Clarifying Information - WAC 388-418-0005

SSI / SSI-related medical benefits:

Reporting requirements for SSI-related medical benefits don't apply to a person receiving SSI medical (S01). SSI recipients report changes to the Social Security Administration.

A recipient of S01 medical and benefits from another program must report changes based on the requirements for the other program.

Reporting Requirements for Basic Food Simplified Reporting: Basic Food households must report when their income goes over 130 percent of the income poverty levels based on the number of eligible household members in their assistance unit. A household meets reporting requirements under simplified reporting when the household reports their income is above 130 percent of the income poverty level, but they remain eligible for Basic Food. The household doesn't have to report any other income changes until one of the following occurs: The mid-certification review (MCR); The eligibility review (ER); or The household income is greater than 200 percent of the income poverty limit. Basic Food households must report when a member has a substantial lottery or gambling win. This information isn't subject to simplified reporting rules. Households must report this change by the 10th of the following month after receiving the winnings.

Reporting Requirements for State Supplemental Payment Program (SSP): SSP recipients don't have to report changes. We decide if someone is eligible for SSP based on information Social Security Administration (SSA) gives us through the State Data Exchange (SDX).

Taking action on changes: When we receive information about someone's circumstances, we must determine the impact on the person's benefits. This includes determining how the source of information impacts the actions we take on the household's benefits and whether we are required to act on it. Depending on the reporting circumstances, we may have to contact the household, contact other parties, or ask for proof of the household's circumstances under WAC 388-490-0005 . Client Reports: Take action based on changes the person reports. This includes when someone volunteers information after we contact them. Get proof of a household's circumstances if they report: A decrease in income that increases their benefits; A change in expenses that increases benefits; or For Basic Food , a change in expenses that increases food benefits and the expenses are questionable given their income and other circumstances. Third-Party Reports: Information reported by anyone other than the household is a third-party report. We must verify information reported by a third-party that conflicts with the information reported at application or recertification if the information is a reportable change.

When information reported by a third-party doesn't conflict with information provided at certification, we must determine if the household is required to report the change based on their benefit program. Hold the information until the next Mid-Certification Review or Eligibility Review, whichever comes first, if it's information the household isn't required to report.

For Basic Food only cases:

If the household And the information And the change happened Then Is required to report the change Total monthly income exceeds the gross income standard; Substantial lottery or gambling win; or Work hours fall below 20 hrs/wk for person who must meet work requirements Is verified upon receipt (information comes from the source: for example, SOLQ, UTAB, current employer or landlord) or a system match from the Social Security Admin (such as SDX), or National Directory of New Hires Less than 60 days before the current month Act on the change. Is not verified upon receipt or a system match Ask the household to verify the information and take appropriate action. Is a system match (SSA, NDNH) 60 days or older Act on the change. Is not from one of those sources Hold the information until the next MCR or recertification. Is not required to report the change Is verified upon receipt Less than 60 days before Act on the change. Is not verified upon receipt (no timeframe) Hold the information until the next MCR or recertification.

If the third-party report shows that we certified or recertified the case using significantly conflicting information, we must verify the report and make the necessary case corrections. This may involve creating overpayments or making a fraud referral.

Example of information that conflicts with, but doesn't significantly conflict with, information used at cert:

Examples of information changing after cert:

c. Changes Verified Upon Receipt:

Information reported from the primary source is "verified upon receipt". This information doesn't require secondary verification. Some examples include: SOLQ; UTAB; A current employer; or A landlord.

Some verified upon receipt sources update ACES automatically and generate alerts for the change. We don't need to take action on these alerts.

d. A Lottery or Gambling Win:

Information provided by the Washington State Lottery data match is verified upon receipt. Staff must take appropriate action to close the case if the client has winnings equal to or over the elderly or disabled resource limit for Basic Food. See Lottery or Gambling Disqualification for Basic Food .

e. Other Reports:

Tickles or alerts from sources not verified upon receipt are considered third-party reports. Determine how to treat these tickles or alerts based on how we treat third-party reports.

f. Department of Corrections Reports and Incarceration: We have to act on Department of Corrections match tickles. These matches are from a primary sources, however, because the tickles are based on data we receive once a month, we must verify the tickles data.

Use FORS to determine whether the client is still incarcerated. Remove the incarcerated client from the basic food or cash household with adequate notice if they are incarcerated more than 30 days.

When the department verifies a client is incarcerated over 30 days, we suspend EBT benefits to prevent fraudulent use. Take the following steps when receiving notification that someone is verified to be incarcerated over 30 days:

Submit a “Suspension of EBT benefits due to Incarceration” request

Document the actions taken and reason for suspension of the EBT account

Include canned text in the termination letter informing of the reason for termination and how to reactivate benefits

When a client contacts the department to report they are no longer incarcerated, request reactivation of benefits and document case action. Benefits will be available within 48 hours of notification they are no longer incarcerated. Contact to the department is also considered a request for reinstatement or application.

g. SSA Death Alerts

We must take action on alerts from SSA of a client's death. This information isn't considered verified upon receipt. Use DOH web portal to verify a client's death.

h. Information known to the department:

Information considered known to the department doesn't need verification to affect a household's benefits. The "department" is any agency under the Department of Social and Health Services including:

Division of Child Support (DCS);

Home and Community Living Administration (HCLA);

Behavioral Health and Habilitation Administration (BHHA);

Developmental Disabilities Administration (DDA); and

Facilities, Finance & Analytics Administration.

It also includes programs within ESA.

ABAWD reporting requirement:

A household must report when a non-exempt ABAWD's hours of employment drop below 20 hours per week. This includes when the non-exempt ABAWD isn't the head of household for Basic Food.