the AREN screen for the AU:
      1. Date and amount of request,
      2. Eligibility for TANF/SFA or RCA,
      3. The type of housing/utility emergency the client has,
      4. The good reason for not having funds to meet their expenses,
      5. The lowest amount needed to end the emergency need and how this amount (include the name, title, and phone number of the person you spoke with if you used a collateral contact),
      6. Whether or not you approved AREN,
      7. The vendor/landlord name and vendor ID number, and
      8. Amount approved (if any).

ACES Procedures

See Additional Requirement - Emergent Need (AREN)

Exception to Rule

Revised September 22, 2016

Purpose:

To explain how, in certain circumstances, the department can grant exceptions to program rules.

WAC 388-440-0001 Exception to rule. 

  • Clarifying Information and Worker Responsibilities

WAC 388-440-0005 How am I informed of the decision my request to the department for an exception to rule? 


Clarifying Information - WAC 388-440-0001

  1. The Secretary of DSHS has delegated the authority for approval of exceptions to rule to the Economic Services Administration, Community Services Division (RCW 43.20A.110).
  2. Direct requests for exceptions to procedures or policies that are not specified in rule to a supervisor.
  3. The Secretary's coordinator for exception to rules is located in CSD Headquarters.
  4. All ETR requests must be submitted through the Barcode ETR Screen.
  5. Each CSO designates an Exception to Rule Coordinator.
  6. Requests for Exception to Rule must accurately cite the rule that is being considered for an exception. Direct questions about the correct citation to a supervisor or the Secretary's Designee in CSD headquarters.
NOTE: Refer to WAC 388-501-0160 for anyone requesting an ETR for medical or dental services or related equipment. 

Worker Responsibilities - WAC 388-440-0001

  1. Determine on a case by case basis, using the criteria in WAC 388-440-0001, whether a request for an exception is appropriate.
  2. If the request isn't appropriate, send client ACES Online letter 0070-03 (05-177) Exception to Rule Not Requested.

If the request is appropriate: 

  1. Submit the request through the ETR Screen in Barcode. The following step by step instructions for requesting an ETR are provided for DSHS staff:​​

  2. Notify the client of the decision regarding the request by sending an ACES Online letter 0070-04 (Approval) or 0070-05(Denial) or use DSHS 05-177(x).
  3. Take action to authorize benefit if exception is approved.
  4. Document actions on the case narrative, and retain completed ETR in the electronic case record.

ACES Information

If any exception is approved,  use the proper valid value (EP - Exception to Policy Recurring or NR - Exception to Policy Non-Recurring) on the AREQ screen to identify the payment as an exception to rule.

Document what was approved in the ETR on the REMARKS screen (F9) behind the screen that contains the information relating to the exception.

If an exception to rule is approved for Disability Lifeline time limits, you must also enter the appropriate ETR code on the WORK screen closure delay reason field:

  •  RM - Receiving Medical Treatment
  •  AF - Alternate Living Facility

Fair Hearings

Revised December 8, 2014

Please see Administrative Hearings.

Fleeing Felons

Revised June 16, 2016

Purpose: 

This chapter explains how being a fleeing felon impacts a client’s eligibility for some department programs.

WAC 388-442-0010 Am I eligible for benefits if I am fleeing from the law or breaking a condition of parole or probation?


Clarifying Information - WAC 388-442-0010

  1. Fleeing felons: We consider someone ineligible when:
    1. A Federal, State, or local law enforcement officer presents an outstanding felony arrest warrant. The officer must be acting on behalf of their agency, and;
    2. The warrant has one or all of the following Uniform Offense Classification Codes:
    • Escape (4901)
    • Flight to Avoid (prosecution, confinement, etc.)(4902)
    • Flight-Escape (4999)
EXAMPLE: John states at his application interview that he is aware of a felony warrant for his arrest. Because we were not presented with an outstanding felony warrant for escape, flight to avoid, or flight-escape by a law enforcement officer, acting in their official capacity and John is otherwise eligible, the worker approves John's application.

2. Probation or parole violations: We consider someone ineligible when an arrest warrant is issued by an impartial party because the individual failed to comply with a condition of probation or parole. What is considered a violation of parole varies from case to case. A corrections officer may tell us that they intend to issue a warrant, but a person's eligibility is not affected until a warrant is issued.

NOTE: We cannot use warrant information in FORS to determine if a client is a fleeing felon or parole/probation violator. Warrants for parole or probation violations must be issued by an impartial party. A DOC Corrections Officer is not an impartial party.

3. Juvenile convictions: A juvenile offender who flees a felony warrant is subject to the same rules as adult offenders. This includes persons who were convicted of a felony in a juvenile court.

4. Probation or parole violation: Violating a condition of probation or parole means an arrest warrant is issued when the corrections officer informs an administrative body or court that an individual failed to comply with a condition of probation or parole.

5. Time periods for fleeing felon and parole/probation violation status: There is no disqualification period. Clients can reapply for benefits at any time. We are required to make a determination of benefits based on whether the warrant used to deny or terminated benefits is still valid. A warrant is not valid if the time period for actively seeking the client has expired.

NOTE: As allowed under federal law, Senate Bill 6411 passed in the 2004 legislative session, restored Basic Food benefits to persons convicted of a drug-related felony. Senate Bill 5213 passed in the 2005 legislative session restored TANF benefits to persons convicted of a drug-related felony.

Worker Responsibilities - WAC 388-442-0010

  1. When we are presented with a warrant for a client:

a. We must consider that person "fleeing" and not eligible for TANF/SFA or Basic Food benefits when:

i. The law enforcement agency or Department of Corrections intends to enforce the warrant within:

a. 30 days from the date we contact the agency to verify the warrant; or

b. 20 days from the date the agency request information about the client as described in Worker Responsibilities #3.

EXAMPLE: Worker is dished an official document through DMS batch. The document is from Kootenai County Sheriff’s office and it is requesting information about Tina. Tina is a current TANF & Basic Food recipient. The document contains a warrant for Flight to Avoid (4902). Worker contacts the sheriff’s office and verifies that the warrant is still active and  that the sheriff intends to enforce the warrant through extradition within the next 20 days. The worker closes benefits with advanced notice and sends a termination notice.

2. Reviewing parole/probation status:

Take the following actions at application, at review, or when adding an individual to the Assistance Unit (AU):

a.    Ask the about outstanding warrants for each member of the household and record the information in ACES.

b.    If the client declares that they are aware of a warrant for parole/probation violations:

i. Contact the Community Corrections Office (CCO) listed in FORS.

ii. Determine the type of warrant issued by the CCO.

a. If the warrant was issued by the CCO (Secretary’s warrant, or bench warrant for example), the client is eligible for Basic Food or Cash if they meet all other eligibility requirements.

b. If the warrant was not issued by the CCO, verify the type of warrant was issued from an impartial party and that DOC intends to enforce the warrant within 30 days before denying or terminating benefits.

NOTE: Do not FRED for outstanding warrants. We can accept client's statement on whether they are fleeing from the law.
EXAMPLE: Robert declares on his application for benefits that he is not fleeing from the law or breaking a condition of parole/probation. The worker accepts his statement and processes his application.
EXAMPLE: Tina declares on her application for benefits that she is not fleeing from the law or breaking a condition of parole/probation. During the interview she says she may have a warrant in Idaho from an old parole violation. The worker verifies Tina has a felony arrest warrant issued from an impartial party in Idaho, and Idaho intends to enforce the warrant. Tina is not eligible for Basic Food or Cash benefits.
EXAMPLE: Same as above, however, Idaho does not intend to enforce the warrant in Washington. Tina is considered eligible for Basic Food and Cash if is meets all other eligibility criteria.

 

       3.  When law enforcement contacts the department: 

If a law enforcement official contacts us regarding an individual, cooperate with the official as required by state and federal law.

a.    State Law - RCW 74.04.062 allows us to disclose current address and location information about cash-only clients to law enforcement officers when all of the following conditions are             met:

i.     They are acting in an official capacity;

ii.    They identify themselves;

iii.   Provide the client's Social Security Number; and

iv.   Demonstrate that the client is a fugitive.

b.     Federal Law - 7CFR §272.1 (c)(1)(vii) Requires us to cooperate with law enforcement officers by providing the address, Social Security Number, and any available photograph of a client          when:

i.     The request is specified in writing; and

ii.    Includes the name of the household member being sought; and

iii.    The person is fleeing to avoid prosecution or custody for a crime, or an attempt to commit a crime, that would be classified as a felony or is violating a condition of probation or parole imposed under a Federal or State law; or

iv.  The person has information needed to apprehend or investigate another household member who is fleeing to avoid prosecution or custody for a felony, or has violated a condition of probation or parole.

v.   The federal law applies to all Basic Food applicants and recipients and supersedes the state law for these individuals.

NOTE: Federal regulations only allow the release of specific information when all of the conditions listed above are satisfied.

    4.     DSHS Staff Reporting Felons:

In very limited circumstances, staff may report a fleeing felon applying for or receiving cash assistance.

  • RCW 74.04.062 allows us to contact the appropriate law enforcement agency when we learn that a person has a valid outstanding warrant. These provisions in state law apply to cash only clients.
  • Federal law under 7 CFR §272.1 (c)(1)(vii) only allows us to disclose information on the whereabouts of a fleeing felon applying for or receiving food assistance as described under section (3)(b) above.  It does not allow staff to initiate contact with law enforcement.

We cannot contact law enforcement to report a fleeing felon for food assistance, even if the person is also applying for or receiving cash assistance.

NOTE: Staff are not required to report fleeing felons to the authorities. 

The only mandatory requirement when provided a written request meeting the requirements under RCW 74.04.062 is to provide the person’s current address, location, and social security number.

Local offices are not required to assist in detaining or delaying a fleeing felon leaving the office in order for law enforcement to arrest them.

Food Assistance - Supplemental Nutrition Assistance Program (SNAP)

Revised Revised May 8, 2014

Purpose:

The Supplemental Nutrition Assistance Program (SNAP), called Basic Food in Washington State, helps low income people buy more nutritious food.

Food Assistance Program (FAP) for Legal Immigrants

Revised June 29, 2012

Please see PROGRAM SUMMARY - FOOD ASSISTANCE PROGRAM.

Food Distribution Program on Indian Reservations

Created on: 
Feb 24 2016

Food Distribution Program on Indian Reservations - FDPIR

The Food Distribution Program on Indian Reservations - FDPIR is a Federal program that provides USDA foods to low-income households, including the elderly, living on Indian reservations, and to Native American families residing in designated areas near reservations.  There are nine FDPIR programs serving 29 areas in Washington.

  • Federal regulations prohibit participation in both the Supplemental Nutrition Assistance Program - SNAP and FDPIR at the same time.   DSHS rules under WAC 388-400-0040 disallow dual participation as well.  
  • The Application for Benefits, DSHS 14-001, asks people if they have received food from another state, tribe, or other source. 
  • Tribal members may choose which program they wish to receive benefits from. 
  • If a Tribal member has been disqualified from FDPIR, they are also disqualified from SNAP for the same period.  

Worker Responsibilities 

  • If a tribal member applying for SNAP indicates that they receive commodities from the Food Distribution on Indian Reservations, inform them that federal law does not allow participation in both programs and ask which food program they would like to use.
  • If the person chooses SNAP:
    • Contact the appropriate FDPIR program and request them to disenroll the member from FDPIR.  
    • Approve SNAP effective the first of the month after their FDPIR benefits end.
  • If they choose FDPIR, deny the application for food assistance based on participation in FDPIR.

FDPIR Programs in Washington

FDPIR Contact

Colville Confederated Tribes

Area of Operation: Colville Confederated Tribes 

PO Box 150, Nespelem, WA 99155

4 Lakes Street, Nespelem, WA 99155

United States

See map: Google Maps

Dorothy Palmer

Manager, Food Distribution Program

Phone: (509) 634-2776

Lummi Indian Business Council

Area of Operation: Lummi Indian Tribe

2616 Kwina Road

Bellingham, WA 98226

United States

See map: Google Maps

 

 

 

Elaine Lane

Director, Commodity Food Program

Phone: (360) 384-2366

 

Makah Indian Tribe

Area of Operation:  Makah Indian Tribe

PO Box 115, Neah Bay, WA 98357

Bldg #40, 90 Resort Drive, Neah Bay, WA 98357

United States

See map: Google Maps

Arriana Moccardine,

Acting Coordinator, Food Distribution Program

Phone: (360) 645-2154

Quileute Indian Tribe

Areas of Operation: (2) Quileute and Hoh Reservations

PO Box 279 (Main Office), PO Box 219 (Food Program), La Push, WA 98350

1 Quileute Nation Street, La Push, WA 98350

United States

See map: Google Maps

Bonnie Jackson

Manager, Food Distribution Program

Phone: (360) 374-2147

 

Quinault Indian Nation

Area of Operation: Quinault Indian Nation

PO Box 189, Taholah, WA 98587

1412 Aalis Drive, Taholah, WA 98587

United States

See map: Google Maps

Ray L Capoeman

Director, Food Distribution Program

Phone: (360) 276-8211 Ext.

Small Tribes of Western Washington

Areas of Operation: (15) Suquamish, Upper Skagit, Shoalwater Bay Tribe, Nooksack, Muckleshoot, Swinomish, Lower Elwha, Tulalip, Sauk-Suilattle, Stillaguamish, Puyallup, Jamestown Tribes, Samish Indian Tribe, Cowlitz Tribe, Snoqualmie Tribe

3040 96th Street, South

Lakewood, WA 98499

United States

See map: Google Maps

Benita R Lewis

Director, Food Distribution Program

Phone: (800) 567-6690 Ext. 228

South Puget Inter Tribal Planning Agency

Areas of Operation: (5) Nisqually, Chehalis, Skokomish, Squaxin Island, Port Gamble/S'Klallam

4822 She-Na-Num Drive SE

Olympia, WA 98513

United States

See map: Google Maps

 

 

 

Carmen Kalama

Director, Food Distribution Program

Phone: (360) 426-3990

Spokane Tribe of Indians

Areas of Operation: (2) Spokane and Kalispel Reservations

PO Box 540, Wellpinit, WA 99040

6208 Ford-Wellpinit Road, Wellpinit, WA 99040

United States

See map: Google Maps

Scott Peone

Director, Food Distribution Program

Phone: (509) 258-7145

Yakama Indian Nation

Area of Operation: Yakama Indian Nation

PO Box 151, Toppenish, WA 98948

802 E 1st Ave, Toppenish, WA 98948

United States

See map: Google Maps

Linda Walker

Director, Commodity Food Program

Phone: (509) 865-5121 Ext. 4694

Foster Care/Relative Placement/Adoption Support/Juvenile Rehabilitation/Unaccompanied Minor Program

Revised December 31, 2013

Purpose:

To give instructions and contact information when working with Foster Care, Foster Care Relative Placement, Adoption Support and Juvenile Rehabilitation cases.

NOTE: Children in foster care, relative placement, adoption support, and juvenile rehabilitation have special confidentiality concerns. Please be sure that your narrative and remark references contain only information regarding financial eligibility. Limit any comments that have to do with the child’s placement, name change or biological parents.

Clarifying Information

*** As a result of implementation of the Affordable Care Act (ACA), this clarifying page may no longer be effective for medical coverage applications received on or after 10/01/2013. Clients under 65 years of age who need to apply for medical coverage on or after 10/01/2013 should be referred to Washington Healthplanfinder. Applications for medical coverage for households where all members are 65 years of age and older should be referred to Washington Connection. ***

The Foster Care Unit is part of the Medical Eligibility Determination Services Section (MEDS) of Health and Recovery Services Administration (HRSA).

The Foster Care Medical Team (FCMT) is responsible for the following cases:

  1. Foster Care
  2. FC Expansion Program
  3. Foster Care Relative Placement
  4. Adoption Support
  5. Juvenile Rehabilitation
EXAMPLE The CSO receives an application for Basic Food benefits. Included in the Basic Food assistance unit is a child currently open on D02 medical. The CSO can add a Basic Food assistance unit and process the AU through “O and P.” However, the CSO must contact the FCMT to finalize the AU .
  1. Foster Care: These are children who reside in a licensed foster care home. The foster care parent receives a monthly payment from Children’s Administration and the child is eligible for Medicaid.
    1. Children’s Administration (CA) sends an alert to the FCMT to inform them a child has entered foster care. FCMT works the alert and opens a D01 (foster care child receiving SSI) or D02 (foster care) case for the child.
    2. D01/D02 foster care cases:
      1. Are assigned to CSO 076.
      2. Display in ACES with asterisks in the address field and AREP screen. The asterisks have been added to insure address confidentiality for the foster care family and child.
      3. Require special coding in the DEM1 living arrangement and DEM1 REL code fields.
    3. When the CSO/CSC and FCMT have a shared D01/D02 case, only the FCMT can finalize or update the case. The CSO can “add a program” to a D01/D02 case but will not be able to finalize the case. CSO/CSC staff will need to coordinate with the FCMT @ 1-800-562-3022 x 15480 to have them complete case actions. FAX number is 360-725-1158. CSO staff should not change the living arrangement or REL code on the foster care child’s DEM1 screen or close out a foster care assistance unit. To make any change to a D01/D02 case or associated cash, medical or Basic Food case the CSO/CSC must contact the FCMT @ 1-800-562-3022 x 15480.
    EXAMPLE Alert 190 is generated on a child who receives TANF with their parent. The CSO/CSC contacts the CPS worker and discovers the child has been placed in Foster Care while the mother enters a residential facility. The child is scheduled to return home after mother completes inpatient stay. The decision is made to leave the child on their mother’s TANF case. The worker will contact FCMT. The FCMT will update the DEM1 living arrangement and add appropriate REL code information for the child, based on information received from Children's Administration
  2. When the CSO/CSC receive ACES alert 190 they need to contact the FCMT before taking any action. When a child is active:
    1. On Family or Children’s medical contact the FCMT. The FCMT will contact CA to determine the child’s status, and if appropriate, open the child on D01/D02 medical.
    2. On TANF with their caretaker and have been placed in Foster Care the CSO will need to:
      • Contact the Children’s Administration (CA) worker
      • Determine if the child should be removed or left on the TANF grant; and
      • Contact the FCMT to update the living arrangement and REL codes on the DEM1 screen.
      • FCMT phone number is 1-800-562-3022 x 15480
      • FCMT FAX number is 360-725-1158.
  3. The Foster Care Medical Team can be reached by contacting:
    MEDS
    PO Box or Mail Stop 45531
    Olympia, Washington 98504-5531
    General Information: 1-800-562-3022 x 15480
    FAX: (360) 725-1158
  4. Foster Care Expansion Program: In 2007, the legislature passed 2SHB 1201, expanding eligibility for Foster Care medical. In this expansion, youth who are in Foster Care on their 18th birthday, if their 18th birthday is on or after July 22, 2007, are eligible to remain on medical benefits through the Foster Care medical program until the end of the month in which they turn 21, as long as they remain Washington residents. They do not need to remain in Foster Care during this time. The FCMT will continue to maintain the medical cases for these youth until they are no longer residents of Washington or have reached their 21st birthday.
  5. Foster Care Relative Placement: These are children that reside with a relative in an unlicensed unpaid foster home. These children are eligible for Medicaid while in Relative Placement.
    1. Children’s Administration sends an alert to the FCMT to inform them a child has entered foster care relative placement. FCMT works the alert and opens a D01 or D02 case for the child.
    2. The relative who cares for the child may apply for cash, medical or Basic Food at the CSO.
      1. During the application screening process the worker will see an active D01/D02 case for the child.
      2. Contact the FCMT to determine whether D01/D02 medical will remain open or if the child will be open on Family or Children’s medical.
        • The FCMT will update the child’s DEM1 living arrangement and REL codes to continue to issue medical through D01/D02 program, or
        • Close the D01/D02 program so the CSO/CSC can issue medical on the TANF or Family/Children’s program. The REL code is added by FCMT to all Relative Placement cases to ensure that FCMT has the ability to track the number of FC Relative placements in the ACES system.
  6. Adoption Support: Is a payment received by adoptive parent who care for children who have been placed by Washington State or another state. These children are eligible for Medicaid through the month in which they turn 19.
    1. Adoption Support cases are approved by Children’s Administration. An alert is sent to the FCMT from CAMIS to open Adoption Support. The FCMT works the alert and opens D01 or D02 medical.
    2. D01/D02 adoption support cases are:
      1. Assigned to CSO 076
      2. Display in ACES with asterisks in the address field and AREP screen.
      3. Require special coding in the DEM1 living arrangement and the REL code fields.
    3. Changes to an adoption support case and any case associated with adoption support can only be made by FCMT.
    4. If the CSO/CSC receive an application for a child on adoption support they should take the following steps:
      1. If the child is already open on D01/D02 contact the FCMT to finalize or update any associated cash, medical or Basic Food case. The FCMT will also work with the CSO/CSC and the family to determine if the child will remain on D01/D02 or be open on Family or Children’s medical.
      2. If the child is not open on D01/D02 but the family states they are receiving out-of-state adoption support and want medical for the child.
      • Call the FCMT and talk to your regional representative. FCMT will assist client to determine if they are eligible for adoption support.
      • If eligible, FCMT will open D01/D02 coverage and notify the CSO/CSC.
      • If not eligible, FCMT will notify the CSO/CSC who will process the Family/Children’s medical application.
    5. A child placed with adoptive parents not known to the biological parents will often be assigned a new Client Identification (CL ID) number. The assignment of a new CL ID number will help ensure confidentiality for the new adoptive family. This new CL ID should never be merged with the child’s old CL ID.
  7. Juvenile Rehabilitation: Are children who reside in a Juvenile Rehabilitation Administration (JRA) group home instead of being incarcerated at a facility. Children who live in these group homes are eligible for Medicaid through the month in which they are paroled.
    1. JRA notifies the MEDS JRA case manager that a child has been placed in a group home. The JRA Case Manager opens a D01 or D02 medical case for the child.
    2. JRA cases are:
      1. Assigned to CSO 076
      2. Display in ACES with asterisks in the address field and AREP screen.
      3. Require special coding in the DEM1 living arrangement and REL code fields
    3. Children in a JRA group home are not eligible for benefits offered through the CSO/CSC. There should never be a jointly shared JRA case between FCMT (CSO 76) and CSO/CSC.
    4. CSO/CSC may see JRA cases in ACES when the child has recently been released from the group home. To add a child back to their family assistance unit or to open new coverage for the child the CSO/CSC must contact MEDS JRA case manager @(360) 725-1519 with the JRA program).
      Case manager will ensure that the child:
      1. Has been released from JRA back to their home and
      2. Will close the D02 coverage, correct the child’s living arrangement and REL codes on the DEM screen and if needed transfer the case to the appropriate local office.
  8.  Unaccompanied Minor Program: The Department of State and the Office of Refugee Settlement worked together to identify minor children who need foster care placement and approve them for resettlement in this country. Children with no known family in the United States are placed in culturally sensitive foster homes and are all Title XIX eligible. When a child has been placed in the Unaccompanied Minor Program (UMP) or has changed placement, the Refugee and Immigrant Assistance program manager receives notification from their International Foster Care Agency responsible for the minor's case management. The Office of Assistant Secretary, Refugee and Immigrant Assistance unit manages the UMP.

Fraud

Revised June 12, 2017

Purpose:

This chapter is about fraud or unlawful practices in obtaining cash, food, or medical assistance. Additionally the chapter addresses Intentional Program Violations, Administrative Disqualification Hearings, and disqualification periods for persons who have broken a food assistance rule on purpose.

WAC 388-446-0001 When does the department refer a cash or food assistance case for prosecution for fraud?

WAC 388-446-0005 Disqualification period for cash assistance

WAC 388-446-0010 TANF disqualification period for fraud convictions of misrepresenting interstate residence

WAC 388-446-0015 What is an Intentional program violation (IPV) and administrative disqualification hearings (ADH) for food assistance.

WAC 388-446-0020 What penalties will I receive if I break a food assistance rule on purpose?


Clarifying Information - WAC 388-446-0001

*** As a result of implementation of the Affordable Care Act (ACA), this clarifying page may no longer be effective for medical coverage applications received on or after 10/01/2013. Clients under 65 years of age who need to apply for medical coverage on or after 10/01/2013 should be referred to Washington Healthplanfinder. Applications for medical coverage for households where all members are 65 years of age and older should be referred to Washington Connection. ***

The FRAUD chapter is related to the BENEFIT ERRORS and the FAIR HEARINGS chapters. An overpayment of benefits often comes before a referral to the court system or to an Administrative Disqualification Hearing for a determination of fraud.

Staff may make a referral for fraud investigation when they become aware of facts that indicate an overpayment has occurred as a result of a client's intent to conceal or misrepresent facts to the department. Potential fraud may also be discovered outside of the process of determining what caused the household to receive incorrect benefits.

  1. Discovering Potential Fraud / Unlawful Activity:

    Discovery of possible fraudulent or unlawful practices may result from complaints or information received by the local office in a variety of ways. Examples include:

    1. Direct calls to the local office or customer service center;
    2. Welfare Fraud Hot Line Complaint (1-800-562-6906);
    3. Client change of circumstance report;
    4. ESD Quarterly Earnings Alert or Comparison Report;
    5. Fraud Early Detection Program (FRED) investigations.
    6. FRED investigations may be requested for active cases to establish ongoing eligibility.
    7. A Quality Assurance Review (QA).
  2. Establishing an intentional overpayment:

    The Financial Service Specialist (FSS) can establish an Intentional overpayment if the client received incorrect cash benefits and there is evidence in the case record showing intent. Intent means that the client knows what facts or changes to report, when to report those changes, had the opportunity to report, and chose not to report. Intent also implies that the client didn't report a change or a fact because they knew that reporting it would probably have a negative effect on their benefits.

  3. The Office of Fraud and Accountability (OFA) Fraud Early Detection program (FRED):

    The Fraud Early Detection program (FRED) is under the direction of the Office of Fraud and Accountability and provides criminal investigators when activities are required that go beyond the scope of the Financial Service Specialist's authority. The purpose of FRED is to:

    • Provide a cost-effective measure for reduction of errors;
    • Save benefit funds for families requiring assistance;
    • Reduce the need to investigate and prosecute recipients by resolving questionable circumstances prior to the authorization of benefits.
  4. How FRED improves program integrity:

    FRED investigators help support program integrity in the following ways:

    • Obtain information requested by the FSS;
    • Use interviews with clients and third parties (called collateral contacts) to resolve questions or inconsistencies;
    • Report findings to the FSS;
    • Make recommendations regarding criminal prosecution;
    • Participate in Fair Hearings, as needed.
  5. Referrals to OFA based on overpayments:

    After establishing an intentional cash overpayment, the case is referred to the Office of Fraud and Accountability (OFA) for possible prosecution. The client has the right to a Fair Hearing over the establishment of the overpayment and the intentional designation. See BENEFIT ERRORS and FAIR HEARINGS.

  6. Establishing Intentional Program Violations for Food Assistance:

    When the overpayment involves food assistance, current policy states that only a court of law or an Administrative Disqualification Hearing can determine an Intentional Program Violation (IPV). The FSS establishes an unintentional overpayment, called Inadvertent Household Error, and refers, with any cash overpayment, to OFA for investigation and potential prosecution.

  7. Threshold for Administrative Disqualification Hearing:

    If the food assistance overpayment, or separate instances of suspected IPV total $450.00, we refer the case for an Administrative Disqualification Hearing, according to local office procedures. See FAIR HEARINGS.

Worker Responsibilities - WAC 388-446-0001

Assistance from Fraud Early Detection Program (FRED)

Disqualification period for cash assistance.

TANF disqualification period for fraud convictions of misrepresenting interstate residence.

  1. When to initiate a Fred referral:

    Initiate a FRED referral though the Client's Electronic Case Record (ECR) when:

    1. A collateral contact does not respond with requested information;
    2. The information received from the client or contact raises inconsistencies, or is unclear, unconvincing, or questionable;
    3. Verification documents cannot be obtained through normal methods available to an FSS;
    4. According to established procedures on initial applications;
    5. The application interview raises questions or concerns about the reported facts and verification can’t be obtained or doesn’t resolve the concern.
  2. Appropriate Fred referrals:

    Some examples of situations where a FRED referral is in order:

    1. The client's household expenses are within $25.00 of the income available, and shelter and utilities are paid up to date;
    2. The physical record indicates previous ownership of real property, but the client states no ownership on a new application. The client does not provide adequate or convincing verification on the status of the property.
    3. Numerous complaints have been received of a client having multiple vehicles on the property and it appears that the client is restoring and selling the vehicles. The client denies any such thing and states that the cars are there temporarily and belong to a relative.
    4. Client reports living alone and the landlord statement reflects the same information; but a complaint received shows others are in the home and supporting the client.
    5. Client has a history of working for cash and not reporting. There is currently no source of income being reported for the household and the client does not have a reasonable explanation of how expenses are being met.
    6. Client states that the non-custodial parent (NCP) has left the home but cannot say where the NCP is located. The landlord states that to his knowledge, both parents reside in the home. The client states that the NCP only comes to visit the children.
  3. Taking action on FRED findings:

    Take action on a FRED response as follows:

    1. If the referral contains facts which adversely affect current or future eligibility or payment, follow procedures found in CHANGE OF CIRCUMSTANCES;
    2. If an overpayment is identified, follow procedures in BENEFIT ERRORS;
    3. Complete the return response to FRED, indicating a summary of actions taken.

Referral to the Office of Fraud and Accountability (OFA)

  1. Complete a referral to OFA and list the documents in the case file that demonstrate intent. See the Procedures Handbook for referral instructions. Documents to examine for the time period include:
    • Rights and Responsibilities signed by client;
    • Application showing facts omitted or false information declared;
    • Eligibility Review reflecting false circumstances;
    • Mid Certification Review (MCR) completed and signed but not reporting the change;
    • Change of Circumstance reporting one change but not another; and
    • Any other document presented by the client or a collateral contact which demonstrates the intent of the client to give misleading or incorrect information to receive benefits.
  2. Initiate an Intentional Overpayment Investigation Referral (OFA referral) through the client's ECR when:
    • An intentional cash assistance overpayment is identified and processed;
    • A food assistance overpayment is completed and determined intentional as defined in #2 of Clarifying Information WAC 388-446-0001 above; or
    • Documents in the case record provide clear evidence of the client's willful concealment of information or intentional failure to reveal information, causing the overpayment.
  3. Set a tickler for a 60-day response from OFA. If no response is received, request a response date. OFA will respond with their decision on forwarding the case for prosecution and instructions to the worker on whether to proceed with the Administrative Disqualification Hearing (ADH) for food assistance.
  4. Follow the CSO policy regarding the preparation of cases for prosecution. In some CSOs, the FSS is responsible for copying documents for the prosecution's case.

Clarifying Information- WAC 388-446-0015

  1. We can combine separate instances of suspected Intentional Program Violation (IPV) for food assistance into one complaint that totals $450.00 or more and can then to present for an Administrative Disqualification Hearing (ADH). (See FAIR HEARINGS for ADH Worker Responsibilities)
  2. Trafficking is when someone attempts to sell, exchange food benefits for anything of value such as cash, drugs, weapons, or anything other than food from an authorized retailer.
  3. The department must prove an IPV with clear and convincing evidence. This means that the evidence must establish that it is highly probable the actions that resulted in the overpayment were intentional.
  4. An IPV can be determined either by a court decision in a criminal prosecution or by decision in an ADH.
  5. We must choose whether to refer an IPV instance for prosecution or for an ADH; we do not pursue both procedures at the same time. Upon completion of an ADH, we may choose to refer the case for prosecution.

Clarifying Information - WAC 388-446-0020

The Disqualified Recipient System (DRS) is a nationwide exchange of information between the Federal government and the States regarding IPV decisions.The DRS interface is a real time web service that interfaces directly with ACES 3G via the electronic Disqualified Recipient System (eDRS). eDRS creates a real time match during application and eligibility review processing in ACES 3G and will show any IPV records for an individual on the Sanction Screen. For more information about online processing and eDRS, see the ACES User Manual.

Worker Responsibilities - WAC 388-446-0020

Verifying Matches

DRS matches are not verified upon receipt. Staff must verify the match with the state that originated the disqualification or with the applicant/recipient. Accept either the written or verbal verification that the originating state has records of:

  • Court decisions;
  • Administrative hearing determinations;
  • Signed disqualification agreements;
  • Administrative disqualification hearing waivers; or
  • Other supporting documentation for IPV disqualifications of the applicant/recipient.

Verify the DRS record matches the individual in the case record. Request the following information about the DRS disqualified individual from the other state:

  • Name;
  • SSN; and
  • Date of birth.

Also verify the information in the DRS match is correct regarding:

  • Offense description;
  • Number of offense (first, second, or third); and
  • Penalty length.

We must provide 10-day advance notice to any client who is being disqualified from food assistance.

NOTE: Do not delay the processing of an application if you are unable to verify the DRS information. Make sure the applicant is aware of the DRS information and that approval while awaiting verification from another state may result in an overpayment.

Timely Disqualifications

 

  1. For an ADH decision, disqualify the person who has committed the IPV effective the first of the month following the date the person and the department are notified in writing of the ADH decision.
  2. For a court decision, a timely disqualification is within 45 days of the date of the written order unless the court specifically sets a different time frame.
  3. If a disqualification is not processed timely, disqualify the person for the remaining time of the penalty period. Do not disqualify a person once the disqualification period that should have been applied has expired. Establish an Administrative Error overpayment for the time period from the first day of the intended month of disqualification until the effective date of action.
  4. Once the disqualification period has been implemented, it continues uninterrupted regardless of the eligibility of the assistance unit.
EXAMPLE: A food assistance client is found to have committed an IPV and is disqualified under a court order dated January 20, 2011. The penalty time is from March 1, 2011 to February 28, 2012. The disqualification must be established by March 1, 2011 to be timely. The decision was delayed in the mail and not received by the department until February 28, 2011. Because of the ten day advance notice rule, we cannot implement the disqualification until April 1, 2011. The worker will need to set up an administrative overpayment for the month of March.

ACES Procedures

Health Care Authority - Apple Health (Medicaid) Manual

Revised December 11, 2014

Due to implementation of the Affordable Care Act (ACA), medical WAC’s and clarifying information can now be found in the Apple Health (Medicaid) Manual.

Healthcare for Workers with Disabilities - HWD

Revised December 9, 2014

Due to implementation of the Affordable Care Act (ACA), medical WAC’s and clarifying information can now be found at Apple Health for Workers with Disabilities, via the Apple Health (Medicaid) Manual.   

In Loco Parentis

Revised December 8, 2014

Please see Living with a Relative or Guardian.

Incapacity and Disability

Revised December 31, 2013

Purpose:

A person must be unable to work due to a mental or physical impairment to meet incapacity or disability criteria for ABD cash or a referral to the HEN program.

  • WAC 388-447-0001 What are the incapacity requirements for referral to the Housing and Essential Needs (HEN) program?
  • WAC 388-449-0001 What are the disability requirements for the Aged, Blind or Disabled (ABD) program? (Emergency WAC currently in effect)

Clarifying Information

Disability program specialists are responsible for determining disability and incapacity for ABD cash and referral to the HEN program.

Applications

  1. Refer ABD cash applicants to the disability program specialist (DPS) when the person claims they have a physical or psychological impairment preventing them from working. These cases require Disability Decision by the DPS. If the person does not meet the disability criteria for ABD cash, the disability program specialist will determine incapacity criteria for the HEN Referral program using the Sequential Evaluation Process (SEP).
  2. Referrals to the disability program specialist include:
    1. Application date.
    2. Any medical records.
    3. Information about unpaid medical bills.
    4.  Date of SSI application.
    5. Information about active medical coverage.
  3. The disability program specialist follows the Disability and Incapacity Evaluation Process in the Social Services Manual.
  4. Clients applying for or receiving long-term care services from Home and Community Services (HCS) are assessed by social service specialists at those administrations. Refer ABD applicants to the HCS social service specialist for a functional assessment.

Disability Review Process

  1. When the Disability Program Specialist sends the Financial Services Specialist a DSHS 14-118 to terminate disability (ABD cash) due to a SSA denial or no longer meeting disability criteria:
    1. Send the person notice that ABD cash is terminated with the free form text provided by the DPS.
  2. When the Disability Program Specialist sends the Financial Services Specialist a DSHS 14-118 to terminate disability (ABD cash) due to no current medical evidence, the FSS:
    1. Sends the person notice that ABD cash is terminated for lack of current medical

Incapacity Review Process

  1. When the Disability Program Specialist sends the Financial Services Specialist a DSHS 14-118 to terminate HEN Referral due to no current medical evidence, the FSS:
    1. Sends the person notice that HEN Referral eligibility is terminated for lack of current medical evidence with the free form text provided by the DPS.
    2. If the FSS receives a DSHS 14-118(X) with a decision after a "no current medical" termination is issued, the FSS:
      1. Extends HEN Referral eligibility if approved and notifies the person that benefits are extended; or
      2. Issues a supplemental notice of termination with details from the new DSHS 14-118(X), if the benefits are terminated.

Terminations for failure to cooperate with treatment

  1. Terminate assistance when you receive the DSHS 14-118 Disability/Incapacity decision stating the person failed to satisfactorily participate in treatment or follow through with a Medicaid application.
  2. If the person reapplies prior to termination, refer the client to the disability program specialist.

Employment

  1. When an incapacitated person becomes employed, the FSS determines if the person remains financially eligible. If the person is no longer financially eligible, the FSS terminates assistance and informs the DPS of the termination.
  2. If the person is still financially eligible, the FSS contacts the disability program specialist to determine if the person is gainfully employed. The ISW will inform the FSS of their decision.

Income - Table of Contents

Revised June 15, 2012

Purpose:

To describe how various types and amounts of income affect a client's eligibility and benefit level.

Allocation and Deeming

Revised May 6, 2014

Purpose:

This section includes cash assistance, medical assistance, and Basic Food rules and procedures for allocating the income of ineligible or non-AU members to an AU, allocating the income of AU members to non-members, and deeming a sponsor's income to AUs with a sponsored immigrant.

WAC 388-450-0095 Allocating income--General.

WAC 388-450-0100 Allocating income--Definitions.

WAC 388-450-0105 Allocating the income of a financially responsible person included in the assistance unit.

WAC 388-450-0106 How does the department count my income if someone in my family cannot get assistance because of their alien status?

WAC 388-450-0112 Does the department allocate the income of an ABD cash client to legal dependents?

WAC 388-450-0115 Does the department allocate the income of a financially responsible person who is excluded from the assistance unit?

WAC 388-450-0116 How does the department count my income if I cannot get assistance because I am an alien?

WAC 388-450-0120 Does the department allocate the income of financially responsible parents to a pregnant or parenting minor?

WAC 388-450-0130 Does the department allocate the income of a nonapplying spouse to a caretaker relative?

WAC 388-450-0137 Does the department allocate income of an ineligible spouse to an ABD cash client?

WAC 388-450-0140 How does the income of an ineligible assistance unit member affect my eligibility and benefits for Basic Food?

WAC 388-450-0145 Income of a person who is not a member of a food assistance unit.

WAC 388-450-0155 How does being a sponsored immigrant affect my eligibility for cash and food assistance programs?

WAC 388-450-0156 When am I exempt from deeming?

WAC 388-450-0160 How does the department decide how much of my sponsor's income to count against my benefits?


Due to implementation of the Affordable Care Act - ACA, medical WAC’s and clarifying information can now be found in the Apple Health (Medicaid) Manual.

Clarifying Information - WAC 388-450-0095

  1. Unmarried persons are not legally or financially responsible for each other.
  2. A stepparent's responsibility for support ceases when death or divorce has terminated the marriage.

Worker Responsibilities -  WAC 388-450-0095

  1. Determine if there is income possessed by someone outside the assistance unit that must be allocated to meet the needs of the assistance unit.
  2. Determine if there is income possessed by someone included in the assistance unit that must be allocated to meet the needs of someone outside the assistance unit.
  3. Refer to the appropriate section listed below for specific allocation rules and worker responsibilities.

Clarifying Information - WAC 388-450-0105

  1. See WAC 388-450-0106 for rules about allocating income of members who are excluded because of alien status.
  2. For the definition of a financially responsible person for medical assistance programs. See WAC 182-506-0010. Do not allow a payment standard deduction for disqualified assistance unit members.

Worker Responsibilities - WAC 388-450-0105

  1. To determine an assistance unit's eligibility and benefit amount, allocate the income of a financially responsible person included in the assistance unit to meet the needs of legal dependents living either in or out of the home.
  2. Determine the countable earned income by deducting the applicable work incentive or work expense and any applicable dependent care deduction for employment related child care expenses, as specified in WAC 388-450-0170, from the financially responsible person's gross earned income.
  3. Combine the financially responsible person's countable earned income and countable unearned income.
  4. Subtract the appropriate payment standard for an assistance unit based on the number of ineligible assistance unit members. Do not include persons excluded from the assistance unit due to disqualification.
  5. To meet the needs of each legal dependent not living in the home, deduct the lesser of the department's one-person need standard or the actual amount paid for court or administratively ordered support.
  6. Subtract the remaining income from the assistance unit's applicable payment standard.
EXAMPLE:

A mother and one of her children receive TANF cash benefits. The mother is employed and pays $275 court-ordered support for a child not living in her home. The mother has two other children who are not included in the assistance unit as they are probation violators. The mother receives $1,500 gross income each month from her employment.

  • $1,500 (Gross earned income) ÷ 2 (Work incentive) = $ 750 (Countable earned income)  - $385 (2014 two-person payment std -2 ineligible children) = $365 - $275 (Paid support for child living outside the home = $90 Countable Income

  • $385 (2014 two-person payment std) - $90 (Countable income) = $295 Grant amount

In this example, the mother's countable earned and unearned income exceeds the payment standard for herself and her eligible child and would render the assistance unit ineligible for cash benefits. However, as the mother has three dependent children she is financially responsible for, her income is reduced to allocate for their needs, allowing her and her child to be eligible for benefits.

A husband and wife apply for TANF for themselves and their two children. The husband receives unemployment compensation (UC) of $800 each month of which DCS garnishes $275 for a child living outside the assistance unit.

  • $800 (Gross UC) - $275 (DCS garnishment) = $525 (Countable UC)
  • $562 (2014 four-person payment std) - $525 (Countable UC) = $37 (Grant Amount)

In this example, the husband's gross UC exceeds the payment standard. However, the husband has one dependent he is financially responsible for which allows the assistance unit to be eligible for TANF.

 

EXAMPLE:

Following the previous example, except the wife's gross earned income is $800 per month and the ineligible husband earns $600 gross income per month.

Ineligible Husband 

  • $600 (Gross earned income) - $90 (Work Expense) = $510 (Countable earned income) - $385 (2014 two-person pmt std) = $125 (available to the assistance unit)

Wife 

  • $800 (Gross earned income) ÷ 2 (Work incentive) = $400 (Countable earned income) + $125 (Available from husband’s income) = $525 - $200 (Paid support for child living outside the home) = $325 Countable income.

  • $478 (2014 three person pmt std) - $325 (Countable income) = $153 Grant Amount

In this example, the ineligible husband's countable earned and unearned income exceeds the payment standard for himself and child. As such, the difference is available to the assistance unit and added to the assistance unit's countable earned and unearned income.

EXAMPLE:

Following the previous example, except the parents are not married.

An employed mother and two children are receiving TANF cash benefits. She pays $200 child support each month for a child living outside the home. The father of the two TANF children resides in the home also. He is employed and not included in the assistance unit because he is a drug related felon. The father also has his daughter residing in the home, she is a probation violator.

Ineligible Father

  • $600 (Gross earned income) - $90 (Work expense) = $510 (Countable earned income) - $385 (2014 two-person pmt std) = $125 (Available to assistance unit)

Mother

  • $800 (Gross earned income) ÷ 2 (Work incentive) = $ 400 (Countable earned income) + $125 (Available from husband's income) = $ 525 - $200 (Paid support for child living outside the home) = $325 Countable income

  • $478 (2014 three-person pmt std) - $325 (Countable income) = $153 Grant Amount

In this example, the ineligible father's countable earned and unearned income exceeds the payment standard for himself and his ineligible child. As such, the difference is available to meet the needs of his eligible TANF children and added to the assistance unit's net income.

 


Clarifying Information - WAC 388-450-0106

  1. If an immigrant was sponsored into the United States, use WAC 388-450-0155, WAC 388-450-0156, and WAC 388-450-0160 to see how much of the sponsor's income we count.
EXAMPLE:

A legal alien mother and one U.S. citizen child receive TANF cash benefits. The mother is employed and pays $200 court-ordered support for a child not living in the home. mother has two other children who are excluded from the assistance unit because of their alien status. The mother receives $1,000 gross earned income each month from her employment.

  • $562 (2014 four-person pmt std) - $385 (2014 two-person pmt std) = $177 Difference between 2 & 4 person pmt std

  • $1,000 (Gross earned income) division sign 2 (Work incentive) = $500 (Countable earned income) - $177 (Difference between 2 and 4 person pmt std) = $323 - $200 (Paid support for child living outside the home) = $123 Countable income

  • $385 (2014 two-person pmt std) - $123 (Countable income) = $262 Grant Amount

The family has also applied for medical assistance for the two excluded undocumented alien children with an emergent condition; refer the client to WashingtonHealthPlanFinder to apply for medical benefits.

EXAMPLE:

An employed mother and her two children receive TANF cash benefits. The mother pays $200 support each month for a child living outside the home. Her husband is excluded from the AU because of his alien status. One of their children is also excluded from the AU because of her alien status.

  • $648 (2014 five-person pmt std) – 478 (2014 three-person pmt std) = $170 Difference between 3 & 5 person pmt std

  • $1,100 (Wife’s gross earned income) ÷ 2 (Work incentive) = $ 550 (Wife’s countable earned income) - $170 (Diff. between 3 & 5 person payment std) = $ 380 - $200 (Paid support for child living outside the home) = $180 Countable Income

  • $ 478 (2014 three-person pmt std) - $180 (Countable income) = $298 Grant Amount                                                                                                                       

The family has also requested medical assistance for the undocumented alien father and child excluded because of alien status. The child is pregnant.  Refer the client to WashingtonHealthPlanFinder to apply for medical benefits.

The father reapplies the following month after receiving injuries in an automobile accident. The father remains TANF-related.  Refer the client to WashingtonHealthPlanFinder to apply for medical benefits.  

EXAMPLE:

An employed mother and her two children are receiving TANF cash benefits. The father of the two TANF children also resides in the home. He is not included in the AU because of his alien status. The mother also has a 17-year old son who lives in the home but is not included in the AU because he is a probation violator. The mother receives $1,400 gross earned income each month.

  • $562 (2014 four-person pmt std) - $478 (2014 three-person pmt std) = $84 Difference between 3 & 4 person pmt std

  • $1,400 (Wife’s gross earned income) ÷ 2 (Work incentive) = $700 (Wife’s countable income) - $84 (Difference between 3 & 4 person pmt std) = $616 - $305 (2014 one-person pmt std -for son’s needs who is a probation violator) = $311 Countable Income

  • $478 (2014 three-person pmt std) - $311 (Countable income) = $167 Grant Amount

The family also wants medical for the undocumented father and the17-year old son. The son is not an excluded person for TANF-related medical. The father does not have an emergency medical condition.

Refer the client to WashingtonHealthPlanFinder to apply for medical benefits.

EXAMPLE:

For Cash Only
A recently married client and her child receive TANF cash benefits. The new husband is an undocumented alien. The client has earnings of $1,200 per month. The husband earns $300 per month. Calculate the client’s cash income per WAC 388-450-0106. Calculate the undocumented alien’s cash income per WAC 388-450-0116. Combine the calculated totals for the countable income.

For Basic Food Only

The same client also receives Basic Food benefits. Count all her income and a prorated share of the undocumented alien’s income. Divide his earnings by the number of people in the AU, subtract the 20% disregard, and the total is his countable income.

  • $ 300 (Husband's Gross earned income) ÷ 3 People in household = $80 each

  • $ 160 (Countable earned income from husband deemed to Mom and child as unearned)

  • $1,200 (Mom's earnings) - 20% (Subtract the 20% earned income disregard) = $ 960 (Total countable earnings) + $160 deemed from husband = $1,120

Clarifying Information - WAC 388-450-0112

For treatment of income of a non-applying spouse, see WAC 388-450-0137.

Worker Responsibilities - WAC 388-450-0112

  1. To determine an ABD/HEN referral client's net countable earned income, apply rules in WAC 388-450-0177.
  2. Combine the countable earned income with the countable unearned income.
  3. When an ABD/HEN referral client is in a medical institution, alcohol or drug treatment center, congregate care facility, or adult family home has income, deduct the payment standard applicable for the nonapplying spouse and legal dependents living in the home.
    NOTE:

    This deduction only occurs when a ABD/HEN referral client is in a medical institution, alcohol or drug treatment center, congregate care facility, or adult family home.

  4. Deduct the lesser of the department's one-person need standard or the actual amount paid for court or administratively ordered support, to meet the needs of each legal dependent not living in the home.
  5. Subtract the remaining income from the ABD/HEN referral client's applicable payment standard.

ABD/HEN Referral Client in Alternate Living Situation

  1. Deduct from the income of an ABD/HEN referral client in a medical institution, alcohol or drug treatment center, congregate care facility, or family home, the appropriate payment standard for the nonapplying spouse and legal dependents living in the home.
  2. Deduct from the remaining income of the previous step the amount that meets the needs of the ABD/HEN referral client living in the alternate living situation.
  3. The remainder is applied to the client's participation toward cost of care.

 


Clarifying Information - WAC 388-450-0115

  1. See WAC 388-450-0116 for rules on allocating the income of a financially responsible person excluded from the assistance unit because of their alien status.
  2. Do not allow the 50% work incentive for a financially responsible person excluded from the assistance unit.
  3. This rule also applies to TANF/SFA-related medical programs, as specified in WAC 182-503-0510 (2). The rules of this section also apply to the RMA program.
  4. For the definition of a financially responsible person for medical assistance programs, see WAC 182-506-0010.
  5. Do not allow a payment standard deduction for disqualified assistance unit members.

Worker Responsibilities - WAC 388-450-0115

  1. To determine an assistance unit’s eligibility and benefit amount, allocate the income of a financially responsible person who is excluded from the assistance unit to meet the needs of legal dependents living in the home and outside the home.
  2. Determine the countable earned income by deducting the $90 work expense and any applicable dependent care deduction for employment related child care expenses, as specified in WAC 388-450-0170, from the gross earned income of the employed financially responsible person who is excluded from the assistance unit.
  3. Combine the countable earned income and countable unearned income of the excluded financially responsible person.
  4. Subtract the appropriate payment standard for an assistance unit based on the number of ineligible assistance unit members. Do not include persons excluded from the assistance unit due to disqualification.
  5. To meet the needs of each legal dependent not living in the home, deduct the lesser of the department’s one-person need standard or the actual amount paid for court or administratively ordered support.
  6. Consider the remaining income as available to meet the needs of the assistance unit members.
EXAMPLE:

A mother and one child receive TANF cash benefits. The mother pays a court ordered support payment of $160 each month for a child living outside the home.  The mother's husband, and father of the TANF child, reside in the home with his 19-year old child, for whom he is financially responsible. The husband is excluded from the assistance unit as he is a fleeing felon. He also pays $100 per month support for a dependent child living outside the home.

Ineligible Husband

  • $890 (Husband’s gross earned income) - $90 (Work expense) = $800 (Countable earned income) - $385 (2014 two-person pmt std for ineligible husband and his ineligible child) = $415 - $100 (Husband’s paid support for his child living outside the home = $315 (Amount to be allocated to the assistance unit)

Eligible Wife

  • $315 (Available income from her husband) - $160 (Wife’s paid support for her child living outside the home) = $155 Countable Income

  • $385 (2014 two-person pmt std) - $155 (Countable income) = $230 Grant Amount


Clarifying Information - WAC 388-450-0116

  1. If an immigrant was sponsored into the United States, use WAC 388-450-0155, WAC 388-450-0156, and WAC 388-450-0160 to see how much of the sponsor's income we count.
EXAMPLE:

A TANF AU consists of a citizen mother and two children. Also in the household is the undocumented father. He is employed and receives $700 earnings.

  • $562 (2014 four-person pmt std) - $478 (2014 three-person pmt std) = $84 Difference between 3 & 4 person pmt std

  • $700 (Husband’s gross earned income) ÷ 2 (Work Incentive) = $350 (Husband’s countable earned income - $84 (Difference between 3 & 4 person pmt std) = $266 Countable Income

  • $478 (2014 three-person pmt std) - $266 (Countable income) = $212 Grant Amount

EXAMPLE:

A TANF AU consists of a mother who was legally admitted under IRCA and her citizen child. The child’s father was legally admitted under IRCA and employed receiving $700 earnings. He is also a fleeing felon. The couple’s undocumented child also resides in the home. This child is pregnant.

  • $478 (2014 three-person pmt std) - $385 (2014 two-person pmt std) = $93 Difference between 3 & 4 person pmt std

  • $700 (Husband’s gross earned income) - $90 (Work expense) = $610 (Husband’s countable earned income) - $93 (Difference between 3 & 4 pmt std) = $517 - $305 (Husband’s needs) = $212 Countable Income

  • $385 (2014 two-person pmt std) - $212 (Countable income) = $173 Grant amount

In this situation, the father is allowed a one-person payment standard for his needs because he is a legal alien. The couple’s undocumented child is allowed only the difference between the payment standard which would include the child if she were a citizen and the payment standard for eligible citizen assistance unit members.

Refer the client to WashingtonHealthPlanFinder to apply for medical benefits.

 

EXAMPLE:

A household consists of a needy mother and father who were legally admitted under IRCA, their undocumented minor child and her U.S. citizen child. The undocumented minor child is employed and receives $700 earned income. The minor parent was recently hospitalized for an emergent condition.

If the minor parent is the primary caretaker of her child, the minor parent would receive a grant for her child after allocating her income:

  • $385 (2014 two-person pmt std) - $305 (2014 one-person pmt std) = $80 Difference between 1 & 2 person pmt std

  • $700 (Minor parent’s gross earned income) ÷ 2 (Work incentive) = $350 (Minor parent’s countable earned income) - $80 (Difference between 1 & 2 person pmt std) = $270 Countable Income

  • $305 (2014 one-person pmt std) - $270 (Countable income) = $35 Grant amount

In this situation, the parents of the minor parent are not eligible for cash assistance as they do not have an eligible child in the home.

If, however, major mom was determined to be the primary caretaker relative of her grandchild, major mom and the grandchild would be eligible for TANF.

  • $478 (2014 three-person pmt std) - $385 (2014 two-person pmt std) = $93 Difference between 2 & 3 person pmt std

  • $700 (Minor parent’s gross earned income) ÷ 2 (Work incentive) = $350 Minor parent’s countable earned income) - $93 (Difference between 2 & 3 person pmt std*) = $257 Countable Income

  • $385 (2014 two- person pmt std) - $257 (Countable income) = $128 Grant Amount

Refer the client to WashingtonHealthPlanFinder to apply for medical benefits.

 


Clarifying Information - WAC 388-450-0120

For situations involving a pregnant minor or minor parent living with his or her parent, the mandatory assistance unit requirement is not affected by marriage, military service or court-ordered emancipation of the pregnant minor or minor parent; see WAC 388-408-0015.

Worker Responsibilities - WAC 388-450-0120

  1. Deduct a $90 work expense from each parent or stepparent's gross earned income.
  2. Combine the net countable earned income for each parent with the parent and stepparent's gross countable unearned income.
  3. Deduct the appropriate need standard for an assistance unit which contains the non-applying parent and stepparent and any other individuals who:
    1. Are living in the home who is not excluded from the assistance unit due to disqualification; and
    2. Are legal dependents of the non-applying parent or stepparent.
  4. Deduct the lesser of the department's one-person need standard or the actual amount paid for court or administratively ordered support, to meet the need of each legal dependent not living in the home.
  5. Deduct spousal maintenance payments made to meet the needs of individuals not living in the home.
  6. The remaining income is available to meet the needs of the pregnant or parenting minor and children of the parenting minor.
  7. Subtract the remaining income from the pregnant or parenting minor's appropriate payment standard.
EXAMPLE:

A household consists of an unmarried parenting minor, her child, the minor's mother and father, and the minor's sister. The unmarried parenting minor is requesting assistance for herself and her child. The minor's father is employed full-time. His gross income is $1,520. Her mother is also employed and receives $850 each month. The family has no other income.

The minor's father pays $500 a month court-ordered support for the support of a daughter not living in the home. Her mother also pays $300 a month for the support of a 14-year-old son living with his uncle. The minor is responsible for paying rent each month.

  • $2,370 [Parent's monthly gross income ($1,520 + $850)] - $180 ($90 work expense for each employed parent)= $2,190 Parent's net income

  • $1,244 (Three-person need standard – mother, father, minor’s sister) + $500 (Father’s court ordered support) + $300 (Mother’s court ordered support) = $2,044 Total of need standard and outside support

  • $2,190 (Parent’s net income) - $2,044 (Need standard and outside support) = $146 Available income to minor and child

  • $385 (2014 two-person grant standard – minor and child) - $146 (Available income to minor and child) = $239 Minor’s two-person grant amount

Worker Responsibilities - WAC 388-450-0130

  1. When residing together, allocate the income of a nonapplying spouse to meet the needs of the applying spouse who requests inclusion in the assistance unit as a needy caretaker relative of specified degree (e.g., a grandparent applying with a grandchild or an aunt applying with a niece/nephew).
  2. Determine the community income of both caretaker relatives, as specified in WAC 388-450-0005.
  3. Subtract a one-person payment standard from the couple's community income.
  4. Subtract the remaining income from the assistance unit's applicable payment standard to determine the grant amount.
EXAMPLE:

Aunt applies for assistance for her nephew and herself as a needy caretaker relative of specified degree. The aunt's husband also resides in the home. Their income consists of his retirement pension of $600 per month. Determine eligibility as follows:

  • $600 (Total community income) - $305 (2014 one-person pmt standard) = $295 Countable Income

  • $385 (2014 two-person pmt standard) - $295 (Countable income) = $90 Grant Amount

In this situation, it would be to the household's advantage to deny assistance to the needy caretaker relative as the child alone would be eligible for a grant amount of $305.

NOTE:

If the allocated income of the non-applying spouse decreases the payment standard to less than the payment standard without the needy relative, advise the needy relative of the option to receive cash benefits for the eligible child(ren) only.

 


Clarifying Information - WAC 388-450-0140

  1. How to count an ineligible AU member's income and resources
    NOTE:

    If a client is ineligible under conditions in both (a.) and (b.), count their income and / or resources at the full amount (a.), not the prorated amount (b.).

    1. Count all the income and resources for ineligible members disqualified for:
      1. An Intentional Program Violation (IPV);
      2. Failing to comply with a work program under chapter 388-444 WAC;
      3. Fleeing a felony charge or conviction; or
      4. Violating a condition of probation or parole.
    2. Count a prorated share of the income and all of the resources for AU members who are ineligible because they:
      1. Are ineligible ABAWDS under WAC 388-444-0030;
      2. Are undocumented aliens;
      3. Are aliens who were determined ineligible under welfare reform;
      4. Failed to declare their citizenship or alien status on the application
      5. Failed to sign the application; or
      6. Refused to get or provide a Social Security number.
    3. Disregard the ineligible member's income if their student status is the only reason they are ineligible.
  2. How an ineligible member affects the SUA:

    We allow the full SUA for the Basic Food AU.


Clarifying Information - WAC 388-450-0145

Non-members are persons in a residence who:

  1. Are not related or otherwise required to be part of the assistance unit. See ASSISTANCE UNITS; and
  2. Do not purchase and prepare meals together.

Worker Responsibilities - WAC 388-450-0145

  1. Income of assistance unit non-members:
    1. Verify the source and amount of the income.
    2. Use the rules in WAC 388-450-0145 to attribute income to the non-member.
    3. Budget the remaining income for the assistance unit.
  2. Expenses of assistance unit non-members:
    1. Obtain a statement from the assistance unit that declares how household expenses are shared.
    2. Clearly document that non-members:
      1. Share expenses; or
      2. Make cash payments to the assistance unit for the non-member's share of expenses; or
      3. Make payments to a third party (vendor payments); or
      4. Have no obligation for household expenses.
    3. If shared household expenses cannot be separated:
      1. Divide the total expenses of the residence by the total number of household members including the non-assistance unit member;
      2. Multiply the answer by the number of non-members to determine their prorated share; and
      3. Do not allow the non-member's prorated share as a household expense.
  3. Income of an ineligible student for Basic Food: Income received by an ineligible student is not available to an assistance unit as follows:
    1. Earned income of an ineligible student is not available to the other eligible members of the Basic Food AU unless the ineligible student makes it available; and
    2. Income received by the ineligible student on behalf of others is not available to the AU unless the ineligible student makes it available. Such income includes, but is not limited to:
      1. Veterans' Administration (VA) educational benefits; and
      2. Other benefits received where the amount depends on the number of dependents.

 


Clarifying Information - WAC 388-450-0155

  1. An Affidavit of Support is a form completed by the sponsor of a prospective immigrant as evidence that the immigrant is not likely to become a "public charge", i.e. primarily dependent on public assistance.
  2. Old affidavits of support: USCIS previously used an I-134 affidavit of support for people who sponsored a family member. We only deem a sponsor's income to a sponsored immigrant if the sponsor completed the I-864 or I-864A.
  3. When the USCIS requires an affidavit of support: The USCIS requires a US citizen to complete an affidavit of support in order to bring a relative into the US as an immigrant. USCIS also requires the affidavit when an immigrant enters the US on an employment-related immigration petition. The USCIS has detailed information on-line about who must have the affidavit at: https://www.uscis.gov/sites/default/files/USCIS/Resources/F3en.pdf
  4. A sponsor's liability: A sponsor may be responsible to repay benefits the department pays for a sponsored immigrant. The process for this is not set at this time. A sponsor is not liable to repay benefits for a period when:
    1. The sponsor is a member of the sponsored immigrant's AU; or
    2. The sponsored immigrant starts to receive benefits after they become a US citizen or have 40 qualifying quarters of work.
  5. When a sponsored AU member withholds sponsor information: Sponsored AU members may choose to withhold information about their sponsor. However, they become ineligible AU members as a result.

Worker Responsibilities - WAC 388-450-0155

  1. Check to see if the client is exempt from deeming under WAC 388-450-0156.
  2. If the client isn't exempt, help them get the information they need to deem the sponsor's income:
    1. Get as much information as possible about the client's sponsor including name, last known address, phone number; and
    2. Attempt to contact the sponsor and get the information you need; or
    3. If you can't get more current information, use the affidavit of support to decide the sponsor's income and resources. Get a copy of the affidavit from the client, the client's sponsor, USCIS, or the Attorney General.
    4. If you can't get a copy of the affidavit of support, try to get another form of verification. Don't delay benefits if you can verify the information from another source.
  3. If the sponsored immigrant is unwilling or unable to provide their sponsor's information, determine eligibility and benefits for the rest of the unsponsored AU members. Don't include the needs of the sponsored immigrant, but include the immigrant's actual income and resources.
NOTE:

Lack of verification of income and resources from a sponsor does not affect eligibility for the unsponsored household member. Do not delay, deny, or terminate benefits to unsponsored AU members based on lack of sponsor verification.


Clarifying Information - WAC 388-450-0156

  1. SSA qualifying work quarters: SSA decides how much income someone must earn in order to earn a qualifying quarter of work. See WAC 388-424-0008 for information on how to decide if someone has 40 qualifying quarters of work.

    If an immigrant has 40 qualifying quarters of work using the spouse's work quarters, the immigrant keeps the exemption even if the immigrant divorces the spouse at a later date.

  2. Children and pregnant women are exempt from sponsor deeming for medical benefits.
  3. Children are exempt from deeming for Basic Food: For Basic Food, we do not deem a sponsor's income or resources to children in the sponsored immigrant's household even if the child is a sponsored immigrant or a U.S. citizen. When the child turns age 18, we must deem the sponsor's income unless the child is exempt for some other reason. See example of deeming of sponsor's income under WAC 388-450-0160 when there are exempt children in the sponsored immigrant's household.
  4. Deeming is time-limited for state-funded benefits: For state funded benefits, we only deem a sponsor's income to the immigrant for five years from the date the sponsor signed the affidavit of support. For federal benefits, we continue deeming a sponsor's income and resources until the immigrant is exempt from deeming under WAC 388-450-0156.
  5. Using in-kind income: We do not deem in-kind income to the client. We add the sponsored immigrant's in-kind and other income outside of ACES and compare against 130% of the FPL to decide if the client is exempt from the deeming process. The United Stated Department of Health and Human Services (HHS) publishes the federal poverty level guidelines.
  6. Value of in-kind income: We use the amount someone would normally pay for items or services (the market rate) as the value of free rent, commodities, goods, or services when we look at a client's in-kind income to decide if they are exempt from the deeming process.
  7. Alien Emergency Medical: If a non-citizen isn't eligible for other medical benefits, that person may be eligible for AEM. We don't deem a sponsor's income or resources for AEM. See WAC 182-507-0110.
  8. Special Immigrants: Immigrants from Iraq or Afghanistan who were granted Special Immigrant status under section 101 (a)(27) of the INA are not required to have a sponsor, and therefore, not subject to deeming rules.
  9. Renewing Indigence Exemptions: While indigence exemptions expire at the end of 12 months, they may be renewed for additional 12-month periods if the eligibility criteria are met.
  10. Reporting Indigence Exemptions: The requirement to report indigence exemptions to the U.S. Attorney General described in WAC 388-450-0156 (7) applies only to recipients of federal benefits and is only done after giving them the opportunity to opt out and decline the exemption. Sponsored immigrants must be told the consequences of opting out of the deeming exemption to avoid indigence reporting. Although recipients of state benefits are also eligible for the exemption, they will not be reported. See Worker Responsibilities #5 for instructions.
  11. Sponsored Immigrants Prior to 12/19/97: For the purpose of income deeming, a sponsored immigrant is defined as an immigrant for whom a person (the sponsor) has signed an affidavit of support (Form I-864 or I-864A) on behalf of the immigrant pursuant to section 213A of the INA. These forms were not used prior to 12/19/97, so legal permanent residents with this status on or prior to 12/19/97 are exempt from deeming.

 

Worker Responsibilities - WAC 388-450-0156

  1. When a sponsor abandons an immigrant:
    1. If the sponsor abandoned the client, look to see if the client meets the exemption for having income at or below 130% of the FPL and explain to the client about the requirement to notify the U.S. Attorney General if they decide to use the indigence exemption.
    2. If the client meets this exemption, the department must notify the U.S. Attorney General only after giving the client the opportunity to opt out and decline the exemption. See Notifying U.S. Attorney General.
  2. Deciding if a sponsor is permanently incapacitated:

    Unless it is questionable, accept the client's statement that the sponsor is permanently incapacitated. If you think the sponsor may not be incapacitated, request a note from the sponsor's doctor.

  3. When a sponsored immigrant gets long-term care services: See WAC 182-513-1325, WAC 182-513-1340, and WAC 182-513-1350 for information on how to treat income and resources for a client who gets long-term care services.
  4. Deciding if the AU has more than 130% of FPL:
    1. Start with the AU's earned and unearned income;
    2. Add any cash or in-kind benefits the client receives from any source.
    3. The result is the client's total cash and in-kind income.
    4. Multiply the current FPL based on the client's AU size by 1.3.
    5. Compare the total cash and in-kind income to 130% of FPL.
    6. If the client's total income is at or below 130% of FPL, exempt the client from deeming for 12 months. See Notifying the U.S. Attorney General.

    EXAMPLE:

    A sponsored-immigrant family of four applies for benefits. The family gets $250 a month from their sponsor and stay in an apartment furnished by the sponsor's church. The apartment has been rented for $600 a month. The husband earns $450 a month and the wife earns $200 monthly.

     

     

    • $450 (Husbands income) + $200 (Wife's income) + $250 (Monthly income from sponsor) + $600 (In-kind income - free rent from church) = $1500 Total cash and in-kind income
    • $1509 (2002 Monthly FPL for a family of four) X 1.3 (130%) = $1961 (130% of FPL to decide on exemption)

     

     

     

     

    In this example, the client's cash and in-kind income of $1500 is less than $1961. The client is exempt from the deeming process for twelve months. This exemption can be renewed if the client's income remains at or under 130% of the monthly FPL.

    EXAMPLE:

    A sponsored-immigrant family of two applies for benefits. The sponsor does not give them money, but they give the clients $300 work of food and household items each month. The immigrant earns $1200 monthly from their job.

     

    • $1200 (Immigrant's income) + $300 (In-kind income from sponsor) = $1500 Total cash and in-kind income
    • $995 (2002 Monthly FPL for two people) x 1.3 (130%) = $1294 (130% of FPL to decide on exemption)

     

    In this example, the client's cash and in-kind income of $1500 is more than $1294. The client is not exempt from the deeming process. Calculate how much of the sponsor's income to deem under WAC 388-450-0160.

    NOTE:

    A client is not automatically eligible for benefits by being exempt from deeming.

  5. Notifying the U.S. Attorney General:
    1. When you approve federal benefits for a client who is exempt from deeming for having income at or below 130% of the FPL, CSD headquarters staff must notify the U.S. Attorney General (USAG). Before you communicate with CSD headquarters staff, explain to the client:
      1. the purpose of the 130% FPL household income determination;
      2. that they have the right to "opt out" of the deeming exemption; and
      3. that the consequence of not giving their consent to the USAG notification is the department counting a part of their sponsor(s)' income toward the budget used to decide their eligibility and benefit level.
    2. If the client gives their consent to the USAG notification take the following steps:
      1. Complete the Indigence Exemption report form in Barcode (under Forms in the client's ECR) adding the following information:
        • Name(s) of the sponsored immigrant(s) who have been approved for federal benefits and their Client ID numbers;
        • Name of sponsor; if there is more than one sponsor, it is only necessary to enter the primary sponsor
        • Which federal programs the immigrant is eligible for and start date of each.
      2. Submit the report to CSD headquarters staff via Barcode
      3. Document in ACES narration that the client is exempt from deeming and that you referred the case to CSD headquarters staff to notify the USAG.
      4. Set a user-generated tickler in Barcode for an Indigence Exemption Review with a ready date of 12 months from date of exemption.
NOTE:

Don't refer a client if they are exempt for any reason other than having income under 130% of FPL (e.g., the client was sponsored by an organization.) Don't refer a client who is receiving only state benefits.

 


Worker Responsibilities - WAC 388-450-0160

Calculate the amount of income to deem for cash assistance, medical programs, or Basic Food as follows:

  1. Total the sponsor's countable earned income (and the earned income of the spouse if appropriate). Subtract 20% from this amount.
  2. Total the sponsor's countable unearned income (and the unearned income of the spouse if appropriate) and add this to the result above.
    • For cash assistance: Subtract the need standard based on the number of people in the sponsor's AU (WAC 388-478-0015 );
    • For Basic Food: Subtract the maximum gross monthly income based on the number of people in the sponsor's AU (WAC 388-478-0060 );
  3. If the sponsor completed an I-864 or I-864A for more than one person:
    1. For Basic Food, divide the countable income by the number of immigrants that are sponsored by the sponsor and any U.S. citizen children in the immigrant's household under the age of 18;
    2. For SSI-related medical, follow instructions listed under WAC 182-512-0795;
    3. For cash, divide the countable income by the number of immigrants that are sponsored by the sponsor;
    4. Multiply by the number of non-exempt immigrants they sponsored that are in this AU.
  4. Document the calculation you just completed.
EXAMPLE:

The client is a single sponsored immigrant. The client's sponsor and their spouse have combined earned income of $2300 and $231 unearned income each month. The sponsor, their spouse, and 12-year old son live in the sponsor's home. The sponsor has signed an I-864 for one other immigrant.

Cash Assistance

  • $2300 earnings - $460 (20%) = $1840 + $ 231 (Unearned income) = $2071 (Combined earned and unearned income)
  • $2071 (Combined earned and unearned income) - 1763 (Need standard for 3 people) = $ 308 (Income deemed from the sponsor)/ 2 (# of immigrants for whom sponsor signed I-864) =  $154 Income we deem to the client for cash assistance

Basic Food

  • $2071 - $1984 (Maximum gross monthly income for 3) = $ 87 Income deemed from the sponsor/ 2 (# of immigrants for whom sponsor signed I-864)
  • $ 44  Income we deem to the client for Basic Food
EXAMPLE:

The client is a single pregnant sponsored immigrant with no income. The client's sponsor and the spouse have combined earned income of $2800 each month. They have no unearned income. The sponsor and the spouse live alone. The sponsor hasn't signed any other affidavit of support.

Cash Assistance

  • $2800 earnings - $560 (20%) = $2240 - 1428 Need standard for 2 people = $812 (Income we deem to the client for cash assistance)
 
Basic Food
  • $2800 earnings - $560 (20%) = $2240 - 1579 (Maximum gross monthly income for 2 people) = $661 (Income we deem to the client for Basic Food)
NOTE:

Because the deemed income is under 185% of the FPL, the pregnant woman is eligible for pregnancy medical benefits.

EXAMPLE:

Example with exempt children in the household: A Basic Food household consists of one sponsored adult, one sponsored child, and one U.S. citizen child. After applying the allowable disregards and deductions to the sponsor’s income, $900 of the sponsor’s income is deemed to the household.

For Basic Food: Divide the deemed income by the number of sponsored immigrants and all children in the Basic Food household, and count only the portion for the sponsored adult. - $900 ÷ 3 (1 adult, 2 children ) = $300 $300 x 1 sponsored adult = $300 (amount budgeted against the BF household)


ACES Procedures

Top of Page

Indian Agencies Serving Tribes With a Near-Reservation Designation

Revised March 25, 2011

Purpose:

Indian Agency Tribes / Counties / Towns
Colville Agency
William E. Nicholson, Superintendent
Connie George, Social Worker
P.O. Box 111
Nespelem, WA 99155

(509) 634-4711

Colville Tribe:
Douglas, Ferry, Grant, Okanogan and Stevens counties
Nez Perce Tribe, Dept. of Social Services
Stella Charles, Manager
Karole White, Social Worker
P.O. Box 365
Lapwai, ID 83540

(208) 843-2463

Nez Perce Tribe:
Towns of Asotin and Clarkston
Olympic Peninsula Agency
Raymond Maldonado, Superintendent
1216 Skyview Drive
P.O. Box 48
Aberdeen, WA 98520

(360) 533-9100

Chehalis Tribe:
Cowlitz, Grays Harbor, Lewis, Mason and Thurston counties

Hoh Tribe:
Clallam, Grays Harbor and Jefferson counties

Quileute Tribe:
King County. Town of Forks.

Shoalwater Bay Tribe:
Grays Harbor and Pacific counties

Squaxin Island Tribe:
Kitsap, Mason, Pierce and Thurston counties

Puget Sound Agency
William A. Black, Superintendent
Albert Milk, Social Worker
3006 Colby Avenue
Federal Building
Everett, WA 98201

(425) 258-2651

Jamestown/ Klallam Tribe:
Kitsap County.

Lummi Tribe:
Whatcom County

Muckleshoot Tribe:
King and Pierce counties.

 Nisqually Tribe:
Pierce and Thurston counties

Nooksack Tribe:
Skagit and Whatcom counties

Puyallup Tribe:
King, Kitsap, Pierce and Thurston counties

Suquamish Tribe:
King, Kitsap, Mason, Pierce, Snohomish and Thurston counties

Swinomish Tribe:
Skagit County

Tulalip Tribe:
Snohomish County

Spokane Agency
Sharon Yepa, Superintendent
Merrita Ford, Social Worker
P.O. Box 389
Wellpinit, WA 99040

(509) 258-4561

Kalispel Tribe:
Pend Oreille, Spokane and Stevens counties

Spokane Tribe:
Counties of Lincoln, Pend Oreille, Spokane and Stevens.

Yakima Agency
Ernie Clark, Superintendent
Larry Carranza, Social Worker
P.O. Box 632
Toppenish, WA 98948

(509) 865-2255

Yakama Tribe:
Grant, Klickitat, Skamania and Yakima counties
Towns of Ellensburg and Wenatchee.

 

Best Estimate Guide

Revised March 25, 2011

Purpose:

CONSIDER Use information from the client, pay stubs, statements from employers, and other available proof of income to answer the following:
Rate of Pay:
  • Does the client receive a salary or an hourly wage?
    • If hourly, what is the hourly wage and how many hours does the client work each pay period?
  • Is the client paid by the piece?
    • If paid for piecework, how much is the client paid for each piece and how many pieces do they normally complete each pay period?
  • Does the client receive tips or commissions?
Pay Dates:
  • What are the client's pay periods?
  • What are the client's pay dates?
  • Is the client paid on the same day each week?
  • Is the client paid on specific days of each month?
Past Income:
  • If unable to anticipate expected hours or pay rate, look at past income:
    • Do the last 3 months represent what the client should get?
    • Do the last 30 days represent what the client should get?
  • Should special circumstances be considered when looking at past income?
    • If the client has a new job, is there a partial first check?
    • Does one of the pay periods include a time the client had leave without pay due to illness or other reasons?
    • Did one pay period include overtime because the client worked extra hours for a sick co-worker?
    • Is the income higher or lower than normal due to seasonal fluctuations?
Recent Changes:
  • Has the client recently lost their job?
    • When will the client get their last check?
    • Will the client get any money from "cashing out" vacation, sick pay, or retirement benefits?
    • Will the client get any severance pay, unemployment compensation, or retirement benefits?
  • Has there been a recent employment change:
    • From full-time to part-time?
    • In the number of hours worked?
    • In the client's wage or salary?
    • From one job to another?
  • Has the client received overtime pay or bonuses?
  • Have there been other changes that would impact eligibility or benefit level?
Changes Expected During the Certification Period:
  • Are the hours going to go up or down?
  • Is the income ending?
  • Has the client’s job just started?
  • Will they receive more paychecks next month than they did this month?

Budgeting

Revised September 13, 2017

Purpose:

This section contains cash, medical and Basic Food rules and procedures for budgeting income.

WAC 388-450-0215 How does the department estimate my assistance unit's income to determine my eligibility and benefits?

WAC 388-450-0225 How are my assistance unit's benefits calculated for the first month I am eligible for cash assistance?

WAC 388-450-0230 What income does the department count in the month I apply for Basic Food when my assistance unit is destitute?

WAC 388-450-0162 for the definition of countable income and its effect on eligibility.

Worker Responsibilities and Clarifying Information using above WACS. 

WAC 388-450-0245 When are my benefits suspended?


Worker Responsibilities 

The following topics are discussed below:

  • Budgeting for Apple Health for Kids and Pregnancy Medical
  • Recording Hours of Employment
  • Best Estimate
  • Averaging
  • When AM Must Be Used to Budget Income
  • Month of Application
  • Client Choice
  • Special Circumstances for Budgeting Income and Expenses
  • Budgeting Income for Medical Programs
  • Budgeting Deductions
  • Effect of Incorrect Estimates
  • Determining the Effective Date When a Client's Income Causes Them to be Ineligible

Budgeting for Apple Health for Kids and Pregnancy Medical

You may choose the budgeting method for Apple Health for Kids (WAC 182-505-0210) and/or pregnancy medical (WAC 182-505-0115) that is most beneficial to the client.

  1. You may choose either anticipated monthly (AM) or averaging (CA) budgeting methods.
  2. You don’t have to use AM method in the month of application.
  3. You may need to use a different budgeting method for cash or food.

These households are continuously eligible; therefore, changes in income or household composition will not affect eligibility for Apple Health for Kids and pregnancy medical

EXAMPLE:
 Peter applies for Basic Food and medical for his 6-year-old son. Peter is employed and earns $1200 every other week. The gross income limit for Basic Food and Apple Health for Kids for a household of two is $2430. He will receive two checks in the month of application. Using the CA method, Peter's income would put him over the income limit for both programs ($1200 x 2.15 = $2580). Using the AM method, Peter will be under the income limit for both programs because only the two checks he will actually receive in the month of application will be budgeted ($1200 x 2 = $2400). Budget his income using the AM method to open up the F06/Basic Food, and set a tickle to adjust Peter's income in a month where he will receive three paychecks.
EXAMPLE:
Scott, Sally and 4 year old Suzie apply for TANF, food benefits, and medical. Scott’s been self-employed for the last 2 years as a house painter but work has slowed down. Sally is unemployed and pregnant. They provided all categorical eligibility criteria and last year’s federal IRS tax return (net yearly income of $36,000.00/$3000.00 monthly). The declared income and business expenses from the last IRS return is below the 4 person FPL for both P02 ($3183.85) and F06 ($3442). Unless questionable, open P02 and F06 based on the information provided. For TANF and food benefits, pend for more recent verification of income and actual business receipts as appropriate.
EXAMPLE:
Christie has mailed an application for pregnancy medical in October. She included all categorical eligibility criteria, EDC statement, and September wage stubs. She’s worked at ABC Bookstore for the last three years. She is a salaried employee, earning $1400.00 gross income per month. The worker verifies her income via SPIDER cross match and as they represent current and/or anticipated income, opens P02 medical.
EXAMPLE:
Jamie leaves an application at the local office, applying for children’s medical for her two kids. She attached all categorical eligibility criteria. The application states she works fulltime, earning $1800.00 gross per month as a transit bus driver. She also receives $400.00 per month in child support. The worker verifies earnings of $2100.00 via SPIDER and the DCS cross match confirms $400.00 per month child support, for a total gross income of $2500.00/month. Even though the declared income is different than the verified income of $2500.00 per month, it is still less than the 3 person FPL of $2862.00 and the worker opens F06.
NOTE:
If the readily available income verification for the household is HIGHER than their declared income but LOWER than the income standard, do not delay processing for verification of the lower income amount.

Recording Hours of Employment

For TANF cases, we must verify and record the anticipated hours that a person will be working in the same manner that we budget anticipated income. This is necessary to capture hours of employment for WorkFirst households. We use ACES (not eJAS) data to claim WorkFirst employment hours towards meeting the federal work participation rate. Treat in-kind income, such as working in lieu of paying some or all of one's rent, as employment, verify the hours and enter the hours into ACES. This intensive recording does not include child-only TANF cases, or self-employment (SE) income. See below for how to code SE hours.

ACES will automatically capture and report employment hours from the ongoing month forward. See the following links for information about how to capture and report employment hours in historical months from the employment start date.

  • Regular employment - WorkFirst Handbook section 8.1.4
  • Community Jobs - WorkFirst Handbook section 8.3.10

Note:  Community Jobs and Job Connection pays the state or local minimum wage, whichever is higher.

For employed persons on TANF, we record:

  • The best estimate of the actual hours we expect the person to work each month when we budget their anticipated income using the Anticipate Monthly (AM) method; or
  • An average monthly amount of hours using the Combined Average (CA) budgeting method and the person’s pay frequency; and
  • The actual date the person’s work began, particularly for new jobs.

For self-employed persons on TANF, ACES will use SE data to calculate the average weekly hours of SE and display that information in eJAS.

  • ACES will apply the 50% SE expense standard deduction or use the parent's allowable, verified business expenses, as appropriate, to determine the amount of the cash grant without any action on your part. Only enter verified business expenses on the ACES EARN screen. ACES will treat all SE earned income expense types as actual business expenses.
  • Self-employment formula to calculate federally countable WorkFirst PT or FT participation hours:
  1. ACES will subtract the parent's allowable, verified business expenses or the 50% SE expense standard deduction, whichever is greater, from her or his gross monthly business receipts.
  2. Divide the result by the federal minimum wage.
  3. The result is the number of self-employment hours per month.
  4. Divide the number of hours per month by 4.33.
  5. The result is the number of hours per week.
NOTE: Though we must capture and verify the hours and start date information to the best of our ability for TANF, it is not an eligibility requirement by itself. We cannot delay or deny benefits for missing hours or begin date information when we do not need it to determine benefits.

Steps to arrive at the best estimate of the client's income

  1. During the interview process, identify all sources of earned and unearned income that are:
    1.  Owned by the client; and
    2. Available to the client.
  2. Subtract any income excluded or disregarded; and
  3. Budget the income remaining using the appropriate calculation method based on the client's choice or the requirements of WAC 388-450-0215.

How to determine the best estimate of a client's income and hours

The best estimate of a client's income and hours is:

  1. What hours you can reasonably expect a client to work (including overtime hours); and
  2. What income is reasonably expected to be received for the pay period frequency?
EXAMPLE Client who is paid yearly $18,000.00 in June, applies in June and estimates they will continue to earn $18,000.00/year. Budget $1,500.00/month for the month of application, then budget $1,500.00/month on-going.
EXAMPLE Jerry, a seasonal farmworker, is in the office for a Basic Food/TANF re-certification. Jerry isn't currently working and has no other income. In the past several years, he has always worked this season and had an average monthly income of $900.00. Jerry states he intends to work as soon as the farms start hiring. Since no source of income is identified, no income should be budgeted. When Jerry starts working, he must report the change for TANF which will affect his Basic Food.  If Jerry was Basic Food-only, he would not have to report until his income exceeded 130% of the FPL.
EXAMPLE Dawn ends her job at Burgertown on June 30th to work at Lotsabooks.com. Burgertown pays weekly on Fridays with a one-week period between the end of a pay period and the payday for that week's work. The job at Lotsabooks starts on July 5th. Pay periods at Lotsabooks are the 1st - 15th and 16th - End of month. Dawn is paid ten days after the pay period ends (the 10th and 25th ). When you estimate the income for July, consider that she will: · Receive the last check for Burgertown on July 7. · Receive the first check for Lotsabooks on July 25th, which will be for a partial pay period. Remember to update her work hours along with her income if Dawn is on TANF.
EXAMPLE  Bob normally works 30 hours per week at a department store. Every other month he works 20 hours overtime to conduct inventory at the store. Since the overtime hours are consistent and are reasonably expected every other month these hours and income must be included and budgeted for the benefit calculation. Bob's average monthly hours would be 30 hours per week x 4.3 = 129 10 hours (20 hours/2 months) = 139 hours per month x the hourly wage = average monthly income.   (Note:  Remember that overtime hourly rate may be higher if weekly hours exceed 40 h
NOTE: What you can expect may vary depending upon length of employment, consistency of hours, wages, and anticipated changes. See Best Estimate Guide. See Interview Requirements for more information on interviews. See Income - Treatment and Income - Special Types to find out if a specific type of income is excluded or disregarded. See WAC 388-450-0005 to decide if income is owned by and available to the client.

Averaging

Use the Combined Average (CA) method in ACES to calculate income when clients expect their income to change from month to month, but want their benefits to stay the same. The income we budget and hours we estimate will depend on the frequency that the person is paid.

It may be appropriate to use past wage stubs to do the averaging if it represents what the client expects to receive. In certain situations, such as new employment or recent changes in the client's rate of pay or work hours, it may be more appropriate to use an estimate from the employer.

  1. Estimate the income and hours per pay period as follows:
    1. If using wage stubs:
      1. Total the gross income from all pay periods where the income represents what the client should receive; and
      2. Divide by the number of pay periods used in step (i).
    2. If using an employer statement, take the anticipated weekly amount and:
      1. Multiply by 1 if paid weekly.
      2. Multiply by 2 if paid biweekly (every other week).
      3. Multiply by 52 weeks per year and divide by 24 pay periods if paid twice a month.
      4. Multiply by 52 weeks per year and divide by 12 pay periods if paid once a month.
  2. Enter the result from step (1)(a) or (1)(b) on the EARN screen in ACES using the CA method and the appropriate pay frequency.
    1. To get the monthly amount, ACES will take the amount from step (1)(a) or (1)(b) and:
      1. Multiply by 4.3 if paid weekly.
      2. Multiply by 2.15 if paid biweekly (every other week).
      3. Multiply by 2 if paid twice a month.
      4. Multiply by 1 if paid monthly.
 NOTE:
The methods listed in step 1 are not inclusive. Based on the type of employment and frequency of pay, you may find that another budgeting method is more appropriate. It is important that you document in the remarks and describe in detail what method you used to determine the income you budget. 
NOTE:
ACES will perform the conversion calculation based on the budgeting method and pay frequency used. See the ACES User Manual for more information.
EXAMPLE:* *
Terry started a new job. The employer states Terry will work 15 - 25 hours per week at $9.50 per hour and will be paid twice a month. The employer does not expect this to change.  Determine the anticipated income as follows: - (15 hours per week 25 hours per week) ÷ 2 = 20 hours per week average - 20 hours per week x $9.50 an hour = $190 per week - $190 per week x 52 weeks = $9,880 per year - $9,880 per year ÷ 24 pay period s per year = $411.67 per pay period - $411. 67 per pay period x 2 pay period per month =
$823.34 per month. ** Determine the anticipated hours as follows: - (15 hours per week 25 hours per week) ÷ 2 = 20 hours per week - 20 hours per week x 52 weeks = 1,040 hours per year - 1,040 hours per year ÷ 24 pay period s = 43.33 hours per pay period - 43.33 hours per pay period x 2 pay periods per month = **86.66, round up to 87 hours per month* *
EXAMPLE:* *
Same situation as above, except client is paid
biweekly (every other week). Determine the anticipate d income as follows: - (15 hours per week 25 hours per week) ÷ 2 = 20 hours per week - 20 hours per week x $9.50 an hour = $190 per week - $190 per week x 2 weeks per pay period = $380 per pay period - $380 per pay period x 2.15 = $81 7 per month* * Determine the anticipate d hours as follows: - (15 hours per week 25 hours per week) ÷ 2 = 20 hours per week - 20 hours per week x 2 weeks per pay period = 40 hours per pay period - 40 hours per pay period x 2.15 = **86 hours per month* *
EXAMPLE:**
Same scenario as above but the client is paid
twice a month.** Determine the average income as follow: $912, $948, $984, 960, = $3,804 ÷ 4 pay periods = $951 per pay period.   $951 per pay period x 2 pay periods per month = $1,902 per month.   Determine the average hours as follows: 76,79, 82, 80, = 317.  317 ÷ 4 pay periods = 79.25 per pay period.  79.25 per pay period x 2 pay period s per month = **158. 5 (round up to 159) hours per month* *
NOTE:  If you are using past work history to estimate future income, remember that the rate of pay may have changed. Use the average hours from the previous pay periods and the new pay rate to calculate the income. 
EXAMPLE:**
Tom applies for cash and Basic Food benefits. He works 20 - 30 hours per week and is paid
every other Friday**. Tom earns the minimum wage of $9.04 an hour. He provides three pay stubs that show 40, 50, and 54 hours per pay period. Tom states he expects his hours to remain about the same as they have been over these periods. Determine the average monthly income as follows: - (40 hours 50 hours 54 hours) ÷ 3 = 48 hours per pay period - 48 hours per pay period x $9.04 an hour = $433.92 per pay period - $433.92 per pay period x 2.15 = $932.93 per month. Determine the average monthly hours as follows: - (40 hours 50 hours 54 hours) ÷ 3 = 48 hours per pay period - 48 hours per pay period x 2.15 = 103.2 (round up to 104) hours per month.
NOTE:
Take the annual adjustment to minimum wage into account when you estimate earnings. The Department of Labor and Industries adjusts the state minimum wage every January. The current minimum wage for the state is available at: http://www.lni.wa.gov/WorkplaceRights/Wages/Minimum/default.asp
EXAMPLE:
Ann was just hired for a new job. The employer states that Ann will start working 40 hours per week beginning July 15th, but because of the time lag in the employer's payroll system, Ann won’t receive her first weekly check until the first Friday in August. Ann will receive a $400 weekly salary every Friday. - Budget no income for this job in July. - For August and ongoing months, determine the anticipated monthly income and hours as follows: - Multiply $400 per week x 4.3 = $1,720 per month - Multiply 40 hours per week x 4.3 = 172 hours per month. Even though Ann is salaried, we also note the correct hours per pay period in ACES. In this example, the client works 40 hours per week.

To find information on entering income and work hours in ACES, see Income Eligibility and Budgeting – (EARN) Earned Income Screen

When AM Must Be Used to Budget Income

  1. For Basic Food only, if an AU is destitute under WAC 388-406-0021:
    1. Use AM for the month of application. If you do not have to use AM for any other reason, you may use either AM or averaging for the remainder of the certification period.
    2. Provide expedited service if available cash resources are $100 or less under WAC 388-406-0015.
    3. See WAC 388-450-0230 to determine if we exclude any of the AUs income for the month of application.
  2. AM and SSI-related medical:
    1. Use AM to budget all of the client’s income if:
      1. A client receives SSI-related medical; or
      2. The AU has income allocated to someone receiving SSI-related medical. The following program codes in ACES require AM:
           
        G G03, G95, G99
        L L01, L02, L04, L21, L22, L95, L99
        S S01, S02, S03, S04, S05, S07, S08, S95, S99
  3. You don't have to use AM to budget the income of a client in the Basic Food AU with someone receiving SSI-related medical if the client doesn't:
    1. Receive SSI-related medical;
    2. Have income allocated to someone receiving SSI-related medical; or
    3. Meet any of the other requirements to use AM under WAC 388-450-0215.
EXAMPLE:
 Sheila receives SSI; her spouse has earned income that Social Security allocates to her. Budget Sheila’s SSI income using AM because the income is SSI. Budget hers spouse's income using either AM or averaging.  Don’t allocate income to a spouse receiving SSI medical.
  1. When clients get SSI, but no one in the AU gets SSI-related medical:

Budget SSI and Social Security income using AM. If there is no other situation that requires us to use AM, use either method for the other sources of income.

Month of Application

  1. AM method is not required
    1. With the exception of those in subsection (5) of WAC 388-450-0215, you do not have to obtain or budget actual income the household has already received in the month of application if you have enough information to reasonably estimate the client's income by averaging.
  2. Conversion of Income
    1. If a client is paid weekly or biweekly and you convert the income using 2.15 or 4.3 method, you must also convert in the month of application, unless:
      1. A full months' income is not anticipated in the month of application. In this situation, budget AM in the month of application and average the income for the rest of the certification period.
      2. The client chooses to use the AM method. If we use AM in the month of application, we must also use it for the rest of the months in the certification period. See Client Choice for more information.
EXAMPLE:
Jan applied for Basic Food on 01/01/12. She just lost her job and has applied for unemployment benefits. In January, she will receive one final paycheck and two unemployment checks. For February and on-going, she will receive weekly unemployment checks. For the application month, budget the final paycheck using AM method since no other earning is expected from this income source, and budget the two unemployment checks using AM method since she did not receive a full-month of UC benefits. For February and on-going, budget the unemployment benefits using CA method (unless Jan chooses to use AM for all months).
EXAMPLE:
Jen applies for Basic Food for herself and two kids on Friday, 07/01/11. She was interviewed on 07/05/11. Jen works full-time and provided a statement from her employer indicating that she works 30-40 hours a week and is paid $9 an hour, every Friday. No change to her employment is expected in the near future. In the month of July, Jen will receive five paychecks. You do not have to request for a copy of the July 1st paycheck or budget 5 checks in July. Use the employer's statement and budget Jen's income for the month of application and on-going using CA/WE method.
EXAMPLE:
Peter applies for Basic Food and medical for his 6-year-old son. Peter is employed and earns $1200 every other week. The gross income limit for Basic Food and apple health for kids for a household of two is $2430. He will receive two checks in the month of application. Using the CA method, Peter's income would put him over the income limit for both programs ($1200 x 2.15 = $2580). Using the AM method, Peter will be under the income limit for both programs because only the two checks he will actually receive in the month of application will be budgeted ($1200 x 2 = $2400). Budget his income using the AM method to open up the F06/Basic Food, and set a tickle to adjust Peter's income in a month where he will receive three paychecks.

Client Choice

  1. If you don't have to use AM, clients can choose either budgeting method unless the client is paid less often than monthly, such as quarterly or yearly. In this situation, we must average the income.
  2. If a client has more than one source of income, the budgeting method for each source does not have to be the same. For example, if a client has two different jobs, you can use AM for one job and CA for the other.
  3. The client's choice should be guided by whether:
    1. They want their benefits to remain consistent through the certification period; or
    2. They want their benefits to change based on anticipated changes in income and hours.
  4. Sometimes the client's circumstances make AM a likely choice, such as when they:
    1. Have stable income such as a regular monthly salary;
    2. Are paid daily;
    3. Expect several changes at different times within the month (e.g. regular hours for the first week, no hours for the second week due to unpaid leave, raise in wages on the third week); or
    4. Expect to get less than a full month's income due to the beginning or end of a source of income.
  5. There are times when one method will be more beneficial to the client. If a client is ineligible using one method, review the case to see if the client would prefer another method.
  6. Calculation methods cannot be changed during a certification period just to maximize a client's benefits. Changing calculation methods to give a client more benefits does not result in the best estimate of the client's income and hours for the entire certification period. Changes in methods may occur at:
    1. Application, eligibility review, or recertification; and
    2. During a certification period only when the client reports a change that was not considered in the original estimate.
  7. When a client is paid biweekly and chooses AM, we adjust the client's case for anticipated changes through the certification period as follows:
    1. Determine which months the client will receive an extra check;
    2. Set a tickle with enough time to budget the extra check for that month;
    3. Give advance and adequate notice to the client.
  8. If a client reports a change in their income and hours, take the following steps:
    1. Determine if the change will last at least a month beyond the date the client reported the change;
    2. If so, re-calculate this source of income.
    3. Document the change and whether or not it is expected to last at least a month beyond the month the change was reported.
    4. Record the actual job start date in ACES. This will allow us to report employment hours for all of the time the client has been working.
NOTE: Inform the client how the choice of methods will affect their benefits and let them choose the method. 
NOTE: If you average income using the weekly or every-other week conversion, you are better protected against payment errors because it accounts for extra periodic checks. Since conversion is based on an annual average, it's safe to convert income received weekly or every-other week even if the client will not get an extra check. 
NOTE: Include the work hours to correspond with the pay frequency selected for budgeting.
EXAMPLE Gina calls us on January 9th to report that she is working. She started work on December 3rd and expects the work to continue beyond the ongoing month. When we enter her income and hours for February and ongoing, we must be sure to record her start date of 12/3 as well.
NOTE: See WAC 388-418-0020 to determine the effective date of a change in the client’s benefits. 

Special Circumstances for Budgeting Income and Expenses

Self Employment. See:

  1. Clients that receive their annual income over a timeframe less than a year under contract: 1. When a client gets their annual income over a period of less than a year as a part of the client's employment contract, average their annual income and hours over a 12-month period unless the client is:
    1. A migrant or seasonal farmworker; or
    2. Paid on an hourly or piecework basis.
  2. Other contract income:
    1. If a client's income that is paid under contract is not the client's annual income (yearly), we average the income over the period of time the contract income covers unless the client is:
      1. A migrant or seasonal farmworker; or
      2. Paid on an hourly or piecework basis.
    2. Examples of employees that may receive their income under contract include:
      1. School Employees;
      2. Bus Drivers;
      3. Farmers; and
      4. Fishers.
NOTE:
For employed TANF clients paid on a piecework basis, record the corresponding hours to the pay frequency as any other pay rate. If the hours are unavailable as part of the income verification process, use the following formula to estimate piecework hours: - Take the gross anticipated income for the pay period; and - Divide by the federal minimum wage, currently $7.25. Enter the appropriate amount in the ‘hours’ field consistent with the job’s pay frequency.
EXAMPLE:
 Linda is employed as a teacher for Evergreen School District. As allowed under her contract, she receives her annual salary of $31,002 in the months of September through June of each year. Because this is the client’s annual income, we budget 1/12 of the client’s yearly income ($2583.50) for each month even though she doesn’t receive a paycheck from the school district in July or August. If she receives TANF, enter her annual hours to correspond with the annual pay frequency. However, if we are budgeting by the individual month, budget the actual hours anticipated for the month.
EXAMPLE:
Jordan is applying for ABD cash receives $12,600 every December from a trust fund that was set up to distribute an inheritance from his grandmother. The fund cannot be accessed in any other manner. We average this income throughout the entire year and budget $1,050 monthly.
EXAMPLE:
Bob is on TANF and is paid per bushel of cherries picked. His wage stubs clearly verify his weekly income, but do not indicate his hours worked. The weekly pay we are budgeting based on the verification is $200.00. To estimate his work hours, we divide $200 by $5.15 to get 38.83 weekly hours. We enter 39 hours, consistent with the pay frequency we used to budget his income.
  1. Budgeting the earned income of a child turning age 18:
    1. Count or exclude the earned income of a child according to WAC 388-450-0070. For cash assistance, consider a client to be a child if they meet the requirements of WAC 388-404-0005.
    2. We use a child’s age on the first day of the month as the child’s age for that month.
EXAMPLE:
If a child turns 18 on August 8, consider them as 17 in August and 18 in September. For Basic Food, you would not budget the child's earnings for August and would budget the income in September.
 NOTE:
ACES reads the age of the child as well as their student status and applies this rule.
  1. Budgeting child support that fluctuates :

You can use either AM or CA to budget child support you expect a client to receive. Determine the amount to budget based on what you can reasonably expect knowing the client's current support, what they received in the past, and changes that you anticipated changes. Document your decision as described in Documentation.

 

When you know of a change in child support income, decide if the new amount is something you can expect to continue or if the original estimate was valid.

  1. If the support is paid through DCS, you can contact DCS and the client to determine if:
    1. There was a change that would impact your estimate for the monthly support (such as a new support order); or
    2. The change could be explained by some short-term situation such as:
      1. Job changes, with a lag between the start of the job and the start of the payroll deduction for support;
      2. Was making larger payments for a period of time to pay arrears, and is now caught up; or
      3. Was off work for a period of time and DCS was unable to collect support.
  2. If the support is not paid through DCS, you can contact the client and request information to help determine why the support changed.
NOTE:
 If you decide the amount budgeted should be changed, see WAC 388-418-0020 to determine the effective date of the change. For clients that receive support through DCS, consider the change as known to the department and don't require additional verification of the amount.
NOTE: 
For Basic Food, if the entire amount of child support arrears is paid off in a single payment, consider the amount for arrears as a lump sum payment and count it as a resource. Count any amount for current support as unearned income. See WAC 388-470-0055 for information on lump sums. 
  1. Budgeting additional cash assistance payments for Basic Food: If a cash supplement is issued due to a change in income or expenses, do not budget the additional cash against the Basic Food without ten days’ notice.
    1. When issuing a cash and Basic Food supplement due to adding a person to both AUs, include the cash supplement when determining the Basic Food supplementary amount for that month.

    7. Budgeting a client's partial Unemployment Compensation:  Refer to ESD's Earnings Deduction Chart to budget anticipated   ongoing unemployment benefits when a client is expected to receive partial unemployment compensation.

See LETTERS for information on timely and adequate notice.

Budgeting Income for Medical Programs

  1. Budget the income the client received or expects to receive for the month of application. 
  2. Use the income you can reasonably expect the client to receive for the month(s) you authorize medical care.
  3. See WAC 388-418-0020 - How the department determines the date a change affects my benefits, and WAC 182-504-0125 - Effect of Changes on Medical, for changes in income after certification.

Budgeting Deductions

  1. Budget allowable expenses for the month you expect the client to have the expense using AM budgeting or an offline average. Dependent care expenses can be converted using ACES.
  2. See INCOME - Effect on Eligibility and Benefit Level to determine if an expense is allowed as a deduction for cash or Basic Food.
  3. Refer to the ACES User Manual for information on entering expenses for deductions.
NOTE: If you choose to average an expense outside of ACES, your documentation must clearly show that you averaged the expense and how you came about the amount you entered for the expense. 

Effect of Incorrect Estimates

  1. When clients receive less income than estimated, do not supplement benefits unless you made an error in calculating the client’s benefits.
  2. If a TANF/SFA-eligible assistance unit receives less income than you anticipated, see EMERGENCY ASSISTANCE to determine if this created an emergent need and if the client may be eligible for AREN.

Determining the Effective Date When a Client's Income Causes Them To Be Ineligible

For information regarding changes that cause ineligibility, see WAC 388-418-0020.

See WAC 388-406-0055 for the effective date of eligibility for cash assistance applications.

See WAC 388-450-0162 for the definition of countable income and its effect on eligibility.

 

Clarifying Information

  1. Count only income received between the first of the month and the date of application. Do not count any income from a new source that is anticipated after the date of application.
EXAMPLE Ted applied for assistance on April 15. His household is destitute because he is a migrant farmworker and received $50 income from a terminated source on April 8, and expects to receive $575 from a new source on April 26. Consider only $50 for the month of application.
  1. If a client receives money after the date of application, and this money is not from a new source, the client is not destitute under WAC 388-406-0021. In this case, we budget the actual amount the client received from the date of application to the date of the client's interview as well as the income we estimate the client will receive for the remainder of the month.
  2. Apply the above procedures at initial application and recertification, but only for the first month of each certification period. At recertification, disregard income from a new source in the first month of the new certification period if income of more than $25 will not be received from this new source by the 10th calendar day after the date of the AU's normal assistance cycle.
EXAMPLE A client whose Basic Food AU number ends in an "8" applies for recertification on May 15. The certification period ends on May 31. The AU is destitute and expects to receive $700 from a new source on June 25. Disregard $700 for June because the AU will not receive it by June 18.

Clarifying Information - WAC 388-450-0245 

Some situations that could lead to a suspension of benefits include when:

  1. Use AM for a client paid weekly or every-other week and they receive an extra periodic check;
  2. Clients get pay from an additional temporary job;
  3. Clients get overtime pay;
  4. Clients get one-time income such as a bonus on individual performance; and
  5. Clients get a quarterly payment from an investment.

ACES Procedures 

Effect of the Puyallup Settlement on Your Eligibility for Public Assistance

Revised March 25, 2011

Purpose:

STATE OF WASHINGTON

DEPARTMENT OF SOCIAL AND HEALTH SERVICES

HOW THE PUYALLUP SETTLEMENT AGREEMENT WILL AFFECT YOUR ELIGIBILITY FOR PUBLIC ASSISTANCE

If you receive the annuity fund payment, it will not affect your cash, food, or medical assistance.

  • When you receive the payment;
  • As long as you keep the payment as cash on hand or in a bank account; or
  • If you make a purchase or investment directly with the cash from the payment.

How you use your payment may affect your cash, food, or medical assistance:

  • If you use the annuity fund payment to buy an item, and the item increases in value, the increase may affect your eligibility for benefits.
  • If you use the annuity fund payment to earn interest from savings, you must report the interest as income. This income may affect your benefits.
  • If you use the annuity fund payment to make an investment, and the investment increases in value, the increase may affect your eligibility for benefits.
  • If you sell, trade, or give away your purchase, savings, or investment, you must tell your local Community Service Office. The money or goods you get in exchange may affect your eligibility for benefits.

IF YOU HAVE QUESTIONS ABOUT YOUR ELIGIBILITY, PLEASE CONTACT YOUR LOCAL COMMUNITY SERVICE OFFICE.

Income - Indian Agencies Serving Tribes Without a Near-Reservation Designation

Revised March 25, 2011

Purpose:

INDIAN AGENCIES SERVING TRIBES WITHOUT A NEAR-RESERVATION DESIGNATION

Olympic Peninsula area:

  1. Lower Elwha
  2. Makah
  3. Ozette
  4. Port Madison
  5. Quinault
  6. Skokomish

Puget Sound area:

  1. Stillaguamish
  2. Upper Skagit/Sauk-Suiattle

Income - Ownership and Availability

Revised December 31, 2013

Purpose:

This section includes rules and procedures for determining whether a client owns income, if the income is available to a client, and what a client must do to make potential income available.

WAC 388-450-0005 How does the department decide if I own a type of income and if this income is available to meet my needs?


Worker Responsibilities - WAC 388-450-0005

Determine if clients have any potential income available.

  1. Making a source of income available:
    1. If someone meets all other eligibility factors, do not delay benefits if they try to make a potential source of income available but isn't able to.
    2. If a client person can't make a source of income available for reasons beyond their control, consider the income as unavailable to the client.
    3. Clients must give proof of how a source of income can be available and when the income will be available. Request verification. Ask for proof that the client has tried to make potential income available. Examples of proof include:
      1. Financial Statements;
      2. Collateral Statements; and
      3. Letter from the person or company that has control of the income.
    4. See VERIFICATION for information on how to ask for proof from clients.
    5. See WAC 388-406-0030  to decide how much time to allow clients to provide the proof.
    6. For medical programs, clients must take all needed steps to get any income (such as annuities, pensions, retirement, and disability benefits) they can receive.
      1. Clients do not have to take steps to get the income if they can show a good reason for not doing so.
      2. Examples of benefits the client must try to make available include:
        1. Veteran’s compensation and pensions;
        2. OASDI benefits;
        3. Railroad retirement benefits; and
        4. Unemployment compensation.
    7. Refer clients to the correct agency to apply for potential income and/or help clients get potential income if they ask for assistance.
  2. When the date income is available changes:
    1. Budget the income for the date you expect the client to receive the income.
    2. Set an alert in ACES for the date we expect the client to receive the income to check if the income is available.
EXAMPLE Susan moved from Texas when her job in Texas ended. Count the income when you could reasonably expect the client to receive it.
  1. Community income:
    1. When a husband and wife live together, count the following as community income:
      1. Income in the name of the husband, wife, or both spouses;
      2. Income that the husband, wife, or both spouses have access to;
      3. Income the husband, wife, or both spouses received; and
      4. Earnings of the husband, wife, or both spouses.
    2. Always count community income as available for cash assistance. It doesn't matter if one or both spouses are applying for or receiving benefits. 
  2. Separate income:
    1. We count income as separate income when the income:
      1. Was received by either spouse before marriage;
      2. Was received as a result of a gift or inheritance;
      3. Was received from separate property; or
      4. Are the earnings of the husband, wife, or both spouses when the spouses live separate and apart.
    2. Separate income becomes community income when someone puts the income an account with community income.
  3. If a client refuses to make income available:
    1. For cash and medical assistance – deny or terminate assistance;
    2. For food assistance - do not deny or terminate assistance.
  4. Income source discovered after grant opening:  Determine if the client knew about the source but did not tell us.
    1. a.  If the client knew of the income source and there is an overpayment, follow instructions in BENEFIT ERRORS to determine the client's intent.
    2. b. If the client didn't know about the income source, determine the client's eligibility from the date the client first learned about the income and the income was available to them.
  5. Jointly owned bank accounts:
    1. When a client has a joint bank account or is holding funds for someone else, determine if the client and the other person have a written or verbal agreement about the amount of the funds available to the client.
    2. If the client and the other person have an agreement, decide if the client uses more than this amount to meet their current needs. Count the excess as available unearned income and budget it for the assistance unit.
    3. If the client and the other person do not have an agreement, decide if the funds are available to meet the client’s needs:
      1. Get a detailed record of the dates and amounts of money deposited into the account or given to the client to hold for the other person.
      2. Get a detailed record of the types and amounts of payments for the other party.
      3. Consider any amount over the itemized payments for the other party as income available to the client. Budget it as unearned income for the assistance unit.
    4. Review the client’s circumstances at each eligibility review, reapplication, or when they report a change in the joint bank account or the source of funds.
NOTE:  Do not count bank accounts held jointly with SSI recipients as a resource for cash or food assistance under WAC 388-470-0045 and WAC 388-470-0055.
  1. Flexible benefits:
    1. Funds offered by an employer to help employees with medical, dependent care, or other expenses are called flexible benefits.
    2. For food assistance, treat the amount of flexible benefits available as a direct cash benefit as income to the assistance unit. If there is no option for a direct cash benefit, do not count the flexible benefits as income to the assistance unit.
EXAMPLE:
Jill receives $180 in flexible benefits each month to apply toward her monthly health insurance premium of $185. This leaves her with a $5 out-of-pocket premium. Jill's worker contacts the personnel department at Jill's work and verifies that employees may choose to receive the allowance for health insurance or the employee can "opt-out" and receive a cash payment of $28 monthly. Jill's worker counts the $28 monthly as earned income to the assistance unit whether or not Jill chooses the medical or the cash option. This is because $28 is available to Jill as a cash benefit each month.
EXAMPLE:
Joyce receives $100 in flexible benefits monthly. Medical premiums are $150 a month, leaving the client with a $50 out-of-pocket premium.

The employer does not offer an "opt-out" cash benefit. Because no portion of the flexible benefits are payable to Joyce, we do not count any of these flexible benefits as income to her assistance unit.

EXAMPLE:
Emily works for ABC graphics and receives a flexible benefits package of $167.00 monthly. She can receive a cash-only option of $30 per month, or use the benefits toward various health insurance options.
  • If Emily chooses the higher-cost health insurance, she must pay for anything over the $167 monthly benefit.
  • If Emily chooses the lower-cost health insurance, she receives the difference between her $167 benefit and the cost of the insurance even if this is more than the cash-out option of $30 per month.
  • Emily chooses the lowest- cost insurance offered by her employer. The premium is $130 monthly, so she receives a cash benefit of $37 each month. We must count the $37 she receives each month in cash as earned income to her assistance unit.
  • If Emily had spent all of the flexible benefits or took the $30 cash-out option, we would budget the $30 monthly amount available in the cash-out option.
  1. Trusts and medical eligibility:

For the impact of a trust on medical eligibility see Trusts, Annuities and Life Estates - Section B. - Trusts.

Income Special Types

Revised March 2, 2017

Purpose:

This section includes rules and procedures on how to treat special income types.

WAC 388-450-0010 The department takes some or all of your time-loss benefits if you get cash assistance while waiting for your claim to be processed

WAC 388-450-0035 Educational Benefits

WAC 388-450-0040 Native American benefits and payments.

WAC 388-450-0045 How do we count income from employment and training programs?

WAC 388-450-0050 How does your participation in the community jobs (CJ) program affect your cash assistance and Basic Food benefits?

WAC 388-450-0055 How d