WAC 182-513-1225 Medicaid Personal Care (MPC)

Effective January 1, 2018

  1. Medicaid personal care (MPC) is a state-plan benefit available to a client who is determined:
    1. Functionally eligible for MPC services under WAC 388-106-0200 through 388-106-0235; and
    2. Financially eligible for a noninstitutional categorically needy (CN) or alternative benefits plan (ABP) Washington apple health (medicaid) program.
  2. MPC services may be provided to a client residing at home, in a department-contracted adult family home (AFH), or in a licensed assisted living facility that is contracted with the department to provide adult residential care services.
  3. A client who resides in an alternate living facility (ALF) listed in subsection (2) of this section:
    1. Keeps a personal needs allowance (PNA) under WAC 182-513-1105; and
    2. Pays room and board up to the room and board standard under WAC 182-513-1105, unless CN eligibility is determined using rules under WAC 182-513-1205.
  4. A client who receives MPC services under the health care for workers with disabilities (HWD) program under chapter 182-511 WAC must pay the HWD premium in addition to room and board under WAC 182-513-1105, if residing in an ALF.
  5. A client may have to pay third-party resources as defined under WAC 182-513-1100 in addition to room and board.
  6. Current PNA and room and board standards are found at www.hca.wa.gov/free-or-low-cost-health-care/program-administration/program-standard-income-and-resources.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.