When do I have to report changes in my circumstances?
WAC 388-418-0005
WAC 388-418-0005
Effective July 1, 2007
WAC 388-418-0005 How will I know what changes I must report?
You must report changes to the department based on the kinds of assistance you receive. The set of changes you must report for people in your assistance unit under chapter 388-408 WAC is based on the benefits you receive that require you to report the most changes. It is the first program that you receive benefits from in the list below. We inform you of your reporting requirements on letters we send you about your benefits.
For example:
If you receive Long Term Care and Basic Food benefits, you tell us about changes based on the Long Term Care requirements because it is the first program in the list below you receive benefits from.
If you receive Long Term Care benefits such as Basic, Basic Plus, Core, Community Protection, COPES, Nursing Home, Hospice, or Medically Needy Waiver, you must tell us if you have a change of:
Address;
Marital status;
Living arrangement;
Income;
Resources;
Medical expenses; and
If we allow you expenses for your spouse or dependents, you must report changes in their income or shelter cost.
If you receive medical benefits based on age, blindness, or disability(SSI-related medical), or ADATSA benefits, you need to tell us if:
You move;
A family member moves into or out of your home;
Your resources change; or
Your income changes. This includes the income of you, your spouse or your child living with you.
If you receive Basic Food and all adults in your assistance unit are elderly persons or individuals with disabilities and have no earned income, you need to tell us if:
You move;
You start getting money from a new source;
Your income changes by more than $50;
Your liquid resources, such as your cash on hand or bank accounts, are more than $2,000; or
Someone moves into or out of your home
If you receive cash benefits, other than WorkFirst Career Services benefits, you need to tell us if:
You move;
Someone moves out of your home;
Your total gross monthly income goes over the:
Payment standard under WAC 388-478-0030 if you receive General Assistance; or
Change from part-time to full-time or full-time to part-time;
Have a change in your hourly wage rate or salary; or
Stop working
If you receive Family Medical benefits, you need to tell us if:
You move;
A family member moves out of your home; or
If your income goes up or down by $100.00 or more a month and you expect this income change will continue for at least two months.
If you receive Basic Food benefits, you need to tell us if:
You move;
Your total gross monthly income is more than the gross monthly income limit under WAC 388-478-0060; or
Anyone who receives food benefits in your assistance unit must meet work requirements under WAC 388-444-0030 and their hours at work go below 20 hours per week.
If you receive Children´s Medical benefits, you need to tell us if:
You move; or
A family member moves out of the house.
If you receive Pregnancy Medical benefits, you need to tell us if:
You move; or
You are no longer pregnant.
If you receive other medical benefits, you need to tell us if:
You move; or
A family member moves out of the home.
If you receive Transitional Food Assistance or WorkFirst Career Services benefits, you do not have to report any changes in your circumstances.
Reporting requirements for SSI-related medical benefits do not apply to a person who receives SSI medical (S01).
If someone receives S01 medical and benefits from another program, they must report based on the requirements for the other program.
EXAMPLE
A family receives S01 medical, TANF, and Basic Food benefits. Because the S01 medical is not SSI-related, they must report based on the cash reporting requirements.
Reporting Requirements for State Supplemental Payment Program (SSP):
We decide if someone is eligible for SSP based on information Social Security Administration (SSA) gives us through the State Data Exchange (SDX). A person does not have to report changes for SSP.
ADATSA reporting requirements:
We count ADATSA as a medical program when looking at what changes someone must report. A person who receives ADATSA benefits must report changes based on the SSI-related medical reporting requirements.
Medical Coverage Group codes included in “children’s/family medical”:
F04
TANF Related
F06
Categorically Needy (CN) for Children
F07
Children's Health Insurance Program (CHIP)
F99
Medically Needy Spenddown
F09
Undocumented Family and Children
Medical Coverage Group codes included in “other medical programs”:
F02
TANF Related
F03
TANF Related
F05
Newborns
F10
TANF Related
R03
Refugee Categorically Needy
Elderly persons / Persons with Disabilities:
Elderly persons and persons with disabilities are people who meet the definition of elderly or disabled for purposes of the Washington Basic Food Program under WAC 388-400-0040.
NOTE:
For Basic Food households where all adult members meet this definition of elderly or disabled and they have no earnings, they are change reporters under WAC 388-418-0005 #3.
NOTE:
All other Basic Food households that do not meet the criteria of elderly or disabled with no earnings, are simplified reporters under WAC 388-418-0005 #6.
7. Taking action on changes:
When we receive information about someone's circumstances, we must determine the impact on the person's benefits. This may include contacting them, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.
Client Reports:
oTake action based on changes the person reports. This includes when someone volunteers information after we contacted them.
oAsk for proof of someone's circumstances before you make any change that increases benefits.
Third-Party Reports:
oIf we receive information from a third party about someone, follow-up on the information to decide how it impacts the person's eligibility and benefits.
oThis may include contacting the person, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.
Alerts Verified Upon Receipt:
oAn interface that automatically update's the ACES case record is "verified upon receipt".
oWe do not need to take action on alerts the interface updates in ACES.
Other Alerts:
oWe do need to take action on alerts not verified upon receipt.
oWork alerts that are not verified upon receipt to decide how the information impacts the person's eligibility and benefits.
oThis may include contacting the person, contacting other parties, or asking for proof of their circumstances under WAC 388-490-0005.
NOTE:
For cash and Basic Food, we do not need to verify changes a client reports that decrease benefits until the next eligibility review, recertification, or mid-certification review.
Currently, Washington has a statewide waiver of ABAWD requirements.
When we no longer have this waiver, people must report when a non-exempt ABAWD receives benefits in the AU and the ABAWD's hours of employment drop below 20 hours per week. This includes when the non-exempt ABAWD is the head of household for Basic Food. See FS E&T Appendix I.
NOTE:
ACES adds this reporting requirement to letters to households with a non-exempt ABAWD who receives food benefits.
WAC 388-418-0007
WAC 388-418-0007
Effective July 17, 2006
WAC 388-418-0007 When do I have to report changes in my circumstances?
If your household has a change of circumstances you are not required to report under WAC 388-418-0005, you do not need to contact us about this change. If you tell us about this change, we take action based on the new information. This includes:
Asking for more information we need to determine your eligibility and benefits under WAC 388-490-0005;
Increasing your benefits when we have proof of a change that makes you eligible for more benefits; or
Reducing or stopping your benefits based on the change.
If you are applying for benefits and have had a change:
After the date you applied but before your interview, you must report the change during your interview; or
After you have been interviewed, you must report changes that we require someone who receives benefits to report as described under WAC 388-418-0005. You must report this change by the 10th day of the month following the month the change happened.
If you receive cash assistance, medical, or Basic Food, you must report changes required under WAC 388-418-0005 by the 10th day of the month following the month the change happened.
For a change in income, the date a change happened is the date you receive income based on this change. For example, the date of your first paycheck for a new job, or the date of a paycheck showing a change in your wage or salary.
If we require you to complete a mid-certification review you must complete the review as described under WAC 388-418-0011 in order to keep receiving benefits.
If you receive TANF / SFA, and you learn that a child in your assistance unit (AU) will be gone from your home longer than 90 days, you must tell us about this within five calendar days from the date you learn this information.
If you do not report this within five days, the child's caretaker is not eligible for cash benefits for one month; and
We continue to budget the ineligible person's countable income as described in WAC 388-450-0162 to determine the benefits for the people still in the AU.
If you report changes late, you may receive the wrong amount or wrong type of benefits. If you receive more benefits than you are eligible for, you may have to pay them back as described in Chapter 388-410 WAC.
The date of a change is normally the date a change happens. Examples of this include the date:
Someone gets married;
A newborn comes home from the hospital; and
Someone moves to a new home.
Income Changes
The date of an income related change is the date someone receives income based on the change. Examples of this include the date:
On the first paycheck that reflects a wage increase; and
On the person's first paycheck for a new job.
EXAMPLE
Sandy is hired for a new job on May 31st. She starts work on June 10th. Her first paycheck is July 5th.
Because this is a change in income, we count the date of Sandy's first paycheck on July 5th as the date of the change.
If Sandy must tell us about the change based on her reporting requirement under WAC 388-418-0005, she must tell us about this change by August 10th.
If Sandy reported this change earlier, we would act on the change based on when we expect her to receive the income.
EXAMPLE
Nick is hired for a new job on May 1st. He receives his first paycheck on June 1st. Nick must report this change of employment status and income by July 10th.
EXAMPLE
Stacey receives TANF and Basic Food. She had her employee evaluation on October 1st. Based on this evaluation, Stacey gets a promotion and a $1.25 hourly wage increase. The wage increase takes effect October 15th. She will receive the first check showing this increase on November 10th.
Because this is a change in income, we count the date of Stacey's first paycheck on November 10th as the date of the change.
Stacey must report this change to us by December 10th.
If Stacey reported this change earlier, we would act on the change based on when we expect her to receive the income.
2. Changes a client voluntarily reports:
If people report a change, we must act on the change they report even if they didn't have to tell us about the change under WAC 388-418-0005. This includes asking for more information or proof of a change when we can't tell the impact on their benefits.
EXAMPLE
Larry receives Basic Food only. He calls and reports that his monthly rent expense went from $425 to $500 monthly.
His worker Bob verifies this change with Larry's landlord based on local office procedures. After he receives proof of the expense, Bob updates the shelter cost for Basic Food.
EXAMPLE
Ian receives TANF and Basic Food. He leaves a message with his worker reporting that he started a job and would like to close his TANF benefits today.
Ian's worker closes TANF benefits based on the request. Since Ian reported that he is now employed, his worker must follow up to see how this impacts his medical and Basic Food benefits.
3. Unverified changes that increase benefits:
If clients report a change that would increase their benefits, we ask for proof of the change. We increase the AU's benefits based on the effective date rules under WAC 388-418-0020.
If they fail to give us proof of the change to increase their benefits, we don't update their case to increase benefits.
We also do not close the case based on their failure to give proof of a change that would increase their benefits.
EXAMPLE
Susan's Basic Food certification period ends on July 31st. She turns in an Eligibility Review form for Basic Food only on May 31st.
Because Susan turned in the ER before the 15th of the month before the month her certification period ends, we treat the form as a change of circumstance report.
5. Temporary absence of an AU member:
If an AU member is temporarily out of the home:
For cash and medical assistance, follow the rules in WAC 388-454-0015 to determine if the person is still eligible for benefits.
For Basic Food, follow the rules in WAC 388-408-0035 to determine if the person is still eligible for benefits.
6. AU member moves out of Washington:
People must be residents of the state in order to be eligible for most programs. If an AU member or the entire AU leaves the state, follow the rules in WAC 388-468-0005 to determine if the person is still eligible for benefits.
WORKER RESPONSIBILITIES
During the application, recertification or eligibility interview:
Inform clients what changes they must report and how much time they have to report the changes;
Explain how to report changes either in writing, by phone, or in person. (See RIGHTS AND RESPONSIBILITIES); and
Give them a DSHS 14-076(X), Change of Circumstance form, and a return envelope to report changes. ACES automatically mails the DSHS 22-900(X), How to Report Changes with the award letter.
When people report a change or when you learn of a change:
Ask for more information or proof if needed. See LETTERS for the rules and the process on asking someone to take an action or give us information.
Take action on the information using the effective date rules in WAC 388-418-0020.
If we averaged their income under WAC 388-450-0215, recalculate this source of income if you expect this change to last at least a month beyond when you learn of the change.
Document:
The details of the change;
The date we learned about the change or the date the change was reported;
The impact on benefits; and
The effective date for any change in benefits.
Send written notice about the change based on requirements in LETTERS even if the benefits do not change.
For Basic Food, if the client does not report a change in medical expenses, but you learn about a change:
Do not contact the AU about the change;
Act on the change only if you can get proof of the change from someone other than the AU; and
Set an alert to get proof of the change at the next recertification. Update the MEDX screen in ACES once you get proof of the medical expenses.
Document in the ACES narrative whether or not we should use the medical expense at the next recertification.
NOTE:
If you later approve medical assistance that covers a person's medical expenses, delete the medical expenses on the MEDX screen and recalculate the person's Basic Food benefits.
