Section 182-513-1316 - General eligibility requirements for long-term care (LTC) programs(1) To be eligible for long-term care (LTC) services, a person must: (a) Meet the general eligibility requirements for medical programs under WAC 182-503-0505, except: (i) An adult age nineteen or older must meet citizenship and immigration status requirements under WAC 182-503-0535(2)(a) or (b);(ii) A person under age nineteen must meet citizenship and immigration status requirements under WAC 182-503-0535(2)(a), (b), (c), or (d); and(iii) If a person does not meet the requirements in (a)(i) or (ii) of this subsection, the person is not eligible for medic-aid and must have eligibility determined under WAC 182-513-1319.(b) Attain institutional status under WAC 182-513-1320;(c) Meet the functional eligibility under: (i) Chapter 388-106 WAC for a home and community services (HCS) home and community based (HCB) waiver or nursing facility coverage; or(ii) Chapter 388-828 WAC for developmental disabilities administration (DDA) HCB waiver or institutional services; and(d) Meet either: (i) SSI-related criteria under WAC 182-512-0050; or(ii) MAGI-based criteria under WAC 182-503-0510(2), if residing in a medical institution. A person who is eligible for MAGI-based coverage is not subject to the provisions under subsection (2) of this section.(2) A supplemental security income (SSI) recipient or a person meeting SSI-related criteria who needs LTC services must also:(a) Not have a penalty period of ineligibility due to the transfer of assets under WAC 182-513-1363;(b) Not have equity interest in a primary residence greater than the home equity standard under WAC 182-513-1350; and(c) Disclose to the agency or its designee any interest the applicant or spouse has in an annuity, which must meet annuity requirements under chapter 182-516 WAC.(3) A person who receives SSI must submit a signed health care coverage application form attesting to the provisions under subsection (2) of this section. A signed and completed eligibility review for LTC benefits can be accepted for people receiving SSI who are applying for long-term care services.(4) To be eligible for HCB waiver services, a person must also meet the program requirements under: (a) WAC 182-515-1505 through 182-515-1509 for HCS HCB waivers; or(b) WAC 182-515-1510 through 182-515-1514 for DDA HCB waivers.Wash. Admin. Code § 182-513-1316
Adopted by WSR 17-03-116, Filed 1/17/2017, effective 2/17/2017