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

(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: (a) General eligibility requirements under WAC 182-513-1315 and 182-515-1506 ; (b) The resource requirements under WAC 182-513-1350 ; (c) The following income requirements: (i) Available income must be at or below the special income level (SIL), defined under WAC 182-513-1100 ; or (ii) 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: (A) Medically needy (MN) disregards found under WAC 182-513-1345 ; (B) The average monthly nursing facility state rate; (C) Health insurance premiums, other than medicare; and (D) Outstanding medical bills, prorated monthly over a 12-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 www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/program-standard-income-and-resources .