WAC 182-513-1318 Income and resource criteria for home and community based (HCB) waiver programs and hospice.

Effective February 20, 2017

  1. This section provides an overview of the income and resource eligibility rules for a person to be eligible for a categorically needy (CN) home and community based (HCB) waiver program under chapter 182-515 WAC or the hospice program under WAC 182-513-1240 and 182-513-1245.
  2. To determine income eligibility for an SSI-related long-term care (LTC) HCB waiver, the agency or its designee:
    1. Determines income available under WAC 182-513-1325 and 182-513-1330;
    2. Excludes income under WAC 182-513-1340;
    3. Compares remaining gross nonexcluded income to:
      1. The special income level (SIL) defined under WAC 182-513-1100; or
      2. For HCB service programs authorized by the aging and long-term supports administration (ALTSA), a higher standard is determined following the rules under WAC 182-515-1508 if a client's income is above the SIL but net income is below the medically needy income level (MNIL).
  3. A person who receives MAGI-based coverage is not eligible for HCB waiver services unless found eligible based on program rules in chapter 182-515 WAC.
  4. To be resource eligible under the HCB waiver program, the person must:
    1. Meet the resource eligibility requirements and standards under WAC 182-513-1350;
    2. Not be in a period of ineligibility due to a transfer of asset penalty under WAC 182-513-1363;
    3. Disclose to the state any interest the person or that person's spouse has in an annuity and meet the annuity requirements under chapter 182-516 WAC.
  5. The agency or its designee determines a person's responsibility to pay toward the cost of care for LTC services as follows:
    1. For people receiving HCS HCB waiver services, see WAC 182-515-1509;
    2. For people receiving DDA HCB waiver services, see WAC 182-515-1514.
  6. To be eligible for the CN hospice program, see WAC 182-513-1240.
  7. To be eligible for the MN hospice program in a medical institution, see WAC 182-513-1245.

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.