WAC 182-515-1508 Home and community based (HCB) waiver services authorized by home and community services (HCS) — Financial eligibility using SSI-related institutional rules.

Effective February 20, 2017

  1. If a person is not eligible for a categorically needy (CN) program under WAC 182-515-1507, the agency determines eligibility for home and community based (HCB) waiver services authorized by home and community services (HCS) using institutional medicaid rules. This section explains how a person may qualify using institutional rules.
  2. A person must meet:
    1. General eligibility requirements under WAC 182-513-1315 and 182-515-1506;
    2. The resource requirements under WAC 182-513-1350;
    3. The following income requirements:
      1. Available income must be at or below the special income level (SIL), defined under WAC 182-513-1100;
      2. If available income is above the SIL, net available income is no greater than the effective one-person medically needy income level (MNIL). Net income is calculated by reducing available income by:
        1. Medically needy (MN) disregards found under WAC 182-513-1345;
        2. The average monthly nursing facility state rate;
        3. Health insurance premiums, other than medicare; and
        4. Outstanding medical bills, prorated monthly over a twelve-month certification period, that meet the requirements of WAC 182-513-1350.
  3. The agency determines available income and income exclusions under WAC 182-513-1325, 182-513-1330, and 182-513-1340.
  4. A person eligible under this section is responsible to pay toward the cost of care and room and board, as described under WAC 182-515-1509.
  5. Current resource, income standards, and the average state nursing facility rate for long-term care are found at https://www.hca.wa.gov/health-care-services-and-supports/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.